News 1/12/11

From Chi-Town Native: “Re: HIMSS. Their swearing off Chicago as a site for the annual conference helped trigger an overhaul of McCormick Place operations. Now they’re returning in future years.” HIMSS scratches its cross-town pal’s back by dragging all of us attendees back to Chicago in the bleak dead of winter (they call it "spring” there once the vernal equinox is past, even during the snow storms) in 2015 and 2019. Being a skeptic, I still fully expect to find overpriced hotels, surly workers, and the bad weather that vendors love since it keeps everyone hanging around the exhibit hall. Still, I found a list of proposed changes that sound good on paper: outsourced convention center management, allowing competing electrical contractors, letting exhibitors do some of their own tasks like sweeping or plugging in a monitor without having team of nasty union workers threatening physical violence, cheaper setup and food services, and free WiFi everywhere.

From Jerry MindMeld: “Re: Detroit Auto Show. The Car of the Year is one nobody you know has driven. What’s the car equivalent of your EMR? Bentley? Produces a cloud of smog like a 1981 Le Car? A souped-up ‘74 Camaro that only one guy can fix?” I told Jerry that some applications are like concept cars: they look good when being showed off by hot models, but when you try to buy one, you find they don’t really exist. I drive a beat-up econobox that’s seven years old, so obviously I’m one of those Point A to Point B types.

From Hello Larry: “Re: eHealth Entitlement in Canada. Despite what Canada Health Infoway has said about speeding up the Manitoba eHealth project, it is essentially dead due to mismanagement, poor planning, and lack of vision. The health minister, in the December announcement that IBM will run the project for $22.5 million, said ‘there has been no progress made, no clinical EMR consultants hired, and once again Canada Health Infoway has dropped the ball on Canadian taxpayers.’” Unverified.

From Longtime Informatics Professional: “Re: stop the presses. ONC clarifies the difference between EMR and EHR.” Their definition is the same as mine: EMRs are electronic versions of paper treatment records, while EHRs focus on the broader health of the patient and extend beyond a single provider’s walls to share information from all clinicians who provide that patient’s care. Where we differ is that ONC seems to believe such an animal exists, so they use the term EHR universally. I believe that’s wishful thinking and therefore EMR is still correct in most cases (certification as an EHR notwithstanding since that implies theoretical product capability, not actual use). I might also quibble that the R in both acronyms suggest the records (database), not the application(s) that created those records, so I stubbornly stick to calling those data-creating applications “clinical systems” on the hospital side, with the collective end result being an EMR (you can buy applications, but not an EMR unless a single product covers every single hospital department, including diagnostic images). I’m open to reader suggestions for better names since I dislike both of these.

Healthcare Management Systems (HMS) hires two execs: Jack Holt (McKesson) as VP of client services and Todd Redmon (Dell) as VP of customer support.

A Computerworld article suggests that FDA may start regulating hospital data networks that connect FDA-approved medical devices. It points out the now-legendary four-day network outage at CareGroup (BIDMC) in 2002 would have been much worse had they not run medical devices on a separate network that stayed up. Said a GE Healthcare systems designer, “I’ve been to meetings of biomedical engineers. If you ask them if there are any cases where IT has disrupted patient care, all their hands go up.” I’ll argue from the IT side, though: some of those so-called biomedical experts, especially on the vendor side, don’t know squat about enterprise networking — they’re used to just happily plugging their stuff into whatever open network jack they can find without letting anyone in IT know, then high-tailing it when the campus network starts crashing. Maybe both observations highlight the need for IT and biomed to be a single organization, perhaps with FDA oversight when medical devices are involved.

Calling all data geeks: Heritage Provider Network is offering a $3 million prize for creating an algorithm that can analyze patient information to predict which ones will need hospitalization six months in advance, which would allow providers to intervene and save the health system billions of dollars. Teams of any composition can pre-register now for the two-year competition. If you’ve ever worked with neural network training, it’s kind of like that: teams get three sets of de-identified patient data containing inpatient and outpatient encounters, medication dispensing, and outpatient lab results. They develop their algorithms using the Training Dataset, which contains a binary flag indicating whether or not the patient was admitted. Once teams have fine-tuned their algorithms, they run them against a Quiz Dataset and submit their results to see how well they predicted admissions. Then comes the grand finale: qualified teams run their algorithms against a Test Dataset to see if their algorithms merely regress well against a known result or whether they are actually predictive (most of the time, perfect regression curves and neural networks turn out to be dumb when fed additional data points).

I hear that National eHealth Collaborative (the former AHIC Successor that supports the Nationwide Health Information Network) will name a CEO in Wednesday.

Thanks to new HIStalk Gold Sponsor Elumin Healthcare Solutions, Inc. The Sammamish, WA company offers management consulting (selection, contracting, implementation, technology, and clinical transformation), consulting services related to products from its vendor partners (Allscripts, Cerner, Epic, and HealthWare Systems), and the MyWay PM/EHR and Payerpath claims management as an Allscripts reseller. They’re an official Epic Consulting Partner, in case you were wondering. CEO Mark Williams has a long industry history, including time spent at Intermountain and Siemens Medical, so you’ve probably run across him at some point. Thanks to Elumin for supporting HIStalk.
 
Google CEO Eric Schmidt says if he wasn’t running Google and if he wanted to get involved in healthcare IT, he would go to the major research universities to find existing software that could be open sourced, concluding that , “My guess is that a platform like that would be remarkably different from the platforms we are using today.”

Thanks to the 692 folks on the HIStalk Update e-mail list who have voted in the HISsies so far. I’ll send a final e-mail reminder Wednesday and we’ll finish it up. As I predicted, a few readers complained as they always do that (a) the nominees were not much different than last year; (b) I must be involved in a romantic relationship with Judy Faulkner since she and Epic were on the ballot a lot; and (c) I must be clueless to have missed some obvious nominees. To reiterate: anyone could nominate and all I did was take the top four vote-getting nominees (or five in one case of a tie) in each category and put them on the ballot.

I’ve also received a few e-mails about HIStalkapalooza. You haven’t missed anything: the online “I want to come” Web page will go up somewhere around January 21 and will be mentioned here. A rather impressive roster of specialists is finalizing details, like how to make an IngaTini and what time the band’s going onstage.

An article by the now-merged Huffington Post Investigative Fund and the Center for Public Integrity questions the digital divide that may be created as providers with affluent patients are able to invest more resources in electronic medical records that those that care for low-income patients (although if I were a wag, I’d say rich organizations may find their higher income and productivity going down if they buy and implement unwisely). I hadn’t heard of this group: National Health IT Collaborative for the Underserved, formed almost three years ago by groups such as HHS’s Office of Minority Health, a big government contractor, and HIMSS.

NCHICA (North Carolina Healthcare Information & Communications Alliance) is soliciting abstracts for its annual conference at the Grove Park Inn in Asheville, NC on September 25-28. The Word application form is here and is due February 1.

Former Eclipsys sales SVP Jay Colfer joins Prognosis Health Information Systems as EVP of client solutions. OpenView Venture Partners made an investment in the company last month.

Butler Health System (PA) says it has personalized patient care by using a location-driven patient flow and communication solution that includes products from Intelligent InSites (RTLS), Ekahau (patient and equipment RFID tags), and Vocera (caregiver voice communications).

The Supreme Court will decide whether states are allowed to ban the sale of prescription data to drug companies. Vermont outlawed the practice, but was sued by data mining companies and drug trade groups because that particular lack of privacy protection makes them billions.

HIStalk links to Epic-related stories provided so many incoming hits to website of The Verona Press that its top stories of 2010 had to be separated into Epic and non-Epic lists. They nicely mentioned HIStalk specifically. Epic articles outdrew other big news stories about deer season, a sausage factory fire, and bear sightings.

E-mail me.

HERtalk by Inga

From Not Sheldon: “Re: Project Shoes. Last night’s Big Bang Theory TV show contained an idea for a smart phone application for a program where you can take pictures of cute shoes, and then learn where to buy them. Of course I thought of you.” I don’t know the TV show, but I love the app! It’s Shazam for Shoes! And speaking of shoes, Mr. H asked me if I wanted Dr. Jayne to provide some surgical shoe covers to help protect my shoe identity at our upcoming sponsor lunch at HIMSS. Of course I turned the idea down flat. I suppose he doesn’t see the sense in lugging a extra pair of shoes to Orlando when the shoes may only be worn an hour. I’m sure plenty of readers understand that sometimes it does make sense to pack six pairs of shoes for three days of travel.

Geisinger Health System (PA) will implement NextGate’s patient indexing software to enhance the sharing of clinical data across the organization.

Northeastern Pennsylvania HIE picks Covisint ExchangeLink to provide clinical messaging support for its participating physicians.

Southern Ohio Medical Center implements MetaCare IntelliDocs clinical documentation solution.

Keystone HIE (PA) and partner GE Healthcare announce plans to expand the region’s HIE to augment its chronic disease management capabilities. Area health case workers will have access to KeyHIE functionality to retrieve cross-team communications and receive auto-generated notifications of patient encounters.

IBM and Complex Medical Information Systems implement HIT solutions built on Lotus Notes Domino in several Russian public hospitals .

Spending for EHR by all providers is expected to grow to approximately $3.8 billion in 2015, with ambulatory EMR making up $1.4  billion of that number. A mere $2 billion was spent on EHR in 2009, including $633.5 million for ambulatory EHRs. That’s an overall compound growth rate of 11.5% and a whopping 14.2% in the ambulatory space. Just in case IDC Health Insights’ numbers are anywhere close to correct, you best hold on tight for the ride.

Michael Critelli, the former CEO of Pitney Bowes, is appointed president and CEO of Dossia, for which he had been serving as board chair.

Staggering: treatment costs for diabetes grew from $18.5 billion in 1996 to $41 billion in 2007. That includes $10 billion for outpatient care and $19 billion for prescription drugs. Nineteen million American adults were treated for diabetes in 2007, twice the number as in 1996.

With the hottie Dr. Jayne now on board, I am am more focused than ever on maintaining my youthful appearance, so this new, free iPhone app has come none too soon  Beverly Hills surgeon Dr. Payman Simoni created it to let users to see how they might look with a bit of enhancing. You can upload a photo of yourself and then play around to create a new nose, face lift, or the like. I went for the eyebrow lift. I think it makes me look more surprised than young, so for now, I’ll continue seeking the fountain of youth.

 E-mail (the un-enhanced) Inga.

Dr. Jayne

By now, you’re wondering, “Is Dr. Jayne really a physician? Does she actually see patients? Does she know what she’s talking about? Does she ever go out for cheeseburgers and beer, or perhaps the amusing house wine?” and other questions. The answer to all these (and many more) is yes! And so, Dear Readers, a bit more information about the newest HIStalk correspondent:

By day, you’ll find me in the CMIO trenches. By night — well, we’ll save that for another time. The life of a CMIO is never dull; there’s always a fire to be put out somewhere, and usually an angry physician behind the scenes holding a lit match.

I can’t blame them, though – they’re faced with tremendous changes that sometimes seem to threaten their core identity. Healthcare delivery didn’t change much for decades, but the past fifteen years have been Mr. Toad’s Wild Ride. Not only in the science behind the practice of medicine, but in how we are compensated, the equipment we must use, and the rules we must follow to care for patients. There are few industries that have gone through this pace of change. Physicians claimed E&M Coding was going to be the ultimate downfall of medicine in America. Meaningful Use makes that look tame by comparison!

My colleagues who view the profession as a calling tend to take this just a little bit personally. Each one of you has worked with these physicians. I spend a good chunk of time with docs like these, doing something between hand-holding and crisis counseling, depending on the person and the situation. Thank goodness for those psychiatry rotations that taught me never to sit between the agitated patient (or colleague) and the door.

When I’m not working directly with physicians, I’m exercising my clinical brain, working on evidence-based order sets, protocols, formularies, clinical reporting, training strategies, and making sure anything new is communicated in duplicate and triplicate for my colleagues who still refuse to read their e-mail (although I bet they use Facebook to see pictures of their grandchildren, but just won’t admit it.)

Speaking of Facebook, a shout-out to my new friends! I have a long way to go to catch up with Mr. H and Inga.

I also see patients, in an old-school, white-coat kind of way. I use the same systems that my colleagues claim I am using to interfere with the practice of medicine, force them into retirement, or otherwise torment them.

When I’m not handing out Kleenex or making sure we are doing quality clinical work, I exercise my technical brain. This is the part of me that loves playing “vendor Jenga” to see if we can actually make diverse clinical systems communicate with each other while using an amount of staff resources equal to half of what we asked for. Pull out the lower blocks and stack them on top – without toppling the tower! Tricky but challenging, and extremely rewarding when it works.

I enjoy working with our analysts and technical teams and helping them understand why (or why not) a particular piece of software is going to be accepted by clinicians or if we need to budget for our Implementation Analysts to start wearing Kevlar. And if they’re nice to me, I write my own SQL queries to get at information I want. And if they’re not nice to me, I might just play the “doctor card” and make sure they have no idea that I even know what Management Studio is. I also work closely with our vendors and doing the odd bit of development work and focus groups.

So, Dear Readers, now you know my skill set. Send me your provider-centric thoughts, questions, and conundrums. These will be answered in our new “Dear Dr. Jayne” feature – although I’ll be responding with a glass of wine in hand and you’re on your own for Kleenex.

E-mail Dr. Jayne.

 Sponsor Updates by DigitalBeanCounter

• Voalte partners with Rauland-Borg Corporation to integrate Rauland-Borg’s Nurse Call with Voalte’s iPhone communications solution.
• MED3OOO’s InteGreat EHR V6.4 earns ONC-ATCB certification through CCHIT. MED3OOO also announces the appointment of Jim Altenbaugh as VP of tech services implementation and training.
• Vocera Communications acquires Wallace Wireless, a developer of software to deliver pages, text messages, and alerts directly to smart phones. The acquisition is Vocera’s fourth since October.
• Lancaster Hospital selects ProVation Order Sets from Wolters Kluwer Health.
• Chadron Community Hospital contracts with Keane Healthcare Solutions for the full suite of Keane Optimum applications, including Optimum Clinicals.
• Geisinger Health System is using Precyse’s NLP coding software and  M*Modal’s NLP voice to text technology to enhance its clinical documentation and coding.
• Vermont Information Technology Leaders (VITL) selects Greenway’s PrimeSUITE EHR to leverage its REC; Colorado Regional Extension Center (CO-REC) does the same.
• Greenway also partners with DiagnosisONE to provide clinical decision support for its EHR deployments.
• NextGen releases v.5.6 SP1, offering several new enhancements such as clinical quality measures for Meaningful Use and 5010 healthcare transaction compliance.
• iMDsoft increases its global presence compliments of its MetaVision Suite, which went live at 45 sites, 11 countries, and in seven languages in 2010.
• OSF St. Joseph Medical Center (IL) renews its multi-year contract with GetWellNetwork and goes live with GetWellNetwork’s system integration for its Epic-based EMR.
• San Luis Valley Regional Medical Center (CO) signs a five-year technology outsourcing contract with CareTech Solutions.
• Holon Solutions will participate on an HIE panel at iHT2 Health Summit in Atlanta.
• CapsuleTech is hosting an enterprise device connectivity  webinar on January 19th.
• Nuesoft announces its Nuetopia service that combines its EHR, billing software, and revenue cycle management services.
• Bridgehead achieves a 40% year-over-year income increase for FY2010 thanks to its focus on the healthcare vertical.

Monday Morning Update 1/10/11

From EHR Geek: “Re: Vitalize. Mr. HIStalk, why didn’t you post the Vitalize purchase of Validus on your real page? It’s only on the HIStalk Fan Page of Facebook.” I was torn on that one. I had just blasted out the SIS news and I couldn’t decide if this item was of broad enough interest to justify another e-mail (I don’t want to give readers alert fatigue), so I just posted it as a Facebook status item until the next scheduled post (this one). That’s another good reason to Friend/Like us there since I usually post news blasts there, too. Anyway: Vitalize Consulting Solutions acquires (warning: PDF) Minneapolis-based Validus Consulting, which has around 60 consultants providing strategic advisory and project leadership services. Vitalize, which offers strategy, EHR implementation, revenue cycle, project leadership, and application / technical resources, says it’s now the largest privately owned HIT consulting firm, with more than 450 consultants. I hadn’t realized that former Allina Excellian (Epic) VP Kim Pederson, who I interviewed awhile back, is a Validus principal. I also didn’t realize until Googling something else that industry pioneer Bill Childs, who just won CHIME’s Lifetime Achievement Award, is a Vitalize VP (there might be no HIStalk if Bill hadn’t broken the HIT journalism ground with Healthcare Informatics). I know and like the Vitalize folks and I’m amazed at the company’s growth under CEO Bruce Cerullo, a long-time friend of HIStalk. 

From Jerry MindMeld: “Re: joke of the day. Dr. Blumenthal was at Congress yesterday during the reading of the Constitution. He looks over at the stenographer and realizes they are typing every word spoken for the entire day, every speech and every vote. He leans over to the guy sitting next to him and says, ‘Jeez, I wish we had that in my industry — it would make practicing medicine a lot easier.’" I’m here all week – try the veal.

From The PACS Designer: “Re: Dimdim. Mr. H, since you now can’t use Dimdim collaboration software due to Salesforce.com’s privatizing it, why not go to Yugma, which is another collaboration application on the web?” I will give it a look. The biggest differentiator among the Webinar-type tools is how well they record and archive the session, especially the audio portion. I also liked ReadyTalk. I’m kicking tires because I really like the idea of providing some kind of education at a higher level of quality than you usually see (i.e., less of a commercial pitch).

From Leopold Stoch: “Re: Paul Levy. Stepping down as CEO of Beth Israel Deaconess.” I guess John Halamka’s boss is down to blogging as a job for now, but I’m sure he will have many opportunities.

New HIStalk contributor Jayne (or Dr. Jayne if you or she prefer) introduces herself below. What sold me on her: (a) she writes well and in a non-stuffy HIStalk way; (b) she’s funny; (c) she has a great education and medical experience; (d) she works in an informatics role, but still maintains a medical practice, so she knows a broad swath of the industry; and (e) she’s an HIStalk fan and gets what we do. E-mail her your greetings if you like. We thought a recurring “Ask Dr. Jayne” feature would be fun, so let’s have any questions you’ve always wanted to ask an informatics doc (what does she think of EMRs, how important is usability, how does she interact with the EMR in the exam room, etc.) Her brand new Facebook is looking a bit bare, so I’m sure she could use a friend or two there.

Listening: Young Fresh Fellows, a Seattle-based alt pop band that’s been around for 30 years. I played their 2009 album and immediately bought it for the gym iPod, which almost never happens. Their music is hard to categorize – sometimes its Pixies punkish, sometimes REM jangly, but it’s always fun (extra points for using “bereft” in a lyric and then rhyming with it).  

I’m intrigued by these poll results: 52% of readers plan to keep the same job and employer in 2011, but a full 42% are expecting to land a better job, either with the same employer (18%) or a different one (24%). Only 3% expect to move to a worse job, with about the same percentage saying they’ll retire or quit this year. New poll to your right: what are your plans for the HIMSS conference?

Thanks for your HISsies nominations. I’m e-mailing out survey ballots this weekend, so watch your inbox and please vote. Thanks, too, to readers who nominated Inga and me for several categories even though the instructions said not to.

HIMSS government relations VP Dave Roberts posts the organization’s priorities for the new Congress, the main ones being keep HIT bipartisan and keep the HITECH money flowing despite all the good reasons it shouldn’t. He also lists what he says are the priorities of HIMSS members, such as establishing a Meaningful Use grievance process and spending even more taxpayer dollars, this time on “health IT action zones.”  He asks for feedback.

Say hello to new HIStalk Platinum Sponsor Shareable Ink. The Nashville-based company’s concept should resonate with quite a few hospitals and practices: you shouldn’t have to disrupt clinician workflow to move to electronic health records. Shareable Ink’s enterprise-grade digital pen and paper technology lets clinicians keep documenting the way they like without turning themselves into patient-ignoring keyboard zombies, yet it translates their work into digital, discrete, and shareable EHR data as if they’d labored over a keyboard instead. Anybody can implement it quickly since there’s no software running on site (it’s zero-footprint Saas) and there’s no boondoggle IT project standing in the way of hospitals and practices anxious to move to EHRs and collect their HITECH checks. It integrates (with registration, EHR, CDR, etc), it pre-fills forms from inbound interface data, and it makes paper smart with form-based electronic rules and outbound alerts (e-mail, SMS, page). You don’t have to force behavior change on set-in-their-ways ED docs and anesthesiologists (not to mention that 90% of hospital daily progress notes are, of course, written by hand and that’s a tough battleship to turn). It must be cool since T-System, whose paper forms (T-Sheets) are an ED mainstay, chose Shareable Ink to power its DigitalShare electronic ED encounter documentation system. Shareable Ink also just released an analytics package that lets organizations mine all the handwritten data it converts, so paper documentation from anesthesia, ED, and progress notes can be electronically reviewed for quality and efficiency metrics without chart pulls. Thanks to Shareable Ink for supporting HIStalk.

I turned myself on a little writing about Shareable Ink, so I headed over to YouTube to see if there was a demo. Here’s one from a year ago, as co-founder and CMO Vernon Huang MD (sounds like a fascinating guy: Hopkins biomedical engineering degree and GWU MD, practicing anesthesiologist, worked for Apple, was a Navy flight surgeon) shows how his sloppy doctor handwriting (sorry, Doc) is turned into an electronic record without his doing anything.

The Walgreens drugstore chain, in my mind, leads the way with consumer-friendly mobile apps for their patients / customers (text alerts, patient-scanned barcodes for prescription refills, health risk assessments, kiosks, EMR, e-Prescribing, etc.). The company’s CMO moderated a digital health session at the CES Digital Health Summit. Too bad the rest of healthcare doesn’t have such clearly aligned incentives (invest in technology, sell more stuff as a result, make more money, everybody’s happy).

Drug maker Roche files suit against a software company it bankrolled and intended to acquire. Medical Automation Systems had agreed to be acquired by Roche for $40 million, but then got a better offer from a competitor. Roche sued, saying it has right of first refusal and shouldn’t be required to participate in a bidding war. The company’s RALS software is used in the Accu-Check and CoaguCheck point-of-care monitoring systems to send results to hospital clinical systems. Wish you’d thought of it, right?

The promotional video for the just-announced new version of the Microsoft Surface coffee table thingy shows people collaborating over radiology images and ultrasounds. It reacts to both touch and objects, where it “seamlessly merges the physical and digital worlds.” It works like a massive iPad on four legs, accepting all kinds of gestures and manipulation. I have to say it seems cool and a pretty good deal, with the new version priced at $7,600 compared to the original’s $12,000 price tag. Imagine an EMR built for a screen that size run by touch – docs would love it. It would also be amazing for patient teaching, but you’d have to bring the patient to the Surface instead of vice versa (unless someone invents a SOW – a Surface on Wheels).

Speaking of the Surface, I found this old picture of MEDHOST’s ED dashboard running on it. I found pretty much no information on MEDHOST’s site about it, so I don’t know if they still offer it or if anyone ever bought one. It looks good, though.

Eris Medical Technologies, created in a Youngstown, OH incubator, will provide its erisRX charge capture management software to Florida Hospital Orlando. Founder Jennifer Wexler used to work at FHO as well as Orlando Health, while co-founder Kelly Bucci comes from Deloitte. 

We had a slip-up in Friday’s post due to a bogus news alert (old Web pages sometimes suddenly pop up as news – I’ve been burned by that a couple of times). Mark Briggs is still CEO at HIE solution vendor VisionShare, which he joined in May – the link we ran was to an older (undated) press release from when he took an earlier job.

J.P. Morgan’s healthcare conference runs this week. Ben Rooks wrote about why you should care (or not) in his HIStalk column from a year ago.

e-MDs says CMS’s first HITECH check for a physician practice went to one of its clients just two days after CMS registration opened. Gastorf Family Clinic (OK) got $21,250 each for its two doctors. They told doctors they’d get big checks and that one’s ginormous.

Speaking of HITECH registration, CMS says 4,000 providers registered for EHR incentives in the first four days after its site went live on January 3.

Inga and I have decided that we should have vendor tee shirts made for HIMSS that read, “Want to be profitably acquired? Sponsor HIStalk.” The list of sponsors recently completing successful transactions (these would be listed on the back) includes Medicity, Ingenix, Picis, Sentillion, Eclipsys, eScription, Sunquest, and now SIS. There are plenty more, but those are some of the larger and more recent ones.

Philips buys Pittsburgh-based medSage, developers of an automated telephone-based system for home health patients to reorder supplies. Their executive bios are fun: “Bob is the ‘Old Guy’ on the medSage Team … has been in the healthcare industry for over 30 years (our abacus will not go any higher) … Bob is the ‘Really Big Guy’ on the medSage Team. (If you have met Bob in person, you know what we mean!) For that reason, Bob is to be Mr. October, November, AND December in the 2009 medSage Team promotional calendar.” Let’s hope they keep Bob happy since if they don’t, it sounds like he’s got a couple of potential discrimination suits to choose from.

A judge overturns a community college’s dismissal of four nursing students for posting cell phone pictures of themselves posing with a placenta on Facebook. The instructor of the students told them it was OK to take the picture as long as any identifying information was removed, even though the students told here they planned to post the pictures on Facebook. The student whose case set the precedent for the others is worried about her reputation preceding her for an eventual job. “I am concerned that my name is all over the Internet. All you have to do is Google ‘placenta.’” She’s right – above is my Google News search result, complete with her smiling placenta pose.

E-mail me.

Why Me? 
By Dr. Jayne

Let me just start by saying that I’ve idolized Mr. HIStalk and Inga for quite some time. So when Mr. H posted that he was interested in finding someone to help out, I was tres excited. I put together a few thoughts, crossed my fingers, and clicked “send” with visions of IngaTinis dancing in my head. A few spins of the planet later, here I am, excited to be part of the HIStalk family!

Why did I want to write for HIStalk? First, I wanted to be able to provide a physician perspective on hot topics in healthcare IT. Now that Meaningful Use is finally here, understanding the real impact the new rules are having on patient care is going to be important. Who better to talk about it than someone who is actually seeing and treating patients?

Don’t worry though, I’m a serious IT staffer (also a shoe aficionado, so the chance to work with Inga was a huge part of this, but we’ll save that for later) who lately spends more time talking the IT talk and walking the IT walk than personally caring for patients. But I still see enough patients to be able to regale you with strange-but-true stories about what happens on the other side of the exam room door.

Second, I enjoy expressing my creative side, love writing, and am fluent in a variety of poetic forms. Healthcare IT words are just about as hard to rhyme as medical words; although it might be possible to rhyme “ruptured appendix” with “clustered index” it would have to be a really special poem to make that work so you’ll all just have to keep reading and see what I come up with. (A special shout out will go to the first reader who pulls that one off.)

Third, IT systems and patients are more similar than most people would think. When they’re healthy they’re happy and you enjoy going to work every day, and when they’re “sick” they can drive you mad. I’ve spent the last several years of my career trying to help bridge the gap between “the IT people” and “the clinical people” and being able to do that on a larger scale seemed cool. We all want the same things – and if I can give the “computer guys” and the “doctors that just hate the system” some tips and tricks to better interact with each other, then I’ve helped make all of our lives a tiny bit better.

Finally, a tiny part of me wanted a guaranteed invite to HIStalkapalooza (OK, maybe it was a very big part). Although I suppose as a team member I’m likely excluded from the “Inga Loves My Shoes” and HIStalk Queen contests, I might try anyway, so dust off those shiny taffeta ball gowns and the ruffled tuxedo shirts, and I’ll see you there.

Say hello to Jayne.

Norwest Equity Partners Acquires Surgical Information Systems

Surgical Information Systems announced this morning that private equity firm Norwest Equity Partners has acquired the company from Vista Equity Partners, its owner for the past four years.

“By maintaining our focus on the financial engine of the hospital, SIS has achieved year-over-year growth that significantly exceeds industry averages. We have also enjoyed success in the perioperative area during some of the most challenging economic conditions in memory,” said SIS CEO Ed Daihl. “Demand for perioperative-specific information solutions is rapidly growing, particularly in anesthesia solutions, and our new partnership with NEP represents the continued evolution of the company.”

The 50-year-old Norwest Equity Partners, headquartered in Minneapolis, manages $4.6 billion in capital, focusing on building middle-market companies. Its major limited partner is Wells Fargo & Co. The firm’s other healthcare IT investment is communications vendor Amcom Software. According to the announcement, the SIS executive management team will remain in place.

SIS executives we spoke to said that hospitals are focusing on the perioperative area in preparation for healthcare reform and potentially declining reimbursement since it contributes up to 60% of hospital margins. That makes the OR and anesthesia business of SIS a highly attractive investment, they told us, with anesthesia alone having a 24% annual growth rate.

The Alpharetta, GA company’s growth has been organic, with new customers, exclusive industry endorsements, and expanded technology partnerships. Its perioperative software was recently certified as a modular EHR.

SIS customers were notified by an e-mail today from Ed Daihl, who described the acquisition as “a new phase of growth that will benefit you with the accelerated delivery of new, innovative software solutions that will support your efforts to optimize the delivery of perioperative services.”

News 1/7/11

From Clarence: “Re: HIMSS. Isn’t the conference in Orlando?” Looks like someone copied over last year’s e-mail announcement for this year’s HIMSS Annual Leadership Survey. Doh!

From Lizzy Thin: “Re: GE Healthcare. Rumor is that several workers in Seattle were shown the door today.” Verified, thanks to my GE media contact, who proactively e-mailed me to tell me the following: “As a part of the continuous review of our priorities and opportunities, we’ve eliminated a limited number of positions due to overlapping responsibility. The majority of the impacted roles are based out of our Seattle office. This does not in any way signal a change to the updates that I’ve given you in the past few weeks. Though a difficult decision, we remain committed to the success of our customers and employees.” Condolences to those affected, with my rare positive counsel being that as bleak as it seems when the career rug is pulled out from under you (it’s happened to me), you are likely to eventually end up being glad it did because it forces you to re-evaluate and focus. Kudos to GE Healthcare for at least waiting until after the holidays and for being honest about it.

From John in the UK: “Re: shares in Fletcher-Flora Health Care Systems. Please, could you inform me of their value?” I contacted CEO Neal Flora, who says to e-mail him so he can verify that you are on their list of shareholders. He’ll then provide the information. His contact information is here.

From Student: “Re: Northwestern University. It’s considering changing the format of its online MS in Medical Informatics from live, synchronous meetings (with instant feedback and collaboration) to asynchronous. Students are concerned about the respectability and quality this will provide. What do you and your readers think of an asynchronous format only?” I think it’s fine as long as the pedagogy is made clear to the faculty, i.e. this isn’t just putting lecture notes online and giving online tests, which I’m sure they already know since the program isn’t moving from classroom to online for the first time. Synchronous learning isn’t convenient to students or professors, especially with the considerable number of non-US based students taking HIT-related coursework (the time zone challenge is tough, as are hospital people who don’t work day shift). Technology supports asynchronous learning quite nicely, with podcasts and video lectures being well suited for it. The key is student collaboration and engagement through asynchronous discussion, projects, and learning that supports multiple learning styles (especially tactile/kinesthetic, which in my experience is tougher in an asynchronous environment, but that just means the instructor needs to plan for it). My conclusion: it’s not only OK, it’s a good idea, provided the proper expectations for student engagement are given to instructors. I’ve always thought that synchronous learning was more show than substance, often mandated by highbrow educational institutions that were not only slow to move online, but anxious to show their superiority over competitors who actually make learning accessible. Today’s synchronous is yesterday’s sage-on-the-stage.

The first sizeable acquisition of the new year will be announced Friday, so look for my news blast as soon as I get the green light to send it out. I’m hoping I’m not tied up at work since that’s always my nightmare – I’m stuck in some meeting sitting on hot news that’s congealing while I impatiently check my watch every ten seconds. I’ve also been given a heads up that a consulting company will be making an announcement tomorrow. If you don’t get my e-mail blasts, now’s the time to put your name and e-mail address in the spam-proof Subscribe to Updates box to your upper right. Tomorrow will be another chance to one-up that smart-alecky colleague down the hall.

eHealth Initiative announces its new board members, including new chair William Jessee of MGMA and Micky Tripathi of Massachusetts eHealth Collaborative.

Motion Computing announces the CL900 Windows 7 ruggedized tablet at CES. Available in Q2 starting at under $1,000, Motion says.

This article impacted Weird News Andy, which he titles “You have WHAT in your colon? I don’t even want to think about how it got there.” A woman undergoing a routine colonoscopy for abdominal bloating is found to have a Blatella germanica in her transverse colon. For you lay folks, that means they found a cockroach in her large intestine, presumably accidentally eaten by her in her infested home. I would have included the picture, but I’m sure your mental one is graphic enough.

HISsies nominations will close soon … make your nominations now. Voting will start this weekend if I get time to put the ballot together and e-mail it out to the HIStalk subscriber list.

I was playing around with Webinar tools the other day and liked Dimdim, which has a goofy name but pretty cool technology. I just got an e-mail from my signup that it’s been acquired by Salesforce.com.

Jobs on the sponsor-only job board: VP Sales Central Region, Senior Software Engineer, Software / Implementation Engineer. That reminds me that I need to figure out why people who don’t work with engines are still called engineers. On Healthcare IT Jobs: Project Manager, McKesson HEO Analyst, Assistant Health Services IT Director.

Travis, the tech-savvy doc who writes HIStalk Mobile for me, is putting up some good stories. Up now: hospital support of mobile devices, next generation iPad speculation, Skype for telemedicine, practices offering online appointment scheduling, Sutter and MyChart, IDEAL LIFE’s health tablet, and more. Drop your e-mail in the Subscribe to Updates box on that page to make sure you don’t miss anything, and if you’d like to contribute guest articles, news, how you use your favorite health-related iPhone apps, etc. give Travis a shout. Thanks much to our sponsors there: AT&T, Vocera, Voalte, 3M, Access, Thomson Reuters, and PatientKeeper. Some of the most interesting technology in healthcare involves smart phones, messaging, clinical communication, health management via technology, etc. and we cover it all there.

I’ll have a new HIStalk contributor to announce shortly. She’s a practicing physician and informatics expert who nonetheless described herself in offering her services as a long-time HIStalk fan and “young, blonde, and love shoes, making the perfect bookend for you with Inga.” I knew her lofty credentials, lack of pretension, and obvious sense of humor would raise Inga’s professional jealousy, which they did, as Inga sniffed to me that our new BFF is “too smart and young and cute and perfect.” They are both wonderful, so readers will benefit as we are able to explore even more issues and offer more useful information. She will be contributing to all three sites (HIStalk, HIStalk Mobile, and HIStalk Practice) and will be on the ground with us at HIMSS. Since Inga is often insecure, I should say that I don’t value or love her any less just because we’re getting help to hopefully achieve higher levels of pretty-goodness. I may need your assistance in reassuring her, though.

LifeIMAGE, which offers a medical image sharing platform, finishes its second funding round with $12 million, raising its total to $17 million. I interviewed Hamid Tabatabaie, president and CEO, a few weeks ago.

4Medica’s Inpatient Cloud EHR and integration engine earn CCHIT certification as an EHR module using hospital criteria.

I don’t find this to be true, do you? A reporter claims that Microsoft Making Name in Lucrative Health Care Records Market. The article suggests that HealthVault is profitable, which it isn’t as far as I know. It also touts Amalga HIS, overlooking the fact that the company shut it down not long after it bought it. The sweeping, big-finish conclusion: “Whatever the reason, Microsoft’s strategy seems to be working – it’s making a name for itself in a sleeping giant of a market that’s only now awakening to the power of business technology.” I’m not saying they aren’t doing some interesting things, but I’d hardly say they’re leading a sleeping market, and some of what they are doing is more in life sciences than healthcare. At my hospital, Microsoft means Windows, SQL, Office, and now Sentillion.

Some scumbag steals three Internet Cafe computers from Brockville General Hospital (Ontario) over the holiday, shutting it down and leaving users (some of them palliative care and rehab patients) without. The hospital doesn’t have the money to replace them, but a local travel agency donated one and is challenging other local businesses to do the same.

I still think this software should win awards: still another patient is saved by a kidney transplant made possible by an application that figures out a complex series of transplants that gives the greatest possible number of donor-recipient marches from the available pool.

University of New Mexico Hospital is reviewing its emergency alert system after a gunman fires a shot inside, but the employee text and e-mail alert took 32 minutes to get out after police had showed up en masse. The hospital says their incident people couldn’t get logged into the Web-based alerting system. They also couldn’t get executive approval to blast the message. The hospital says it will  hire a consultant. Something to think about before the reporters show up. I bet employees were already burning up Twitter and Facebook.

The local paper covers IT raises at University of Missouri and the hospital, noting that 52 employees were promoted with raises in December alone. It suggests that a just-opened IBM facility in town may have forced the university to give raises to keep staff.

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HERtalk by Inga

From Joe Walsh: “Re: HISsies. I am aware that the HISsies are just a bit tongue-in-cheek, but how serious is the proposal for a Lifetime Achievement Award?” I’d say all the categories are as serious as readers want them to be, but that one in particular is totally serious. As Mr. H often mentions, 100% of the nominations and final voting come from readers. Many of our past winners have been touched by the recognition. Todd Cozzens, for example, was quite appreciative of Picis’s Best HIT Vendor award a couple of years ago, and even the irreverent Jonathan Bush seemed to love winning HIT Industry Figure of the Year. We also know some organizations stuff the proverbial ballot box in favor of the home team (at least before we starting sending ballots directly to the HIStalk subscriber list last year instead of letting anyone vote), but ever that suggests that folks consider the HISsies an honor. 

From Elmer: “Re: Kudos. Love your blogs. You guys are the glue to what’s going on in HIT.” Thanks, Elmer. As Mr. H will tell you, I’m chronically insecure and need loving encouragement every now and then, so your words are appreciated.

From AA CoolNeal: “Re: A MEDITECH rap song. Funny rap song composed (supposedly) by former MEDITECHers. I worked there for 10 years and the song does hit all the highs and lows.” Very clever. And reminds me of many things I don’t miss about working for a big company.

From Eero Saarinen: “Re: Cerner win. Columbus (IN) Regional Hospital has signed a contract with Cerner. No surprise; they’ve been in negotiations for many weeks. CRH has used Cerner PathNet and Apache for several years but the new deal is a near-total McKesson replacement.” Unverified.

University of Kentucky Healthcare and Central Baptist Hospital are among the first recipients of Meaningful Use incentive checks. Kentucky Medicaid has already issued a $2.8 million check for UK and $1.3 million for Central Baptist. An additional 25 Kentucky providers have begun the application process.

Partners Healthcare is borrowing $420 million for EMR improvements and debt refinancing.

Healthcare represented 17.6% of the US economy in 2009, with total spending of $2.49 trillion (with a “t”). That’s up from 16.6% of GDP in 2008. Reminds me of when I was interviewing for my first job in HIT. I wasn’t sure I wanted to leave my budding career in finance, but my soon-to-be new boss convinced me that the business of healthcare and computers was going to become increasingly important. Obviously he was right.

I see that Bill O’Toole, an occasional HIStalk contributor, is offering a complimentary white paper to providers considering the purchase of an EHR. He’s founder of the O’Toole Law Group, spent 20 years as corporate counsel for MEDITECH, and has a friendly writing style.

Spectrum Health (MI) launches its MySpectrum smart phone app created with the InterSystems Ensemble integration and development platform.

Saint John’s Health System and St. Vincent Jennings Hospitals join more than 80 hospitals as part of the Indiana HIE.

Maricopa Integrated Health System (AZ) renews its agreement with MedAssets for multiple Web-based, revenue cycle tools.

New on HIStalk Practice this week: a peek at Cerner Ambulatory. Hospitals buying up practices. A physician review of the Motion J3500 tablet.  A couple of my New Year’s resolutions. Health reform may boost house calls. HIStalk Practice traffic, by the way, grew 25% in 2010. If you haven’t stopped by yet, it’s time to check out what you have been missing.

Jennie Stuart Medical Center (KY) implements ChartWise:CDI for clinical documentation.

LinkedIn is rumored to be going public this year, making it the first social network to do so. Which reminds me: I am pretty social, so feel free to connect with me on LinkedIn or Facebook. Mr. H is not quite as social as me, but seemingly better connected, so make sure you friend and connect with him as well. And don’t forget to join the HIStalk Fan Club on LinkedIn and to like us on the HIStalk Facebook page.

Cleveland Clinic and MetroHealth Medical Center say they will begin sharing patient records using Epic’s Care Everywhere program.

Dr. Lyle Berkowitz, MD, another occasional HIStalk contributor and medical director of clinical informatics at Northwestern Memorial Physicians Group, asked us to give a plug to HIT X.0 (Beyond the Edge). That’s a new sub-conference that will run during HIMSS and focus on innovation and the future. One session that looks particularly fun is called HIT Geeks Got Talent.  Eight companies will be given 2-5 minutes each to show off their coolest, newest technology. A panel of judges will give feedback, then audience members will have a chance to text their vote for the best product. The call for contestants is still open If you have some bleeding edge technology you’d like to demonstrate. There’s no extra charge for the HIT X.0 sessions, but Dr. Lyle said attendees are advised to pre-register to get a guaranteed seat. Mr. H tells me he’s in and planning to sit on the front row.

A patient drives his Chevy Blazer through the doors of a Kelowna General Hospital (BC) after being told he’d have to wait 45 minutes to see an ER doctor. The hospital estimates damages of $15,000. I wonder if the hospital is now checking into one of those Web-based apps to display ER wait times.

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• Imprivata OneSign is named a premier solution in SC Magazine’s 2011 Reader Trust Award competition, which honors best-in-class security products and services.
• maxIT Healthcare promotes Mike Sweeney to president, reporting to CEO and Chairman Parker Hinshaw. maxIT also names Reese Gomez executive vice president of solution management.
• McKesson takes top KLAS honors in eight separate categories, including Best in KLAS in Community HIS for its Paragon solution. Horizon Practice Plus also wins Best in KLAS for  Practice Management (26-100 physicians).
• The MED3OOO-owned CPU Medical Management Systems partners with Revenue Advantage to provide hosted interactive voice recognition applications to billing companies and healthcare providers.
• Allina Hospitals & Clinics chooses Greenway’s PrimeSUITE for providers in Minnesota and western Wisconsin largely due to Allina’s Epic-based EMR.
• YouTube Video: Using RXHub and External Med History in eClinicalWorks v 8.0.
• Carefx expands its presence in the UK by partnering with Northgate Managed Service, and agrees to deploy its Fusion healthcare interoperability platform with Cambridge University Hospitals.  Trillium Health Centre (Canada) also goes live with Fusion.
• AT&T includes MedApps as part of their ForHealth telehealth products and solutions.
• maxIT Healthcare appoints Mike Sweeney to President; he will manage day to day operations and will report to Parker Hinshaw (CEO).
• SC Magazine Awards names Imprivata as a finalist in the Best Multifactor Product category for the Reader Trust Award competition.
• CentraState Healthcare System chooses MobileMD for their HIE.
• Frank Stellato is announced as myHealthDirect’s Chief Financial Officer; he’s been with the company since July 2010 and was most recently CFO of MedAssist. Doug Cobb also joins myHealthDirect’s board of directors.
• Ochsner Health System (LA) goes live with Orion Health HIE.
• Lake Medical Group selects GroupOne Health Source to implement eClinicalWorks EMR system for its roughly 50 healthcare providers.
• Nuesoft has a nice entry on their blog asking the question: Are more doctors adopting EHRs?
• CynergisTek CEO Mac McMillian will present at the HIMSS Southern California Chapter meeting on January 13th in Orange, CA.
• North Highland acquires Insight Solutions Group.
• OnePartner selects MobileMD for its HIE.
• Nason Hospital (PA) will use tablet-based e-Forms completion from Access, integrated with MedSeries4 and the Soarian document management application.

News 1/5/11

From Stan: “Re: article in Applied Clinical Informatics on why people discount personal experiences with HIT. I think your readers might find the free download worth reading. Best regards from Switzerland.” The author, Jon D. Patrick from the University of Sydney, Australia, took heat for publishing user reports of ED system problems. His editorial says the problem reports of experienced system users are dismissed as unscientific anecdotes to protect IT interests, the organization’s investment, or its executives from criticism instead of treating those reports as an early warning system. While I don’t buy the idea that user IT perceptions should always be taken at face value, he’s right about the weird dynamic: the IT department and all the suits who signed off on the deal shoot the messenger because they are emotionally invested in it. They honestly believe that complaining users are troublemakers or fools who aren’t blessed with their big-picture vision (specific, serious IT problems are often dismissed on the basis of the greater good, of course). That’s like blaming a patient for daring to develop a post-surgical infection since it makes the surgeons look bad (which wouldn’t surprise me either).

From The PACS Designer: “Re: iPad 2. Sometime later this month, we’ll be seeing Apple’s next version of the iPad, being called the iPad 2 or 2nd Generation. Business Insider gives us an early look on what might be in the iPad 2 and what will probably be done to  the current iPad price. Sources in Japan are reporting that early production models seem to indicate that the iPad 2 will have two cameras, with the rear camera having the ability to record a movie when needed by users.”

From Healthcare Idiot Savant: “Re: Missouri State Senator Brad Lager from North Missouri (R-12). Recently started a new job — wait for it — in Government Affairs for Neal Patterson’s Cerner Corporation. Certainly there can’t be any conflict of interest there, right?” According to a bio in the KC business magazine, A bit of advice if you want to reach Missouri state Sen. Brad Lager: Try to give his e-mail inbox a break. ‘Between my Senate e-mail and my e-mail at Cerner, it’s about 1,000 messages a week,’ says the time-starved 34-year-old. As a measure of Cerner’s good corporate citizenship, the Northland medical software giant makes concessions to allow Lager the four-day legislative schedule he keeps from January through May. He’s back in the office at Cerner on Fridays as a senior strategic analyst in the Health-e Services group. I found some old documents that said Neal’s wife Jeanne donated $25,000 to his 2008 campaign for state treasurer.

From DigDug: “Re: taxes. We are hearing a rumor about tax changes for consultants who pay their own travel costs up front and are reimbursed by the client. There should be no tax implication, as the consultant is not claiming any deduction or tax relief for the travel, but we are hearing that the government now considers these reimbursements as taxable. Any insights?” I’ll use a reader lifeline here since I don’t know. Anyone?

From Lori: “Re: HIStalk. I’m writing to express how much I love and enjoy reading HIStalk! I stumbled upon it on Facebook and have been on it ever since! I enjoy looking at the industry as it continues to unfold. I’m able to do that now with HIStalk! Thanks again!” Thanks.

From NoName: “Re: evidence of an EMR implementation improving patient safety.” An article from East Carolina University and academic medical center Pitt County Memorial Hospital (NC) in Journal of Antimicrobial Chemotherapy finds that its inpatient Epic EMR implementation was accompanied by a 29% reduction in antimicrobial use. Clostridium-caused nosocomial infections dropped by 19% and MRSA infections went down 45%. The EMR doesn’t get all the credit, though: the article suggests that better pharmacist oversight of antibiotic usage, made possible by having immediate electronic access to patient information and orders, allowed them to intervene more effectively. However, order sets built into Epic did reduce the ordering of excessively high antibiotic doses. The good news is that all EMRs can support these efforts if hospitals use them appropriately, so not having Epic isn’t an excuse.

From Roy G. Biv: “Re: weird interview questions. One from Deloitte: how many ridges are there on the edge of a quarter? From my own experience, I’d say that’s about right as far as the average Deloitte consultant’s contact with reality is concerned.”

Listening: The Jessica Prouty Band, which I’m giving special attention since I know her mom, who spent time in HIT. This is a teen band, but you’d never know it since they play hard-rocking prog-metal (to my ear, anyway – think Within Temptation or Evanescence). They’ve toured, won a bunch of contests, and are playing Downtown Disney in California on January 15. I like their sound a lot.

I’m really excited to introduce a new HIStalker, DigitalBeanCounter. DBC e-mailed after seeing my cry for HIStalk help and will be doing some interesting things with us, starting with collecting and writing up sponsor news items in the Sponsor Update section. He’s got a ton of energy and a great attitude (the opposite of me, in other words). It’s great to have DigitalBeanCounter on our little team. I’ll hook him up with an e-mail address soon, but he was anxious to jump right in.

Speaking of which, thanks to the amazing people who e-mailed offering to help out. I’m still sorting through them, but as Inga told me, they’re all so good we want to work with every single one of them (seriously). My several hundred daily e-mail count has swelled lately to the point that I’m behind even after working through the holiday. Any perceived slight is unintentional – I just don’t have a lot of time left between my full-time jobs (hospital and HIStalk).

Former A.D.A.M. CTO Keith Cox is named (warning: PDF) CEO of the Health Information Partnership for Tennessee, which is using a $11.6 million federal grant to connect Tennessee’s RHIOs. 

Advocate Lutheran General Hospital becomes the second Advocate hospital to sign up for PerfectServe’s clinical communications system.

Reminder: HISsies nominations are open, so let’s have yours, please. Every year someone squawks when the final ballot comes out, claiming that I was clueless in omitting some obvious nominee for Best CEO or some other category. I remind them readers do the nominating – I just choose the most-nominated items for the ballot. For example, only one person has nominated Neal Patterson for the “Pie in the Face” award so far, so either Neal has changed considerably in your mind from his unbroken streak of past wins or everybody’s assuming someone else will keep the wheels of democracy turning.

I mentioned a new story about new Cerner contracts in tiny Idaho hospitals. Vince Ciotti of H.I.S. Professionals e-mailed me some thoughts and agreed to let me run them here.

Your Web site is so good and read so much, please don’t take this as a criticism, but as an attempt to set the record straight for your many thousands of readers…

Regarding your piece on Cerner’s $1.3M "deal" for a hospital in Idaho, I’ll bet that is capital (one-time) costs, which are rather low with Cerner’s "remote hosting" approach. This would include primarily implementation fees, and maybe some on-site hardware (e.g: med scanners).

Operating costs are another matter, since remote hosting (also known as ASP or SaaS) usually has a hefty fee per month for processing and storing data at one of Cerner’s two data centers in KC. It is probably six figures per year, and could approach seven figures depending on how many apps were purchased..

So, the TCO (total cost of ownership) over five years should be right up there with the fees most other large vendors charge (e.g.: Meditech, McKesson’s Paragon, Siemens Medseries 4, etc.) for a 14-bed hospital. The best bargains for such a small site are the "Big 3" in the small hospital market: CPSI, Healthland, and HMS. Their TCO over five years should be far less than Cerner, Meditech, McKesson, etc.

In addition, these small-hospital vendors have all apps a small hospital needs, including ERP, which Cerner usually turns to someone like Lawson or Microsoft, increasing their TCO even more. CPSI can even include an integrated PACS and Time & Attendance system, all extra with the "high-end" vendors like Cerner, Siemens, McKesson, etc.

Are the "high-end" EMRs any better? That answer could be a PhD thesis of 10 pages, but the bottom line is: one can achieve Meaningful Use with any one of them! Yes, Cerner probably has far more features than CPSI, but can a 14-bed hospital ever afford the IT and clinical staff to implement them? I doubt it…

This is not to knock Cerner. Millennium is an excellent clinical system, a worthy competitor to Epic in the large and Medietch in the mid-size hospital markets. But for a 14-bed facility, it’s like a newlywed couple starting out with a BMW. They’d be much better off with a Honda, and spend the difference on their kids (patients)!

Former Parkland Hospital SVP/CIO Jack Kowitt is named EVP of outsourcing vendor PHNS.

I mentioned a while back that I was surprised by a British survey that found that 84% of people there use their smart phones as alarm clocks. I bet they’re sorry now: a New Year’s-related software bug causes iPhone alarms to stop working at midnight, causing people to oversleep. At least most of them were off Saturday, I assume.

German mega-vendor CompuGroup acquires Belgian practice software vendor Belgiedata, continuing its worldwide expansion.

Care Innovations, a telehealth and independent living joint venture of GE and Intel, is operational with management in place.

Cleveland, desperate to replace lost manufacturing jobs, kicks off construction this month on the $465 million Medical Mart & Convention Center, hoping it can ride the coattails of Cleveland Clinic to bring high-paying jobs there (like every other city wants to do, but this one’s backed by clinic CEO Toby Cosgrove). Locals get stuck with the tab in the form of a quarter-penny bump in the sales tax. The project, which has yet to sign any tenants, will cost taxpayers up to $840 million over 20 years and competes with a similar project in Nashville that already has landed HIMSS as a renter.

Open source integrator EHR Doctors, which holds a contract to provide the Social Security Administration with its HIE platform for exchanging disability claims documents, says the agency has approved its C32 Continuity of Care Document.

AliveCor’s iPhone ECG is a snap-on back for the iPhone 4 that turns it into an ECG machine. Amazing, but not yet FDA approved. 

E-mail me.

HERtalk by Inga

From Bill Belichick: “Re: Meditech. They will be buying out ambulatory partner LSS and will oversee future product development and business planning. I believe it will most likely be announced by Meditech following their next board meeting this month. This will get Meditech right into the ambulatory market and add much credibility to the product line with the new Meditech branding. It will likely offer customers much more competitive pricing.” Unverified, that but sounds like a good strategic move.

Vitality’s GlowCaps are made available for $10 a cap on Amazon. The AT&T wirelessly-connected GlowCaps are intelligent pill vial caps that use light and sound as patient reminders. Adherence data is recorded each time the pill bottle is opened, then compiled as periodic compliance reports.

Telecare, a provider of wireless communication tools for chronically ill patients and their physicians, secures $4.46 million in a mixed securities offering. The company is headed by CEO and founder Jonathan Javitt, who has a pretty good track record of aligning with and/or building growing companies. Some of his previous enterprises include CodeRyte and Clinitek (now Siemens). He was also the founding national medical director and SVP for the United Healthcare division that is now Ingenix.

Imaging outsourcing firm Foundation Radiology Group raises $3.5 million, bringing its 2010 fundraising efforts to $9.5 million. The new funds come from Chrysalis Ventures and Health Evolutions and will be used for unspecified growth.

I’ve been amused and confused by all the responses to the Epic interview question about the cost of a pear. Mr. H and others used their programming logic to calculate the cost, based on the known prices for an apple, orange, and grapefruit. I would have replied totally differently, I guess, since I  have a much simpler sales brain and an IQ that’s a good 30 points lower than Mr H’s.  Anyway, I would have said that we don’t have pricing for the pear, then pose the question, “How much do you think the pear is worth?” Or perhaps, “If you are willing to buy all the fruit today, I am sure we can come up with a package price that would be acceptable.” Incidentally the question was originally posed to a project management prospect and not for programming or sales job. Maybe a PM would do a SWOT analysis on the pear to develop the right answer.

MEDHOST says that 12 facilities have now purchased OpCenter, the company’s executive decision support solution that was introduced a year ago.

CHIME and HIMSS name Charles E. Christian the winner of their 2010 John E. Gall Jr. CIO of the Year Award. Chuck is CIO at Good Samaritan Hospital (IN).

Texas Health Resources acquires the 420-physician MedicalEdge Healthcare Group, which marks the second-largest purchase of an independent physician practice in the US. THR can now boast more physicians than its chief rival, Baylor Health Care System (620 versus 500). THR is where HIStalk contributor Ed Marx serves as CIO.

Patient flow software provider Central Logic hires Jeff Porcaro as VP of engineering and technical services. He previously served in senior management for Symantec and Novell.

I sent an e-mail over the weekend about the HIStalk-hosted, sponsor-only lunch at HIMSS and another just now about our other activities during the conference. If the e-mails did not find their way to the correct contact, let me know. And if you aren’t a sponsor, I bet you’re wishing you were because you just know that what we’re planning is bound to be fun.

ONC issues a final rule to establish the permanent certification program for HIT. For the permanent program, organizations must be accredited and authorized by the National Coordinator and must conduct post-certification surveillance. I didn’t look into all the nitty gritty details, but you can find more specifics here.

Four nursing students are expelled from Johnson County Community College (KS) after photographing themselves with a human placenta and posting the picture on Facebook. The school’s director of nursing said the students’ “demeanor and lack of professional behavior surrounding this event was considered a disruption to the learning environment and did not exemplify the professional behavior that we expect in the nursing program.” One of the students is now fighting back in federal court, seeking an injunction against the school. The 22-year-old claims her future earnings from her chosen profession are at stake because of a “momentary lack in judgment.” As one who committed a least a minute’s worth of judgment errors at that age, I hope she is allowed to finish her degree.

In an another Facebook-related story, a thief displays more than a momentary lack in judgment by stealing a flat-screen TV from a gas station’s restroom (I will refrain from making comments about the stupidity of having a TV in a gas station restroom). A customer uses his credit card to pay for gas, then hides the TV under his shirt and takes off. The gas station manager uses the credit card information to look up the thief in Facebook and sends him a friend request. Thief accepts request, despite not knowing manager (clearly not the brightest bulb on the tree). Manager tells thief that if he returns the TV, he won’t call the police. Thief ignores the request and before long ends up in jail.

E-mail Inga.

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• Informatics Corporation of America is named a Top Healthcare VAR by Everything Channel’s CRN Magazine.
• Cancer Centers of North Carolina – Ashville implements iKnowMed EMR. iKnowMed is a division of US Oncology, which is now a division of McKesson.
• CynergisTek CEO Mac McMillan is presenting at the upcoming Security/HITECH conference sponsored by the SoCal HIMSS chapter. January 13th in Orange, CA, if you are in the area.
• MED3OOO announces a strategic partnership to form the Jersey Health Alliance. The Alliance, which includes a network of physicians and hospitals from Hudson County, NJ, will utilize MED3OOO software, consulting, and services.
• Cool video: Allscripts Android Patient File Overview.
• Sentry will attend the seventh annual 340B Coalition Winter Conference in San Diego.
• NTT DATA completes its acquisition of Keane.
• Aetna completes its acquisition of Medicity.
• Vermont Information Technology Leaders selects Greenway’s PrimeSuite as a preferred EHR partner.
• Michigan Health Connect (MHC) chooses Medicity to carry out its HIE.
• Nuance announces its Dragon Dictation voice technology is the secret sauce behind the LG Voice-to-Text app; offered free via the Windows Phone Marketplace.
• AT&T ramps its their presence in the HIT space.
• Payment Processing, Inc. partners with AdvancedMD, citing integration and security advantages.

Monday Morning Update 1/3/11

From Mighty Mite: “Re: HISsies Lifetime Achievement Award. I like that proposed category. The name that comes to mind is Rob Kolodner, MD for his incredibly important work at the VA, his ONC work when Bush gave him a mission and no money, and his open source work, where he’s trying to build systems for poor countries that can’t afford $100 million systems (can we either, really?)” I can’t quibble with your pick. In the interest of offering choices, other names that come to mind are Octo Barnett, Neal Pappalardo, Paul Egerman, John Glaser, Bill Childs, and many more from the provider side, although their work maybe hasn’t been quite as non-commercial as that of your nominee. I’ll be interested to see who readers suggest. The HIT industry has finally been around long enough to have a history worth recognizing.

Nearly 2/3 of my survey respondents say their software vendors focus on releasing enhancements that help sales instead of current users (we could have another debate about why those desires differ). New poll to your right: what employment changes do you see for yourself for 2011? The poll takes comments, so leave yours if you want. My vote: same employer, same job. I get recruiter calls all the time like everybody else, but I’m really happy at the hospital where I work.

It’s hard to believe it’s 2011. It’s comforting that the person I kissed as the ball dropped was the same as last year and presumably will be the same next year (I like romantic predictability). I lost Internet connectivity for nearly a day starting Friday afternoon, but the broadband company was good enough to send a tech out on New Year’s Day to replace my modem while I was making chili and whipping up killer guacamole (probably because I have business class service paid for by the hospital). I was lucky during that Netflix-free period to accidentally spot an IFC marathon of the funniest TV show in history, The Larry Sanders Show, which is being DVR’ed as we speak. Hey now!

You know what 2011 means: it’s HISsies time. Nominations are open here. In a week or so, I’ll use the nominations to create the final voting ballot, which I’ll send to HIStalk e-mail subscribers only to prevent ballot box stuffing. I’ve deleted some tired categories and added some fun new ones. Winners will be announced at HIStalkapalooza and I always invite some of the big category winners to say a few words there (they usually pass since they don’t get the HIStalk thing, but what the heck – at least I offered).

Inga e-mailed sponsors about our little appreciation lunch at HIMSS and is sending out RSVP information this week. If we missed you somehow, contact Inga.

I need your advice as readers for my New Year’s resolution. I’m fortunate to not need to make a living from HIStalk since I work full time and have little interest in money, which gives me the freedom to do work that’s not necessarily commercial in nature (or even projects that cost me money, if I think they are useful to the industry as a whole, especially the provider-siders). What projects should I be working on? Education, sharing of best practices, innovation, social networking, charitable work, etc. purely for the benefit of hospitals, practices, and patients? I have limited time, but I do have connections and resources that could be put into play for the right initiatives. I need your help in identifying those possibilities. E-mail me if you have suggestions.

Cerner must be throwing out some low prices lately, even based on per-bed license charges. This article on Idaho hospital EMR projects describes Cerner, being implemented at North Canyon Medical Center for $2 million, as “an economical system that works well for smaller rural hospitals.” Syringa Hospital (a strangely satisfying hospital name) paid $1.3 million.

A reader mentioned not being able to find a 990 form (the IRS tax form for for non-profits) on the Patient Privacy Rights Web site. I asked Deborah Peel, MD and she says they’re putting it up, but she sent over a copy anyway. I’ve given it my usual look-over and there are no secrets: income and expense of around $200K, it pays one relatively modest salary to a full-time executive director, and Deborah Peel takes no salary, In fact, she’s the organization’s biggest individual donor, so it’s costing her money, not to mention time. I’m disappointed that HIMSS didn’t invite her to speak at the conference this year. I don’t necessarily agree with her in every case and sometimes she provides more emotion than hard data, but I’m glad she crusades for privacy and security since without her there might be no rational compromise. She’ll be the keynote speaker at the Computers, Privacy , and Data Protection conference in Brussels, Belgium (January 25-27). I spent time with her at HIMSS last year and she’s a hoot, not just smart and sincere, but cynically funny in an HIStalk-approved way.

New announcements from Medicity: (a) Children’s Dayton chooses Medicity’s Novo Grid to connect with its partners and affiliated physicians, sending out results, reports, and face sheets from Epic clinicals and McKesson patient accounting and receiving back lab and rad orders; (b) CHRISTUS Health will expand its use of Novo Grid to include ProAccess Community, MediTrust Cloud services, ambulatory orders initiation, referrals, and CCD exchange, all across seven states and extending to an additional 900 physicians; (c) Hoag Memorial Presbyterian Hospital (CA) announces that it connected 250 providers to its HIE in five months using Novo Grid; and (d) Medicity’s iNexx platform has been certified as a modular EHR by Drummond Group, qualifying its users for Meaningful Use.

Hospitals always announced their first baby of the new year, so I’ll proudly flash the picture of the first new HIStalk Platinum Sponsor of 2011: Marietta, GA-based Nuesoft (not to mention that they’re also supporting HIStalk Practice at the Platinum level, too). You saw their fun Lady Gaga parody video and the pic of their booth people dressed in hideous 70s fashions, but that’s not all they do. Their offerings include NueMD PM and billing software; NueMD EHR (CCHIT certified); Nuesoft Express management software for college health clinics; Nuevita student health clinic management and EHR; RCM and billing services for college health; and the Nuetopia medical billing service in which the company provides an EHR, PM, billing, EDI, clearinghouse, and services. NueMD, they note on their site, is Internet based, not just browser based. Thanks to Nuesoft for its support of HIStalk and HIStalk Practice.

Speaking of Nuesoft, they’re darned good at making videos. I ran across the one above on YouTube. If you’ve seen other fun, HIT-related videos, let me know.

A job site’s annual list of weird interview questions that gets picked up by newspapers everywhere includes one from Epic: “An apple costs 20 cents, an orange costs 40 cents, and a grapefruit costs 60 cents, how much is a pear?” You figure it must have something to do with logic and formulas since it’s a programmer test. Nothing related to word length or consonant count makes sense (since the first two fruits have the same number of each but different prices), but the formula of (vowels-1) x 20 works, which would price a pear at 20 cents. I’m lazy and immature, but the college tested my IQ as 162 back in the day, which offers no real benefit except I can answer questions like this.

A hospital in England starts conducting patient satisfaction surveys via iPads.

MedTech Publishing, which publishes Healthcare IT News in a business relationship with HIMSS (and also Healthcare Finance News), takes over the HIMSS-acquired Government Health IT. I wouldn’t consider that good news since I’m a semi-fan of the latter but not at all of the former (even though I don’t read either, so I probably shouldn’t have an opinion at all). HIMSS will continue running the Government Health IT Conference and Exhibition. Also part of the deal: MedTech will take over the dead tree publications related to the HIMSS conference that it has previously printed under contract (those papers that are always being thrust at you by cute girls in ball caps every 15 feet as you try to traverse the convention center, necessitating hilarious evasive maneuvers). Neil Rouda, MedTech founder and chairman, is being replaced, and rather vague wording suggests that HIMSS is buying a majority interest in the company. It’s not like they were running a lot of hard-hitting, industry-unfriendly stories anyway.

E-mail me.

News 12/31/10

From HISJunkie: “Re: SureScripts as an ATCB just for e-prescribing. How an e-prescribing clearinghouse be an objective judge about a vendor’s functionality? If I don’t use their clearinghouse, where does that put me? I think the certification process is going to get much stranger in the new year.”

From Athenahealth Win: “Re: win. They just took out a huge Allscripts/GE-IDX install. Should be announced soon.” Unverified.

From Limber Lob: “Re: Maryland Board of Physicians newsletter article on e-prescribing of controlled substances. I really enjoyed the first two and last two sentences. Another EHR skeptic!” It reads: “The health care community has lived through the initiation of electronic health records. They will, we are told, save time and money and reduce medical errors … Use of the term ‘interim final’ by the DEA suggests that this field, and the concomitant federal records, are evolving. For more information, go to the Internet.”

From Promises Promises: “Re: gag clauses. None here.” This document lists Allina’s terms and conditions for practices that want to use its Excellian (Epic) system. It says Excellian isn’t a substitute for human thinking and requires practices that want to use it remotely to: (a) verify its behavior; (b) don’t rely on it for anything critical – ask the patient instead; (c) don’t use it to communicate any important results; (d) look out for programming errors; (e) test it before letting users on; and (f) don’t disclose Epic’s trade secrets. You’d think they didn’t have much confidence in their $250 million implementation from all the disclaimers, but I’m sure that’s just the Allina and Epic lawyers expensively talking.

Listening: new from Ryan Adams (just to be clear, not Bryan Adams – this one’s from North Carolina instead of Canada and is married to Mandy Moore). Actually, the new double album consists of three-year-old tracks that had been gathering dust until he started his own record label and released the 80s-theme concept album a couple of weeks ago. Sometimes it sounds like U2, sometimes like Tom Petty, sometimes like The Cars or Spandau Ballet. I guess those are the 80s musical references at work. And Watching: Doc Martin on Netflix, which is a very nice British dramedy. If it’s realistic, the Brit GPs store paper medical record folded into a little 5×7 or so envelope, so they must not churn out the insurance- and lawsuit-required documentation like here. I could spend hours looking at and listening to Louisa (Caroline Catz).

I have Uri Geller sitting right here beside me and he’s telekinetically moving your fingers to the Subscribe to Updates box to your upper right, forcing you to type in your e-mail address and name so that you might live a fuller life in HIStalk one-ness. You will receive no spam since I don’t care about money enough to sell or rent the subscriber list to the many companies that keep asking. You will, however, get everything important in HIT as soon as Uri or I push the “send” button.

A family member got an iPad. I played around with it for a few minutes and liked it a lot (amazing display), although I think smaller tablets sold by competitors might be more my speed. It was nice to have a display larger than that of my iPod Touch but a bit much to haul around. I like the idea that you can get a no-contract AT&T data plan for it for $25 per month for 2GB (cheaper than an Aircard, but that’s in addition to your smart phone plan, unfortunately). I’m really happy with my iPod Touch despite still not having played any MP3s or videos on it (I take a second-generation Nano to the gym since I’m rough on stuff there). It is amazingly handy to grab the Touch from the nightstand and be checking e-mail or Web browsing at WiFi speeds within five seconds of having the urge to do so. Mrs. HIStalk probably hates it since on those rare occasions I watch TV with her, I constantly pounce on the Touch to recite trivia from IMDB about whatever she’s trying to watch or do the “alive or dead” quiz about some actor on the screen. The shows she watches aren’t very cerebral, so I think I may be more fascinating anyway, although I don’t have the nerve to ask if she agrees.

Ed Marx has updated his Why I Fired and Rehired Myself post, which he’s good about doing in response to your comments (even the nasty ones).

Here’s a shout-out for HIStalk pal Michael Christopher and CarePrecise, which offers a variety of ways to access the federal government’s healthcare provider database with data points on three million providers that include UPINS, Medicare IDs, state license numbers, phone numbers, separate tables of newly added and newly dropped providers, etc. They also have medical marketing tools for you vendor types. Michael’s a genius, so you get to talk to him if you buy something (I talked to him once as Real Me and not Mr. H and was mightily impressed, which doesn’t happen too often).

I wasn’t quite prepared for the immediate response to my casual blurb about maybe needing to hire someone to help Inga and me out. I expected to get an e-mail or two, but not from household name type people (VPs, retired CIOs, people who have published or edited magazines, etc.) Let’s just say I’m honored that folks at that level read HIStalk, much less want to help with it, and I want to hire every one of them because they all sound great. It’s a low-rent operation here, so we’ll see how it turns out (I’m behind on responses, but I’ll get there). Several did the same as Inga when she first contacted me years ago: listed 10 sassy, cynical, funny reasons I should hire them. Here are some of the ones I liked as showing a deep understanding of the HIStalk (anti) corporate culture:

1. I am considered a pain in the ass by 95% (or more) of people who know me.
2. I know the industry, the jargon, and where some of the bodies are buried.
3. I really, really want a cool avatar like Inga has, although I firmly insist on a bit of virtual Botox.
4. Smart-ass, I am (much more fun if you say it like Yoda). Above all, this is the personality trait that appears to be the key to the HIStalk inner sanctum.
5. I am certain that you’ll get more impressive volunteers to write for you than me. That being said, you shouldn’t pick them because they’re too busy and they suck in their own perceptions of HIT.
6. My husband says, “I’d hire you. You are smart and cute.”
7. But enough about me, let’s talk more about me.
8. I am a passionate sports fan, mainly that of European soccer. I will defend to the end the reason for soccer not blossoming in America is that our social fabric is built on competition, not community, and therefore we cannot support soccer on a national or regional scale. It has nothing to do with boredom or slow-moving play, as we support baseball and American football, which border on tedium with the amount of time-outs, commercials, and gratuitous jock-adjusting. Soccer is like the ballet — no matter how much you hate it, you know it will end at a reasonable hour.
9. Actually, in all candor, my experience makes me a perfect fit for this role, not OJ and the leather glove, but an honest-to-goodness Isotoner glove-type fit.
10. I always attend HIStalk events at HIMSS!

I think I’d need one of my attorney readers to help decipher the legalese, but it sounds to me like Cerner and Mayo Clinic prevailed in an intellectual property lawsuit they brought against a former Mayo physician. Mayo said he took his knowledge of a natural language processing application that Mayo was commercializing to Merck, which may or may not have planned to commercialize NLP software (depending on who you believe). Cerner apparently licensed the software from Mayo and sells it as Discern nCode. He wrote it in MUMPS for you haters out there. I lost interest at this point (earlier, actually), but if you didn’t, here you go.

Wolters Kluwer Health buys EMR training software developed by a research team at University of Tennessee. Its intended audience is schools of nursing for training students on EMRs. UT gets a cut of sales. The iCare web page is here.

Geisinger Health System (PA) notifies 3,000 patients of a data breach that occurred when a former doctor at one of its hospitals e-mailed information about his patients to his home e-mail account. Geisinger says it notified patients because the information wasn’t encrypted even though it’s almost certain that nobody else saw it. So there’s your first HITECH-related action and one that doesn’t involve EMR bribes – it requires providers to send breach notices to affected patients.

Thirty-six top-earning executives at the University of California are threatening lawsuits against the UC system if it doesn’t increase their retirement payouts. The university is changing its pensions (most of us would need a dictionary to know what those are) since they were underfunded by $20 billion by the perpetually fiscally irresponsible state. Among those signing the demand: UCSF CIO Larry Lotenero (paid $377K) and UCLA health system CIO Virginia McFerran ($477K), along with mostly hospital and investment management people. The bank bailout is going to look like a child’s allowance as states start going broke over wildly generous salaries and pension plans, loading their payrolls with double-dipping “retirees” and employees jockeying their positions for their last year before retirement since guaranteed lifetime payments are based on final salary.

Strange lawsuit: a mentally ill patient who had spent years in a psychiatric facility sues its operator, the State of New York, for nearly letting him die with an untreated infection. He wins, but the state asks the judge to give it his $1.7 million award in return for treating him without payment for 10 years. The judge agreed, so the patient got nothing.

Happy New Year!

E-mail me.

HERtalk by Inga

ONC names Surescripts its sixth Authorized Temporary Certification Body, but only for e-prescribing and privacy and security.

Central Florida RHIO names Jeanette Schreiber its new chair. She’s associate dean and chief legal officer for the UCF College of Medicine.

One week after hitting a last-minute snag, McKesson completes its acquisition of US Oncology.

I am back at home after a week of holiday merriment in the land of No Internet. I had intended to make it a working vacation, but underestimated how very slow my connection would be. After two days of pulling my hair out each time the connection dropped, I finally had to fess up to Mr. H that my escape from civilization was not going as planned and that, alas, HIStalk Practice would have to skip a day. Now, as I sit at my desk using lightning-fast Internet, I must say that I am surprisingly happy to back at work. I promise that my renewed attitude has nothing to do with the Help Wanted sign Mr. H posted during my absence, nor the fact that two dozen people more qualified than me are vying to become Mr. H’s new BFF. Actually I am pleased that so many people “get” how fun this job can be and I am hoping it will give both Mr. H and me more time to work on some other fun projects.

Speaking of fun projects: the upcoming HIStalkapalooza event during HIMSS. Mr. H spilled the beans on a few details and I must also make a couple of comments. First, I have high expectations for contestants in the “Inga Loves My Shoes” contest. It’s quite easy to participate – just pick out the most fabulous pair of shoes from your closet and wear them to the party. A trusted Inga stand-in will eye your feet and select the winning footwear. If shoes aren’t your thing but you want to impress the HIStalkapalooza universe (and definitely me), dress your very best and you will automatically be in the running for HIStalk King or Queen. Here is a tip for the soon-to-be-legendary King and Queen contest: if you are wearing a straight-from-the-booth vendor tee shirt,  you will not win this incredible honor. Those wearing tuxedos and chiffon will automatically make the semi-finals. Wearing pirate costumes or pink pants may only get you a Mr. or Ms. Congeniality award. I am trying to convince Mr. H that we need some amazing prizes for our lucky recipients, but no decisions yet. Meanwhile, I am dreaming of IngaTinis, red carpets, and dancing the night away.

An Ohio surgeon is sentenced to a year in prison for having his office manager pose as a doctor while he was out of the office. The office manager for Dr. Charles C. Njoku had previously been sentenced to three years of probation, including one year of home confinement. The two also must pay restitution of $131,000 for billing Medicare and Medicaid as if the office manager were the doctor seeing patients.

I would love to know which EMR this doctor uses. An internist treating a complicated patient complains that her EMR will not allow her to write an evaluation exceeding 1,000 characters. When the physician calls the EMR help desk for assistance, the tech replies, “Well, we can’t have the doctors rambling on forever.” And the industry wonders why doctors resist EMR adoption.

The mHealth market continues to boom, with over 200 million apps now in use. About 70% of people worldwide are interested in owning at least one mHealth application and are willing to pay for it. Countries with large populations and limited healthcare options, such as India and South Africa, are the most interested in mHealth. Look for the number of mHealth apps to triple by 2012.

Puget Sound Blood Center (WA) is launching the GCI ConnectMD private medical network to connect with Swedish Medical Center, Cherry Hill Campus.

Government auditors report that the CDC lost or misplaced more than $8 million in property in 2007, including a $1.8 million hard drive and a $978,000 video conferencing system. Whoops. The CDC says it has now instituted better controls and that 99% of its property was accounted for in 2009.

A computer tech in Michigan is arrested for allegedly violating state hacking laws and gaining access to his then-wife’s e-mails to confirm his suspicions that she was having an affair. Turns out she was, with her ex-husband. The wife (who is now actually the alleged hacker’s ex-wife) realized the computer had been hacked when personal e-mails showed up in a child custody pleading involving her first husband (hacker was husband number three). Computer geeks, lots of husbands, and adultery – it just doesn’t get much juicier than that.

Sponsor Updates

• Greenway Medical Technologies announces a new web site covering EHR adoption incentive programs.
• PatientKeeper is moving to new headquarters in Waltham, Massachusetts in a building adjacent to the Massachusetts Medical Society and the New England Journal of Medicine.

E-mail Inga.

News 12/29/10

From BeKind: “Re: Texas patient privacy breaches. Mentioned in this article.” It also mentions that JPS Health Network is spending $94 million on its Epic implementation.

From Jennifer: “Re: QuadraMed QCPR. Now fully certified!” CCHIT certified QCPR as a hospital EHR on December 23.

From Skinny Minnie: “Re: vendor gag clauses. A billing vendor’s new customer did a YouTube testimonial about why they switched from their previous vendor (service and cost). The previous vendor told the customer they were violating the terms of their contract, which says they can’t ‘disparage or denigrate’ them, and insisted they make their new vendor take the video down.” No link was provided, but I found a YouTube video featuring a customer of the same ‘new’ vendor explaining why they replaced the same ‘old’ vendor, specifically mentioning the monthly cost of each. Either the ‘old’ vendor missed this one or it didn’t get taken down after all.

From Alfonso: “Re: healthcare IT tools for Accountable Care Organizations. I ran across an article touting two companies that are attracting VC and private equity interest – MedVentive and AmalgaMed. Investors are looking at the next two years as being critical for capturing market share as payment reform in the form of ACOs restructures healthcare delivery.” AmalgaMed is a new startup founded by a couple of entrepreneurs with benefits management experience.

Genesis HealthCare System (OH) sells $20 million worth of buildings to pay for an EMR system, freeing up cash flow to fund mission-critical projects.

TPD has updated his list of iPhone apps.

Who knew that Tom Selleck was a cheesy-mustached technology thought leader way back in 1993? Or at least he sounded that way as he read the script that AT&T gave him for these old commercials. I ran across a mention of this compilation video on something called Dvice, from Syfy.

Inga and I have been swamped lately, with a ton of new sponsors, interviews, HIMSS planning, etc. I’m thinking I need to hire someone part-time to help out. I could use someone who knows the industry, writes really well, and enjoys dealing with cool people like our sponsors and contributors by e-mail and telephone. Pay won’t be impressive, but it’s a good chance to learn and to get your name out there. Those interested should do like Inga did years ago: e-mail me and tell me why I should hire you since my natural inclination is to just suck it up and work more hours myself.

Registration for CMS’s Medicare and Medicaid EHR incentive programs starts next week. Instructions and the link to the registration page (when it’s turned on) are available here. You can register now even if you haven’t implemented anything yet.

Weird News Andy notes that of the 20 least-efficient charities in the country, only one relates to healthcare: Charleston Area Medical Center Foundation (WV), which runs an administrative expense ratio of 49% and earns one star from CharityNavigator. In comparison from the most-efficient list, Brother’s Brother Foundation, which includes medical supply donation among its projects, runs an expense ratio of 0.0% and has earned a four-star rating from CharityNavigator (which is where I always look first before donating). I have to be honest: having worked for hospitals nearly all of my life, they’d be last on my list of organizations to which I’d donate. Charity is big business at that level, with highly paid foundation employees, lots of private club donor schmoozing, and constant trading of favors (like donors making their contributions contingent on hiring their company as a vendor or giving their worthless kids phony jobs). Not to mention that I would never fund a charitable cause that pays executives $1 million or more like many hospitals.

Cerner shares are continuing their generally upward trend, closing Tuesday at $96.01. You could have bought shares for $72 in September (or $16 in 2003).

India-based NIIT Technologies Limited acquires the Preferr patient referral system, developed by Visions@Work of Clermont, FL.

E-mail me.

HERtalk by Inga

Manatee Health System (FL) will spend $2.5 million to implement Cerner, with Manatee Memorial Hospital and Lakewood Ranch Medical Center making the switch in August.

St. Joseph’s Hospital Health Center (NY) will hire at least 25 people "with considerable information-technology (IT) experience, preferably in the health-care field." The additions will double the size of the existing IT department.

UPMC introduces a mobile version of MyHealth Connect, giving users smart phone access to UPMC Health Plan information. The initial phase includes details on UPMC’s provider directory. Future versions will include a virtual ID card and access to members’ PHRs.

US Oncology names Karen Gibson SVP and CIO of its technology services, reporting to EVP Asif Ahmad. She was previously CIO of Life Technologies and of GE Healthcare Information Technologies.

Sponsor Updates

• Cumberland Consulting Group promotes Mary Francis Shaw, Dao Dang, and Chris Wolfert to executive consultant.
• Allscripts CEO Glen Tullman will join the founders of Wikipedia and eMedicine to discuss the impact of the Internet on healthcare on January 6 at the University of South Florida Alumni Center in Tampa.
• CareTech Solutions offers a money-back guarantee to hospitals that try its Solution Found service desk offering.
• Picis will incorporate the AORN Syntegrity framework into its perioperative suite.

E-mail Inga.

Monday Morning Update 12/27/10

From The PACS Designer: “Re: Flock. As the number of social web sites continues to increase, it becomes a challenge to keep up with all the goings-on amongst your web friends. Now you can have all your social web sites in one browser with Flock. You can view HIStalk’s Facebook and Twitter sites in one place to keep your browsing activity from consuming too much of your time. TPD hopes everyone had a Merry Christmas and wishes all a Happy New Year!”

From Nicole: “Re: Merry Christmas. My kids like reading HIStalk with me and often ask me to read them the news clips. My son (the oldest) likes the business news, my daughter liked the story about Zsa Zsa’s husband.” That’s fun. I’m hoping HIStalk isn’t your story of choice because it puts them to sleep faster at bedtime. I’m a fan of  “out of the mouth of babes” wisdom, so I’m picturing them at HIMSS passing judgment on speakers and booths. I bet they would have priceless observations.

From FamilyPhysician: “Re: instant messaging. Doximity lets you find any healthcare provider in the US (not just your hospital system) and communicate via text securely if they agree. I use it from my iPhone, but you can also use it from the web. Hospitalist groups in my area are using it as well as outpatient docs like me.” This isn’t quite the objective testimonial it seems since it came from a Doximity co-founder, but I’ll allow it since the product seems pretty cool. You can only give it a test drive if you’re a doc since the sign-up form checks your name against a list of licensed physicians.

From ChiefCookandBottleWasher: “Re: Jim Stalder. You interviewed him a few years ago. He has joined Cook Children’s Health care System in Fort Worth as their new VP/CTO. They’ve gone through a number of IT leadership changes over the years.” Verified, according to his LinkedIn profile. I assume he replaces Tracy Waller, who left in August to work for an oil company services company as an IT consultant. Jim was CIO of Mercy Health Services (MD) when I interviewed him three years ago.

I expected readers to vote their preferred form of FDA regulation of clinical systems in order of least- to most-comprehensive. That wasn’t how it played out, although survey topics stirring up more emotion seem to generate less reliable results. For whatever reason, the most-restrictive choice (vendors must prove safety and effectiveness the same as drug makers) was the #1 choice. New poll to your right, for providers: is your software vendors’ enhancement road map more focused on making new sales than meeting the needs of existing customers? You are welcome to leave comments.

Listening: Patto, described by the reader who suggested it as “raw, bluesy rock n’ roll with a jazz twist.” The band was obscure even its 1970-73 lifespan and tracks are hard to find on the Web, but it still sounds good (to me, it’s UFO meets Steppenwolf). Check out the guitar solo on this one. The namesake founder, who also started up Boxer, died in 1979 at 36.

John Stone is named CIO at Fairmont General Hospital (WV). 

It’s eight weeks until the HIMSS conference, just so you know. I’ll be starting up the HISsies in the next couple of days. Below are the results from last year. I’ve already decided to add two new categories, Most Fun Vendor and Best Informatics Professional, but the floor is open for your ideas of additional categories. I like to change them up a little each year. I’m thinking about adding a Lifetime Achievement Award as a serious award.

2010 HISsies Winners

Smartest vendor strategic move
athenahealth guarantees Meaningful Use

Stupidest vendor strategic move
GE Healthcare loses enterprise clients

Best healthcare IT vendor
Epic

Worst healthcare IT vendor
GE Healthcare

Best CEO of a vendor or consulting firm
Jonathan Bush, athenahealth

Best provider healthcare IT organization
Cleveland Clinic

Provider or vendor organization you would most like to work for if salary, benefits, and job title were not factors
Epic

HIS-related company in which you’d love to be given $100,000 in stock options that can’t be cashed in for 10 years
Epic

Most promising technology development
Smart phone apps

Most overrated technology
Speech recognition

Biggest HIS-related news story of the year
ARRA/Meaningful Use

Most overused buzzword
Meaningful Use

When _____ talks, people listen
David Blumenthal

Most effective CIO in a healthcare provider organization
John Glaser, Partners

HIS industry figure with whom you’d most like to have a few beers
Judy Faulkner, Epic

HIS industry figure in whose face you’d most like to throw a pie
Neal Patterson, Cerner

HIStalk Healthcare IT Industry Figure of the Year
David Blumenthal

Each year right about now, I start getting more e-mails asking about the HIStalk event at HIMSS. We plan to have the sign-up page live by January 15 or so. I can tell you this one’s going to be memorable – the sponsor, [name coming soon], is going crazy with super-fun ideas that the 500 or so lucky attendees will enjoy (Inga and I keep trying to probe their upper limits: How about we shine a giant HIStalk logo on the outside of the building? Done. Say, wouldn’t it be cool to bring in a professional video crew so I can run party video on HIStalk afterward? You got it, Mr. H.) So for you as a prospective attendee: Did you ever want to feel like a celebrity on Oscar night, making a dramatic entrance on the red carpet while sipping an IngaTini and being interviewed on live camera? Do you like great food and an open bar? Do you like the idea of a full-length concert at HIMSS with a real band playing on a real music hall stage? Did you enjoy the “Inga likes my shoes” contest last year, all the other fun beauty queen sashes, the HISsies, and surprise guests? Would you enjoy special recognition for physicians in the audience, beautiful ladies in their best party fashions as orchestrated by Inga, and maybe even a King and Queen winner just like at your prom? It’s so big and crazy that the sponsor convinced me to use the name to which I was jokingly referring to it as our plans got more ambitious: HIStalkapalooza, sponsored by [name coming soon]. So there you have it: HIStalkapalooza, Monday, February 21, 2011, 6:30 until 11:30 p.m. Eastern at BB King’s Blues Club in Orlando. Thanks very much to [name coming soon] for helping me honor HIStalk’s sponsors and readers in a soon-to-be-legendary way.

Weird News Andy’s radar picks up this story: Beth Israel Deaconess Medical Center (MA) admits that its surgeons miscounted vertebrae in three surgeries in the past three months despite taking the usual precautions, causing them to operate on the wrong part of the spine. The hospital says human error was involved and it can’t find a connection, although two of the three surgeries were performed by the same surgeon. The hospital also admits that it is working to fix problems found by inspectors, including using a checklist developed by another hospital to help surgeons mark their site correctly.

RAND had glowing things to say about CPOE in its 2005 study paid for by Cerner and other HIT vendor. Its new analysis, sponsored by a non-vendor group, finds that healthcare IT hasn’t generally improved the Core Measures scores of hospitals using it. However, the conclusion of the study’s lead author isn’t that HIT isn’t effective, but rather that outcomes measures are too broad to show HIT-related improvements. It was the usual drawing room type study that linked readily available but questionably useful information together to draw new conclusions: the HIMSS Analytics database, the AHA survey, and Core Measures numbers. It would be great if the effects of HIT were so dramatic that overall outcomes improved (not just Core Measures ones), but that’s probably not realistic, especially over a short timeframe. You’d have the same problem trying to make a quality case for almost anything: management changes, process redesign, policy changes in the use of drugs or devices, or better credentialing of staff. Measuring quality isn’t as easy as measure drug safety and effectiveness, where it’s not that hard to set up control groups, measure specific and immediate physiologic changes of effectiveness in patients, and monitor for easily recognized adverse reactions.

Thanks to Imprivata for its support of HIStalk, joining us as a Platinum Sponsor. I think you may infer from the above that the Lexington, MA company is justifiably proud of its #1 rating in KLAS’s Single Sign-On category. The company offers the OneSign single sign-on suite (say that three times …), OneSign authentication management, and the Imprivata PrivacyAlert system that detects and audits EMR snooping. Resources: a OneSign webinar, an overview of OneSign VDA for virtual desktops, and a data sheet covering PrivacyAlert and its out-of-the-box data support for Millennium, Sunrise, Meditech, and other healthcare apps. You might also want to check out Identity 360, the company blog. I don’t recall if I mentioned this, but OneSign Secure Walk-Away won the Security Innovation of the Year award from the British Computer Society two weeks ago. It uses a webcam to detect when a clinician walks away from their logged-in workstation, forcing a new user log in with their own credentials to improve security and avoid medical mistakes. I interviewed CMO Barry Chaiken just a few months ago.  Thanks to Imprivata for keeping the HIStalk wheels turning.

Strange lawsuit: a neuroradiologist and an endocrinologist playing a round of golf take their second shots of the first hole and head off to find their balls. The endocrinologist finds his and takes his shot, shanking the ball into the head of the neuroradiologist, blinding him. The neuroradiologist sues the endocrinologist, saying he should have yelled “Fore!” The appeals court throws out the case as had two previous courts, saying that the neuroradiologist was standing 15-20 feet from the endocrinologist at a 50-80 degree angle, making it unreasonable to expect the other golfer to yell “Fore!” before swinging since nobody was even close to his expected line of fire. The neuroradiologist’s attorney probably did little to elicit sympathy for his client, who has been unable to practice full time since the original 2002 incident, by claiming his eight-year lost income is “more than you and I will ever make in a lifetime.”

Canada-based healthcare document management solutions vendor Accentus acquires two transcription companies: ZyloMed (FL) and Transolutions (IL).

Virtual Radiologic completes its all-cash, $170 million acquisition of Nighthawk Radiology, paying a 100% premium to the market closing price of NHWK when the deal was announced in September.

A gastroenterologist’s editorial in the Cleveland Plain Dealer says EMR should stand for End of Medical Rapport, an unwelcome technological intrusion into the doctor-patient relationship being pushed by insurance companies, the government, and EMR vendors. I don’t buy this a bit since my doc is a big EMR user and, if anything, it makes our time together more valuable to me. As in most of life, it’s not what you have, but how you use it. His method: (a) we chat for a couple of minutes before he even looks at the screen since the assistant or nurse has already entered my vitals and chief complaint; (b) the monitor is placed on the desk beside the patient chair, so we’re still sitting close to each other and the monitor is to our side instead of between us; (c) he quickly looks up the information he needs, then turns back to me for the rest of our session; (d) he doesn’t type while we’re talking and generally hardly at all while I’m in the room; (e) if we’re talking about something, like my lab values, he pulls them up on the screen and we go over them together. Now my doc is great overall: he doesn’t wear a white coat because he thinks it’s too authoritarian, he always leads off with a friendly handshake and some chit-chat, and he is highly supportive of helping patients find their own healthcare answers, so it could be that his patient style is just so good that the EMR can’t overcome it. Maybe someone should write a how-to guide for docs on how to minimize EMR disruption since I’m pretty sure it can be done.

I don’t think I’ve ever watched a soap opera even once (being a non-viewer of Unemployment TV, I didn’t even know they were still on), but apparently on All My Children last week, someone named Greenlee got into a hospital’s computer using a stolen password to find out that someone was pregnant. Scenery-chewing overacting and hammy dramatic gestures ensued, I’m certain.

E-mail me.

News 12/24/10

From Donde Esta: “Re: hands-free interface. Interesting.” A group in Switzerland uses Microsoft’s Xbox Kinect 3D motion controller to enable voice and gesture commands with PACS.

From Woody the Wabbit: “Re: Allscripts. As positions EMR and PM positions open in Raleigh, they will be moved to India.” Unverified.

From AccidentalCIO: “Re: Meditech. On a conference call last week, they said customers will need to purchase their data repository to meet the requirement for electronic capture of quality measures. Nothing on their site, no press release. No other customers that I know have been made aware.” Unverified. I e-mailed the Meditech press contact, but haven’t heard back.

From Vanilla Ice: “Re: GE Centricity Enterprise. I hear they’ve told customers it’s going into maintenance mode.” Not exactly, according to my GE contact who tracked down “conversations” the company is having with customers (I’m quoting that since I don’t know exactly what it means, so I’ll use their word). GE says that, to demonstrate their commitment to the success of existing customers, priorities have been changed to help them rather than going after new sales. Not many were buying anyway, of course, and I can’t imagine there are more than a few dozen existing customers left, but GE is at least promising to support them in their quest for HITECH money and other benefits.

Testing 1-2-3 … can you hear me? OK, maybe we were silly to post the day before what is a holiday for most folks. But Inga and I are hard-working, salt-of-the-earth types who don’t want to let our equally dedicated readers down just because most people are sleeping late, shopping, and preparing to overeat. We’ll keep it short, but we’ll make sure to include something useful or entertaining that the less industrious will miss.

A CEO sent me this today, wanting to renew their HIStalk sponsorship: “We absolutely want to continue our support and participation with HIStalk. In fact, I personally believe it’s the most valuable marketing dollar we spend.” Nice! I appreciate that very much. And from another CEO, “Thank you again for all you do. I do not know of anyone who does more to keep everyone honest in this less-than-honest business of healthcare.” I know it’s like a tiresome grandparent whipping out endless pictures of a shriveled, newborn grandchild while everybody rolls their eyes, but I promise to brag only infrequently.

The VA finds that employees are using Web-based applications to store patient information, which CIO Roger Baker says is both a security challenge and a call for the VA to offer something similar. They discovered residents and employees using a Yahoo calendar and Google Docs to store patient information, going back to 2007. Apparently it was a primitive interoperability project: the residents covered multiple hospitals and needed to see VA patient information while off campus. The VA blocked access and sent letters to those whose information was stored there, even though it was secured.

Weird News Andy offers this Christmas gift to all. A woman sues her surgeon, who she claims was negligent in performing her hemorrhoidectomy. The gas she passed during the procedure was ignited by the surgeon’s electrosurgery pen, setting her genitals on fire. She lost the case.

Pinnacle Health (PA) reports exposure of patient information when its contracted transcription vendor inadvertently opens up its server to the Internet.

Verizon provides a $100,000 grant to UMDNJ-University Hospital for the STAT-MI system, which allows ambulances to send ECGs directly to a hospital cardiologist’s smart phone so that patients having a heart attack can be transported directly to the cath lab.  

Jobs on the Sponsor Job Board: Senior Software Engineer, VP of Sales, Application Consultant. On Healthcare IT Jobs: RN Clinical Informatics Transformation Leader, Senior Clinical Analyst, Enterprise Integration Architect, Meditech EDM Consultant.

CCHIT certifies Ingenix CareTracker as a Complete EHR.

Just a suggestion: sometimes I use the HIStalk mailing list to offer benefits to those readers on it (first notice of stuff, HISsies voting privileges). If you haven’t signed up, that “Subscribe to Updates” box to your upper right is your ticket to paradise.

The news that Dell is acquiring InSite One caught me by surprise since I had just finished interviewing the company’s CEO. I’ll have it up soon.

Strange: Zsa Zsa Gabor’s husband (her eighth) is admitted to the hospital after he apparently mistakes Zsa Zsa’s nail glue for his eye drops and seals his eye shut. I figured he might be a bit old to be taking care of himself since she’s 93, but he’s only 66 and planned to run for Governor of California this year until Zsa Zsa’s health became an issue.

Vermont’s REC adds Greenway’s PrimeSUITE to its list of preferred EHR partners.

A hospital in Canada loses $1.5 million to a minimally supervised accounts receivable clerk responsible for loading its ATM machine with cash. The $40K per year employee treated nine friends to a trip to Hawaii and had blown $400K on slot machine gambling at a local casino.

I hope your Christmas is just peachy and that Santa brings you whatever you want. All is right with the world when the marathon of A Christmas Story is on, gift wrap is strewn everywhere, and the smell of turkey or beef or tofu or whatever traditional food you cook is wafting over the Cowboys on the big screen. Once the holidays are behind us, HIMSS looms, so you know it’s going to be a whirlwind (for me, anyway). Thank you for being involved with HIStalk in whatever fashion. I’ll be here with the usual Monday Morning Update, which probably means working Christmas Day, so don’t forget to come back.

E-mail me.

HERtalk by Inga

From Zebedee: “Re: St. Joseph’s. Merry Christmas, Inga, thanks for an educational year. I heard this story on NPR this morning.” The Catholic church strips St. Joseph’s Hospital and Medical Center (AZ) of its religious affiliation after providers terminate a pregnancy. Hospital officials insist the surgery was in line with Catholic teachings and was performed to save the mother’s life; the local bishop disagrees and severs the church’s tie with the hospital (facility excommunication?) St. Joseph administrators insist the move will have little effect on its ongoing operations or hurt donor contributions.

From Sam the Snowman: “Merry Christmas, Inga. You never seem to age in your pictures. Keep it up.” Thanks for noticing, Sam. Clean living.

Florida’s Agency for Health Care Administration awards Harris Corporation a four-year, $19 million contract to implement a statewide HIE infrastructure.

Also from Florida: Good Samaritan Medical Center and West Boca Medical Center are using the RF Surgical Detection System to prevent and detect foreign items inadvertently left inside patients during surgery.

Let the registration begin. Beginning January 3rd, eligible providers and hospitals can apply for participation in the Medicare EHR incentive program. Eleven states will open Medicaid registration the same day; other states will begin accepting Medicaid applications in coming months. David Blumenthal says, “It’s time to get connected,” which is kind of a hokey statement at this point in the game. But heck, maybe he is just in the holiday spirit.

Rhode Island MSO Polaris Medical Management selects DiagnosisONE as its exclusive provider of clinical decision support for EHR deployments.

McKesson wins anti-trust approval to complete its $2.16 billion purchase of US Oncology on Tuesday, the same day an interim court order stalls the acquisition. The Supreme Court of the State of NY puts the purchase on hold, based on a case filed against McKesson by the Cancer Clinics of Excellence. The network of oncology practices claims the deal breaches an existing contract it has with McKesson.

In India, seven health department employees are suspended after allegedly organizing a “vulgar dance” program at work. I bet Mr. H’s holiday party outlook would be greatly improved if his hospital hosted a similar program. He might even wear a Santa hat to show his support.

From Luke O’Cyte: “Re: Santa and shoes. We know that’s not you sitting in Santa’s lap because the real Inga would never have posted a photo that didn’t show her fancy shoes!  Obviously this photo was one of a woman wearing inappropriate shoes, which necessitated the cropping of the photo, lest it clue viewers in that this wasn’t the ‘real’ Inga! Here’s hoping that Santa brings you lots of fancy footwear for under the tree, and with that note, I give you The 12 Shoes of Christmas:

On the twelfth shoe of Christmas,
my true love sent to me
Twelve sandals peeking,
Eleven flip-flops flopping,
Ten pumps a-pumping,
Nine loafers dancing,
Eight moccasins a-walking,
Seven slippers slipping,
Six golf shoes putting,
Five golden boots,
Four peep toes,
Three Mary Janes,
Two canvas runners,
And a high heel in a shoe tree!”

Brilliant. Thank you, Luke, my newest BFF. Wishing all readers a lovely holiday!

E-mail Inga.

Dell To Acquire InSite One

Dell announced this morning that it will acquire InSite One. The Wallingford, CT company offers cloud-based, vendor-neutral medical image storage and archiving, with 800 clinical sites as customers. Its InDex enterprise architecture is based on the IHE framework and supports recovery and migration services.

Dell says the company’s technology will extend Dell’s Unified Clinical Archive solution.

Berk Smith, Dell’s vice president over healthcare and life sciences, said, “As the first company to bring cloud technology to the medical archive space, InSite One will help Dell’s healthcare customers take advantage of the economics and scalability of the cloud for medical archiving and retention. And looking beyond archiving, the cloud will also be a valuable tool for information exchange which is foundational to the transformation of healthcare.”

Terms of the acquisition were not announced.

News 12/22/10

From Vendor Prez: “Re: RFID tagging of HIMSS conference attendees. I think this is appalling. As an exhibitor, the last thing I want is for the attendees to feel more ‘targeted’ that they already do. Frankly, if exhibitors can’t get attendees in their booth on their own merit, they don’t deserve to capture key information from drive-bys. This is pitiful and my company will not be participating. We will however, proudly display the HIStalk Sponsor poster that you always drop by!” Above is the end result of tracking us attendees like stray cattle via the RFID chip tucked away in our badges. Vendors pay $3,000 for the basic package up to more than $20,000 for a turnkey tracking service. You can opt out on your conference registration like I did. And thanks to Vendor Prez for displaying our amateurishly made “We Power HIStalk” signs in their booth. I know it’s hokey, but we are really proud that many HIStalk sponsors participate because they want to support what we do. As you might imagine, I really appreciate that.

Speaking of which, you would think the stray cattle tracking company could at least spell the name of its excessively vendor-friendly partner correctly.

From Chatty Cathy: “Re: instant messaging. Do nurses typically use it in hospitals to communicate with each other and with doctors? Just curious.” In mine, the PCs are theoretically locked down and IM clients aren’t allowed, although I’m sure someone has figured out a way to bypass that (like using an online chat client like Meebo or the ones built into Yahoo or Google). I like the question, though, and would appreciate comments. It’s a pager-driven world in many hospitals, made kind of IM-ey with Amcom’s Web-based paging app that lets people chat primitively back and forth. Staff could also use SMS messages or specific VoIP apps. They could even use FaceTime video calling if they have iPhones or iPads.

From IT Begins: “Re: Ingenix. Appears to be the first steps of unveiling strategy around the recent acquisitions.” Inga covers it below, but Bethesda Healthcare System (FL) chooses Ingenix to manage the revenue cycle of both the hospital and its outpatient services. Ingenix will provide its Electronic Financial Record, coding solutions, patient financial counseling, an ED information system (since it bought Picis and can offer ED PulseCheck), and full-time employees in scheduling, registration, HIM, PFS, and decision support. It sounds like a great business move, although odd that a hospital would hire a company owned by an insurer to manage its revenue cycle, most of which involves dealing with insurance companies. Who better, right?

From Epic User: “Re: FDA oversight of EHRs. Epic’s ‘fear of stifling innovation’ doesn’t resonate with this long-time user of their applications. They routinely fail to prioritize making simple changes to their system (icons, language on screens, similar functions in different applications) that are consistent and would reduce user confusion / error. They also fail to prioritize making enhancements to their systems requested by customers year after year (apart from the annual voting, which is application-based and not focused on consistency across applications), and instead focus on new features that help sell the systems (e.g. focus on ‘what sells’ vs. ‘what’s useful’. If FDA oversight stifles their innovation and helps make their systems more consistent from application to application in terms of functionality, user experience, etc. then that’s a good thing.” Here’s who I blame for that: customers and prospects, since most vendors work pretty much the same as you describe, i.e. creating what the market demands. If customers don’t like their apps or feel they endanger patients, then it’s their fault for writing that check anyway. I’m growing weary of hearing how big, bad vendors prey on helpless health systems and their excessively paid C-level leadership who can’t be bothered to understand exactly what they are getting in return for their many, many millions of dollars or creating a vision of how it could be better. I’d like to see better applications, but those voting with their dollars are saying otherwise – guess whose vote counts? If there’s a demand for iffy software applications, unhealthy Big Macs, or illegal drugs, economics assures that someone will meet that demand.

This is sobering, but not surprising: Fitch Ratings downgrades the bonds of Lima Linda University Medical Center (CA) BBB with a negative outlook due to poor liquidity and inconsistent financial results (54 days days cash on hand). Once concern is the $1.4 billion it will need in capital over the next 10 years, mostly for seismic compliance requirements (which management has already said they can’t possibly meet) and implementation of electronic medical records.

The chief nursing officer of Capsule, Susan Niemeier, receives a slew of social media awards for her work under the pseudonym Nurse Sue.

KLAS releases a report covering single sign-on, concluding that high customer expectations aren’t always met, but that they are generally glad they implemented it. Imprivata edged out Microsoft (Sentillion) for the top ranking.

This sounds like something I’d come up with: UMass Memorial Health care allegedly hires hot models for $75 per hour to approach mall shoppers and football game attendees and ask them to give cheek swab DNA samples for its bone marrow registry. Those agreeing were told that their insurance would pay the $100 charge, only to find that their EOBs showed charges of $8,400, not to mention that many of them may not have been made aware that they were obligating themselves to donate marrow if they matched. A hospital worker supposedly told the models, for which the hospital paid up to $4 million, to wear short black skirts, heels, a white lab coat, and colorful wigs.

Good news: today is the shortest day of the year, meaning it can only get better when it comes to driving home from work in the dark.

The guy who robbed and shot Wheaton Franciscan Healthcare IT VP Tim Belec in WFH’s parking lot three year ago is finally sentenced to 12 years in prison after pleading guilty to a single charge of attempted intentional homicide. I never heard how Tim did after taking two bullets in the chest, but I Googled his name and articles I ran across indicate that he’s back on the job at WFH.

A Dean Health System (WI) doctor breaks hospital rules by storing patient information on her laptop, which was then stolen. The hospital sends the usual “so sorry, how about some free credit protection?” letters to 3,000 surgery patients. And in Virginia, Centra notifies 14,000 patients that their billing information was exposed when an employee atttending a Georgia conference has her laptop stolen from her rental car.

Cerner opens a Collaboration Center in its London offices. I’m not clear on what its point is, but the Cerner UK GM says it will help clients “identify their respective organisational imperatives, such as financial savings or patient safety initiatives, and align them with the capabilities of Cerner Millennium.” I guess it’s like a Vision Center for existing customers.

David Brailer’s Health Evolution Partners launches Halcyon Home Health, which he says will “redefine how home care is delivered” through clinical excellence and IT. Its Web site (above) isn’t quite ready.

The government of Hong Kong starts the next phase of its EHR project, soliciting proposals for pilot projects and interface work that involve patient-facing health applications and standard terminology. Proposals are due by January 31.

Healthland’s inpatient EHR earns CCHIT certification as a Complete EHR.

I happened to drive by one of those consumer lab store fronts the other day and noticed a somewhat fun sign in their window pitching their lab tests: “Sex, Drugs, and Cholesterol.”

iSoft finds a new source of revenue: offering another company’s technology that will extract information from its EMR and de-identify it for researchers (hopefully not selling it outright). The Cliniworks platform sounds kind of cool, actually.

The GAO says HHS missed the 2007 date set by Congress to develop a plan for an electronic system to support sharing of information in public health emergencies. I guess they aren’t Meaningful Users.

Clinical trials software vendor DrugLogic files suit against Oracle, claiming patent violations related to two life sciences software companies that Oracle acquired, Relsys and Phase Forward. In the mean time, Oracle turned in killer Q2 numbers, with revenues up 47% to $8.6 billion and profit up 28% to $1.9 billion.

The local Massachusetts paper runs an interview with eClinicalWorks CEO Girish Kumar Navani, focusing on the company’s local economic impact and impending move to bigger quarters. Tidbits: eCW will be hiring 100-200 people in 2011, it has more than 1,300 employees, its new building will cost $18 million, 2010 revenues are expected to be $130-$150 million, and its five-year goal is to have 100,000 providers and 100 million patients.

We’re having the usual semi-lame holiday events at work this week (you can’t say Christmas, of course, since somebody’s lawyer would show up before you finished the sentence). There are always a few really disturbing souls wearing Santa hats in an unwelcome public display of carefully orchestrated holiday exuberance (especially since they are usually the really obnoxious people or oddballs who haven’t said a peep since last Christmas). There’s the white elephant gift exchange, which everybody hates because it comes with pages of rules and the person who organizes it always seems to parlay their knowledge into ending up with the only good gift. There’s the door decorating contest, where hastily covering a door with old gift wrap and cut-out occupant pictures is considered extraordinary effort worthy of a noble prize, like a free frozen yogurt in the cafeteria. Leftover celebration food is dumped unceremoniously and anonymously on break room tables, fallen upon instantly and ravenously by beaming IT geeks who should be applying some of their vaunted analytical skills into questioning whether it’s a good idea to eat something that’s been standing at room temperature in a different conference room or office until everyone got tired of looking at it and decided to deposit it in the collective food trough rather than throw it out (hey look, everybody, there’s deviled eggs in the break room!) Guys wear hideous light-up Santa ties and ladies show up in Christmas sweaters smelling of mothballs from their once-yearly exposure to air (the sweaters, not the ladies). But the worst thing is that it will be over in a week, leaving a long stretch of no holidays as the serious work restarts. I’m going to study this holiday phenomenon once I finish my current observational research that questions why a large percentage of men puzzlingly spit in the urinal before or after using it for its intended purpose.

E-mail me.

HERtalk by Inga

A Puget Sound-based public radio station compiles a list of the 86 “top-earners” from area hospitals, including 15 executives who earned over $1 million in 2008. On top: former Swedish CEO Richard Peterson, whose total package exceeded $8 million.

The 600 physician member Morris-Somerset IPA (NJ) contracts with eCast Corporation for its ACO-Care HIE product.

Essent Healthcare (TN) selects ProVation Order Sets  from Wolters Kluwer Health as its electronic order set solution. Essent operates five hospitals across four states.

Billings Clinic (MT) signs a multi-year agreement with Craneware for five charge process applications and implementation services.

Child Health Corporation of American will offer LodgeNet Healthcare’s eSuite interactive television solutions to its owned hospitals.

More than a quarter of doctors in the Czech Republic have declared their intention to resign and emigrate to a better-paying country if their government can’t address pay concerns, long hours, and poor working conditions. The starting base salary for a Czech physician is about $11,000 year. In nearby Germany, pay is about $96,000 a year.  Government officials claim the current financial crisis prevents them from increasing doctor pay.

Vista Health System IPA and Central Jersey Physician Network IPA form a new accountable care organization, Optimus Healthcare Partners LLC. The organization will initially include 650 physician members.

HIT consulting firm PHNS realigns its management team following its acquisition by the ConJoin Group. PHNS founder Richard S. Garnick will remain as CEO.

The Texas Organization of Rural & Community Hospitals Foundation is offering QuadraMed’s ICD-10 Countdown Program and Readiness Assessment Services to its 150 member hospitals. Almost 70 hospitals have already contracted for the program.

mdi Consultants will be the anchor tenant for the Nashville Medical Trade Center, according to the center’s management company. Market Center Management Company also announced the creation of a Global Business Development Center to be located within the center. The 1.5 million square foot development is scheduled to open in 2013 and expected to attract 160,000 visitors a year.

Sponsor Updates

• Wishard Health Services (IN) expands its use of Surgical Information Systems (SIS) products to include SIS Anesthesia, SIS Analytics, and SIS Com.
• Ochsner Health System (LA) goes live on Orion Health HIE.
• CDW and Greenway Medical Technologies announce a partnership to offer a practice EMR package that includes PrimeSUITE 2011, technology, and services.
• BayCare Health System (FL) partners with MEDSEEK to develop and deploy an integrated eHealth solution for consumers, patients, clinicians, and employees.
• Bethesda Healthcare System (FL) picks Ingenix to manage RCM functions for its hospitals and outpatient facilities. Ingenix will deploy its Electronic Financial Record technology as well as provide full-time onsite staff to manage RCM functions.
• Momentum Billing LLC (CA) chooses Advanced MD’s medical management software for its medical practice operations and RCM business.
• McKesson says that Community Hospitals and Wellness Centers (OH) is the 100th hospital to go live on its Paragon HIS.
• Cumberland Consulting Group has been honored as a Patriotic Employer for supporting employees who serve in the National Guard and Reserve. The company was nominated by Major John Gobel, one of its consultants who served 20 years in the Guard, stayed on in the Reserves, and served in Iraq.

I stepped away from my HIStalk duties yesterday and met with The Jolly Guy. I shared with him my special request for fabulous boots. Santa said, “maybe.” True story: he asked me to leave out a glass of vino on Christmas Eve, in lieu of milk and cookies. My kind of Santa.

Send holiday greetings to Inga.

Monday Morning Update 12/20/10

From The PACS Designer: “Re: ResMD from Calgary Scientific. ResMD has been mentioned on HIStalk Mobile several times as an up-and-coming mobile solution for referrers only, since FDA approval is still pending for radiology use of the iPhone. Now that ResMD image viewing software has been adapted for the iPhone, referrers can get very good image quality and navigation when viewing images of their patients.”

From Digital Bean Counter: “Re: Alere Health. The EVP/CIO was finally let go. It was a longstanding belief held by many that he was single-handedly responsible for the demise of Alere’s poorly implemented Pega-based clinical health management system.” Unverified – he’s still on their Web page. I couldn’t place the company name, so I Googled to find that it offers online wellness programs, a PHR, and a health portal.

Listening: reader-recommended and Minneapolis-based catchy power pop from Sing It Loud. Sounds kind of Gin Blossomy or Weezerish to me in places, although I could have done without their note-for-note cover of Get Down Tonight. I’ve listened to stuff from the two albums on Rhapsody and I kind of like it – it would make nice driving music. They’re recently defunct, apparently parting ways just three months after releasing a new album. The reader’s family member produced the album and used his Hammond B3 organ on it, which is always a plus.

It’s been a great weekend so far as I write this Saturday evening. I worked ten hours at the hospital Friday, came home and worked another eight hours on HIStalk stuff, including doing a cool interview that I’ll run Monday (although I took a break to escort Mrs. HIStalk to our favorite sexy Asian bistro for some fine pad kee mao), worked on the HIT course I teach, got up way before dawn and worked another several hours on HIStalk, ran eight sweaty miles on the gym’s treadmill while blasting Metallica and REM into my skull and trying to impress the lithe young females running effortlessly just as fast as me while reading their Kindles and chatting on the phone, had some private time with Mrs. HIStalk sitting in front of the fireplace (which might have been triggered by my fighting off leg cramps from my just-finished run since she may have thought that I was performing a mating ritual with all my spastic leg-flexing and prancing around that threatened to topple the Christmas tree), planned our upcoming out-of-the-country beach break, and am now settled in for a few more hours of HIStalk work with college football on. It doesn’t take much to make me happy, which is probably why I rarely think it sucks to be me even when it might.

Athenahealth warns that FY2011 earnings won’t meet expectations, expecting $0.68-$0.78 vs. expectations of $0.85. Shares dropped around 10% on the news, but started a move back up Friday. As the graph above shows, the last trade was at $40.99, vs. a 52-week high of $47.82.

A Huffington Post Investigative Fund article covers the IOM’s just-begun study of the safety of electronic medical records systems. An interesting quote from Peter Pronovost, one of the most influential patient safety experts in the country: “There is a need for the basic science of safety of HIT. There is still a lot of basic knowledge we don’t have.” During the IOM’s two-day meeting last week, Epic’s representative repeated the mantra of boss Carl Dvorak, urging that any recommendations not stifle innovation. Human-computer interface expert Ben Shneiderman said, “Until we have a more public data collection, we will not have quality.” IOM hasn’t posted the minutes from Wednesday’s meeting that I can find. I think the writing is on the wall: FDA’s going to get involved in clinical systems oversight, in the form of a vendor registry and voluntary surveillance program if I had to bet.

HIMSS and RSNA incorporate IHE USA. HIMSS VP Joyce Sensmeier will be its president.

Weird News Andy knows how to repurpose an old joke. Q: How do you get from the pancreas to the uvula? A: Practice, practice, practice. He’s referring to Google’s just-announced Body Browser.

We missed mentioning another sponsor KLAS win. GetWellNetwork was the category leader in Interactive Patient Systems, with a 100% “would buy again” score. It’s amazing to me how many HIStalk sponsors lead their markets, although not as amazing as how many have been successfully acquired in the past couple of years (I’m resisting the urge to claim that as a sponsor benefit).

India is moving to what it calls Telemedicine 2.0, going beyond videoconferencing to live streaming of data and images to mobile phones. A pilot project involves detection of retinopathy in premature babies, offsetting a shortage of specialists.

Thanks to new HIStalk Platinum Sponsor Vocera, providers of instant voice communication systems that enhance staff efficiency and improve patient flow for more than 650 hospitals and 450,000 daily users. It runs on voice-powered communication badges and smart phones, connecting healthcare workers to each other and to alarm and alert systems, and is exclusively endorsed by the American Hospital Association. The company just made some nice acquisitions that bring in products for managing patient hand-offs. The San Jose, CA company announced Q3 numbers that include a 39% year-over-year growth rate, 22 new customers, and 31 new employees. They not only now support HIStalk, they were an original Founding Sponsor of HIStalk Mobile. Thanks to Vocera for their support.

Jack Janoso, originally hired by Sharon Regional Health System (PA) as CIO, is named acting CEO after the incumbent is fired.

My e-mailed copy of December’s Microsoft HUG Connection (which I can’t find online) says that HIMSS is canning its Users Group Alliance Program and turning the Microsoft Health Users Group over to Microsoft. I could never figure out how HIMSS could justify running vendor-specific user groups in the first place, so I can’t say I’m crushed that they’ve flip-flopped. I don’t know what happens to their Cisco group, Community for Connected Health, the only other one. The same, I’d guess.

HIMSS Analytics names Marc Holland as VP of market research. He previously ran System Research Services, an HIT market research and competitive intelligence firm.

About half of provider readers say would be less likely to participate in an HIE if its technology was owned by an insurance company, with most of the other half saying that wouldn’t matter to them. New poll to your right: if some level of FDA oversight of clinical HIT is required, which options do you like? You can choose multiple items and click the Comments link to elaborate.

Nine employees of St. Joseph’s/Candler Health System (GA) are disciplined for uploading a cell phone photo taken of an x-ray of “a male patient’s pelvic region” to Facebook. The hospital says the information wasn’t identifiable, so the employees broke hospital policies but didn’t violate HIPAA. An investigation found that a radiology employee left their workstation logged in while doing a procedure in another room, allowing someone to access the image twice in that time. The hospital fired three employees, disciplined three, and suspended three without pay.

More WikiLeaks stuff, this time an embassy report on Cuban healthcare. It claims hospitals are infecting patients with Hepatitis C, providers administer chemo and radiation treatments without meds to treat symptoms and side effects, the government jails homosexuals with HIV/AIDS, one doctor works 14-hour days and then hitchhikes home because low salaries preclude buying a car, providers aren’t allowed to access the Internet or attend conferences, rich foreigners get first crack at the best medical facilities, and government officials seek their care from other countries. Most interesting: the government supposedly banned Michael Moore’s movie Sicko, which criticized the US health system and lauded Cuba’s, for fear that Cubans would immediately recognize the movie as bogus since they have no such access to the excellent care the movie claims (Moore made a statement saying the US government made that up to discredit him).

I like to cruise the Web sites of sponsors every couple of months just to see what’s new. Here’s what I found:

• FormFast is offering a January 20 Webinar on lean healthcare strategies, featuring the well-known author of book on that topic.
• I’ve been following the Facebook posts of Cumberland Consulting Group, which instead of being dry and infrequent corporate drivel, are regular, cute profiles of its people and their goings-on.
• Lindsey Jarrell and Colin Konschak of DIVURGENT Healthcare Advisors have their book, Consumer Centric Healthcare: Opportunities and Challenges for Providers, published by ACHE. It’s available for $67.50.
• “Local” consulting form North Highland opened a new office in Jacksonville, FL.
• Orchestrate Healthcare and its partner Vangent won a $3.3 million contract to support a Meaningful Use HIE deployment for the Indian Health Service.
• IntraNexus ran a case study of Oswego Hospital, which uses its Sapphire browser-based hospital information system that includes CPOE, results reporting, a clinical repository, barcoding, documentation, and other applications.
• ZirMed released a free iPad app for its patient kiosk, which lets patients check in at doctors’ offices and send their information to its system. Future plans include real-time insurance verification and handling of co-pays.
• Informatics Corporation of America won the attendee-chosen Best in Show from a field of 38 vendors at a November payer and provider summit.
• Philips has started an Innovations in Radiology group on LinkedIn.
• Stockell Healthcare Systems offers a webcast on its InsightCS revenue cycle system.
• SCI Solutions has a good list of archived webinars, some created by hospitals, including How Can I Make My Customers LOVE Accessing My Hospital and Recipe for Success: How to Sweeten Physician and Patient Relationships.
• Orion Health had several announcements last week: its Rhapsody integration engine was chosen my Genesis Health System, the company was chosen as the primary technical provider for Alaska’s HIE, it announced an enhanced release of Orion Health EHR, and it just released GA of Version 4.1 of its Rhapsody integration engine.
• MedVentive’s founder and CMO Jonathan Niloff did a best practices Webinar called ACOs: Old Concept, New Name – Tales from the Field in late November. It’s available on their site through February.
• maxIT Healthcare has tagline I hadn’t seen, “Meaningful Use Requires Meaningful Assistance”, highlighting its 400 clients and their 350-consultant average experience of 19 years.
• Carefx will be at January’s eHealth Initiative Annual Conference in Washington and the 2011 Military Health System Conference the week after that.
• MyHealth DIRECT is growing and has openings for several client services positions.
• CynergisTek CEO Mac McMillan’s article (warning: PDF), Make Meaningful Sense of Meaningful Use: What to Do Right Now, is featured in the December issue of New Perspectives from the Association of Healthcare Internal Auditors.
• Cyndi Cahill of Vitalize Consulting Solutions was elected to the CHIME Foundation’s board of trustees. The company was just named #4 on KLAS’s list of professional services providers, landing in the top ten for clinical implementation, staff augmentation, and technical services.
• Mary Carr RN of iSirona just ran Part 3 of her series on steps to medical device integration success.
• Sentry Data Systems demonstrated its drug tracking, 340B, and business intelligence solutions at the ASHP Midyear a couple of weeks ago.
• MobileMD’s 4DX HIE scored (warning: PDF) 93.64 on its most recent KLAS report, with an all-green report card and all-green trending.
• AdvancedMD is offering white papers for practices that include Medical Practice Optimization and A Prescription for e-Prescribing: How to Make It Work for Your Practice.
• BridgeHead Software CEO Tony Cotterill was interviewed on the topic of protecting healthcare data, covering archiving, storage management, and data migration.
• Culbert Healthcare Solutions is offering consultant positions.
• Software Testing Solutions offers an analysis of how its solution can help Sunquest LIS users meet CAP requirements.
• Holon exhibited at the ASHP Midyear this month, with one of its offerings being Virtual Central Order Entry Pharmacy, its Web-based solution to distribute order entry workloads using custom rules to allow pharmacists to manage physician orders from any location.
• Virtelligence participated in the HIMSS Southern California meeting this month.
• Renaissance Resource Associates has a number of open consulting positions (Epic, GE, and all major vendor systems).
• EHRScope’s frequent blog postings cover industry news and product information.
• Salar has posted a demo of TeamNotes, its clinical documentation system recently selected by PinnacleHealth (along with its charge capture system).
• PatientKeeper offers a number of archived Webinars, including ones on physician adoption, CPOE, and physician portals.
• We ran an interview with MedAptus CMO David Delaney, MD on the subject of revenue cycle management tools a couple of weeks ago.
• NPC Creative Services highlights some of it public relations and press release work on its site. I believe Inga told me they were instrumental in steering a couple of new sponsors to HIStalk, which I appreciate.
• Keane Optimum has earned Complete EHR certification.
• An Intellect Resources blog entry covers how to choose your professional references.
• Enterprise Software Deployment posts its holiday card online, complete with staff pictures (who doesn’t like looking at people pictures?)
• Diligence Analytics offers its cost-effective, professionally conducted research and analysis services to HIT vendors.
• A2M posted a list of of some of its big-name consulting clients.
• MED3OOO just announced a strategic partnership with Emergency Reporting in which it integrated that company’s Web-based fire/EMS system with MED3OOO’s EMS billing and recovery services.
• Daniela Mahoney RN, president and CEO of Healthcare Innovative Solutions, will present Co-Pilots to your CPOE Success – Clinical and IT Collaboration and other CPOE-related sessions at the Ohio Hospital Association CPOE meeting in Dublin on January 18. She will also present several sessions at the South Carolina Hospital Association’s STEEEP Summit the following week.
• Anson Group posted its well-written review of last month’s mHealth Summit, comparing the rise in mHealth to that of Facebook.
• Capsule is running a “Wish I Had Time To … “ story contest for nurses. The entry deadline is March 31 and the submissions will be published as an interactive storybook on their site. Winners will be chosen by Facebook Likes.

I know many readers will be bugging out for the holidays this week. My wish for you is joy, peace, and unconditional love. Enjoy the break, then get right back here afterward because HIMSS will be just a few weeks away and it’s going to get crazy around here.

E-mail me.

News 12/17/10

From Wireless Observer: “Re: InnerWireless. They’ve raised at least $75M in VC cash. Their VCs are just flushing their investment — there is no way they will ever recover what they put in. A transaction amount will never be mentioned because it will be embarrassingly low. This company has been a bit of a financial horror show. Not only did they burn tons of cash, don’t forget that IW bought what was left of Pango Networks (billed as a ‘merger’)and killed that company. And if anyone remembers, they developed the SPOT RTLS solution to the tune of $6-8M and killed that one, too. Not a good track record, to say the least.”

From HIPAA Hound: “Re: Hans Rosling BBC video lecture on the statistics of national wealth and health in the last 200 years. Pretty interesting in a geeky way.” It is pretty cool, not just for the information it conveys about countries advancing in income and health, but in the graphical way the information was presented. It also supports something I find myself saying a lot: public and global health is not all that related to healthcare services delivery. Only in some countries are hospital and insurance considered synonymous with health.

From Orion’s Belt: “Re: JPS. Not only is their new CIO’s background light when it comes to hospitals, they’ve chosen a consulting partner, Accenture, with very limited EMR experience, especially with Epic. I’d keep an eye on them if I were in your business :).”

From Laddie: “Re: Texas Health Resources. Dealing with a severe outage of their Epic EMR caused by a Citrix upgrade that coincided with the 09 upgrade.” Verified. CIO Ed Marx says he’d love to blame a vendor, but the buck stops with him and it was a leadership failure in his mind. To Ed’s credit, I’ve heard CIOs say  lot of surprising things, but that’s the first time I’ve heard that. Many of those I’ve known would have been making excuses left and right and looking for an IT director to fire as a sacrificial lamb. I can say from first-hand experience that when you have Citrix problems, things get very exciting – lots of systems go dark since it’s a single point of failure for all the major apps of many hospitals (although it has to be a big failure since it’s not hard to work around a failed server in the Citrix farm).

From CYAO: “Re: University Health Care System (GA). Appointed an ED physician as CMIO to lead their EMR implementation.” Shannon Stinson, MD is named VP/CMIO. The announcement took a little shot at McKesson, which is egressing as Epic is ingressing. Said the CEO, “For many years, University and McKesson successfully partnered on clinical and financial information system projects. However, recent experience with McKesson has not been as successful.” You know the relationship had to have soured if it warranted a CEO dig in a press release.

From The PACS Designer: “Re: Opera 11 browser beta. TPD is experimenting with Opera 11 after being a Firefox advocate for a long time. Some recent Firefox changes result in numerous hiccups that make the Firefox browser less attractive for use.” I like Opera myself, although I rarely use it except when I’m testing some Web change I’ve made to make sure I didn’t screw it up. I use Chrome 90% of the time, with Firefox making up the rest (but it’s noticeably slower). Opera feels very lightweight and fast to me and it just seems smoother (and extra points for working a Spinal Tap reference into the page’s description, shown above from a Google search). I know I’d rather have a root canal than use IE.

I’ll be beaming these instructions to you telepathically when you least expect it, so do these things now and I’ll stop: (a) put your e-mail address in the spam-proof Subscribe to Updates box to your right, ensuring that 6,490 more ambitious souls aren’t the first to know that your company has been sold or your 1998 arrest record has been unsealed and printed verbatim here; (b) check out HIStalk Practice and HIStalk Mobile; (c) Friend (Inga or me) or Like (HIStalk) on Facebook to help that nice Zuckerberg boy dominate the world; (d) show some sponsor love by perusing their ads and clicking reflexively at the many interesting ones so those companies won’t crush my ego by abandoning me; (e) instantly find mentions about a company or person by dropping their name in the search box to your right, which digs through all three sites at your command; and (f) tell your friends and enemies to read HIStalk, but don’t get their hopes up by laying it on too thick. Thanks for reading, commenting, writing, rumor-reporting, and e-mailing. And be nice to Inga since she’s fragile.

The very nice Sunquest folks sent us a copy of a letter from President and CEO Richard Atkin that was e-mailed to customers Thursday afternoon, with the explanation that they know we’ve already written about their new investor (on December 3), but that they can comment now that the deal’s done (I really was touched a little that they remembered us, to be honest, but then again I’m easily won over with flattery). As we wrote earlier, an investor consortium led by Huntsman Gay Global Capital has taken a substantial equity position in Sunquest, but the company will remain independent and Vista Equity Partners, which bought the company from Misys, will continue as the largest single shareholder. The letter says the funds will be used to increase the field sales force, expand the regional consultant program, develop more products, create executive and strategic advisory boards, and possibly acquire other companies. My assessment is this: there’s not much of a safety net given the large amount of debt involved, but if management can use the money wisely and strategically to move to the next level, nobody’s going to worry about it. Like always, strategy and execution (in the form of management) will decide the outcome.

Listening: reader-recommended Dashboard Confessional, an emo band that I’m surprised I haven’t mentioned since I do listen to them occasionally.

KLAS just published its Top 20 Best in KLAS awards. I’ll probably dig deeper into it later, but here’s what has struck me so far:

• Epic was named as the highest scoring vendor overall, with Hayes Management Consulting taking the top spot among professional services firms.
• If you’re a single-vendor shop, the highest ranking software suite by far was Epic, but McKesson took two of the top four spots (Paragon and Horizon). Most surprisingly to me, Siemens Soarian came in #3.
• I always like to look at Worst in KLAS, the bottom-ranked products in the hospital application categories: GE Centricity (hospital EMR), CGI Sovera (document management and imaging), Emergisoft (ED), McKesson Pathways (scheduling), GE Centricity (lab), Cerner ProVision (PACS), McKesson STAR (patient accounting and patient management), Mediware WORx (pharmacy), Sunquest (radiology), and McKesson Horizon (surgery management).
• Some products did very well in one of KLAS’s subcategories, which means they can’t win an award, but some of them did earn a 100% “Would Buy Again” customer rating, which is to me the most useful measure of all.

RelayHealth’s RelayClinical EHR earns ambulatory EHR certification from Drummond Group, giving the company a trifecta of offerings (EHR, HIE, and PHRs).

Former Eclipsys CEO Andy Eckert is named CEO of CRC Health Corporation, which offers behavioral care services.

Xconomy Boston gives a status update of the integration of the former Sentillion into Microsoft. It’s still a work in progress and a lot of it is hush-hush, but former Sentillion CEO Rob Seliger has been promoted to GM of product management for all of the Healthcare Solutions Group, which includes HealthVault and Amalga, and references were made about new products yet to be announced.

I’ll take Things in Common for $200, Weird News Andy. And the Jeopardy answer is: blood pressure, surgeons’ egos, reimbursements, and meth users from the ceiling. The question: what are things that fall in the ED? A man shows up at a Louisville hospital’s emergency department with what he says are alcohol burns, but the woman who gave him a ride says his car-based meth lab had exploded. The police come, the man tries to climb into the ceiling to drop down into another room to escape, but he misjudges and crashes to the hallway floor. The police spokesperson’s assessment was cynically dry: “I would say it’s unusual for anybody that’s in the hospital to try and escape through the ceiling tiles.”

The VCs behind MedPage Today (which has an interest in the KevinMD site) sell out to Everyday Health, which runs ad-supported health and lifestyle sites that include that of Jillian Michaels.

Jobs on the sponsor-only Jobs Page: Application Consultant, West Coast (Nuance), Software/Implementation Engineer (MobileMD), Eclipsys Activation Consultant (Enterprise Software Deployment). On Healthcare IT Jobs: Client Manager, Soarian Clinicals Consultants, Dragon Trainer/Systems Analyst, McKesson Paragon Consultants.

Cerner founders Neal Patterson and Cliff Illig are sued for $3 million by their golf course partners, who claim the guys stiffed them on payments due.

I’ve said nice things about Nextgov, but this won’t be one of them. What were they thinking when they wrote the Wednesday story above? David Brailer quit as national coordinator nearly five years ago, in April 2006. David Blumenthal has been in that position since March 2009, but Rob Kolodner held the job between the Daves. Not to mention that its CMS, not ONC, that will “hand out” HITECH money (oh, if it were only that simple). When I saw the clumsily breezy headline, I thought that Health Evolution Partners was cutting Brailer’s pay and I wondered how (and why) Nextgov sleuthed that out.

A British hospital opens a communications room for hearing-impaired patients that offers assistive devices for hearing aid wearers and Webcam access to a sign language interpreter.

The board of 136-bed Rice Memorial Hospital (MN) approves $4.7 million to purchase a clinical information system. Its preferred vendor is Epic, which would make this one of the smallest Epic implementations ever, I would guess (assuming Judy goes for the deal). Now this is interesting since Epic contractually gags its customers from divulging what they paid, so you never see a price breakout: Epic was the cheapest of the five vendor proposals, with the cost detailed as $1.2 million for the license fee, $100K for hardware, $800K for implementation, and $2.6 million for five years’ of maintenance.

I was digging through the statement (warning: PDF) made this week by the FDA’s Jeffrey Shuren at the IOM’s Committee on Patient Safety and HIT meeting. Tidbits: (a) he implies that EHRs are medical devices for which FDA has elected not to enforce existing requirements, but FDA is interested in IOM’s opinion on whether it should start regulating them; (b) he suggests that clinical decision support will be a targeted area; (c) FDA believes interoperability should be standardized; (d) systems should be monitored with real-time surveillance. He points out that FDA oversight can take several forms: requiring manufacturers to register, running a voluntary post-market surveillance program, requiring manufacturers to follow ISO-like quality management programs, or require vendors to submit information before putting their products on the market.

Oracle announces Cloud Office 1.0, a Google-like suite of Microsoft Office-compatible word processing, spreadsheet, and presentation apps. That’s probably not the best news Microsoft has heard lately.

Former Allscripts EVP Mark Karch is named EVP of Apparture Inc., which offers Web-based marketing solutions for healthcare companies.

Strange: a woman in Australia reports to police that her iPhone has been stolen from her purse while she’s visiting a hospital. They track it down using its GPS-like application and call in a police helicopter to swoop down on the thief, a 16-year-old boy riding a stolen bike.

E-mail me.

HERtalk by Inga

From Eel Shoes: “Re: non-HIT matters. At this time of year, i don’t think we are hearing enough eel stories. I wondered if Inga had tried the soft but durable eel skin shoes?” I was quite amused by the reader that posted this comment, as well as the follow-up eel conversations. I am not an eel expert, though I once had a soft and durable pair of brown eel-skin pumps that have since been donated to Goodwill. As of late, my shoe fancy has been leaning towards new boots. Here is the pair I’d love to see under the Christmas tree (size 8, if anyone has Santa connections).

Cleveland Clinic will implement 3M’s Codefinder Computer-Assisted Edition software for inpatient and outpatient coding.

athenahealth expands its board with the appointment of its former COO, David E. Robinson. Before joining athenahealth, he was an EVP of SunGard Data Systems.

MedSynergies appoints former Dell/Perot exec James Dye as SVP of client management. MedSynergies also names Brid Kealey as SVP of human resources and Chris Walker VP of performance and change management.

Ephrata Community Hospital (PA) begins implementation of its Meditech EMR and expects to complete the first stage of the transition in early 2011.

Tool maker Stanley Black & Decker will pay $61.2 million cash for mobile workstation and asset tracking provider InfoLogix. InfoLogix will become part of Stanley’s Healthcare Solutions business, which Stanley is seeking to expand.

Hospital billing company and Tenet subsidiary Confer Health Solutions will close two of its seven offices as it tries to improve efficiencies. Conifer will close offices in Anaheim and Alhambra and consolidate its California work in its remaining Anaheim office. Closures will affect all 100 Modesto employees.

Colorado Regional Extension Center (CO-REC) announces its approved list of 14 EHR products.

Atlantic Health (NJ) forms an ACO that  encompasses a seven-county area. The health system has already aligned with more than 300 participating physicians.

The price tag for OSU Medical Center’s Epic EMR: $100 million over the next five years. Once implemented, Ohio State doctors and hospitals have the potential to earn $25 million in ARRA money.

Kaiser Permanente promotes CIO Philip Fasano to EVP and CIO. CEO George Halvorson says the promotion reflects the “magnitude of Phil’s impact and contribution to our organization.”

UC Davis concludes that EMRs impact physician specialties differently (duh). The initial implementation of EMRs decreased physician productivity 25 to 33%. Over time, internal medicine providers adjusted to the new technology and slightly increased their productivity, but pediatricians and family practice doctors did not recover to their original productivity levels. The conclusion: there is a  “mismatch between technology design and the work-flow requirements and health administration expectations” for different specialties.

Sponsor Updates

• API Healthcare introduces the Electronic Employee Record, designed for healthcare organizations to store and maintain employee information, track trends, and create forecasts.
• Wills Eye Health System (PA) contracts with NextGen for its EHR and PM products.
• Children’s Hospital Central California subscribes to CapSite to improve its capital expenditure process.
• Wellsoft signs a two-year extension contract with Premier, allowing Wellsoft to remain the sole contracted supplier of EDIS for Premier’s member hospitals.
• St. Tammany Parish Hospital (LA) selects RelayHealth as its partner to build its community-wide HIE.
• HIStalk sponsors placing in the KLAS top ten of all vendors are 3M, Philips, Picis, Sunquest, McKesson, and Merge Healthcare.
• Sponsors in the professional services top ten in KLAS are Hayes Management Consulting, Vitalize Consulting Solutions, Ingenix, and McKesson.
• Sponsor products earning a Best in KLAS title in their segment are eClinicalWorks EMR (ambulatory EMR 26-100 physicians), Greenway Medical PrimeSuite Chart (ambulatory EMR 6-25 physicians), e-MDs Chart (ambulatory EMR 2-5 physicians), McKesson Paragon (community HIS), Allscripts Sunrise EPSi Decision Support (business decision support), Wellsoft EDIS (ED), McKesson Pathways Financial Management, Materials, and HR Manager (financial/ERP), McKesson Horizon Practice Plus (practice management 26-100 physicians), Greenway Medical PrimeSuite Practice (practice management 6-25 physicians), e-MDs Bill (practice management 2-5 physicians), and Nuance eScription (speech recognition).
• Sponsors named Best in KLAS in the professional services category are Navicure (claims and clearinghouse services)and CareTech Solutions (IT outsourcing – extensive).
• Precyse Solutions ranked #2 in KLAS’s transcription provider category, but outscored everyone in report quality.
• UPDATE: we missed one! MedPlus’s ChartMaxx took Best in KLAS in the document imaging and management category, winning the #1 spot seven times since 2002. MedPlus has 140 implementations and 415,000 users.

E-mail Inga.

News 12/15/10

From Nasty Parts: “Re: InnerWireless. Their VC backers want their money. Look for it to be acquired soon.” Unverified. The Richardson, TX company offers wireless infrastructure. It struck me as odd that its board of directors has four members, all of them money guys from different VC companies.

From THRGuy: “Re: JPS Health Network, Fort Worth. The interim CIO, has been named CIO. So a complex hospital implementing a complex EMR hires a CIO who has never had that job before?” I thought maybe he’d been there a long time, but it’s just been a year. His LinkedIn profile indicates no college degree, either. But it’s the same argument that college football teams go through: do you pay huge dollars to bring in a big-name ringer who could fail or bail, or do you figure your chances are about as good going with a known quantity who seems capable? Especially when a successful EMR implementation shouldn’t be under the CIO’s control in the first place. I will say from the cheap seats it does seem like a puzzling choice, but I have to assume they have the knowledge and incentive to pick the best candidate. And like coaches, CIOs are replaceable if things don’t work out, even when it’s not their fault. UPDATE: Joe Venturelli e-mailed to say that he obtained a bachelor’s degree in design from School of Visual Arts, which I see he’s updated on his LinkedIn profile. He also notes that he was CIO for NewHope Bariatrics. Thanks for the update.

The IOM’s Committee on Patient Safety and Health Information Technology, which is conducting a year-long study on the safety of HIT, held its first meeting Tuesday, continuing through Wednesday. Tuesday’s presenters: Gail Warden (University of Michigan), David Blumenthal (ONCHIT, which is paying for the study), Peter Pronovost (Johns Hopkins), Lawrence Shulman (Dana-Farber), Rainu Kaushal (Cornell), Dean Sitting (University of Texas Health Science Center at Houston), Sumit Rana (Epic), Madhu Reddy (Penn State), Ben Schneiderman (University of Maryland), and folks from NQF, Geisinger, AHRQ, FDA, CMMS, and CCHIT. I’m not exactly sure why Epic had someone presenting (or CCHIT, for that matter – what about the other EHR certification bodies?) The key agenda item was the last one in Tuesday’s session – what is the government’s role in overseeing HIT safety?

David Blumenthal will deliver a keynote address at the eHealth Initiative’s annual conference in Washington, DC on January 19-20. He speaks at a lot of events, but I don’t ever see anything quotable, so I assume he sticks to the standard EMR stump speech.

Weird News Andy is intrigued that patients in England are raising huge amounts of money for US cancer treatments after being told by NHS that nothing can be done and being offered no financial help, only to find that the same treatment is actually being delivered in England as part of clinical trials. Some parents claim their kids were turned down for the trials because those running them didn’t want make their study look bad.

Cathy Bruno, CIO of Eastern Maine Healthcare, wins the CIO of the Year award from the New England HIMSS chapter.

Cerner opens an employee health and wellness center this week for Deffenbaugh Industries, a Kansas City trash company. I noticed that Liking Deffenbaugh on Facebook puts you in the running for a Stinky the Garbage Truck toy, just in case you haven’t chosen a Christmas gift yet for that special someone.

Federal CTO Aneesh Chopra, speaking at a Brookings Institute forum on Internet policy, talks up the healthcare data sharing platform Direct Project as an example of the government’s role as a convener to facilitate innovation.

The Tampa VA hospital launches a $3 million Smart Home project to rehabilitate veterans with traumatic brain injury. Apartments are set up to keep patients re-learn activities and to monitor their movement using a real-time location system.

Healthcare IT vendor Cegedim clarifies news reports suggesting that up to 4,000 French pharmacies rigged its software to underreport taxes due using a secret code, with authorities estimating revenue loss of up to $534 million over three years. The company says it highly doubts that the one known tax fraud case translates into 25% of all pharmacies in France, also pointing out that the change is traceable if they tried anything sneaky.

Massena Memorial Hospital (NY) gets a local newspaper mention for its use of Meditech’s bedside medication barcoding system.

A study published in Archives of Internal Medicine finds that patients who receive care from multiple hospitals and EDs have more medical errors, treatment delays, and duplicate testing, with the conclusion being that data-sharing technology might pay its way by improving that situation. At least what the (free) abstract says about the (not free) article. Sometimes I wonder why you still have to pay for medical journal articles in an age where publishing costs are close to nil, especially since much of the heavy lifting is done by unpaid peer reviewers anyway.

iSoft sells its financial management software group, trying to pay down debt and focus on its core clinical systems business.

The government of Ontario seizes Hôtel-Dieu Grace Hospital due to high executive turnover and a wrongful termination lawsuit. The hospital was under review for a series of pathology and surgery errors.

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HERtalk by Inga

CHRISTUS Health plans a seven-state rollout of Medicity’s ProAccess Community and MediTrust Cloud Services, plus ambulatory order initiation, physician referral, and CCD exchange. They were already using Medicity’s Novo Grid technology.

Now on iTunes: Dragon Medical Mobile Recorder from Nuance Communications. The app allows users to dictate at the point of care via iPhones, which is then delivered to the eScription and Dictaphone Enterprise Speech platforms or to Nuance’s outsourced transcription services.

Moses Cone Health System (NC) implements Proficient Health’s Proficient Orders to streamline communication with local physicians and facilitate future participation in the North Carolina HIE.

Discovery Health Records Solutions completes a $2 million equity offering with the backing of Silverhawk Capital Partners.

CCHIT names three new members to its board of trustees and 11 commissioners to start terms on January 1.

Elliot Health System (NH) implements EMC and VMware solutions to virtualize and consolidate its IT infrastructure. EHS says the VMware vSphere platform eliminated the need to purchase 130 physical servers and resulted in a 50% reduction in data center power usage. EHS, which runs Epic EMR and McKesson financials, next plans to deploy a private cloud to deliver EMR services to physician practices.

MedVirginia announces that it’s the first community HIE to connect with the VA’s and DoD’s Virtual Lifetime Electronic Record (VLER). MedVirginia is leveraging its existing open source CONNECT gateway to the NHIN to enable clinical information exchange based on the CCD C32 format.

Surprising: almost 90% of providers are actively planning or piloting a PHR solution, according to a new KLAS report. Providers are trying to decide whether to partner with their EHR or HIE vendors or choose a free-standing, no-cost solution. Many providers are interested in free options because they can brand them as their own. Microsoft is the most-considered PHR vendor, followed closely by Epic and Google.

Also new from KLAS: satisfaction scores for ambulatory clearinghouses. Navicure, ZirMed, EDI Gateway, and Capario earn the top scores while Emdeon’s indirect product was noted as “most improved.” KLAS also points out that providers are willing to pay higher fees for more functionality if it can make practices significantly more efficient and shorten A/R cycles.

Community Memorial Health System (CA) chooses Wolters Kluwer Health’s ProVation Order Sets as its electronic order set solution.

The executive director of the 10-county Rochester RHIO says all 15 hospitals in its region are connected, as well as labs, elder care agencies, and health insurance companies. In addition, over 360,000 patients have signed consent forms to allow their doctors’ offices see their records online.

Salinas Valley Memorial Hospital (CA) sends a company-wide memo announcing that between 100 and 120 employees will lose their jobs by the end of the year as the hospital tries to trim operating costs. Affected workers include 40 nurses, unit assistants, clerical workers, housekeepers, and nutrition workers. The hospital has already eliminated 205 employees since July. I am pondering the exact wording on that memo. Perhaps, “Merry Christmas! You are Fired!”

MMRGlobal names Sunil Singhil EVP and adds two new members to its board of advisors. Singhil is a co-founder of  Nihilent Technology and its former COO. Joining the board are Qualcomm VP Michael J. Finley and Spalding Surgical Center CEO John R. Seitz.

A Michigan pilot dupes the AMA, hospitals, and specialty colleges into believing that he is a physician. Apparently William Hamman attended medical school, but dropped out. At some point over the last 20 years he tweaked his resume to include a medical degree from the University of Wisconsin-Madison. He had spoken at meetings and universities since 1992 and for five years served as the co-director of Western Michigan University’s Center of Excellence for Simulation Research. He joined William Beaumont Hospital (MI) in 2009 as an educator and researcher. A routine background check by Beaumont eventually uncovered Hamman’s lack of credentials and he resigned. Nice job of vetting over the first 20 years.

Emergisoft partners with Crystal Cruises to implement EmergisoftMaritime, the first EHR designed specifically for cruise ship healthcare. I believe I must do a site visit in order to provide readers with a full product evaluation.

Sponsor Updates

• SCI Solutions wins an eHealthcare Leadership Gold Award recognizing its outstanding healthcare Web portals.
• CDW Healthcare signs up to be a channel partner for Greenway Medical Technologies, offering Greenway’s PrimeSUITE.
• Lower Bucks Hospital (PA) selects Wellsoft EDIS.
• Mindray signs a deal to become the sole distributor of iMDsoft’s MetaVision in China and will also make it available to customers in 10 other countries.
• Hopkins County Memorial Hospital (TX) chooses the Access Intelligent Forms Suite for printing barcoded and data-populated forms on demand.
• The Alaska eHealth Network picks Orion Health to provide its HIE solution in a hosted SaaS mode.
• Lisa McVey, VP and CIO for McKesson Provider Technology and RelayHealth’s provider and consumer business units, wins a Women in Technology award in the enterprise business category.

E-mail Inga, MD, PhD, FACP, CPA

Monday Morning Update 12/13/10

Half of readers from hospitals say their CIO reports directly to the CEO, with a fairly even split of the remainder reporting to the CFO and COO. New poll to your right, for providers: if an HIE’s technology platform is owned by an insurance company (as in Axolotl and Medicity), would your organization be less likely, more likely, or equally likely to participate in that HIE? Click the Comments link on the poll to add yours.

The president of the Australian Medical Association says the government’s EHR efforts should focus on making information available to doctors in real time: labs, rads, meds, and discharge summaries.

Trustees of Campbell County Memorial Hospital (WY) vote to buy themselves iPads and 3G accounts, claiming their $15,000 hospital cost will save time and copying expense. Otherwise, it’s an all-paper hospital, with CPOE and ED order entry “in the mill.” That jibes with my personal experience: electronic executive toys (and the IT support to keep them running) are always of highest priority, with no justification required except, “These are cool … we want them.”

A CDC survey finds that around half of physician practices uses EMRs, but only 25% of practices use a system that meets “basic system” functionality, with just 10% using a “fully functional” EMR that includes medical history, drug interaction checking, e-prescribing, electronic ordering of lab and radiology tests, and viewing electronic images. Still, the use “fully functional” EMRs has gone from 3.1% to 10% since 2006. Laggard states include Kentucky, Louisiana, and Florida, in which more than 60% of physicians in practice do not use any form of EMR. Leading the pack is Utah, with 51.5% of office-based doctors having access to a basic EMR.

ONC announces December 10 approval of two more certification bodies: ICSA Labs and SLI Global Solutions. They join CCHIT, Drummond Group, and InfoGard Laboratories.

Children’s Dayton chooses Medicity’s Novo Grid for exchanging information with its physicians and partners.

An EMT who took a crime scene photo of a dead woman and posted it on his Facebook avoids jail time, but is sentenced to 200 hours of community service and the permanent loss of his EMT license. His attorney blamed the man’s “raw sense of humor.” Social networking may also have been involved in the woman’s death: her parents say she was killed after an enemy spread false rumors on MySpace that she was romantically involved with the man who was eventually convicted of killing her over the incident.

The Army is testing the AHLTA EMR on mobile devices that include the iPad, iPod Touch, iPhone, Sprint HTC EVO, and Samsung Epic.

An ortho tech at Memorial Medical Center (CA) is arrested and charged with stealing 23 computers from the hospital.

An interesting WikiLeaks disclosure: drug company Pfizer hired investigators to check out Nigeria’s attorney general, hoping to uncover evidence of corruption that would force him to resign. A Nigerian state had sued the company for $2 billion, claiming its testing of meningitis drug Trovan there had killed 11 children (it was later heavily restricted in the US and banned in Europe). Pfizer settled for $75 million in July, but the AG had already been removed after corruption articles were run in local newspapers.

Above is a good interview with Stuart Rosenberg, MD of Beth Israel Deaconess Physician Organization, which just signed an “Alternative Quality Contract” with Blue Cross that pays the group a fixed amount for its HMO patients. He was paid over $700K in the organization’s most recent tax return, which despite being an ample income, doesn’t seem all that excessive considering what non-clinical hospital executives make.

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News 12/10/10

From Patella Poker: “Re: Joint Commission. Big news on medication reconciliation. They’ll start scoring again on July 1 with no phase-in period. I bet a lot of hospitals will have to rush to squeeze this in with all their other initiatives.” The “streamlined and focused” version of the National Patient Safety Goal for hospitals includes creating an admission medication list (and developing a policy for doing something similar in non-inpatient areas), comparing the home meds brought in against those ordered, providing written medication information at discharge, and instructing the patient to keep an up-to-date list and let providers know of changes.

From Kiosk Guy: “Re: VA. They have again selected Vecna. They originally won the award in July 2010, but it was protested by a competitor and the competition was done over last month.”

From Hirudo M: “Re: Aetna. What does its purchase of Medicity say about Aetna’s ongoing partnership with IBM? Aetna is using IBM’s HIE strategy and infrastructure for ActiveHealth.” Good question. That deal was just announced in August and there was a big press release about some Aetna-IBM HIE work in Puerto Rico just a couple of weeks ago, when Aetna was quietly well into its Medicity courtship.

From The PACS Designer: “Re: Pogoplug. We’ve been hearing more about different types of cloud apps lately and now there’s a personal cloud appliance called Pogoplug. Pogoplug turns your hard drive into an Internet accessible device so you can use any browser to call up your files with your iPhone and other mobile devices through a free online service.” The hardware component is $70 and the service is free. You can even stream music videos from your home PC anywhere on the Web, including your smart phone. The pitch is that in 60 seconds you’ll have your own personal cloud running your own content from an external hard drive.

Listening: reader-recommended Ned Evett, which I loved instantly. Well-produced killer guitar riffs, powerful drumming, excellent vocals, and good songwriting and big hooks. Forget the endless technical mention that he’s a “fretless” guitar player and focus instead on some really rhythmic blues, pop, or prog (it could pass well for all three). I’m really liking the Middle of the Middle album on Rhapsody (Shine Like a Diamond on Me is amazing, like the Beatles meet Pink Floyd). I’ve listened to all four albums and they’re excellent. This would be among the best stuff I’ve heard in a long time. I can’t get enough, other than my fingers are getting sore from drumming along on my desk. He’s opening for Joe Satriani on some tour dates.

The webcast of ONC’s day-long PHR Roundtable from last week is now online. They’ve also posted 16 new 90-second Beacon Community videos, one of which I’ve included above.

HealthCare Partners Medical Group goes live on Unity RIS/PACS from DR Systems.

Say hello to NCR, supporting HIStalk as a Platinum Sponsor. The Duluth, GA company is the #1 provider of patient self-service solutions, offering pre-registration, appointment scheduling, and bill pay online, which as they point out, can help preserve the patient experience as hospitals face being swamped with 32 million newly insured patients. Some of its healthcare self-service offerings a check-in kiosk, the eClipboard wireless unit for check-in and registration, mobile reminders and results, ED triage and check-in, revenue cycle management, patient portal, and a wayfinding kiosk. There’s a good video from Richmond Bone & Joint Clinic on their site, featuring the clinic’s CEO. Thanks very much to NCR for not just coming along for the HIStalk ride, but chipping in for gas.

Weird News Andy uses a deadpan delivery for this story, captioning it “You might be expecting twins, Mr. Plettell.” A British man receives a letter from a hospital inviting him to drop by for his ultrasound, urging him to bring along his maternity record. His mates (I’m picturing Andy Capp lookalikes) are encouraging him to show up in a dress and wig, which probably wouldn’t really be all that odd in England since they seem to find cross-dressing endlessly hilarious.

Greg from Citizens Memorial Hospital (MO), the super-progressive 74-bed hospital, tells me about work they’ve done there with Google Health.

We implemented Google Health in March of 2010. The initial response was large, mostly due to local TV news coverage. We send medications, labs, procedures, allergies, and conditions to Google Health. Our next step is working on sending radiology and other reports. We have the ability to import Google Health information as an external document in the EMR. It’s currently a manual process that has to be initiated outside of Meditech, but in the future, we’re planning to automate this process. As more patients and other providers start using the service, it will become a more valuable report. Since we are the only provider in our area sending data to Google Health (with the exception of a few national pharmacy chains), most of the reports we import have only the data we sent.We promote Google Health in conjunction with our Clinic Patient Portal. Users can sign up for both on our website. Information is verified by our HIM department and we contact the patients if necessary to verify their identity before linking their records.  We also have guest PCs in our rural family practice clinics so that patients can sign up at the clinic.

Ross Martin MD MHA, esteemed leader of The American College of Medical Informatimusicology, makes his Interoperetta available as an MP3, explaining that 85% of all humans should listen to it to provide herd immunity against dangerous subliminal messages that could be introduced by the questionably motivated fan who requested the MP3 version in the first place. I think Ross is simultaneously opening and closing the loop, in other words. I’m trying to cajole him into creating an HIStalk theme song in preparation for future HIStalkapaloozas.

On the Jobs Page, for sponsor postings only: Payer/Provider Connectivity Project Manager, Eclipsys Activation Consultant, Segment Marketing Manager. On Healthcare IT Jobs: Cerner ePrescribe Builder, Director EHR Systems Division, McKesson Paragon Consultants.

Orlando Portale, chief innovation officer for Palomar Pomerado Health (CA), tells me he’ll be demonstrating some prototype Android healthcare apps for tablets (EHR access and remote physiological monitoring) at Cisco’s Community for Connected Health Summit, which will be held Monday of the HIMSS conference. Jason Hwang, co-author of The Innovator’s Prescription: A Disruptive Solution for Healthcare will open the session.

Speaking of Cisco, I notice that they’ve released a personal version of their high-quality video telepresence system called umi (there’s supposed to be a bar over the non-upper cased U, but darned if I know how to type that character, which might have been one of those marketing-inspired gaffes since nobody can actually type out the name). Unlimited service is $24.99 a month, although the broadband specs are pretty beefy for non-FiOS residential customers (1.5 mbps upload). It works with your HDTV. I’m picturing a Webcam porn industry vertical sales, but there are probably other uses.

Cerner’s innovation subsidiary is assigned a newly awarded patent for a genetic banking system for securely storing genetic profiles.

I know it will seem odd since the Thanksgiving to New Year’s period is pretty slow for a lot of people, but Inga and I are super-buried at the moment. We’re working on lots of news items, several interviews, and a heavy load of new sponsor activity (thanks for that!), not to mention that we need to start planning for our HIMSS events and the HISsies nominations and voting. It’s the funnest job in the world, of course, but be patient or maybe even forgiving if you are waiting on something from us. I don’t expect our loads to lighten until after the conference. We may need to hire someone or something.

In the first Microsoft Amalga news I’ve heard in awhile, UW Medicine (WA) finally pulls the trigger after a two-year evaluation and licenses Amalga for translational research. That’s one slow sales cycle.

An Ohio doctor, angry that his uninsured patients can’t afford the lab tests they need, strikes a deal with LabCorp and an online lab test marketer to offer his patients discounted tests (example: a $148 lipid panel costs his patients $18). The patients simply order their tests from the county medical society’s site, pay by credit card, and go to LabCorp to get the tests. Everybody can use the service except residents of NY, NJ, and RI. Says the doc: “It’s like using Amazon.com to buy your lab tests.”

Drug and device companies are arming their sales reps with iPads for showing sales pitch presentations to doctors. Medtronic just bought 4,500 of them, Boston Scientific 2,000, Zimmer Holdings 1,000, and Abbott 1,000. It figures that the coolest, state-of-the-art technologies in a doctor’s office will be carried by a drug rep trying their best to keep healthcare costs high.

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HERtalk by Inga

From Camus: “Re: Drummond certification. Am I the only person finding it bizarre how fast the companies certified by Drummond have gone from relative obscurity to MU certified? What happens when practices pick these companies and the company goes out of business in nine months? It’s like wine — you just don’t go from planting vines to world-class cabernet in six months.” The issue is not unique to Drummond. I see plenty of “obscure” vendors on CCHIT’s list. I’ll also point out that Drummond’s certification clients include plenty of familiar names that are hardly fly-by-nights, including Allscripts, GE, and McKesson. I suppose your point is that certification does not guarantee a company is financially sound. Agreed. And I might point out that just because a company is financially viable and has a certified product, a buyer may still be left out in the cold if the vendor makes a business decision to sunset a certified product.

The HIE space continues to heat up as health systems and regional exchanges align with vendors. Recent announcements include:

• Beacon Community of the Inland Northwest (WA), a regional collaboration led by Inland Northwest Health Services, chooses the Orion Health HIE solution.
• Vantage HGT RHIO (PA) selects Verizon’s Health Information Exchange platform.
• The Children’s Medical Center of Dayton (OH) picks Medicity to provide bi-directional connectivity between the medical center and affiliated physicians and partners.

Tift Regional Medical Center (GA) implements the remote access management solution of Minicom Advanced Systems as part of its two-year process to consolidate two data centers.

Cymetrix aligns with Siemens Healthcare to provide conversion support for clients moving from legacy patient accounting systems to Siemens Soarian.

Maryland’s REC, CRISP, has signed up its 200th client.

Anvita Health, a provider of clinical analytics, hires Darren Schulte, MD, MPP as VP of Clinical Strategy. He was previously at Alere Health, where he served in executive positions related to clinical product strategy and development.

In Australia: 98% of GPs use computers for some clinical purpose and almost two-thirds are paperless. A mere 2% of the GPs use paper records only.

Rush-Copley Medical Center (IL) chooses Thomson Reuters Pharmacy Xpert, a clinical intelligence dashboard that helps pharmacists with medication management.

The VA awards Carefusion and technology integrator MicroTech a contract to supply Pyxis to 153 VA medical centers and 17 outpatient centers.

Providence Care of Kingston, Ontario, contracts with QuadraMed for QCPR, Enterprise Scheduling, and Electronic Document Management. Providence Care will also use QuadraMed technology to share clinical data with existing QuadraMed clients Kingston General Hospital and Hotel Dieu Hospital.

Wolters Kluwer Health acquires iCare, developer of an educational program that trains nursing students how to document care in an EMR.

Streamline Health Solutions posts Q3 revenues of $4.5 million, up 9% from a year ago. Earnings were $95,000 ($.01/share) compare to last year’s $296,000 loss ($.03/share.) The company says the improved results are a result of higher license system sales and increased recurring revenue from maintenance contracts.

This week I posted some new videos to HIStalkTV, including a few product demos, an interview, and a fun Lady Gaga spoof by Nuesoft. I must admit the posting task is time consuming, but only because once I get on YouTube I’m easily distracted by other fun videos that have nothing to do with HIT. For example, when I was looked at the Swype demo, I noticed a suggestion for the World’s Fastest Typist from a 1985 David Letterman episode. How can one not get sucked into watching a competition between shoulder pad-wearing women typing on IBM Selectrics with Letterman commentary?

Troubling: only 15% of CIOs think they’ll be ready to qualify for Meaningful Use incentives by April 1, 2011. That’s about half the number who said in April that they’d be ready. CIOs cite CPOE implementation as their biggest challenge, with more than half noting concerns with getting clinical staff to use the systems.

MED3OOO appoints John Wallace as a SVP on its business development team. He was previously SVP at mPay Gateway and served in leadership roles at Misys Healthcare.

Wemedx earns top marks in a KLAS report on outsourced transcription services. KLAS says overall the market “remains a high-performing, competitive segment.” Other top vendors include Precyse, Encompass, and TransTech.

This week’s must-read items on HIStalk Practice: GPs in the UK head to supermarkets. Hayes Management Consulting gets into the holiday spirit. Social media increase participation in online health programs. Building physician alliances in Northern California.

Sponsor Updates

• InSite One will offer its InDex image archive management and access solutions as a per-site license, independent of its hosted and on-site cloud services.
• Keane Optimum earns ONC-ATCB certification as a complete EHR from CCHIT.
• Berkshire Health Systems (MA) chooses Allscripts PM/EHR solutions for its employed physicians and will offer to host and support it for its 300 affiliated doctors.

E-mail Inga.