News 11/10/10

HERtalk by Inga

From Lars Ellison: “Re: ARRA push back dates and repeal. I agree with you 100%. Even with the shift of power in Washington, I do not think that Meaningful Use is going away. On another HIT front, we recently received ‘off the record’ confirmation from the Minnesota pharmacy board that the 2011 e-prescribing initiative would probably (leaning towards very likely) be pushed back to give dentists and doctors more time to comply with the initiative.” Lars is referring to Minnesota’s e-prescribing mandate requiring all providers and dispensers to “establish, maintain, and use” an electronic prescribing program by January 1, 2011.

Customer satisfaction with Siemens Soarian is climbing as customers report improvements in service and product quality, deeper clinical adoption by clinicians, and better interfacing with Siemens’ pharmacy system. Soarian still lags in CPOE adoption, though 23 hospitals are now on CPOE compared to three just two years ago. Soarian sales are still lagging due to lingering negative perceptions.

If this HIStalk thing doesn’t work out, being a social media manager for a hospital might be fun. Reportedly the demand for social media manager or interactive marketing specialists is on the rise as hospitals attempt to increase their social media presence and teach physicians and execs social media basics. The role is so new that it’s hard to pinpoint typical compensation, though one hospital recently offered job-seekers between $60,000-$80,000 a year. Eighty thousand AND you get to post to Facebook all day long.

The Cleveland Clinic plans to lay off nearly 200 employees from a variety of administrative and clinical jobs. The health system says the layoffs are the result of a challenging economy and restructuring.

CPSI announces the formation of its new IT Managed and Professional Services business unit. The division will offer managed IT and professional services for its existing hospital clients.

Emdeon reports net income of $3.73 million for the third quarter, compared to a loss of $7.21 million last year. Revenue was up 4.4% to $245.92 million compared to $235.46 million in 2009.

Several companies have sent notes asking if I’ll be attending RSNA later this month in Chicago. I’m not, though I think I’d like to go one day. I’m amazed that a conference for a single specialty could be so huge (60,000) and attract attendees from all over the world. The enormity of it intrigues me, though there is also the whole “Michigan Avenue shopping opportunity before Christmas” thing that sounds appealing as well.

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Speaking of huge conventions, HIMSS is just over three months away. I have secured my travel arrangements, which include a hotel half a mile away at $125/night. That’s definitely cheaper than what I paid in Atlanta and Chicago the last couple of years. Thus, I’ll have more spending money for the important things like fashion accessories. And speaking of fashion, Mr. H and I are scheming a few new things for this year’s annual HIStalk reception. Without leaking too many details, the gracious and fun folks from Medicomp are helping us with a red carpet entrance, which will allow all divas, wannabe-divas, and “I want to hang out with divas” to make an appropriate entrance. The “Inga Loves My Shoes” sashes will be once again be awarded to worthy candidates, so don’t leave your hot shoes at home. New this year: we will be encouraging cocktail attire and will award AMAZING prizes to the best dressed guests. We haven’t figured out what those amazing prizes will be, but are happy for any and all suggestions. The party sign-up will be sometime in January, but it is never too early for fashion planning.

CMS is conducting final testing of its system to handle registration, attestation, and payments for providers participating in the Meaningful Use program. Registration opens in early January.

According to the local paper, Banner Boswell and Del E. Webb medical centers have completed their conversion to Epic EMR. An RN with Boswell was quoted as saying the system seemed complicated at first, but was “easy to learn.”

Update: A US District Court judge dismisses a false claims suit filed by whistleblowers against Midwest Orthopaedics at Rush, several of its physicians, and Rush University Medical Center. The lawsuit, originally filed by a hospital executive and a fellow surgeon, stems from accusations that Rush physicians routinely overbooked their schedules and relied on residents to perform surgeries.

University of Utah Health Care installs TeleTracking’s TransferCenter software to speed patient transfers.

Saint Barnabas Health System (NJ) contracts with InSite One’s InDex Vendor Neutral Enterprise Archive to connect its six hospitals into a single, long-term data storage solution.

Sponsor Updates:

• Sage Healthcare announces the addition of six new practices running its PM and EHR applications. The healthcare facilities represent over 150 providers.
• CynergisTek CEO Mac McMillan will be the keynote speaker at next week’s Mississippi Hospital Association HITECH seminar on security.
• Mercy Memorial Hospital (MI) selects several Allscripts clinical products, including Sunrise Enterprise 5.5, EHR and PM for its employed and affiliated physicians, and Allscripts Care Management.
• Community Memorial Health System (CA) purchases PatientKeeper’s product suite, including CPOE, Physician Portal, Mobile Clinical Results, and eSignature
• RelayHealth launches its new Payer Connectivity Services 5010 and Beyond Program at the Workgroup for Electronic Data Interchange 2010 Fall conference this week.
• Frimly Park Hospital (UK) says that within months of going live with Picis solutions, it has improved utilization of its OR suites by 5%.
• Methodist Children’s Hospital (TX) claims its implementation  of T SystemEV has allowed them to save $1.5 million in one year though improved documentation and increased efficiency.
• Children’s Hospital Boston plans to implement iMDsoft’s MetaVision Anesthesia Management System.
• Gillette Children’s Specialty Healthcare (MN) selects Carefx and Indigo Indentityware’s solution for secure identity management and context workflow. In addition, West Hertfordshire Hospitals NHS Trust picks Fusionfx to provide an aggregate view of patient information within a single portal.

E-mail Inga.

From the mHealth Summit 11/8/10

Washington, DC is pretty nice this week given that (a) it was a bit chilly and windy on Sunday but nicer today, and (b) it’s getting dark really early now with the time change (that’s not just Washington’s problem, but since I was here on the day of the time change, I’m blaming them). I like the city, to be honest, even though I loathe the politicians, lobbyists, lawyers, and federal contractors that crawl all over it.

I’m staying in the Grand Hyatt Washington, which hurts a bit less now that I’ve seen it than when I first saw that I would be paying $181 per night out of my pocket. It’s a really nice hotel, two blocks from the White House in Penn Quarter, just down from the main entrance to Chinatown and Verizon Center. It’s also close to lots of funky restaurants, which is a plus. Even the $30 per day self-park fee didn’t seem so bad once I saw what parking cost at the nearby open surface lots. It’s just a couple of blocks from the convention center, an easy walk across a parking lot and up one street.

A friend met me here Sunday, so we took a nice stroll by the White House and down the mall to the Capitol. I took her to Clyde’s of Gallery Place just down the street from the hotel for dinner, which is was what I modestly expected, but with low happy hour prices and a clubby atmosphere that made it quite nice — the $6 empanadas and mussels were good, the $2 PBRs were cold, and the pumpkin bread pudding was pleasantly fall-ish. If you’re looking for someplace cheap and unchallenging near the Convention Center, it’s a safe walk and it feels nicer than the prices would suggest.

About the conference: it’s rather the anti-HIMSS, which I’ll explain as follows. Suppose you really like Las Vegas, with the noise, the glitz, the fakery, the conniving thieves at every turn, and the general sense that lots of people there are expending their pent-up immorality a safe distance from home where nobody knows them. That’s HIMSS.

mHealth Summit has 2,400 attendees (less than a tenth of the HIMSS crowd), most of whom seem to be academics, global health people, federal workers, and people from other countries that are way ahead of us in mHealth (and that’s quite a lot of countries). Vendor presence is minimal. Many of the attendees are young and idealistic, trying to solve big world problems (hunger, infectious disease, etc.) instead of landing their dream job working for a vendor and walking around self-importantly with smart phone in one hand and a mirror in the other. It is, therefore, quite un-HIMSS like – serious people getting serious education mostly working for noble causes underwritten by government money.

Here’s the interesting part: as non-commercial as it is, you might not like it. I felt way out of my comfort zone not seeing the same faces, the neon sprawl of the exhibit hall, and the presenters claiming they had finally reached healthcare Nirvana just by implementing version 26.2 of some vendor’s 1980s clinical system. I recalled that old National Lampoon story about two guys who found an alternate universe version of Las Vegas where the slots paid out freely and the hookers and drunks were absent, but all they could think of was going back to the real, gritty, sleazy Vegas. That’s how I felt today – I kind of missed the debauchery and shallowness.

Logistically, everything was mostly very well done. This was a long day, with the first session starting at 9:30 a.m. and the last one ending at 6:30 p.m. (without those big scheduling blocks that HIMSS leaves open to force you to the exhibit hall – you had to really dig to even tell when the exhibit hall was open). Lunch was scheduled for an hour, but somehow the planners slipped big-time in offering  what was optimistically described as, “Lunch On your Own, concessions stands will be available.” Make that “stand” in the singular: 2,400 attendees were cut loose simultaneously from the one and only keynote, only to find ONE single-line concession stand from which to buy $9 salads and $7 sandwiches. It looked like starving refugees threatening to overwhelm a UN aid truck, to use a global analogy. The line was huge, even at the end of the scheduled hour, and people were still trying to get food well into the next session. The convention center had several signs indicating that food was available elsewhere, but I looked all over the building and there was none. Somebody really goofed. I could have quit my hospital job if I’d had a hot dog cart on the sidewalk just below the window where the line ran.

It was clear from the beginning that this conference was thinking bigger than HIMSS, which fixates on vendors and in-hospital productivity applications to the exclusion of population health. I sketched this on my agenda:

US hospitals < acute care services delivery < US healthcare system < US population health < global population health

HIMSS is mostly in the leftmost category and entirely in the first two (inside the walls of providers almost entirely because that’s the vendors that pay them richly). mHealth Summit is mostly in the rightmost category and entirely in the last two. If you don’t like hearing about charity-funded SMS messaging projects in Kenya and Tanzania presented by volunteers, you should probably stick with HIMSS.

The 2,400 attendees hail from 48 countries. There are 125 exhibitors, a couple of hundred press people, and a ton of poster presentations. The big sessions are in the ballroom, which was nice because it has tables in the round (a place for your laptop, in other words) and free (slow) WiFi.

This site has a lot of information about various mHealth projects. Also mentioned was this site, which will have a cool summer internship program up soon. I jotted down the Web address of this Hopkins-led global health program and this interesting health information project from the Bloomberg School of Public Health at Hopkins.

I liked this quote: “Global is not the opposite of domestic.”

HHS CTO Todd Park was one of the early keynotes. He was pretty good, although he went a little bit too fast for me to be able to follow him. He mentioned that over 100,000 expectant mothers have signed up for the Text4Baby service. He says HHS will be launching similar SMS messaging services for obesity and childhood health. He also said that the HHS-led change in reimbursement will make mHealth a viable business (a feeling not shared by any of the speakers I heard, but I digress).

The next session was a panel, with a couple of speakers standing out. A doc from India said mHealth is important because there’s no way they’ll ever have enough doctors to deliver the care that’s needed. They also don’t have enough broadband penetration, but they do have 675 million cell phones. Allen Hightower from the CDC gave a lot of information, but it sounded to me like they’re doing nothing more than collecting survey information in the field with smart phones. He seemed to bristle a little when the moderator summarized his talk in that way, but that’s what it sounded like to me.

David Gustafson from University of Wisconsin got spontaneous applause a couple of times for saying that mHealth is not ready to scale up because nobody knows what patients and families need and want, the available information is often conflicting and of unverified reliability, and the smart phone form factor has significant limits for many people (small screen and keyboard.) He said research is taking too long and needs to reach the field faster. He expressed his believe that mHealth should be regulated as a medical device (that part didn’t get him any applause – everybody else thinks it’s the Wild West, but will settle down on its own without getting the regulators involved).

Nearly every session addressed the mHealth business model, or rather the lack of one. You get the feeling that maybe it’s not really going to fly given these common speaker opinions that I wrote down:

• Nobody has any idea whether mHealth really affects outcomes because it hasn’t been formally studied.
• There is no business model for mHealth. Companies and programs are almost entirely funded by grant money or by governments that are in the healthcare delivery business.
• Most mHealth applications are interesting and cute, but they don’t fit into the workflow of clinicians or the lifestyle of people. If your app requires going to some dedicated Web site to see or input information, nobody’s going to use it (they didn’t mention PHRs, but all the arguments seemed applicable).
• Doctors either don’t know about mHealth apps or don’t recommend them because they might affect their incomes.
• The only commercially successful mHealth application is Nike Plus, which has two million users who share exercise data via social networking and apparently buy a crapload of Nike stuff.
• One speaker said the conference will be obsolete within three years because broadband will be ubiquitous and SMS messaging apps will be ancient history.

We’ll hear from Bill Gates tomorrow, but one speaker quoted Bill’s take on mHealth, which you might expect to be gung ho since he’s both a technology guy and a world health leader. He’s not fooled into thinking that sending SMS pill reminder messages will change the world, however. “Bathroom scales have been around a long time, but we still have obesity.” In other words, technology doesn’t automatically change behaviors, and it’s behaviors that are often the problem (people don’t take their medicines, don’t stop risky behaviors, and ignore advice). 

I jotted down a couple of interesting items. One researcher said there’s precious little research data on chronic disease management since it takes place in the home. She’s thinking that data sent in via mHealth apps in those homes could be very useful in looking at disease management. Also mentioned was that some countries (not ours, of course) are building a cloud-based PACS image sharing backbone for smart phones to avoid the cost of having each provider buying their own. And a third, which wasn’t surprising: most of the mHealth innovation isn’t happening in the US, but rather in China, India, and Africa (if you’re uncomfortable when anyone suggests that the US is not the world’s admired and envied leader in everything, that’s another reason to not attend this conference – the folks here are a bit more globally objective).

Probably the best speakers were Denis Gilhooly from Digital He@lth Initiative and Joseph Smith of West Wireless Health Institute. They both had short presentations in a panel discussion, but I thought they were objective and authoritative.

I wish the conference used the technology that Inga talked about from MGMA where you texted your questions to the speakers instead of hogging the aisle microphone. The conference allowed long Q&A sessions and as happens every damn time, eager beavers darned near sprinted to the microphones, droning on and on from their written notes, clearly in love with the sound of their voices that were wasting the time of a huge roomful of eye-rolling attendees who wondered if indeed there was a question somewhere in their long monologue (and for a couple, there clearly was not). Starting with the third session, I just started walking out as soon as Q&A was announced, which was for the safety of the microphone droners because I wanted to body-slam them Terry Tate, Office Linebacker-style.

The exhibit hall was low key, mostly non-profits it seemed, with a few vendors. The oddest was a lady in a rather lurid booth selling herbal products, boasting of such medicinal miracles as “Virgin – Again,” herbal Viagra, and “Cleavage Enhancer.” Either she showed up at the wrong event or she has insight into the particular needs of people who attend mHealth events. I can’t quite see strolling up among peers and casually asking for those products, which may have been a shared opinion since people were steering a wide berth around her booth as though there had been a chemo spill. The evening reception was in the exhibit hall, so maybe she’ll get some takers after the drinks have flowed for awhile.

So my takeaway is this: mHealth is not and probably never will be profitable. Insurance companies may pay a little something here and there for some simple apps that might save them a few dollars, but the bottom line is that even if mHealth apps improve health outcomes (which seems debatable), the funding model just isn’t there to turn it into a business. For that reason, it makes sense that the conference attendees are mostly global health people, who I admire (and would admire more if they would do more work in this unhealthy country instead of focusing only on everybody else’s). mHealth, like global health, is a worthy cause that makes a poor business for most of the people in it, who largely self-selected that calling without worrying about cashing in anyway. Kudos to them.

Tomorrow is Ted Turner, Bill Gates, and another long day of sessions. I’m leaving Wednesday morning, so that will be my last report from here.

The ConJoin Group Acquires PHNS for $250 Million

The ConJoin Group, an IT and business services company, acquires HIT services firm PHNS for $250 million. Private equity firm Actis backed the investment.

The new entity will keep the PHNS name.

Monday Morning Update 11/8/10

From Wireless Observer: “Re: Sprint-sponsored article in one of the rags called The Future of Wireless in Healthcare. I find it interesting that it didn’t mention WiFi in hospitals and clinics, but of course the telecom-centric view is that ‘wireless’ only means 3G/4G/broadband. Most wireless data in healthcare is transmitted over WiFi networks. I have been hearing for years (mainly from the telecom side) that WiFi will collapse under its own weight due to capacity limitations, leaving 3G/4G in buildings to step in and save the day. That hasn’t happened and never will, at least if the likes of Cisco has any say. There is no doubt that more data requirements are driven by mobile devices and 3G/4G will be the primary means of transmitting it. But how can you ignore WiFi completely when talking about the future of wireless in healthcare?”

From The PACS Designer: “Re: Microsoft Office 365 Beta. Last month marked the official launch of the beta for Microsoft’s online Office 365 feature set for business enterprises. The Office 365 application is cloud based and focuses on giving users a complete package of business functions to improve office efficiencies for clients through the use of cloud resources.”  

From Chump Change: “Re: Microsoft. CEO Steve Ballmer sold $1.3 billion in stock last week and plans to sell another $700 million in the next few weeks.” I’ll bring that up with Bill Gates when I have lunch with him Tuesday (along with everyone else at the mHealth Summit).

The Missouri HITREC announces its 10 preferred EHR vendors, with Cerner missing the cut. Make that 12 with Cerner among them: the organization reconsiders (probably with encouragement) and adds Cerner and Pulse to the list strictly because they are local vendors. That’s what everybody was worried about with the HITRECs: they can pick whomever they want for whatever reason. Unless those two local companies just happened to be #11 and #12 on their original ranking sheet, that means providers don’t get to hear about higher-scoring systems. I don’t know that being local makes a vendor a better choice. I doubt Neal will drop by on his way to work to make sure everything’s working OK.

News 11/5/10

From Elihu Smails: “Re: Citrix. I believe it’s responsible for many of our industry’s technology issues. Without their stepping in and serving up virtual sessions for EMR systems collapsing under their own client-server weight in the late 90s and early 2000s, the industry would have been forced to move to the Web and to modular platforms. I have nothing against their making lots of money, but for the sake of our industry, I wish they hadn’t saved the butts of the EMR vendors.” I couldn’t agree more. Citrix has customer advantages (security, low end user device requirements, central app management, remote capabilities, low bandwidth) but it did indeed let lazy vendors keep selling apps that were already long in the tooth and technologically overripe. Those systems work, but for dozens or hundreds of millions of dollars, you might expect a little more vendor capital investment. I always say that implementing Citrix is like eating at Denny’s: something nobody intentionally plans to do or is particularly thrilled about.

From DemoChic: “Re: social media policy. Not sure if other vendors have them, but here is NextGen’s, posted as it encourages users to post on Twitter and Facebook from their user group meeting.” The policy seems reasonable, asking that participants identify themselves, refrain from posting proprietary or defamatory information, and not contact other social media users through other means. Companies that don’t have such a policy can get some … ahem … ideas there. The meeting starts Sunday in Orlando.

From HIStalk Evangelist: “Re: my RN friend’s review of your site. She said this, which I found adorable: ‘Thank you for the HIStalk website … it’s very informative in a non-sterile manner.” Both the comment and the evangelism are cool – thanks.

From HIT in the Fog: “Re: Epic project at UCSF. We have had two people leave our 75-person team and the project is on schedule, under budget, and within scope. I’m not sure where the rumor to the contrary comes from, but it’s inaccurate.” Thanks.

It’s amazing how many fun people Inga and I get to meet by various electronic modalities. If you want to connect with us (other than via plan old e-mail, but we like that a lot too), my LinkedIn profile is here (flattering pic, don’t you think?) and Inga’s is here (hot legs!) The HIStalk Fan Club that Dann started is up to 1,177 members, so thanks for that – how many people can tell their moms they have a fan club? As a Round-Number Milestone Fixated American, I also notice that the HIStalk e-mail blast list has hit an even 6,400 verified subscribers. We’re on Facebook, of course, so feel free to Friend us or to Like HIStalk if you want to turn our frowns upside down.

Listening: The Greenhornes, a Cincinnati-based garage band whose members made up much of The Raconteurs. I like the sound. Their new album comes out next week.

The local TV station covers the Epic implementation at New Hanover Regional Medical Center (NC). It says the project will cost $56 million and generate $13.7 million in HITECH money.

A Catholic newspaper talks up the $450 million Epic system in place at the 28-hospital Sisters of Mercy Health System (AR). The corporate web site features MyMercy (their name for it) prominently.

Children’s Boston chooses the MetaVision anesthesia management system from iMDsoft.

CIO salaries: Packard Children’s Hospital at Stanford (CA), $700K. Medstar Health (MD), $642K. Saint Barnabas Health Care (NJ), $538K.

Jobs on the Sponsor Job Page: HIE Team Lead, Director Strategic Marketing Initiatives, Allscripts Consultants. On Healthcare IT Jobs: Cerner FirstNet Analyst, Electronic Clinical Applications Manager, Meditech Advanced Clinicals Consultant.

I doubt anyone cares much about Misys PLC these days (let’s face it, they added no value to the HIT companies they bought and sold), but just in case you do, the IRS rules that its sale of most of its Allscripts shares carries no tax liability. Shareholders will get their billion dollars.

Of all the things Weird News Andy could have observed about this story involving the use of mannequins to train nurses, he zooms in on the fact that the dummy’s hair looks like that of Rod Blagojevich.

Thanks to brand new HIStalk Platinum Sponsor Carefx. You may think of them as offering single sign-on, provisioning, and an enterprise master patient index. They do, but as the informercial guys say, “But wait – there’s more!” The Scottsdale, AZ company offers several products that help close information and workflow gaps among users of existing systems: BI dashboards, an eReferral portal, and the SOA-powered Fusionfx collaboration and patient information aggregation platform (a scalable community portal providing real-time queries to existing systems). You may remember that the company got an exclusive license from Cleveland Clinic this past May to market its dashboards covering core measures, mortality, physician scorecards, throughput, and patient experience. Inga and I thank Carefx for supporting HIStalk.

Steven Nickerson, formerly of Philips and McKesson, joins The Beryl Companies as VP of sales. The company offers a variety of services related to patient engagement and follow-up.

Ottawa Hospital engages the startup of three recent college grads and former game developers to develop physician iPad apps for patient information and lab results.

ONC wants input on consumer use of HIT and electronic health information to manage their health. Comments can be left (and read, surprisingly) on the Health IT Buzz blog entry called Strategy for Empowering Consumers.

Strange: a New York woman, upset over her father’s death due to heart failure, tries to hire a hit man to kill the two doctors and two nurses she says were involved. She is arrested by an undercover FBI agent posing as a would-be murderer after taking her $400 down payment. Not surprisingly, she’s having a psych evaluation.

I’ll be heading off to the mHealth conference in Washington, DC this weekend, weighing whether I’d rather pay $10 a day to use the hotel’s fitness center (Treadmill Timeshare) or turn blue for free while taking a chilly 4-mile jog around the National Mall, but at least getting to see cool sights while my nose hairs freeze. If you’re going, maybe I’ll see you there. If not, I’ll be posting from the conference each day.

E-mail me.

HERtalk by Inga

From Za: “Re: ARRA. Will ARRA be pushed back or repealed because vendors and thus providers will likely be unable to meet the required timelines? My guess Is Horizon Clinicals is a victim of ARRA and I suspect there will be others. The bulk of vendors are struggling with rewrites. ARRA upgrades will need to be implemented and there aren’t enough resources to get everyone up in the timetable.”  I would be shocked if the dates were pushed. Repeal flat out won’t happen. Then again, healthcare always seems to find  millions to spare when it comes to lobbying, so you never know. Based on the ONC-ACTB certification announcements to date, most of the ambulatory vendors seem to have their products ready to go, and in theory, the RECs will shoulder some of the implementation load for primary care providers. I’d say at this point that community hospitals are the ones most at risk of missing ARRA deadlines.

Speaking of community hospitals, KLAS finds that community hospitals with fewer than 150 beds are giving more consideration to the larger vendors than traditional community clinical IS vendors. Meditech remains the most-considered vendor for community hospitals, but providers are also taking more interest in Cerner’s hosted offering and McKesson’s Paragon, and to a lesser extent Epic.  KLAS does not mention this (probably because the report had been in the works for awhile) but I don’t see any of the “traditional” community hospital solutions (CPSI, Healthland, HMS, Keane, and Siemens MedSeries4) on HHS’s list of  ONC-ATCB certified products.

AT&T announces a new practice area called AT&T ForHealth, established to accelerate delivery of wireless and advanced networking services in healthcare. As I understand it, the ForHealth area includes an mHealth group handling HIE connectivity, disease management, and telehealth initiatives; a healthcare mobility team; and, a healthcare marketing group.

The VA awards QuadraMed a five-year, $211 million contract to implement its Quantim Coding, Compliance, and Abstracting solution for ICD-10 coding and compliance. The VA will also add QuadraMed’s Physician Query Tracking and Central Reporting tools, as well as rely on QuadraMed for implementation, technical training, and support services. The VA has been using Quantim since 2005.

Former Allscripts, Misys, and Eclipsys VP Mike Etue joins Ingenix as SVP of provider sales.

Fort Worth, Texas-based HIE SandlotConnect says its exchange contains over 1.5 million patient records and connects more than 1,500 providers.

Boston-based Shareable Ink says it’s relocating to Nashville after securing $4.5 million in Series A funding from Tennessee investors. In case you missed it, T-System CEO Sunny Sunyal talks a bit about his company’s partnership with Shareable Ink in this interview posted yesterday.

Fairview Northland Medical Center and Fairview Lakes Medical Center (MN) go live on Epic.

A former UCSF Medical Center employee is sentenced to a year in prison for using the social security numbers of co-workers to complete online health surveys. Cam Giang received a $100 voucher to Amazon for each of the 382 online surveys he completed. Bet the shopping was good while it lasted.

The Alliance of Chicago picks Ignis Systems’ EMR-Link to provide EMR-to-lab connectivity for its 25-member community health centers.

When its merger with MaineHealth is finalized next month, Pen Bay Healthcare (ME) will receive $3 million and an Epic EMR system.

Medical imaging management provider DICOM Grid secures $7.5 million in Series A financing. The investment will accelerate DICOM’s market expansion and product development.

In case you are still not catching all the hot news featured on HIStalk Practice, here are some of this week’s highlights: (a) workflow analysis, HIT integration, and specialty specific solutions contribute to quality and safety improvements in the outpatient setting; (b) why findings from a recent CompTIA study sound pretty weak; (c) a one-on-one chat with President Obama, who shares his opinions on the significance of IT in healthcare. OK, I made that last one up, but you never know what compelling news you might be missing if you aren’t tuning in.

Sponsor Updates

• NextGen partners with InstaMed to offer providers InstaMed’s merchant processing services, including patient collections and automated posting into the NextGen PM system. NextGen also announces its NextGen Inpatient Clinicals version 2.4  has earned CCHIT 2011 Inpatient EHR premarket certification. Certification under the ONC-ACTB program is pending.
• MidSouth eHealth Alliance (TN) extends its CareAlign system contract with Informatics Corporation of America to include the Middle Tennesse eHealth Connect HIE.
• MEDecision presents its concept for advancing technologies that support patient-centered medical homes in a just published e-book, The Patient-Centered Medical Home: The Cornerstone of Healthcare Transformation. Download here.
• FormFast announces a November 11 webinar featuring Barry Runyon of Gartner entitled World class doctors, world class treatment, broken workflow processes.
• 21st Century Oncology (FL) chooses the Sage Intergy for its 90 radiation therapy centers in 16 states, noting its strengths in handling complex, multi-facility billing.
• The OB department of Good Shepherd Medical Center (OR) selects the Access Universal Document Portal to electronically transfer perinatal documents from GE Centricity into Meditech’s Scanning and Archiving system.
• Picis introduces LYNX I/Point, a new charge capture solution for hospital-owned infusion and oncology treatment centers.
• United Hospital System (WI) activates multiple clinical components of  Sunrise Enterprise solutions from Allscripts, including CPOE, pharmacy, and ED. At both Kenosha Medical Center and St. Catherine’s Medical Center, 100% of ED physicians were entering orders electronically on Day 1.  In its next phase, United will deploy the Allscripts ambulatory EHR for its employed physicians.
• Methodist Children’s Hospital (TX) says it saved $1.5 million in one year after implementing T SystemEV in the ED, which allowed it to speed up discharges and transfers, reduce paper chart management time, and improve infusion documentation for charging.

I noticed that I have almost 1,000 followers on Twitter, which I find a bit amusing and somewhat surreal. Mr. H has a few hundred more followers than me, though I have a few hundred more tweets. Quality tweets over quantity?

E-mail Inga.

News 11/3/10

From Biometric Man: “Re: palm vein scan technology. It’s 100 times more accurate as a fingerprint and nearly impossible to hack. The scanner converts the subcutaneous vein pattern into thousands of zeroes and ones, all encrypted and behind the firewall. It’s then encrypted again to AES 128 bit. It’s useless for crime investigation since you can’t leave your vein pattern at a crime scene. Scanning helps prevent medical records overlays and merging, identify theft, lack of ID for unconscious patients, slow registration processes, and having someone overhear the patient’s Social Security Number or other private information when the clerk asks. UW Health has put up a patient guide to the technology, complete with video.”

From NoMoreCoffee: “Re: nancydoll’s rumor of GE Healthcare’s enterprise solution leader. Yes, absolutely true. A few other changes at that level, but no layoffs yet of technical people.”

From Duuude: “Re: Seattle Children’s. This is a good synopsis of what’s going on after the two medication error deaths.” I’ve been through the common post-error reactions of awareness meetings, mandatory training, and process redesign (usually of the quick-and-dirty variety) at my own hospitals. Unfortunately, (a) it happens only after someone dies from a mistake, and (b) going gung-ho after one kind of problem usually means it’s just a different one that harms the next patient. Technology is not usually to blame other than it fails to address the main issue: the lack of information at the place and time it’s needed. I can never figure out why hospitals don’t put up a portal for nurses, aides, and technicians that contains how-to videos, audio instructions, and links to resources. Lots of money is spent on technology to enter and deliver orders, but not much on actually executing those orders correctly. The processes that cause patient harm are usually on the sharp end of the stick: preparing drug doses, marking a surgical site, setting the correct radiation dose, or reacting to the patient monitors. I say this all the time but it’s good for the newbies to understand: HIT’s benefit isn’t how many errors it prevents, but rather how much harm it prevents. There’s a big difference. It’s not much consolation to prevent 90% of errors by number only to find that the incidence of patient harm hasn’t changed much because they stayed in the 10% (see: CPOE). If you implement a lot of technology without changing your outcomes, then you haven’t accomplished much (see: Most Wired).

From Remington: “Re: UCSF. Looks like the GE collapse wasn’t entirely their fault. The Epic team there is already hemorrhaging members due to a combination of inept UCSF employees and absurd out-of-scope demands.” Unverified. Epic usually controls those issues well. 

I got the new iPod Touch, courtesy of Mrs. HIStalk, who knows that the way to this particular man’s heart is through his USB cable. Other than its crappy low-res camera, it’s amazing in every way: impossibly slim and light, FaceTime video calling, HD video recording, the super-fine Retina display, multitasking under the iPhone OS, great WiFi performance, long battery life, tons of apps (SMS messaging, Kindle reader, price comparison by barcode scan, etc.) I was telling Inga all the cool stuff I was doing with it when I realized there was one obvious omission considering that most people think of the iPod as a music player: I had yet to load or play even one MP3 (which is still the case since I’m streaming Pandora from it instead). Not many things can change your life for $219 and no recurring expense, but this is one of them. I’m taking it everywhere, maybe even to bed.

Anvita Health announces its patented application that creates personalized drug regimens using EMR data, comparative effectiveness, and the drug formulary.

If you haven’t made your HIMSS hotel reservations, better get on it. The HIMSS reservation system has good rates, which has been the case for the last 3-4 years (they were definitely not competitive before then). They guarantee the lowest price, which means nothing — you do your own legwork to find out you paid too much, take time to tell them about it, then they get to match the price they didn’t originally offer. I wanted a cheap place not far away and found a hotel I liked, but it was sold out on the HIMSS site. Not on the hotel’s own site, though – in fact, I got a AAA discount that made the price less than what HIMSS was quoting. If you want to be cheap like me (I’m at around $80 per night), you could also Priceline a room and maybe save money. I’ve done that – you can often take a taxi to/from each day and still save money, especially in Orlando where hotels are dirt cheap (and sometimes just plain dirty, so choose at least three stars on Priceline).

Speaking of HIMSS, it will be time to gear up here soon: the HISsies nominations and voting, preparations for our first-ever HIStalk sponsor lunch, and of course details on the big HIStalk bash on Monday night. I think we’ll have some new sponsors coming on board in time to ride that wave if history is a good indication, so thanks to the current sponsors who predated them in supporting Inga and me.

Listening: Horace Pinker, highly melodic, energetic, and smart pop-punk from Chicago. It’s a head-bobber for sure. I heard it on the iPod on HIStalk Radio, the Pandora station that adjusts the playlist as I give tunes thumbs up/down as they play. Others I liked: Metric, Arctic Monkeys, Death Cab for Cutie, and The Strokes.

Fujitsu releases the HOPE/EGMAIN-RX EMR for practices in Japan. It will cost around $25,000.

Michael Donner, former SVP/chief marketing officer of Eclipsys, is named VP of marketing at Tech Data.

Tech firms in India are calling the HIT spending “another Y2K opportunity,” but the Wall Street Journal observes that hospitals aren’t big on sending work offshore, most of the work isn’t the commodity programming work that usually gets sent overseas, and hospitals worry about privacy. It also notes that Indian companies are establishing offices here and offering to do work from either country, with lower prices for choosing offshore. 

Industry longtimer Kerry de Vallette is named sales SVP of revenue cycle vendor SPi Healthcare.

Board members at Regional Medical Center (SC) argue over the $2 million needed to finish its Cerner implementation, with one trustee expressing surprise that the project doesn’t already meet Meaningful Use requirements that would allow the hospital to get $5 million in HITECH money. The CIO explained that the project was started in 2008 before the requirements were defined.

CapSite releases its revenue cycle management study. From the copy they sent me, it appears that hospitals are keeping their core patient accounting systems, but planning to add RCM components from other vendors and are budgeting money accordingly. Most interesting: of the top four strategic priorities for hospitals, two of them involve RCM.

The San Francisco Department of Health chooses eClinicalWorks for its 800 physicians.

Regional Medical Center at Memphis (TN) approves a $20 million capital budget for FY2011, with $6.3 million of that going toward its $21 million EMR project. That’s twice the amount the 418-bed hospital is budgeting for building maintenance. It’s the home of the Elvis Presley Memorial Trauma Center, which sounds strange to me.

Cerner will offer remote hosting in the UK in an agreement with Equinix.

Thomson Reuters launches Pharmacy Xpert, a clinical dashboard that uses real-time clinical surveillance information, patient information, and Micromedex content to help hospital pharmacists manage medication therapy. Pre-built profiles include monitoring of antimicrobials, anticoagulants, and hypoglycemic drugs, as well as IV-to-PO conversion and managing drugs with a narrow therapeutic index.

Cleveland Clinic’s eighth Medical Innovation Summit (to be more precise, it’s run by their Corporate Venturing Arm) started Monday afternoon and runs through Wednesday. Wednesday’s session on HIT includes David Brailer (Health Evolution Partners), Craig Feied (Microsoft), Martin Harris (Cleveland Clinic), Martin-J Sepulveda (IBM), and Vishal Wanchoo (GE Healthcare). If you like reading tweets more than I do, they’re here. 

Several doctors in Australia are disciplined for ordering excessive lab tests, with one ordering 6,000 pathology tests for 771 patients. The director of the Professional Services Review watchdog that found the problem blames computers that make it too easy to order banks of tests without thinking.

The Hartford business paper profiles ProHealth, Connecticut’s largest physician group, and its $14 million technology investment. They see HIT as a key to success under healthcare reform, allowing providers to improve coordination, reduce duplicate work, and use outcome information to develop new programs.

The just-ended TEDMED conference in San Diego had some big-name speakers, among them Sanjay Gupta, David Blaine, Ozzy Osbourne, Tony Robbins, and Deepak Choprah. Among the attendees were Steve Wozniak, Martha Stewart, and Quincy Jones.

E-mail me.

HERtalk by Inga

From Snoopy: “Re: my naivete. I have a confession. As a daily reader, I find it intriguing that your commentary, cadence, and wit are so closely tied to Mr. HIStalk’s. I’ve read Mr. HIStalk say that you are a real person with a custom cartoon-ized representation on these pages. Now for the naivete. How is it that you can circulate around conferences, interview executives, and still remain on the DL? Regardless, it’s a valuable contribution you and Mr. HIStalk (if you’re truly not the same peeps) make to the industry and having the ‘Practice’ part of HIStalk was a great and welcome addition that provides value to all who visit.”  I can assure you that I am real and not a pathetic attempt by Mr. H to be in touch with his feminine side. I take it as a supreme compliment that my wit is comparable to Mr. H’s and appreciate the kind words about HIStalk Practice. Perhaps Mr. H and I have a similar cadence, but he wins the commentary award hands down. As for staying on the DL at conferences, I leave the fun shoes at home.

Eastern Maine Medical Center installs Dialog Medical’s iMedConsent application, which will interface to Millennium.

The Methodist Hospital (TX) and Dell Services launch a program to deploy NextGen EHR and PM at five hospitals in the Methodist system. Dell will provide hosting, training, and software support for the 289 physicians and staff that are part of the Methodist Hospital Physician Organization. Earlier this year, Methodist announced it would subsidized the purchase of NextGen for its affiliated physicians. 

The Nuance Healthcare folks sent over this video that highlights the use of Dragon Medical. Apparently they shared it at a recent sales meeting and the crowd was howling.

Mediware Information Systems reports Q1 results: revenues of $12.5 million and net income of $1.1 million. That’s a 17% increase in revenues and 70% jump in income from last year.

TomoTherapy’s Hi-Art is the top-rated radiosurgery/radiation therapy product in KLAS’s new report on the radiation delivery market. Varian Clinac iX was the highest ranked oncology solution.

Holy Cross Hospital (NM) selects athenaClinicals and athenaCollector for its owned physician group of 40 providers. Holy Cross will also offer athenahealth’s services to affiliated community physicians.

Huron Consulting Group acquires Click Commerce, a provider of software solutions and professional services for academic medical centers and research institutions. Click Commerce president Nick Stier, COO Gary Raetz, and sales and marketing VP Gary Whitney will serve as a Huron managing directors. Terms were not disclosed.

Sponsor Updates

• Culbert Healthcare Solutions is now an Epic-certified consulting firm.
• SRS is listed again on the Inc 5000 List of Fastest Growing Private Companies.
• ACT Medical Group (NC) chooses NextGen’s PM/EHR for its 70 clinicians and 400 locations, including a telehealth service in which clinicians will work offline and sync data later.
• The Medical Society of Delaware signs with RelayHealth as a solution partner. The society will support technologies that connect patients to doctors, including sharing lab results via secure messaging and personal health records.
• NorthBay Healthcare (CA) picks Keane Patcom for its enterprise-wide revenue cycle management solution.

E-mail Inga.

From the eClinicalWorks User Meeting in Orlando
By eCW Superuser

I arrived here on Saturday morning and got registered and checked-in easily. The pre-conference was, to my surprise, packed.

The Saturday evening reception in the exhibit hall was well attended. I was impressed by the size of the hall and the number of vendors exhibiting at the conference.

The keynote hall was massive and full, with 3,000+ attended the keynote (500 walk-ins included). It began with John Halamka discussing Meaningful Use and telling the crowd how to meet MU objectives. He was very complimentary of eCW referred to them as a moral company because, in his own experience, they cared more about their clients.

Girish presented  the company overview and 2010 accomplishments. Sam Bhat ( co-founder) and Girish did an hour-long live product showcase of V9 with EBO 5 (real software, noy PowerPoint). Version 9.0 is not just an incremental step, but a whole new ball game. It incorporates modules for patient communication, interoperability, and mobile and text messaging into the EHR with On-Demand Activation (similar to apps for the iPhone or iPad). There’s a fancy patient portal called 100Millionpatients.com. With eCW P2P, you can send your referrals and charts from eCW to other providers even if they don’t use eCW (similar to NHIN Direct).

The fall festival happy was simply awesome. It was very family-friendly, yet the live band kept everyone hopping . I saw kids at 11 p.m.dancing. The Halloween costumes with face paintings and make-your-own crazy hat booth were fun.

Here are some other highlights:

• Customer Panels (primary care, Speciality care, eRX, Portal, interoperability for community records) were very informative.
• eCW employees are enthusiastic about their success and were very helpful at the conference.
• Sessions were well attended.
• eCW has a very excited customer base.
• Community record technology called eHX is being widely used by hospital clients

McKesson To Buy US Oncology for $2.16 Billion

McKesson announced this morning that it will buy US Oncology in a deal valued at $2.16 billion, including debt, from its private equity owners. The transaction is expected to close by December 31.

McKesson says the acquisition will have a modestly positive impact on its earnings starting in FY2012.

US Oncology, based in The Woodlands, TX, has annual revenue of around $3.5 billion and has relationships with 1,300 community-based oncologists. Its technology offerings include the iKnowMed oncology EHR, a physician collaboration portal, and clinical trials matching.

McKesson chairman and CEO John Hammergren said this about the acquisition:

McKesson is committed to improving the health and vitality of our customers, with the ultimate goal of improving the health of patients. The combination of US Oncology and McKesson will enhance our ability to achieve these goals in one of the most important segments in healthcare. Community oncology practices need strategic support that offers not only technology and distribution solutions, but also value-added clinical and reimbursement management services that enable them to provide the highest-quality, most efficient care to their patients. With this acquisition, McKesson will offer a compelling suite of services and solutions to community oncologists and other partners in the rapidly evolving specialty business.

US Oncology CEO Bruce Broussard, who will stay on to run the new McKesson unit, was quoted as saying,

With the health-care marketplace moving rapidly toward reimbursement based on quality and cost-effectiveness, our physician customers need access to deep clinical, operational and information technology capabilities to create integrated networks that continually enhance the quality of care in a cost-efficient manner. In joining McKesson, we are building the scale and expertise necessary to empower our customer base to shape the future of health care.

Monday Morning Update 11/1/10

From California Dreaming: “Re: privacy statement on Amazing Charts Web site. Funny stuff!” It is funny. “ … USE COMMON SENSE WHEN USING THIS SITE AND THE AMAZING CHARTS SOFTWARE, AS WE ARE NOT RESPONSIBLE FOR YOUR LIFE AND DECISIONS … USE COMMON SENSE WHEN GETTING INFORMATION FROM THE INTERNET, SOFTWARE, LIBRARY, ENCYCLOPEDIA, DOCTORS, OR ANYBODY ELSE. WEAR SUNSCREEN, USE SEATBELTS & CONDOMS WHEN APPROPRIATE, AND PROTECT YOUR EYES WHEN USING POWER TOOLS.”

From Ex-Concerro!: “Re: layoffs. Concerro laid off all but one of its QA department and demoted the VP of engineering. They have been unable to stabilize the product since 5.0, which was an attempt to turn a shift-bidding product into a scheduling product.” Unverified.

From Personal Problem: “Re: palm biometrics for patient ID. I would refuse to use it since those can be intercepted or hacked. Then what — get a new palm?”

From Nancydoll: “Re: GE Healthcare IT Enterprise Solutions. Laurent Rotival ousted – there on Monday, gone on Tuesday.” Unverified. GE doesn’t comment on personnel issues. His LinkedIn profile is unchanged.

From Aldonza: “Re: PKI security. Have solo practitioners or small groups tried it? Some technologists say its simple to implement, others are skeptical.” Your comments are welcome.

The Dubai government talks up HIMSS Middle East 2010, expecting 300 people at the November 8-10 conference.

A new report by HIT research and advisory firm CapSite covers the HIM market: vendor penetration, mind share, buying plans, etc. based on information gleaned from 500 hospitals. They sent over the full report for me to check out and it was interesting – hospitals are considering lots of new HIM vendors for buying opportunities of an extremely short time frame (less than a year). The table of contents is here (warning: PDF).

The eClinicalWorks user conference started Sunday in Orlando, with over 2,500 attendees.

Weird News Andy rises to the “beer bottle in the colon” challenge, saying, “I raise you some precious gems. I suppose this guy wanted to be the King of Diamonds. what a card!” Police in India arrest an airline passenger on the rumor that he is carrying diamonds. His bags were found to be empty, but he fidgeted suspiciously during questioning, claiming his hemorrhoids were acting up. The hospital X-rayed him and found 42 condoms’ worth of precious stones that he had swallowed. The diamonds were re-mined with the help of laxatives and bananas.

From the last poll, it’s an even split whether “best places to work” companies are really all that great to work for. New poll to your right: will you be participating in the upcoming HIMSS Virtual Conference?

Epic put up a fun Halloween-inspired home page for the weekend, including some bats randomly flying around (since they’re in the Midwest, that made me think of John Candy and Dan Aykroyd in The Great Outdoors, if you’ve seen that scene).

Quality Systems (NextGen) reports Q2 numbers: revenue up 14% to $81.5 million, EPS $0.46 vs. $0.41, with both revenue and earnings falling short of expectations. The Street was looking for $85.7 million and $0.49.

Meditech’s quarterly numbers: revenue up 23%, EPS $0.89 vs. $0.57.

CPSI’s Q3 numbers: revenue up 24%, EPS $0.45 vs. $0.37.

Memorial Healthcare System (FL) signs up for ExactCost’s Cardiovascular Service Line software, allowing it to support activity-based costing.

Chubb Group adds an insurance program for the healthcare IT industry, covering defective software that causes patient harm, liability for data breaches, and the cost of notifying consumers of a data breach.

States don’t have the expertise or money to develop the Health Insurance Exchanges, consumer insurance marketplaces that are mandatory by 2014. HHS announces Early Innovator grants that will be available to up to five states who develop systems that other states can use. HHS announces said that it will announce financial help for all states in February.

A Massachusetts court gives the OK for a private equity firm to take over Caritas Christi, Boston’s Catholic hospital system, for $895 million. Cerberus Capital Management will turn it into a for-profit entity. Closing is expected within a month. The company can cleave ties with the Catholic Church for a $25 million payment.

Microsoft’s HealthVault personal health platform will enter the Chinese market as the company signs an agreement with iSoftStone Information Technology. The announcement says that a total of 150 hospitals are connected to its platform worldwide, which seems pretty skimpy.

St. Joseph’s Hospital (CA) devotes its annual gala to raising money for its EHR, raising $160K from 600 guests who got to play around with iPads and the Microsoft Surface coffee table thingy.

West Penn Allegheny Health System (PA) will lay off 400 employees, most of them from West Penn Hospital, in a restructuring plan.

I really like this idea: a team from Norwood Hospital (MA) and its community health partners use a $200,000 grant to create a LifeBox within their EMR. Hospitalists interview patients about their backgrounds and record the wishes, values, and goals of those patients in their LifeBox so that other caregivers can understand what’s important to them. I think Norwood is one of the Caritas Christi hospitals that will soon be going for-profit.

Sponsor Updates

• Three hospitals in Sweden will implement iMDsoft’s MetaVision for their ICUs, ORs, and PACUs.
• eClinicalWorks announces its Version 9.0 and a new site, 100millionpatients.com, as a patient portal with PHR access.
• RelayHealth’s RelayClinical EHR receives ONC-ATCB certification from Drummond Group.
• Allscripts was a joint presenting sponsor of the Walk to Cure Diabetes held October 30 in Raleigh, NC.

E-mail me.

Article Review
Health information technology: fallacies and sober realities

 

A reader asked me to review this paper, which just appeared in the October issue of JAMIA.

The first thing I noticed is that it was published as a “viewpoint paper.” Rightly so: it’s a lot of footnoted opinion. The problem with opinion papers is that those who agree with their conclusions laud the work as pivotal, long-overdue, and seminal. Those with different points of view say that fancying up personal opinions in a published article, by grant-funded academics, is no more credible than watercooler chatter.

It’s a mildly interesting piece, but the only folks likely to proclaim it as a work of great insight are those who have already convinced themselves that electronic health records, the companies that sell them, and the providers use them successfully are clueless and/or evil (I should mention that the authors use the broad term health information technology, but are writing specifically about clinical information systems from what I can tell).

My red flag went up immediately with this sentence in the abstract: The twin issues of the failure of HIT adoption and of HIT efficacy stem primarily from a series of fallacies about HIT. An article that can definitively state the reason that providers don’t use EMRs or that they underperform would indeed be useful, right? Only if the statement is backed by proof, which I don’t see here.

The authors come up with a Letterman-like list of 12 "misguided beliefs about HIT.” Who holds these beliefs is not documented, but the implication is that the authors observed them in some capacity. Maybe they are right and these exact 12 misguided beliefs mean that HIT is in need of a reboot. Or, maybe they worked back from the conclusion that HIT needs a shake-up and selectively chose the ones that made their case.

Here are the 12, reworded to make the opinions of the authors clear:

IT risks are not as minor or easily manageable as IT people think.

The article says that “many designers and policymakers believe that the risks of HIT are minor and easily manageable” (without referencing how they know that). They correctly observe that it’s hard to develop and implement systems as planned, that humans are fallible, and that software problems are hard to prevent and can have widespread impact. Everybody reading that paper or this post probably already knows that.

Being an opinion piece, the authors recommend as a solution: regulation and/or independent, external validation. I agree that some degree of oversight is needed for specific types of HIT. That’s still just an opinion (that of the authors and me). I’d like to have seen citations of articles researching the outcomes of getting the government involved in product regulation.

HIT is a medical device.

This is stated as a fallacy: “the belief that HIT can be created and deployed without the same level of oversight as medical devices.” That’s not really a fallacy since that’s the current state. It’s just another way for the authors to opine that the government should start regulating clinical software.

The article makes a good (but obvious) point: humans can’t be relied on to catch computer mistakes. It doesn’t make another equally good and obvious point: computers catch a lot of human mistakes. Based on the conclusion that HIT can’t be trusted unless it’s regulated, hospitals should immediately stop using bar code scanning, CPOE, clinical decision support, etc. because they might mislead gullible but otherwise error-free clinicians.

The following unreferenced conclusion about lack of FDA oversight would have been struck out of any article not labeled as an opinion piece: “The current approach can no longer be justified.” Says who?

Humans are not the problem when software fails to improve outcomes or efficiency.

This is another obvious point. Outcomes are system-related (people, processes, oversight, etc.) Bad users acting individually aren’t usually the problem. I also don’t know anyone who would say that — is this really a common fallacy that required debunking?

Just because clinicians use a system doesn’t mean it works.

The conclusion seems to be that “meaningful use” is situational, which is absolutely true. Sometimes users don’t get a choice in the decision to use or not use a system. Still, we’re talking about highly educated and licensed professionals who still bear the responsibility to speak up if a system is unsafe.

It’s also true that the same problem happens with paper. Individual providers don’t necessarily get to decide for themselves whether to complete certain kinds of paper documentation, regardless of whether they see value in that activity.

Clinical work is messy and can’t be rationalized into something linear.

It is true that programmers think linearly and logically, so IT systems are designed that way. But it’s also true that software often organizes and standardizes, which is the only hope to improve medical care beyond individual decision-making with whatever information is at hand.

This is the “medicine is an art” argument, which has some merit. But the argument that primitive clinical decision support systems interrupt clinician workflow (true) means we need “new paradigms for effective HIT design” is a leap. I don’t really know what they mean by that. I suspect the authors don’t, either – it’s easy to say that today’s systems don’t always perfectly match the work clinicians do, but hard to say exactly what they should be doing differently. Today’s systems continue to evolve, albeit a lot more slowly than I’d like.

Rightly or wrongly, clinical practice — within the same organization, on the same medical service, and by individual practitioners — is inconsistent, situational, and often illogical. Paper couldn’t fix that problem and neither can technology. I’m all for taking shots at the HIT industry where it’s warranted. However, if the argument is being made that clinical work is admirably illogical, then turning programmers loose to somehow pave that particular cow path doesn’t seem like a great idea.

Front-line users are stuck with poorly designed and inefficient IT systems because people above them incorrectly think they will solve problems.

I’ll buy that. End users often get a few productivity aids, but are stuck with awful features otherwise. Hospital executives make decisions for employees whose work they can’t begin to understand.

I found this statement a bit of a lark even though I agree with it in a pie-in-the-sky kind of way: “Healthcare does not exist to create documentation or generate revenue, it exists to promote good health, prevent illness, and help the sick and injured.” If the authors have figured out a way to improve healthcare by eliminating documentation or working for free, then I’d like to hear it. If not, then they should not blame software for reflecting reality.

Providers drive the design and adoption of HIT by voting with their dollars. If products aren’t meeting their specifications, they presumably wouldn’t be buying them. Software reflects the way things are, not the way we wish they could be. Vendors would go broke fast trying to sell systems that don’t reflect reality.

Software designers assume that their software is perfect and any problems must be due to bad users. Computer consistency is not the same as intelligence.

I’ve worked in the industry for a long time and I’ve never heard this belief expressed. Software designers (among which are often the users themselves) know the limits of what they can envision and deliver. They expect bugs, reworking unforeseen design flaws, and improvement by iteration.

Software is designed to do things that humans are not good at: keeping lists, calculating, and reminding. There’s no doubt that sometimes user interfaces (like the Three Mile Island example cited) are misleading or allow important information to be missed.

The conclusion is that “HIT must support and extend the work of users,” which sounds nice but is hard to define. It also seems to presume that none of today’s HIT systems do that, which I would say is just plain wrong.

HIT systems are designed for a single user working on a single patient doing individual discrete tasks.

That’s often true. Systems don’t always optimally facilitate collaboration, but that doesn’t mean they are worthless. It’s early in the HIT adoption game, so today’s systems are actually yesterday’s systems, designed in the 1980s and 1990s with simple functionality: record, calculate, display. Customers are buying those systems, though, and deriving benefit. You don’t see many hospitals going back to paper.

I agree with this argument. We need better systems that go beyond today’s 1980s paradigms of simply automating repetitive tasks. However, as long as customers keep buying available systems instead of working to demand and design these new ones, this kind of innovation probably won’t happen.

Computerizing paper processes doesn’t help much. Paper will persist.

The article says that paper forms are more than data repositories –  they are artifacts that support situational awareness and coordination. Suggesting that “HIT designers and administrators” are unaware of that fact is insulting.

Hospital executives and HIT vendors may toss around the “paperless” buzzword, but nobody’s paperless and that’s not necessarily bad. I don’t see either providers or vendors who are so enamored with the “paperless” concept that they fully believe that paper is bad and computers are good.

Frankly, I don’t get why this is a “fallacy” and a bad one at that. It seems too obvious to be a fallacy.

Putting clinicians together with programmers won’t necessary create usable systems.

That is undeniably true. Asking users what they want and then turning programmers loose to deliver it is not exactly IT leadership. Users are way too limited in their perceptions and preferences. Their world view is often limited to a single facility, profession, and specialty. That makes it hard to design a one-size-fits-all application that vendors can sell to hospitals of all sizes (which should have been on the fallacy list – that no product meets the needs of all sizes and types of hospitals, no matter who else has implemented it).

The article suggests involving a lot of people who aren’t working in the industry (like the authors). That sounds great on paper, but software designed by committee is usually terrible, a Frankenstein of pet ideas that make the cut only because the most aggressive and outspoken committee members convinced the silent majority to agree.

Conclusions

The authors of this paper are academics. I like their objectivity, but I’m left with the feeling that they are disillusioned about this fact that is distasteful to them: both healthcare and healthcare IT are businesses that, rightly or wrongly, make decisions based on their own self-preservation, not high-minded academic ideals. 

If HIT is as bad as the authors say, why are customers buying it? Nobody’s putting a gun to their heads (although HITECH is a step in that direction).

The authors conclude that the right HIT metric should be not be adoption or usage, but population health. They are correct. I’ve been saying that for years. We’re still in the primitive stage of HIT, automating simple care delivery tasks that may or may not have profound health impact. People are paying millions of dollars for systems that sometimes behave like 1980s database programs: they accept data entry, store it, and regurgitate it in ways that are useful, but hardly revolutionary. I agree that in many cases, providers should be spending the money elsewhere. But it’s their money.

It’s easy to criticize any industry for doing the wrong things or not doing the right things. It’s also mostly irrelevant. MBA 101 tells you that business aren’t good or bad, they simply meet the needs of their customers. Otherwise, they would cease to exist. If you don’t like vendor products, blame the customers who are buying them (and who in many cases, directly influenced their design). As an analogy, it’s too easy to blame the fast food industry for obesity than to fault their customers for creating the demand in the first place.

The track record of vendors who rewrote systems from scratch certainly doesn’t encourage more of the same. The development of Millennium nearly took Cerner down. Soarian turned Siemens into a punch line. A vendor thinking about rewriting a major clinical suite will need to be willing to live without 5-7 years of sales (since prospects don’t want to buy an orphan product) and had better not have impatient shareholders or investors. Not many vendors are strong enough to sit on the sidelines for that time, much less to amass the resources and expertise needed to undertake such a project.

I have less confidence than the authors that adding government oversight and a bunch of non-industry academics to the mix will make things better. That’s how the government does things, and government systems reflect all the bad characteristics the authors decry: they are user-unfriendly, task-oriented, outdated, and massively expensive.

I agree with two major themes from this article: (a) independent oversight of clinical information systems would be a good thing, and (b) the state of healthcare software is as disappointing as the state of healthcare itself. I didn’t need this article to tell me that, though.

NTT Data To Acquire Keane

Japan-based IT provider NTT DATA corporation announced this morning that it will acquire IT services firm Keane, Inc. as part of its plans to expand to the US market. Terms were not disclosed, although sources indicate a price of $1.2 billion.  

The president and CEO of NTT DATA, a quoted subsidiary of Nippon Telegraph and Telephone Corporation, said in the announcement, ““This transaction with Keane will allow us to provide comprehensive IT services including system development and management of mission critical systems in North America. Keane has a superior reputation in the area of application and infrastructure services, as well as deep industry expertise. I believe that this, combined with their unique global delivery model and our global scale, offers more cost-effective and higher value solutions to our customers.”

Keane’s healthcare offerings include IT services, revenue cycle, the Keane Optimum application suite, and the NetSolutions suite for long term care facilities.

Keane was sold three years ago for $854 million to a California outsourcing firm backed by a Citicorp private equity investment. 

Rumor of the acquisition was posted on HIStalk last Friday after a tip from Broadway Joe.

News 10/29/10

From Domestic or Import?: "Re: this NEJM case study. Has Weird News Andy found this yet?” He has not. I’m sure there’s a fascinating story about how a full bottle of beer found its way into this inebriated man’s rectosigmoid colon, but I’m equally sure I’d rather not hear it.

From Man Up, MCK: “Re: most outrageous comment EVER. From the McKesson earnings call transcript, McKesson CFO Jeff Campbell claimed that nearly non-existent revenues for Horizon Enterprise Revenue Management were due to customers who aren’t buying anything except clinicals and are also pushing back their implementations (it’s the customers’ fault, in other words). He also mentions ‘new and latest requirements’ for HERM. What new requirements are causing them to basically stop all installs? The requirement that it work? I think you should ask the customers if it was really their choice to stop the installs. He said it was going to take ‘a number of quarters’ to meet those requirements — is it two, or three, or four? But the most outrageous comment ever is this: ‘… our customers are saying to us, we’re happy running that 20-year-old to 30-year-old software we bought from you 20 or 30 years ago.’ Are you kidding me? Their customers are happy to be on Star and Series, with no embedded contract engines, no professional charge billing capability, bolted-on claims scrubbing, no online bill pay, and no online registration? Customers just called up in the last few weeks to stop installs of a next-gen system that’s been touted for years and said, ‘That’s OK, we’re really happy running this old software, no rush from us?’” I actually do believe that to a certain extent – customers probably aren’t thrilled, but are used to McKesson’s deferred promises and have Meaningful Use to keep them busy short term (which will quite likely bite them long term when reform comes knocking). Also, the CFO’s reality is filtered through layers of corporate underlings like the president of the revenue cycle business they just fired, so maybe he really believed what he was told about how happy the customers are to wait and how impressive HERM will be … someday.

Listening: Atomic Tom, sounding great in the above video playing live on iPhones on the B-train of the New York subway (the video claims their instruments had been stolen, but they now admit that didn’t happen). A cool link sent by a reader, even if it does smack of an intentional viral campaign (multiple camera coverage, carefully mixed audio, and a convenient Apple tie-in).

Microsoft announces Q1 earnings after Thursday’s market close: revenue up 25%, EPS $0.62 vs. $0.40, beating estimates. The Windows, Office, and server software groups put up good numbers, while $527 million in ad revenue from the Bing search engine wasn’t much consolation for its $560 million loss. Still, these are good results and a nice bellwether for a hopefully-recovering economy.

Zynx Health announces a five-site pilot of its software and services solution that prepares hospitals for being involved in accountable care organizations. It will address clinical decision support in improving mortality rates, readmission rates, length of stay, and total costs.

Shore Memorial Hospital NJ) promotes Fred Banner from CIO to vice president, having worked his way up from PC specialist in his 20 years there.

A reader asked me if I knew of any possible candidates for a big health system corporate CIO job that requires CIO experience, but also a strong IT vision for healthcare’s future state (person-centric and involving wellness and not just care delivery). Send me your recommendations if you have any and I’ll pass them along.

University of Michigan Health System and 570 West Michigan doctors form Physicians Organization of Michigan, what they hope will be a statewide network of independent physicians. Benefits mentioned include EMRs and telemedicine.

To-dos for you: (a) drop your e-mail in the spam-proof Subscribe to Updates box to your right to get instant alerts when I post something new, allowing you to feel smug as you sprint down the hall like Paul Revere alerting everyone of some big HIT development, not because you want them to know, but because you want them to know that you knew first; (b) support HIStalk’s sponsors by checking out the ads to your left and clicking those that catch your eye as interesting; (c) Friend Inga and me or Like HIStalk on Facebook so that we can have the illusion of being BFFs; (d) make Inga happy by reading HIStalk Practice and signing up for the e-mail updates there (when Mama ain’t happy, ain’t nobody happy); (e) send me your rumors, news, and guest articles; and (f) tell people you know about HIStalk and the other sites since the ad budget is … well, zero. Thank you for reading.

Cerner just announced $65 million in quarterly profit, but it wants Kansas City to buy the computers for its new $63 million data center without charging it taxes, then lease them back to the company. That would save Cerner at least $3.7 million over 10 years even though it would create no new jobs, just the transfer of 11 existing positions from North Kansas City.

North Carolina public health agencies, free clinics, and community health centers will get broadband services from the initial phase of the NC Telehealth Network, with the $7.2 million cost paid out of a $12.1 million FCC Rural Healthcare pilot program. I couldn’t follow the confusing list of organizations, offices, and grants that were involved, so if you are really interested (I wasn’t), then you should probably read the announcement instead of relying on my impatient summary.

PinnacleHealth System (PA) chooses (warning: PDF) electronic documentation and charge capture solutions from Salar, Inc. I interviewed Todd Johnson, president of Salar, this past February. Sometimes my interviews are lame (usually because the person I’m interviewing is just not interesting or can’t quit pitching their product or themselves, so I rationalize) but this one’s good.

An investigative article from The Center for Public Integrity questions the effectiveness of having a 29-doctor AMA group recommend to CMS how much their profession should be paid for performing individual procedures. CMS accepts more than 94% of those recommendations, leading to “rubber stamp” criticism. Part of the group’s job is to deflate the times specialist groups claim it takes to the procedures they’re paid to perform. A former member of the group says specialists scratch each other’s back in the meetings, but everybody fights with the primary care docs (which the article says nearly always lose to the specialists who successfully get big payments for performing procedures). It was also noted that, even with major technology and efficiency breakthroughs, the group almost never recommends that work units be reduced.

Palomar Pomerado Health (CA) is chosen as a Pyxis development partner by CareFusion.

Sponsor jobs: HIE Team Lead, Clinical Executive Physician, Clinical Executive Nurse. On Healthcare IT Jobs: Clinical Pharmacist, Metadata Administrator, Senior Manager Healthcare Solutions Marketing, Senior Data Specialist.

Curaspan says 354 hospitals and over 2,500 nursing homes use its Web-based discharge planning, referral, ride sharing, and transportation applications.

Ingenix forms an independent physician advisory board to guide its healthcare technology direction. Among them are Joseph Heyman (who was on some Health IT Policy Committee work groups), Salvatore Volpe (president of the New York State chapter of HIMSS), Martin Harris (his ubiquity precedes him), Gregory Reicks (an osteopath who is board president of an HIE), and Alice Loveys (a CMIO).

Charleston Area Medical Center (WV) cuts $40 million from its budget due to low reimbursement, high drug costs, and $16 million worth of software upgrades. They didn’t say which systems were being upgraded, although I seem to remember that they’re a Siemens shop.

The fired CEO of 15-employee, Indianapolis-based EMR vendor iSalus Healthcare sues the company for breach of contract. Mark Day says he was fired after telling the board chair that he was suspicious that employees were stealing software. The board’s termination letter said he was let go for telling a prospect that iSalus was in trouble and warning the customer of some of the company’s untrustworthy executives, also asking the prospect for a job if things went south there (I’ll hazard a guess that they didn’t sign on the line which was dotted). Day says that conversation was misinterpreted.

Boston-based MedNetworks is developing software based on Harvard-licensed technology that maps the social networks of people and clinicians. The startup plans to sell the information to drug companies, insurance companies, hospitals, and the government. It says that the influence of friends and colleagues may be more important than formal experts when it comes to changing healthcare behaviors or getting doctors to prescribe specific drugs. One of the founders is Harvard professor Nicholas Christakis, whose social network book landed him on Time’s 2009 list of the most influential people in the world. I might have to get a copy.

E-mail me.

HERtalk by Inga

From Za: “Re: my McKesson rep. Said that while it has not been verified, Horizon is on life support. Pretty sure this is not news other than I am gloating a bit because when I got to my current hospital, they were looking at McKesson Horizon and I told them there is no way that mess would ever work. I like being right!” Unverified and purely conjecture, we’ll quickly disclaim, but it’s coming from a hospital CIO who’s usually right.

From Trinketeer: “Re: MGMA goodies. I know you like evaluating all the vendor freebies at trade shows. I brought home a bunch of stuff for my kids. My 10-year-old remarked that it was ‘the same old stuff’ and nothing very good.” Kids say the darnedest things. I have to agree with the 10-year old, except for my souvenir photo with the alligator (redacted for anonymity, of course). It supported alligator conservation, but as I said on HIStalk Practice, all I could think of was how nice his skin would look on a pair of pumps.

I  am back from New Orleans and trying to find the bottom of my e-mail inbox. If you care to know what practice administrators are talking about and what vendors and pundits are telling them, we have three days of highlights on HIStalk Practice.

While at MGMA, I had a long conversation with an Allscripts executive. One of the topics discussed was the company’s decision to discontinue upgrades to the Peak Practice EHR. While I can understand how this decision is disturbing for end users, I must admit that Allscripts seems to be trying pretty hard to reduce the pain. A bit of background if you haven’t been following the story:  Peak Practice is an EHR that Allscripts acquired in the Eclipsys purchase, which Eclipsys had acquired from developer Bond Medical. Apparently the Peak product has a number of functionality gaps and only 300 users. Allscripts has applied to have it ONC certified and won’t sunset it per se, but they won’t be releasing enhancements to it, either. They’ll offer Peak users free like-for-like MyWay licenses and perform the data conversion at no charge. Change is difficult, but I can’t fault Allscripts for making what is probably a good business decision and I commend the company for trying to make things as right as possible for the Peak Practice clients. An interesting side note: Bond Medical founder Travis Bond is now a MyWay reseller.

Another MGMA reflection: I asked several of the smaller vendors if they were going to obtain ONC-ACTB certification, and if so, through which certifying body. Those going the CCHIT route said it was easier since they were already CCHIT certified and/or they thought the CCHIT label was more prestigious. No one specifically named InfoGard as their certifying body. Those going with Drummond noted it was less expensive and faster. One vendor, interestingly, said they were “negotiating” with the certifying bodies to find the best price and suggested that more certifying bodies would soon be announced. And, I don’t recall a single EHR vendor saying they would not seek certification of their products.

HIMSS is hosting another virtual conference November 3-4. I “attended” the first one two or three years ago, mostly because I was curious about the virtual format. The conference is free for “qualified” participants and $99 for “non-qualified” HIMSS members. I can’t find anywhere on the HIMSS site that clarifies what it takes to be qualified, but I can say that when I tried to sign up for a conference a year ago, I didn’t have the secret requirements. I am mildly amused because my status must have recently changed, having received two separate invites from HIMSS this week. I should clarify that neither invite was for “Inga,” but for her counterpart in the “real” world. Since not much has changed on my end, I have to assume HIMSS is under pressure to boost attendance, probably to please its 25+ sponsors. If I have time, I’ll probably accept an invite and lurk around a bit.

Rush University Medical Center (IL) awards a five-year, $25 million contract to Siemens Medical Solutions for medical equipment and HIT consulting services. The press release does not provide a breakdown on equipment versus consulting services, but it does specify a whole bunch of hardware for its new facility opening January 2012. The HIT consulting services will focus on providing “a more efficient electronic infrastructure for managing patient information and services.” Rush, by the way,  is in the process of implementing Epic.

GE Healthcare and UPMC announce that their imaging joint venture, Omnyx, is working to digitize the pathology process and eliminate the practice of pathologists using glass slides and microscopes. If glass slides and microscopes disappear, I wonder what schools will teach in seventh grade science class? So far GE and the non-profit UPMC have invested $40 million in the project.

Trustees for New Hanover Regional Medical Center (NC) approve a $56 million move to Epic (that will be another McKesson Horizon de-install). The investment in software, hardware, and implementation is only $15 million more than the $41 million than upgrades to their existing systems were going to cost.

Cerner announces third quarter results, which were up from last year. Revenue was up 13% to $462.7 million and earnings per share were $0.71 vs. $0.57, beating estimates excluding special items.

Northeast Hospital Corporation (MA) will deploy Merge Healthcare’s PACS and ECM systems.

Sponsor updates:

• Advanced Pain Management (MD) selects the SRS Hybrid EMR. Which reminds me: while at MGMA, the SRSsoft folks told me they are working on an app store to be released early next year. It will give users a quick way to add innovative extras to the core application.
• RelayHealth aligns with TransforMED to provide a communication tools that aids primary care providers by establishing patient-centered medical home models of cares.
• EDIMS earns ONC-ATCB certification through CCHIT for its ED EHR product.
• St. Paul Radiology (MN) says its accounts receivable days has decreased 35 to 40 percent since implementing ZirMed RCM tools.
• CareTech Solutions and nine of its healthcare clients are recognized for excellence by the Web Marketing Association.
• SCI Solutions, a provider of access management solutions, completes its fiscal year with 42 new customer contracts representing 86 hospitals.
• Voalte is named a Mobile Health Expo 2010 award winner in the category of outstanding contribution to the growth and success of nursing and mobile health communications.
• Mobile Health Expo also awards PatientKeeper for the best innovation in mobile health technology for patient safety.
• Eastern Connecticut Health Network chooses Access Intelligent Forms Suite to auto-index patient forms in Meditech Scanning and Archiving.

E-mail Inga.

News 10/27/10

From Southern Belle: “Re: Epic. I hear they’re thinking about changing their consultant non-compete agreement from one year to two.” Unverified.

From Blame the Dog: “Re: BlackBerry tablet. Here’s some video up of a demo of the eUnity PACS virtual workstation running quite seamlessly on the BlackBerry PlayBook through their fancy new QNX-based Tablet OS. I’m a big fan of the trend Apple has started with (finally) user friendly tablets, and there’s been a lot of interest in healthcare for the iPad so far because of the cost and usability factors, but I have a feeling there are more than a few healthcare CIOs out there collectively holding their breath for the PlayBook. Apple has some management tools for the iPad and I think they’re starting the realize the potential there, but they’re still nowhere near RIM on the enterprise, information security, and compliance management front. The PlayBook is going to be a BES-compliant device, meaning all those hospitals out there with existing BlackBerry infrastructure don’t have to do much to start putting the PlayBook into lab coat pockets early next year. No matter what, RIM, Google, and Apple are finally giving hospitals and practices simple and cost-effective devices that can integrate more comfortably into existing workflows. No more bulky notebooks posing as tablets, no more clumsy laptop carts, no more silly workstations in every exam room. Finally.”

From BCS Luv: “Re: Epic. Who’s implementing it in Boise?” I’d have to guess St. Luke’s since Saint Alphonsus just went up last week on an unnamed system (Cerner, I assume, since St. Al’s is a Trinity hospital and their Genesis Project runs Cerner, if I remember correctly).

Inga is posting live from MGMA on HIStalk Practice with our patented blend of news, rumors, booth critiques, and observations (she says she got hit in the head by a lady’s tossed beads, which I hope doesn’t mean that she flashed her, French Quarter-style). Check out her posts from today and yesterday.

Core Health Technologies releases its HL7 survey results (warning: PDF). Demand for HL7 expertise will increase, said 85% of CIOs. Respondents predicted that Cloverleaf will lead the integration engine market.

Cardinal Health signs a marketing agreement with Swisslog that will allow Cardinal to offer that company’s drug packaging and distribution technologies.

New York eHealth Collaborative plans to spend $129 million in state and federal money to create a statewide electronic medical records network.

UW Health (WI) is using palm scanning to positively identify patients and to reduce identity theft and insurance fraud. They spent $70,000 for 200 of the scanners.

McKesson announces Q2 numbers: revenue up 1%, EPS $1.25 vs. $1.11, missing on both revenue and earnings excluding a one-time asset sale. Revenue for Technology Solutions was down 3% (with some one-time adjustments), with the press release saying the reduced operating margin “was impacted by continued investment in our clinical and enterprise revenue management solutions.” The company also wrote off $72 million because of Horizon Enterprise Revenue Management, which readers have told us is in big trouble with high development costs and rumored missed deliverables. I looked up their term asset impairment charge and it means (in my non-accountant interpretation, anyway) that an asset’s value has declined even faster than it’s being depreciated and amortized, requiring  one-time adjustment in value.

Disappointing perfomance in McKesson’s Technology Solutions business was surely the cause of Monday’s big McKesson reorg, which I mentioned on Facebook (actually the performance would have been great without the HERM charge). Clinical and revenue cycle groups will be combined to form Health Systems Enterprise Solutions (seems odd). The president of Revenue Cycle Solutions was let go. Several other products (workforce management, surgery, performance, analytics, HR, etc.) are being combined under Health Systems Performance Management. Enterprise Imaging will be made part of Medical Imaging. Sales teams will be integrated with their business lines. They seem to be focusing on differentiating Horizon vs. Paragon prospects.

Healthland promotes sales VP Angie Franks to CEO. Former Interim CEO John Trzeciak of Francisco Partners will keep his board seat.

Surescripts expands (warning: PDF) its e-prescribing network to become a “national backbone” that will allow exchange of clinical messages, expanding on its work with CVS’s MinuteClinic. The company is marketing itself as a trusted network, using messaging tools made possible by its investment in secure messaging vendor Kryptiq. Surescripts says it will follow standards for NHIN, HL7, CCD, CCR, etc. VA CIO Roger Baker was quoted as saying that the Surescripts network would help his organization connect with community providers. John Halamka was also quoted, although in a non-committal way (he doesn’t generally shill products, just ideas). This is a big announcement, both in length and in impact. Implementation dates: Net2Net connect to allow providers and vendors to connect outside their networks (December), Message Stream secure messaging (December), and Clinical Message Portal for providers who don’t have an EHR (January). I had to refresh my memory about who owns Surescripts: the founders, the National Association of Chain Drug Stores, the National Community Pharmacists Association, CVS Caremark, Express Scripts, and Medco.

Even Weird News Andy is speechless at this article (well, almost – he only said “wow”). In England, a quadriplegic home care patient, convinced that he was not receiving good nursing care, puts a bedside camera in his room. It caught an NHS agency nurse panicking after incorrectly adjusting his ventilator’s controls and setting off its alarm. The nurse, who says she was given no training on the ventilator, couldn’t get it restarted and didn’t know how to resuscitate him. It took paramedics 21 minutes to arrive and give him oxygen, but by then he had suffered major brain damage, reducing his mental capacity to that of a child. NHS says it’s sorry.

Panasonic invests in Houston-based CardioNexus, announcing its intention to become a global leader in personalized preventive medicine. CardioNexus, formed last year, is a product of Baylor College of Medicine’s commercialization organization and works with Texas Medical Center, which was already working with Panasonic. The company focuses on early detection of heart disease, which I assume means imaging.

Sage Intergy Meaningful Use Edition is ONC-ATCB certified by Drummond Group. Also earning certification, but from CCHIT: GE Centricity Practice Solution version 9.5.

AirStrip Technologies provided some clarification about its agreement with Sprint that I mentioned recently. Users can choose any mobile device (including Android-powered ones in the next couple of weeks, but 80% of their users are on iPhones so far). Those users generally use AirStrip on their personal smart phones (makes sense – they wouldn’t want to have to carry two). Sprint helps the hospital pay for AirStrip to encourage them to use more Sprint devices, but they help subsidize the cost for all users, not just those who choose Sprint smart phones. AirStrip gets what it says is better 4G performance from Sprint, which will allow it to eventually expanding its offerings to real-time video collaboration, imaging, and extended historical waveform data. Thanks to AirStrip for the clarification. I usually steer clear of proclaiming a company or technology as “hot” since I’m just a cheap seat observer, but I’m pretty sure they are.

Folks I know at Cedars-Sinai tell me that they’re up on Epic’s nurse documentation and care plans. They’ve also shut down CareVue now that they’re live on device integration and doing some physician documentation in the ICUs.

Our Lady of Lourdes (NY) chooses Allscripts EHR for its 16 employed medical groups. They’ll also implement Allscripts Remote, which allows physicians to access the system via the iPhone, iPod Touch, iPad, BlackBerry, Android, and Windows Mobile smart phones.

Martin Memorial Medical Center (FL) borrows $25 million for equipment they say is EMR and HITECH related, including smart pumps and patient monitors.

A prospective sponsor e-mailed me a question I’ve not been asked and couldn’t answer without digging through some stats. How many unique people read HIStalk each month? The answer: just over 19,000. I also noticed the countries they’re from: the US, of course (over 93%), then Canada, Australia, UK, India, Israel, Ukraine, UAE, China, and so on. All I see from this end is a blank screen that I have to fill each day while sitting in my inner sanctum and playing music at excessive volume levels, so it’s fun to occasionally be reminded that real people are on the other end.

Healthcare futurist Jeff Goldsmith says HIT adoption is lagging because there’s no return on investment. He says the payment system is largely at fault for piling tedious documentation requirements on doctors, made worse by new quality measures (I assume those prescribed by Meaningful Use are among them). He says he would have done Meaningful Use differently, offering providers an immediate malpractice shelter for following guidelines instead of a payoff down the road. He also thinks that hospitals buying practices will drive more HIT usage than Meaningful Use since the new owners will want them to communicate with each other (and will want to monitor and control their performance, which Jeff didn’t say but I will). His estimate of consumer influence on EHR adoption by doctors: “nearly zero” since people have stayed away from PHRs in droves and the improved communication that patients really want doesn’t require IT. Jeff’s an investor in some startups, which I’d love to do if I had the money (although I probably therefore wouldn’t have it for long since those rarely pay off).

Francisco Partners takes a majority stake in Quantros, which sells quality and risk applications. The private equity firm is no stranger to HIT, with investments in AdvancedMD, API Healthcare, Healthland, QuadraMed, and T-System. I interviewed Quantros CEO Sanjaya Kumar this past April. Worth a read (or re-read). I have to say that if your vendor is bought by someone, you should hope that it’s Francisco Partners since they appear to be the most patient, most HIT-savvy, least change-demanding acquirer out there. They seem to help the companies they invest in succeed instead of slashing and burning their way to a fast payoff.

A Modern Healthcare article says that the AMA is getting into the EMR business with its Amagine project, which will go live in 2011 after the current pilot in Michigan is finished. It will charge vendors to list their wares on a portal, then take a cut of the action. AMA will actually providing technical support and possibly implementation services. I’m having a rather strong reaction to this, but leave a comment at the bottom of this post and let’s hear what you think first.

Ever wonder how those frequent flier patients get to your ED? By ambulance, of course. One health commissioner said, “The misuse of ambulances speaks to our health system. If we had a place as user-friendly as an emergency room, people would likely use it. The fix is to have more primary care and a better way to get to it.” One New York patient called for a ride to the hospital 313 times in one year. Like the rest of healthcare and the country in general, relying on personal responsibility is a bad idea, especially with a government willing to subsidize stupid decisions by taking money away from those too responsible to make them.

HealthPartners launches virtuwell (annoying all lower case besides being a pun), an online MinuteClinic-type alternative to office visits that offers online nurse practitioners around the clock. Online users (only in Minnesota for now) get a diagnosis, treatment plan, and prescriptions for $40 or less, depending on insurance.

The Wisconsin State Health Information Network is named as the overseer of the statewide HIE, set to launch next year.The group is a non-profit with members Wisconsin Hospital Association, the Wisconsin Health Information Organization, the Wisconsin Collaborative for Health Care Quality and the Wisconsin Medical Society.

Sponsor Updates

• All Children’s Hospital (FL) will use GetWell Town from GetWellNetwork as its interactive bedside TV system offering Internet browsing, games, movies, and behind-the-scenes clinical applications.
• RelayHealth beats the mandatory 2012 date for complying with Version D.0 of the NCPDP pharmacy claim standard. The company’s prescription transaction solutions are compliant now.
• RelayHealth also announces at MGMA its RelayAnalytics Financial Diagnostics, a visibility dashboard into claims and remittance information.
• Revenue cycle vendor ZirMed announces that it has processed 750 million healthcare transactions and is doing 20 million per month. The company says its 39% annual growth rate required adding two executives: former Allscripts sales VP Kevin Weinstein as VP of marketing and Kraig Brown as sales VP.
• MEDSEEK announces its Sprint to Meaningful Use solution, which will help organizations meet the MU goals involving patients and families.

E-mail me.

Monday Morning Update 10/25/10

From Polemic: “Re: Epic-certified resources. Only Epic knows and they’re not sharing. That leaves everyone else to make sense of what it means when someone claims to be Epic-certified (what module, what release, etc.) Tightly controlled certification keeps qualified people in high demand, but doesn’t seem to take into account the rate at which they are signing new accounts. One has to wonder whether the ‘we’re Epic, you’ll do it our way’ approach won’t perhaps come back to bite them someday.”

From Celling Yourself: “Re: AirStrip’s Sprint announcement. I don’t get this. AirStrip’s target customer carries an iPhone, which doesn’t work on Sprint.” It is interesting since the deal offers hospitals Sprint’s help creating an in-building Sprint infrastructure for running AirStrip’s apps on 4G smart phones, but AirStrip says it’s staying carrier agnostic. I can’t imagine docs giving up their iPhones (and thus AT&T now and possibly Verizon soon) or carrying a second Sprint-capable device only for on-property access. It sounds like little more than a targeted Sprint promo for its infrastructure business.

From Former McKessoner: “Re: long overdue. I’m one of the many departures from the McKesson senior sales ranks since the June 1 beginning of the fiscal year. It took over 10 years, but the Horizon undoing is coming fast. No new business, customers grudgingly upgrading.” Unverified. All I’ve seen is the recent KLAS report, which says Horizon lost more clients than it gained in 2009 (along with the other faders you might expect — QuadraMed, GE, and Eclipsys). The company has announced nothing pertaining to its Horizon strategy as far as I know, so unless a customer verifies they were told something officially (and those I’ve asked haven’t responded), I’d say it’s business as usual.

From Introspect: “Re: Houston hacker. Here’s an update with the hospital’s side of the story. I wish you had withheld judgment until at least hearing both sides of the story.” I agree, although I assumed the newspaper’s account was accurate and complete and I did hedge my bets by referencing the hospital’s “apparent” security incompetence. The original article said the hospital had to hire outside help to fix the problems the kid claimed he told them about. The CIO’s story is different, although he didn’t mention the problems the kid says he discovered. He says the 21-year-old had installed “back door” code on the hospital’s server that would have let him bypass security to log on at any time, which he accomplished by using a doctor’s password instead of actually penetrating the hospital’s security (I’m surprised he was able to do that with a doctor’s security privileges, which I assume means any doctor could do the same, but that’s not my area of expertise). As the CIO says, “He didn’t discover a breach, he was the breach.” The outside help was engaged to make sure the kid didn’t do anything else, the CIO told the newspaper.

At least most readers think their employer’s economic conditions are no worse than they were six months ago, although more say they’re unchanged than better New poll to your right: what’s your experience working for an employer that has won a “best place to work” award?

It’s easy to confuse patients about healthcare benefits. A non-profit clinic in California sends out ID cards to all its recent patients that include the patient’s name, medical record number, and doctor name. They wanted to speed up registration by giving staff information needed to look up patients in their new EMR. Puzzled patients seen at the clinic but not its regular patients are calling their providers and insurance companies demanding to know why they’ve been turfed off to a new clinic and doctor.

RemCare, fresh off $2.7 million in new financing, renames itself (warning: PDF) after its product, Care Team Connect. The Illinois company’s product helps hospital care managers by creating evidence-based discharge care plans and coordinating care, reducing readmissions.

Vanguard Communications, which offers the MedMarketLink marketing service for specialty practices, signs a partnership deal with Intuit Health to market its portal.

HP announces its Slate 500 would-be iPad competitor, which it will market to businesses (note the medical apps featured in the above promo). It’s more expensive (starting at $799) and runs Windows 7, meaning that unlike the iPad, it supports Flash. It comes with 2 GB of memory (which is needs since it’s running Windows), has a shorter battery life (Windows again), and does not support 3G (WiFi only). I’m guessing all of those facts led to the decision to steer a wide berth around the consumer market created and owned by Apple in the hopes that businesses are so pro-Windows they’ll pay more to get less. This will be problematic: all those users with iPhones, iPods, and iPads at home are not likely to be thrilled by their employer’s offering. Apple doesn’t make mistakes too often, but failure to reach detente over Flash is a big one since that’s one of few chinks in its armor and it involves all of its products as its competitors will tell you constantly.

Mobile Health Expo announces its 2010 award winners. HIStalk sponsors winning were PatientKeeper (best patient safety innovation) and Voalte (outstanding contribution to nurse communications).

Greenway acquires Visual MED’s PACS technology, which will power its PrimeIMAGE solution for its PrimeSUITE 2011 EHR.

The radiologist who founded teleradiology services vendor Virtual Radiologic launches an early stage venture fund that will invest in consumer, healthcare, and technology companies. Sean Casey was kicked out of the company, which he started and took public, with $68 million worth of stock. It was the subject of a private equity buyout for $294 million this past May.

HHS CTO Todd Park is added to the speaker lineup of the mHealth Summit next month, run by the NIH, its foundation, and the mHealth Alliance. Also speaking: Bill Gates, Ted Turner, and US CTO Aneesh Chopra. I’ll be filing daily reports from there as will HIStalk Mobile editor Dr. Travis Good.

The Austrian man who was the first person to use a mind-controlled robotic arm for driving dies in a single-car crash that may or may not have been related to the technology.

I can’t decide if HIMSS is clueless or evil with this announcement: attendees at the Orlando annual conference in February will be tracked by RFID for the benefit of exhibitors, who can “… derive a more accurate score of a visitor’s buying potential.” RSNA has been doing this, apparently, triggering specific booth ads to play based on who’s around (Philips is a happy customer cited in the above promo video). An RFID tag will be attached to conference badges that will let vendors track attendees by job and employer (and name if the conference allows it), ending the days of anonymous and obligation-free booth cruising. The technology will log booth visits and duration by product being viewed and will alert vendors in real-time when a “key prospect” is in the area (CIO alert! Ignore everyone else!) The conference keeps getting more similar to a cattle butchering operation: you’re herded into a holding pen (the exhibit hall) since the token educational offerings (getting less useful every year) intentionally go dark during major booth hours, you’re fed and watered in the exhibit hall with vendor snacks until it’s your turn with the the high-paying exhibitors, and now you’ll be tracked like livestock throughout the process. Let me just say that, as a paying attendee and member, I resent the hell out of this (I’m sure I can get info on how to cripple the RFID tag and I’ll run it here if so). I can imagine what was going through the minds of the HIMSS dim bulbs who approved this: hey, we can charge vendors even more by selling them the personal information of attendees, vendors can pounce like snakes when attendees identified by job title as a decision-maker enter their air space, companies can monitor whether competitors are encroaching into their proprietary neighborhood, and HIMSS can justify its exorbitant exhibiting costs by showing who dropped by. People seemed to be resigned to letting HIMSS do whatever it wants in the name of picking the pockets of its vendor members. I say it’s time for provider members to push back and make the conference theirs again. Being tracked as nothing more than a roving sales prospect is just insulting. HIMSS apparently doesn’t extend its claimed interest in patient privacy to its own paying customers in the Ladies Drink Free model in which it pimps access to low-paying providers to high-paying vendors.

AHRQ spends $26.5 million of its ARRA money to hire a high-powered PR agency. Ogilvy Washington will “market and promote” the findings of Patient-Centered Outcomes Research in a newly created Publicity Center. I didn’t volunteer to have my taxes used for wasteful economic stimulus projects, but if I had, I’m pretty sure dozens of millions for a HHS PR wouldn’t have been on my list even though the general idea of comparative effectiveness research is a good one (but hugely expensive – $1.1 billion in stimulus money).

Four NICU babies in a hospital in Canada are given insulin instead of heparin in their TPNs, killing one of them.

Shares in athenahealth jumped by 23% on Friday after good Q3 numbers that beat estimates.

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From BeKind: “Re: the Senate Committee on Veterans’ Affairs testimony about MUMPS. This dialog occurred at 75:26 in the video.”

Senator Richard Burr: If you maintain MUMPS can the private sector have full access into the VA system, into the MUMPS system, for the exchange of electronic information?

Roger W. Baker, Assistant Secretary for Information and Technology, Department of Veterans Affairs: I would answer it this way, I believe just as much as if we implemented it in any other language because at the bottom it’s the data that’s important.

Senator Burr: Let me turn to Mr. Tullman if I can just simply because he’s out there. Now, let’s see what the limitation is.

Glen Tullman, Allscripts CEO: What I would say is again that you can extract data from any system. What we’re really talking about, and I don’t want to get too technical, is the native exchange of information. So you can pull information out of a mainframe system and put it into a PC if you want two people to talk to each other. The question is why would you do that when you could have two PCs that were talking with each other? So again we think MUMPS was the right decision to make when it was made. We think there’s a reason to carry it forward. We’re just saying as we go forward into the future we need to broaden the understanding of what systems to use, what architectures to use, and what the general reason we need these systems for and that is for communication and I think that’s this idea of this community is important and no one’s using MUMPS to build systems that communicate and exchange data efficiently today in anywhere else but the US government.

Wow, there’s a lot of interesting stuff in this video of the committee meeting, which runs two hours (meaning I didn’t listen to every word yet). The chair, bless his heart, leads off by reminding everybody that the VA and its contractors flopped big-time with CoreFLS and the projects it had to kill because they weren’t being managed well. Ed Meagher talks about the VistA Modernization Committee’s recommendation to put VistA on a stabilization program while developing its replacement. Glen criticizes MUMPS-based systems (meaning not just VistA, but his company’s competitors Epic, MEDITECH, QuadraMed, etc.) and saying the military’s evolution requires new EMR requirements for data sharing. He also says its replacement should be either Microsoft-based or open source (technically, VistA sort of open source, so I assume he means non-MUMPS open source). He says its time for the government to learn from the private sector.

Tom Munnecke, a former VA guy who helped build VistA, testifies at around the 61 minute mark. He credits the original VistA developers, all of whom were clinicians turned developers, for its success, starting it with “good enough” and then refining it from field experience instead of sitting around writing specs. He said MUMPS criticism isn’t new, going back to the beginning, but it works and has been stable. He likes the open source idea for a VistA replacement but cautions against throwing out the lessons learned from VistA. He also advocates additional forms of communication other than the EMR, saying that 25% of VistA’s use was the Mailman app used to simply communicate among professionals (comparing that to today’s social networking). He talks up personalization that can be delivered by cheap, easily implemented tools.

The chairman also asks VA CIO Roger Baker directly what assurances he can give that they won’t screw up again like they did with their replacement scheduling system. He cites the VA’s cancelled or retooled projects as proof that they’ll kill projects with minimal chance for success (the “fail fast” approach of identifying and killing the dog projects fast before they cost too much). Munnecke agrees, but says users need to scale back expectations and allow the software to develop instead of going for the gold-plated Cadillac upfront.  

Munnecke: “Mr. Tullman’s comments have a number of technical issues that I think we need to talk about over coffee some time, but I probably largely agree with his conclusion. I don’t want to be characterized as pro-MUMPS. I do want to be characterized as having a very successful legacy system that has accomplished a lot and just going with the standards of the information technology industry and thinking we’re going to take the shiny new technologies and word on PowerPoint presentations and develop a successful system is not going to work.” When interrupted by Sen. Burr’s comment that he’s never heard anybody comment that DoD actually has working EMR software and wondering why it’s so hard to send DoD medical records to the VA, to which Munnecke replies, “I think you’d have to look at DoD actually throttling back CHCS and crippling the features that were design into it for communication in order to protect their bureaucratic stovepipes.”

Sen. Burr’s summation (in which he repeatedly refers to VistA as “the MUMS system”): “It is absolutely essential, in my estimation, that private sector companies buy in to what technology decisions you make at VA because of exactly what Mr. Tullman references, and that’s that this is no longer our population of people that we’re taking care of. They’re bouncing back and forth … if we want to reach the efficiencies long-term of private healthcare, as most have realized, then we’ve got to have this interoperability solved … if a company like Allscripts, a leader, is questioning whether they’ll be able to exchange through your system, I think we ought to pause for a minute and talk to those companies and find out what is your concern …”

Then came the comments BeKind mentioned above. Sen. Burr mentions that three people in the room have iPads, yet soldiers returning from the military hospital at Landstuhl have paper medical records taped to their chests, saying that the VA should collaborate with the private sector.

News 10/22/10

From Wee Man: “Re: [vendor name omitted]. The rumor you recently ran about halted implementations and delayed upgrades for [product name omitted] is true, I’m 95% certain. Also, the same company’s flagship clinical product line [product name omitted] is going to maintenance-only.” I’m chickening out in naming the company since this is big news if it’s true and I’d hate to get in trouble just in case it’s not. I’ll say just this: the non-anonymous source is a good one, this rumor fits with some earlier stories and customer survey results that I’ve run, and some mighty big hospital systems are going to be super PO’ed if it’s true. If you have confirming evidence, send it my way.

From FormuLarry: “Re: Micromedex. They’ve released free versions of their drug information application for the iPhone and iPod. It’s not as slick as Epocrates, but the price is right.”

From Stifler’s Mom: “Re: Epic certifications. Can anyone share the exact numbers of certified people out there for products like Prelude, Bridges, Beacon, Cadence and the year/version? Also whether they have clinical backgrounds?” I’m pretty sure there’s only one source for that information so I wouldn’t get my hopes up, but if anyone knows, send it over and I’ll forward to Stifler’s Mom (I gave this non-anonymous HIStalk pal that name years ago and she adores it, not to mention it makes me cackle every time because I have a puerile sense of humor).

From Broadway Joe: “Re: Keane. Being purchased by NTT Data for $1.2 billion.” Rumor is that the Japanese company (part of Nippon Telegraph & Telephone Corp.) is in advanced talks to buy Keane, which is half owned by Citigroup. The deal is imminent, Tokyo newspapers are saying. Keane offers application, BPO, and infrastructure services, not to mention its healthcare presence (Keane Healthcare Information Systems), which markets the Keane Optimum system and other products.

From Oops, Here: “Re: glitches. We are not aware that any of these patients were injured after death.” Errors in loading UK driver’s license organ donor information to the NHS databases cause the wrong organs to be removed from 25 donors. Nobody noticed until prospective donors (the ones not already dead, in other words) complained that their information was wrong.

From Matt Mucha: “Re: my blood pressure chart. I’m a Web developer from Krakow, Poland who also happens to have hypertension. I created a tool to let people keep records online and share them with a doctor. I know you’ve written healthcare apps in the past, so I hope you can relate :). Check out the video and forums. I’m not profiting from the site in any way.” It’s a pretty slick with a clean design. Nice job. Take a look. 

From Greed Earns Justice, Eventually: “Re: McKesson/HBOC scandal. Sales SVP Dominick DeRosa pleaded guilty in 2000 to one count of aiding and abetting securities fraud by hiding side agreements to manipulate revenue recognition. This past April, the judge overrode the prosecution’s request for probation and sentenced him to a year in federal prison. While waiting 10 years for his sentence, he appears to have built quite a resume, serving as CEO of OneWeb Systems, VP of sales at Transcend Services, and executive VP of sales at CareMedic. Rumor is that he was at MedAssets before getting the bad news about jail. Mastermind and former president Al Bergonzi is apparently doing his 41 months in Atlanta after being given more time than the prosecution requested. He’ll get out Christmas Eve this year. He’s been doing consulting work for former friends and one of the many HBOC acquisitions he coordinated. CEO Charlie McCall, who almost got off, is due to be release in 2019. Controller Timothy Heyerdahl was released in 2008 and CFO Jay Gilbertson was released earlier this year. I wouldn’t be surprised if he’s still in HIT somewhere.” He didn’t even mention Jay Lapine, one of few corporate counsels to ever be indicted for securities fraud (he got off on criminal charges a year ago and then settled the civil case against him, barred by the SEC from involvement with publicly traded companies for five years). McKesson’s executives, desperate back in 1998 to prove they could run something sexier than drug warehouses, paid Charlie $14.5 billion for a company everybody knew was a house of cards ready to collapse if he couldn’t fast-talk some rubes into taking it off his hands in a hurry. He did, with the announcement of the accounting scandal just a few months later evaporating $9 billion in McKesson shareholder value in a single day (the stock went from around 90 to less than 20 and still hasn’t hit that level since). Not to mention that a lot of HBOC software was as crappy as their corporate books, also widely known by nearly everybody. It’s always ugly for the foot soldiers when greed meets stupidity. Sorry for the rant, but what those guys did to McKesson’s employees (many of them unfortunate conscripts due to HBOC acquisitions), their hospital customers, patients, and to the industry really ticks me off even after a decade. 

Hosted pharmacy applications vendor MedKeeper announces its acquisition of DoseResponse from Keystone Therapeutics, a competitor in outpatient anticoagulation management software.

I mentioned the 21-year-old Georgia computer tech who was arrested for accessing a hospital’s computer system. I’m beginning to think he got a raw deal. He was working on a physician group’s hospital connectivity problems and documented seven problems with the hospital’s server, hoping to impress the hospital enough to land him a job. The hospital CIO and security person met with him, asked him for a copy of his resume and a list of the problems he found, and then came back in with police officers to arrest him. The kid’s been in jail since last week, with the hospital claiming he’s a danger to them since they can’t fix the problems he cited without outside help. Maybe the hospital should swallow its pride, admit its apparent security incompetence, and hire the kid cheap.

Acuitec announced its iCare mobile anesthesia apps for the iPhone, iPad, and iTouch at the American Society of Anesthesiologists conference in San Diego this week. Jessica sent me a press release that I can’t find online anywhere to link to, so you’ll have to take my word for it. The above is a shot of its Vigilance remote presence monitoring system running on an iPad, which I found while looking unsuccessfully for the press release. The Birmingham-based company is a joint venture with Vanderbilt University.

HIStalk pal Justen Deal sent over a position listing for “geek interns” at his Vieu Health startup that was a fun read (he’s a really good writer in a Joel On Software kind of way). I was hooked enough to read the whole thing. If you’re a techie and want to be underpaid (so Justen says), but live and ski free at a resort, get a MacBook Pro and a BlackBerry Torch, and work with “misfits, rebels, square pegs, and troublemakers,” you might want to connect with Justen. I have no idea what Vieu Health is building since they haven’t said yet, but it’s something to do with electronic health records and networks. Maybe I should follow his lead and get some interns myself since I always seem to be buried.

Former NaviNet SVP Tim Mills is named VP of sales and marketing of revenue cycle management company Avisena.

The Toronto newspaper profiles the involvement of Telus in Canada’s move toward digital healthcare. It mentions that Telus provided the software and technology behind The Ottawa Hospital’s plan to buy 3,000 iPads to run on the Telus-provided wireless network to access an aggregated database. That hospital’s CIO says the information needed by key staff members that is available electronically has gone from 30% in 2008 to 100% now. It also mentions the Oacis product, mentioned several times here previously. The healthcare division of Telus is bringing in $400 million a year. It’s a well-done article. Somehow Telus Health seems to come in under the radar in the US, but it’s an impressive operation run by a a large telecommunications company.

Cardinal Health Foundation will award $1 million in medication and OR safety grants in 2011 for the fourth consecutive year. Applications are due by December 3, 2010.

The Chicago Sun-Times covers the local healthcare use of iPads: University of Chicago Medical Center will give iPads to all of its internal medicine residents, a plastic surgeon uses her to explain reconstructive surgery to breast cancer patients, and one hospital says at least half of its ED docs bought their own iPads once they found that they could use the EMR on them.

Jobs on the HIStalk Sponsor Job Page: Clinical Executive Physician, Clinical Executive Nurse, Healthcare Consulting Lead. Platinum sponsors get free listings there. On Healthcare IT Jobs: Epic BSA Ambulatory EMR, Clinical Product Specialist, Epic Consultants.

In Germany, CompuGroup Medical AG says it will invest $180 million in its software over the next five years, most of that to further develop its Software Assisted Medicine medical knowledge system.

Ontario’s health administration is slammed by an auditor’s report that found the same expensive practices previously found in eHealth Ontario scandal last year: single-source contracts, overpaid consultants, and excessive expense reimbursement. One temporary executive who was making $275K per year billed the hospital an extra $150K for helpers, $14K for bonuses, a Christmas lunch, and world-wide travel, including $500 in telephone charges in one hotel stay.

Q3 numbers for UnitedHealth Group, parent of Ingenix: revenue up 9% to $23.7 billion, with net earnings of $2.15 billion in earnings from operations, easily beating expectations on revenue and earnings. The company gave guidance of $94 billion in revenue for the fiscal year. Ingenix revenue was $592 million, up 23%, with $70 million in earnings from operations. The announcement also gave the cost of the Q3 acquisitions by Ingenix (Axolotl, Picis, and A-Life Medical, I assume) at $1.9 billion in cash. UnitedHealth market cap is $41 billion.

Odd lawsuit: a couple says a waiter at the local Steak ‘n Shake gave their child a bottle of Blair’s Mega Death hot sauce for his chili, causing him to break out in hives (assuming the child wasn’t hitting the restaurant on his own, maybe the parents should have intervened). They’re suing for $10,000 in compensation and $50,000 in punitive damages.

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HERtalk by Inga

CMS incentive payments are taxable. That’s the opinion of Steven Waldren, director of AAFP’s Center for Health IT. I’d never really thought about it, but that hardly seems fair. Definitely not nice.

Cerner Ambulatory tops the list of a recent Ovum report entitled Selecting an Ambulatory EHR Vendor in the Healthcare Market. I mentioned this on HIStalk Practice yesterday, but it perplexes me so much that I’m also asking HIStalk readers to share their impressions. I don’t know much about Ovum (which is a division of DataMonitor) so I asked them to provide me more background on their research methodology. No response as of yet. Cerner, along with eClinicalWorks and GE Healthcare, make their short list of top vendors based on strong brand names “in the ambulatory market” and for demonstrating “market-leading positions.” The report also says Cerner is the “most versatile and multi-faceted” of all the vendors reviewed (which included Allscripts, Sage, NextGen, athenahealth, and Amazing Charts.) To be fair, I know Cerner ambulatory by reputation only, so for all I know Ovum is spot on. The Cerner folks have graciously offered to dispel my skepticism and asked me to stop by for a demonstration at MGMA next week.

Follow-up: back in March I mentioned the former MedAssets employee who was arrested after using a fake identity to get her job and stealing financial information on more than 1,200 patients. Katina Candrick was sentenced to 10 years and ordered to pay more than $163,000 in restitution. As I was looking for a photo of Candrick, I noticed that in 2008 she had been charged with fraud, falsifying identity, and fraudulent possession of a controlled substance after posing as a medical clinic employee and attempting to pick up prescription drugs at a CVS pharmacy.

HealthGrades says that overall hospitals are improving, but the gap between the best- and worst-performing hospitals is substantial. A typical patient would have a 72% lower risk of dying in a 5-star rated hospital compared to a 1-star rated hospital, and a 53% lower risk of dying by going to 5-star rated hospital compared to the US hospital average.

Baptist Health System (AL) contracts with Passport Health Communications for Passport’s IntelliSource software for revenue cycle management.

Virtual Radiologic is named the top-rated vendor in the KLAS Teleradiology Study 2010. KLAS notes that teleradiology contracts had historically been held by local radiology groups, but now hospitals and clinics have 40% of the contracts. Look for teleradiology volumes to rise in the next few years.

athenahealth posts a 33% in increase in third-quarter revenues ($63.1 million vs. $47.4 million). Excluding one-time items, the company’s net income doubled from last year, coming in at  $6.4 million or 18 cents per share. Analysts were looking for a 27% increase in revenue and 13 cents share. Basically, a darn good performance. The always entertaining Jonathan Bush will provide more details at 8:45 a.m. Friday on CNN.

AirStrip Technologies collaborates with Sprint to offer a bundled solution that includes Sprint’s clinical grade in-building coverage and AirStrip services for hospitals agreeing to expand or extend an enterprise commitment to the Sprint network for more of their employees.

Thomson Reuters releases a new version of Clinical Xpert Navigator mobile for iPhone, iPod Touch, and iPad devices.

Lots of good stuff on HIStalk Practice this week: in addition to the usual posts, we feature several HIT Vendor Executives who shared their opinions on what attendees will be discussing next week at MGMA 2010 in New Orleans. We also published a handy vendor guide summarizing what each of our exhibiting sponsors will be highlighting at MGMA (you can download a PDF to print and take along). Do us a favor: stop by their booths, ask for a tour of their offerings, beg for a trinket, and tell them thanks for powering HIStalk and HIStalk Practice.

Sponsor Updates

• Greenway introduces PrimeSPEECH, an integrated direct-to-EHR speech technology and PrimeIMAGE PACS solution. Both solutions are fully integrated with Greenway’s PrimeSUITE EHR and physician workflows.
• MED3OOO acquires health benefits consulting firm Insurance Solutions Group.
• Voalte partners with Meru Networks to extend its capacity in hospitals running the Voalte application. The company also announces a trial at Parkview General Hospital (IN).
• For the third year, Vitalize Consulting Solutions earns a spot on the Philly 100 List, coming in as the 57th fastest growing privately held company in the greater Philadelphia area.
• Bronx-Lebanon Hospital Center selects the Allscripts Care Management solution, which will integrate with the hospital’s existing Sunrise Clinical Manager system. Bronx-Lebanon also recently deployed Allscripts solutions in its ED and 40-physician multi-specialty practice.
• SRSsoft is named to Deloitte’s Technology Fast 500, which lists the 500 fastest growing (by revenue increase) high-tech companies.
• MedPlus parent company Quest Diagnostics releases its Q3 financials: revenues of $1.9 billion, down 1.7% from last year; net income rose to $198 million ($1.13/share) compared to $192.2 million ($1.02/share).
• McKesson signs an exclusive agreement with MedVentive to offer that company’s SaaS-based Analytics Advisor analytics solution to the payor market, where it connects payors and providers transparently around clinical and financial performance metrics.

I’ll be traveling to New Orleans this weekend to attend the MGMA conference. I’ll be on the lookout for cool HIT stuff, collecting giveaways, and hopefully learning a few new things. Look for updates and photos.

E-mail Inga.

News 10/20/10

From Buck Dharma: “Re: CIO salaries. Are you still keeping a list? Long time reader — appreciate the effort you take to keep this thing fresh.” I stopped running CIO salaries a few years ago when it became kind of a pain to dig them up from tax records, but I’ll try to do some every now and then when I have time (remind me or tell me the ones you want to know). Here are a few new ones for you: Partners Healthcare, $803K. Sentara, $692K. Memorial Hermann, $834K. Detroit Medical Center, $391K. Adventist Health System, $774K. Centura Health, $468K. Children’s Dallas, $635K. University of Maryland Medical System, $569K. Suddenly I’m feeling poor.

From A-Rod: “Re: Audax Health Solutions. One of few healthcare firms to be selected by Google to beta test a unique machine learning algorithm. Audax plans to use it to tag and sort healthcare content to predictively suggest it to the Careverge user.” I’ve read the buzzword-oozing About Us page for Audax and I still have no idea what exactly they do — something to do with social networking and benefit management (you would think they could be succinct being that they apparently worship Twitter and Facebook). Google or not, I ran out of interest before I ran out of prose.

From Elsie: “Re: UPMC. These are the folks whose $5 million CEO earlier this year closed the only hospital in Braddock, one of the nation’s most underserved cities, and are now rushing to demolish the building. UPMC rationalizes saying they want to turn the site over to Allegheny County for ‘future development’. Anybody who’s seen Braddock, the embodiment of poverty and urban decay in America, knows it’s just block after block of boarded-up storefronts and empty lots. Taking away that community’s only healthcare facility is the antithesis of humanitarian.”

From K-Rod: “Re: anesthesiologists. I agree that they are on the edge for patient safety. Wonder when (or if) surgeons will get there? What you may not know is that these talented nurse anesthetists can sing!” I’ve mentioned these amazing guys before — The Laryngospasms. They’d make great entertainment for an HIStalk event, right?

From WillOurSoftwareEverWork: “Re: McKesson Horizon Enterprise Revenue Management. Implementations have been suspended and Release 2.0 is delayed until next year.” Unverified. I e-mailed a CIO who should know and I think Inga tried an informal company contact, but we haven’t heard anything so far. Consider this false until someone confirms.

From Careener: “Re: DHIN. I don’t know if you saw this Delaware dust-up (no, not former witches as US Senate candidates). The Republican candidate for US Representative took a shot at his opponent over the Delaware Health Information Network, saying it is ‘mismanaged … with no tangible benefit.” I was involved with DHIN as a provider and it was, and is, an unqualified success, with Delaware being the first state to have statewide results delivery, HIE to EMR integration, and public health integration for pandemic and reportable results reporting. It is the model other stares are following. Love reading your updates, please keep up the good work.”

From Lady Pharmacist: “Re: National Hospital and Health-System Pharmacy Week, October 17-23. It’s that time of year again. Can you kindly give a shout-out to pharmacists and pharmacy technicians? If you’re thinking that hospital pharmacists and pharmacy techs are like the drugstore ones that Jerry Seinfeld makes fun of above, you couldn’t be any more wrong. Imagine a small group of professionals who handle with virtually 100% accuracy the thousands of medication-related orders generated in a hospital each day, except unlike lab and diagnostic radiology orders, any one of those orders could kill a patient because of an incorrectly prescribed dose, method of administration, allergy, or conflicting therapy. Pharmacists and techs prevent untold errors every day as unchallenged medication experts whose only interest is patient safety. The hospital pharmacy is a complex, demanding environment involving drug procurement and distribution, clinical monitoring, professional consultation, heavy duty informatics, significant clinical and research work, and careful monitoring of the use of high-risk meds that cure when used correctly and kill when not. I’ve worked in hospitals for quite a few years and watched the transition of hospital pharmacists and techs from the lick-and-stick pill pushers that Jerry skewers to professionals adding indisputable value to patient care with their brains and not just their hands, quietly and unassumingly preventing innumerable bad outcomes without much glory. If you look at the most tragic medication errors (see: Quaid babies), you will nearly always find a situation where doctors and nurses mishandled drugs without pharmacy involvement. My hospital is featuring Pharmacy Week in the lobby display case, so maybe yours is, too.

Listening: Bad Religion, prototypical SoCal punk for over 30 years. Strong harmonies, angry but literate lyrics (the lead singer is a Cornell PhD and UCLA college professor), and a hard rock edge make them better than the Ramones if you ask me. I played a few seconds of two songs from Stranger than Fiction and instantly bought it for my gym iPod. Love it.

Encore Health Resources is named to Modern Healthcare’s 2010 Best Places to Work in Healthcare, which I’m sharing since they sponsored last year’s HIStalk reception at HIMSS. They just hired their 100th employee. That’s Dana and Ivo above, of course. HIStalk sponsors making the list: maxIT Healthcare and MEDecision.

ThinIdentity changes its name to Aventura. They need to learn to write more disciplined press releases — this one prattles on without giving even a hint at what they sell until the final “About” paragraph (answer: some kind of logon/logoff tool). Their Web site is much better at using the few precious seconds of the average Web attention span to get to the damned point.

Grady Memorial Hospital (GA) chooses Apollo Health Street to convert its legacy patient accounts to a new PA system. 

How do you tell when a CEO is lying? (no, smart aleck, not when his or her lips are moving). According to a researcher’s algorithm, lying CEOs tend to overuse words like we and our team to refer to the company in presentations, also showing fake exuberance with words like fabulous, fantastic, and extraordinary. Honest ones say I, me, or mine to indicate that they take ownership of their claims. That’s until this article came out, of course, which will tip off CEO media handlers to coach their lying executives better.

Cerner will become a reseller of address checking and patient classification software from SearchAmerica, which is part of mammoth credit scoring vendor Experian.

Former Cerner LifeSciences CMO Robert Dubois MD, PhD is named chief science officer of the National Pharmaceutical Council. Their mission statement sounds noble, but based on their sponsors (drug companies) and their emphasis on innovation and value (the “we have enough scientists to sort of prove that our unbelievably expensive drugs are actually a good value” approach), I’m guessing the scientific aspect mostly involves marketing.

Illinois Bone & Joint Institute chooses the SRS Hybrid EMR for its 242 Chicago-area providers.

Weird News Andy awakens from apparent dormancy with this offering, which he titles “Smurfitis?” Police in the Baltimore area are called to check on an 89-year-old woman, who they find blue, motionless, and smelling of decomposition on her bathroom floor. Instead of checking for a pulse, they call up her son and tell him she’s dead. Three hours later, a guy sent over from the State Anatomy Board to transport her body for use as a medical cadaver notices that she’s breathing. She is rushed to the hospital and discharged to hospice a couple of weeks later, where she died for real shortly afterward. The police chief says the case is “deeply disturbing.”

A Claremont Graduate University research team introduces the HealthATM, designed to give low-income health clinic patients access to their health information anywhere. It can be used to schedule appointments, request prescriptions, look up lab results, and review medical content. Community clinics enrolled up to 100% of their patients, 75% of whom wanted to use it regularly. What a fantastic idea – not everybody has Internet access and PC knowledge.

Lake Health (OH) introduces digital way-finding to its all-digital TriPoint Medical Center. It offers visitors a kiosk-based virtual guide that helps them locate their destinations, including the ability to have directions sent by text message. That makes me reflect on the odd design of hospitals compared to other public buildings, where visitors (many of them first-timers) are expected to traipse around back hallways and through multiple buildings to find lab, radiology, registration, and all kinds of other departments, often within a single visit and involving visitor-unfriendly jarring architectural change along the way since hospitals are often expanded patchwork over decades without any obvious continuity (“take the Red Zone elevator to seventh floor and then follow the blue stripe, then make the first left through the closed double doors marked ICU Waiting …” Clearly the unspoken paradigm is: you may be our customer, but it’s your job to come to us, no matter how hard we make that task. I confess that I can and do easily get lost in my own sprawling hospital campus, hoping that nobody notices my backtracking and frequent “where the heck am I” cognitive dissonance pauses until I finally give up and ask whoever’s at the nearest nursing station.

In Canada, Queen Elizabeth Hospital (PEI) warns of ED delays due to the implementation of Cerner’s FirstNet and PowerNote, which the assistant medical director says have a steep learning curve.

Bartron Medical Imaging wins FDA approval for its medical imaging software, which uses image segmentation algorithms developed by NASA for analyzing satellite images to find abnormalities in diagnostic images, such as those for mammography. I snagged the knee slice above from the company’s sample image database (you can log in as user guest and password guest).

The FDA issues urgent Class I warnings for the recalled CareFusion Alaris PC 8015 smart IV pump, saying its intermittent wireless network lockups prevent nurses from making programming changes, with the resulting runaway pump potentially causing serious patient injury or death in some circumstances.

A 21-year-old computer technician hired to fix a Georgia doctor’s computer uses the doctor’s password to sign on to a hospital’s computer system. He’s arrested and charged with computer theft, computer forgery, password disclosure, and “theft by taking.” The hospital’s HR VP says he thinks the man was trying to show off his computer knowledge to get a hospital job offer. Doh!

Doctors in Taiwan say their counterparts in China want to work with them on telemedicine and preventive medicine programs via cloud computing, given Taiwan’s superior capabilities in IT and medicine.

An investigative article by ProPublica finds that hundreds of doctors shilling drug company products have been accused of professional misconduct, have been disciplined, or don’t have adequate credentials. They created an online database that lets you look up any doctor to see if they’ve been paid promotional fees for any of seven big drugmakers.

In the UK, the Cambridge University Hospitals trust will take a pass on the defunct NPfIT’s Cerner Millennium or iSoft Lorenzo offerings, choosing instead to do their own system selection.

East Tennessee Children’s Hospital releases its iPhone app, which offers hospital information, maps, directions, parking information, health articles, and a place to store medical information.

E-mail me.
 

HERtalk by Inga

David Blumenthal calls on HIT vendors to “include providers who serve minority communities in their sales and marketing efforts,” expressing his concern that EHR adoption rates are lower among providers serving Hispanic or Latino patients who are uninsured or rely upon Medicaid. Having once made my living making sales, I can assure Dr. Blumenthal that salespeople (and their bosses) are happy to sell their EHRs to just about anyone who will buy them. If this segment of providers isn’t buying EHRs, I doubt it is because vendors aren’t knocking on their door, but because these doctors don’t have the money. These are the physicians who have forgone the bigger incomes to treat the uninsured/underinsured and who rely on reimbursements from Medicaid, not the higher-paying commercial carriers.

Philips Healthcare posts a 14% increase in revenues to $2.67 billion for the third quarter. North American sales grew 11%.

Emdeon wins a subcontract from CSC to perform IT services for the Department of Defense Pharmacy Operations Directorate. As part of the 51-month contract, Emdeon will develop interfaces for immunization tracking and lab systems.

Nebraska Medical Center subscribes to the CapSite database to improve its capital expenditure process.

Marion General Hospital (OH) pays a $1.2 million fine for self-reported Stark law violations that occurred between 2003 and 2009. The hospital’s president says it failed to do the proper paperwork for several physician-related matters, including payments to to independent physicians who saw indigent patients and provided emergency room call. The hospital also did not properly document providing office space and services at below-market rates. If I didn’t know better, I would think the US attorney handling the case is running for re-election. In a statement that seems to ignore the fact that the case was self-reported, he remarks, “This is a significant victory for taxpayers and another step in our efforts to protect the Medicare Trust Fund.”

Texas Health Resources and Alliance HealthCare Services (CA) contract with Sy.Med to provide credentialing software.

Union Hospital of Cecil County (MD) selects Wolters Kluwer Health’s ProVation Order Sets as its electronic order set solution.

The Scarborough Hospital in Toronto picks Access Intelligent Forms Suite to integrate with MEDITECH Magic. The Access product will improve forms management by pre-filling forms with patient information and auto-index barcode forms into the EHR.

Audax Health Solutions appoints Henry DePhillips MD as president of healthcare operations. He was previously with McKinsey and was chief medical officer of MEDecision.

RCM software provider Avisena hires Timothy Mills as VP of sales and marketing. He’s worked at NaviNet, Spheris, and CareScience.

Healthcare and financial transaction provider TransEngen appoints Mike Pileggi as EVP of sales. He was previously in sales roles with mPay Gateway and Misys Healthcare Systems.

Shareable Ink launches Shareable Ink Analytics for Anesthesia, a business intelligence module of its anesthesia record.

The American Hospital Association extends its exclusive endorsement of AT&T’s HIE services. AT&T Healthcare Community Online enables the secure exchange and sharing of patient data across multiple health systems. AHA also endorses AT&T’s voice and data networking services and wireless services.

Management Health Solutions, a provider of supply chain software for healthcare, acquires Hospital Inventory Specialists, which offers inventory management solutions and analytical services.

Eight of Minnesota’s largest healthcare organizations connect their Epic systems to electronically share patient data. All are members of the Minnesota Epic User Group using Epic’s Care Everywhere software. The network includes access to estimated 3.6 million patients, or 75% of Minnesotans.

The CDC awards CACI International a 10-year contract to support the CDC’s IT infrastructure. The contract has a ceiling value of $1 billion.

The board of directors of the Perkins County Hospital District (NE) approves a $1.5 million allocation to implement an EHR at the 20-bed Perkins County Community Hospital.

Xerox expands its healthcare footprint with the acquisition of pharma tele-services company TM Health.

KLAS reports that vendors offering integrated workforce management solutions are winning more deals than companies offering standalone staff scheduling products, even though providers prefer the functionality of stand-alone products. The top rated vendor was McKesson, followed by Clairvia, Concerro, API, and Kronos.

Evangelical Community Hospital (PA) commissions Keane Optimum as its financial, clinical, and EHR solution.

A reader sent me a note last week, noting that my avatar depicted “a very sweet young lady worthy of my attention strictly in a fatherly way.” A lovely and I am sure well-intentioned comment. A question to my fellow female HIT-types: why do you suppose that that statement leaves me disappointed and reminiscent of my early teens, when only the Ted The Geek-type boys noticed my existence? 

E-mail Inga.

Monday Morning Update 10/18/10

From Improper Setting, Here: “Re: CVS is caught stocking meth labs.” A $75 million software bug? Drug chain CVS is fined that amount for illegally selling pseudoephedrine (generic Sudafed) from its stores in California and Nevada. The congestion remedy had been moved to behind-the-counter sales since it’s used to manufacture methamphetamine. Meth makers found that they could simply make repeated buying trips to CVS to accumulate enough of the drug, made possible by a CVS software bug that couldn’t detect repeat sales. The apparent personal best: one customer bought the drug 10 times in 53 minutes from a single CVS store.

From Alicia: “Re: IntraNexus and biometrics. A big piece missing in medical device integration is patient identification, where this might be useful to bind patient ID to medical devices, especially if what they say about vein print is true. Right now you need a myriad of systems such as RFID and/or bar code and it’s usually done indirectly by bed number association.” The shots above from Fujitsu’s PalmSecure illustrate the concept.

From The Purple Computer: “Re: UPMC. Say it and people will come. How many nurses are they giving up?” UPMC rolls out a $16 million “branding campaign” centered around bold, humanitarian healthcare thinking — a purple logo (“fresh and progressive, yet warm and feminine … distinguishes us from the sea of blue in the academic medical center and health insurance space.”) Obviously they’ve let the marketing people run wild. Non-profit hospitals have gone over the edge when they start throwing around terms like “space” to refer to healthcare delivery. If their hospitals aren’t already full, I doubt there are enough patients will switch just because they’re tired of the blue-logo places. Maybe their competitors (if any are left other than West Penn) should run their own UPMC ads during Unemployment TV hours (daytime judge, talk, and soap programs) to dump more uninsured patients onto the newly purpled.

From Jailbreak: “Re: EMR vendor VP. I wrote you before about a sales VP with a criminal record and am amazed his new EMR employer didn’t check references. Here’s a threat to me from the VP, who can’t even write.” I’ve omitted names and details, but the purported e-mail from the VP, nearly unintelligible, is kind of fun in an illiterate, ransom note kind of way: “Why are you such a [genitalia synonym omitted] and hide you indenty .. Law suit coming … You dam well i never stole nothing from you … I will make sure I get on EVERY doctor website (EMRUPDATE) for example to let them know how bad and far back the [company name omitted] technology is … will not even get a whiff of 2011 cchit and over the EMR SUCKS The statements will come from various doctors … NOMATTER what you do I survive.”

From DyingToKnow: “Re: HCA. Persistent rumor in KC this week – HCA is switching from Meditech to Cerner. What’s the real scoop?” I mentioned from a sound inside source that HCA is doing a small Cerner pilot, facing an extensive effort and cost to move to Meditech 6.0 and figuring they might as well explore their options. I think that’s the limit of HCA’s commitment so far.

From Volare, WoOh: “Re: Moses Cone. They had a 1.5 hour recorded demo of Epic on their physician page, but it looks like it’s been taken down. There is also a CEO video talking about the $80-120 million Epic investment over the next five years.”

From Yosemite Sam: “Re: Most Wired award. I heard that AHA is discontinuing it. Maybe the commentary on HIStalk made them see the light.” Unverified. It can’t be because the award is pointless since that’s always been the case, so I’ll go with the obvious: with Meaningful Use, who cares about a phony award sponsored by skin-in-the-game HIT vendors and magazines trying (but failing) to perpetuate the myth that more HIT is always better? If the rumor is true, the CIO dilemma begins: should you leave the Most Wired vanity entry on your resume once the award is sunsetted? Here’s the award that actually means something: use IT to improve patient outcomes and/or reduce your costs, in which case your reputation will precede you without your having to wave flimsy evidence of it around. Too bad there’s no profit involved in that to attract the interest of AHA, HHN, CHIME, McKesson, and the other Most Wired conspicuous HIT consumption cheerleaders.

From HIT Geek: “Re: Siemens layoffs. The timing of Siemens layoffs follows the fiscal calendar. They are often announced on or shortly before the fiscal year-end (9/30). This year’s round is no exception. It is numbers-driven, with no concern for holidays or employee morale.” You would think well-educated MBA-type VPs could use their legendary quantitative skills to look forward more than one quarter, but that never seems to happen with any company. It’s like, holy crap it’s year end and the numbers suck, so start dumping people.

From Hogs Get Slaughtered: “Re: Cerner and Ingenix. Gonna take on 3M’s monopoly and crazy, hostage-style pricing.” Cerner will integrate coding and PPS solutions from Ingenix with Millennium.

From Kay: “Re: patient estimation tools. Patients want to know what the cost of the service will be and how much they will owe. The time of ‘wait and see’ is over — not just what it costs, but how much they will have to pay. Thirty states require the hospital to provide cost information. Vendors that provide a quick and easy 270/271 transaction code check based upon the hospital’s charge master cost for the service and the patient’s insurance plan  would be able to provide the most accurate estimate for the patient. A cost estimate at time of scheduling, pre-reg, or registration will meet state requirements and help the hospital compete. Time-of-service collection of the accurate out-of-pocket balance reduces collection expense and bad debt. These tools also allow checking addresses and creditworthiness. With medical identify theft on the rise, being able to immediately know that the ID provided by the patient may be associated with ID theft protects the hospital from lost revenue and also prevents the contamination of the EMR.” Kay works for Iatric Systems, which offers this kind of solution.

From ePatient Advocate: “Re: PracticeFusion. The ad-supported vendor said at Health 2.0 that they are the largest and fastest-growing EHR. No breakdown on how many are getting ‘free’ (aka pharma ad-sponsored version) and if patients want their docs to be getting drug rep visits via their EHR.” There’s an overview and demo above, just in case you’re interested. I didn’t watch it all, but ads and patient data sales didn’t seem to be emphasized.

I’m back from a break. Thanks to Inga for capably covering while I was away. I’m sure I’ll inadvertently repeat some of what she wrote about last week, but I’ll catch up eventually. That wasn’t really me in the picture she ran, by the way — that was just some sly Inga impishness. And thank God she didn’t sent out minute-by-minute Chilean miner updates since apparently the entire world had two full days to ignore pressing problems while watching feel-good bios of oppressed miners now turned instant but probably short-lived superstars (the most interesting aspect of that story is that the mining company is too broke to even pay their wages, much less the dozens of millions it cost a previously safety-indifferent government to get them out to create the mother of all political photo opportunities).

I bet not many people can say they couldn’t wait for vacation to be over to get back to their jobs, but I can (especially my HIStalk “job”, but I even missed my hospital one). I missed seeing people in scrubs and white coats, feeling the on-campus energy, and doing geeky IT stuff.

Readers don’t have a lot of confidence in the ability of Windows Phone 7 to compete with iPhone and Droid, it seems. New poll to your right — another economy check. From your employer’s perspective, how is the economy doing compared to six months ago? All I know is that my IRA value went up 10% last month, which is nearly as fast as it was going down for the past several.

Chuck Christian (Good Samaritan Hospital) and Judy Kirby (Kirby Partners) win the CHIME Collaboration Award for writing the IT internal marketing book that I’ve mentioned here previously. Chuck co-wrote it with Kirby VP Steve Bennett.

Yuma Regional Medical Center (AZ) names pediatrician Bart Bernstein, MD as its CMIO. He will lead the 333-bed hospital’s Epic implementation, which is costing $73 million. I noticed that the hospital has put up a website hoping to recruit candidates for its 40 newly open Epic-related positions. For some reason, they spell Epic as EPIC, which I see often but don’t understand since even Epic doesn’t go all-caps (unlike Meditech or MEDITECH, whichever is correct since I can’t figure that out at all). My rule is that only acronyms get capitalized and neither Epic nor Meditech is an acronym. It‘s usually those UPMC-style run-amok marketeers that demand to capitalize words against all logic or to stick annoying symbols on them like a proud rancher branding his steers.

Getting a local paper Epic mention: University of Colorado Hospital, spending $67 million.

Listening: the brand new debut album from The Band Perry, three young siblings cranking out polished country pop that sounds more genuine than the usual Disney-style, photogenic and overproduced hat-wearing faux cowboys/cowgirls pretending to know who George Jones and Ralph Stanley are but whose impeccable makeup might melt at the sight of an actual mandolin or pedal steel guitar. They’re from one of my favorite small towns: Greeneville, TN.

Stuff you can do if you want: (a) add your item free to the HIStalk Events Calendar; (b) click the Like button on the Facebook widget to your right or friend Inga or me; (c) search the amazingly deep HIStalk archives using the Search All HIStalk Sites box to your right; (d) send me rumors, news, or a Readers Write article; (e) check out the other sites, HIStalk Practice and HIStalk Mobile; (f) support my sponsors by perusing the ads to your left and clicking any of interest to see what’s new with the folks who keep the virtual printing presses running here at HIStalk; (g) thank yourself on my behalf for reading and for telling others about HIStalk.

On the Sponsor Job Board: Healthcare Consulting Principal – Washington DC, Allscripts Consultants, McKesson Build Analyst. On Healthcare IT Jobs: Senior Analyst – Provider Integration, Application Specialist, Clinical Sales Specialist, Epic Project Managers.

It’s American Idol, EMR style. Intellect Resources, looking to quickly hire 90 short-term Epic trainers for Mount Sinai Medical Center, is running a one-day audition in New York on November 5. The job pays a fixed rate of $20 per hour and lasts for a maximum of 24 weeks.

The Milwaukee newspaper profiles Epic with some interesting facts, with the most interesting one being confirmation of our June report that Aurora is dumping its $150 million Cerner system for Epic, which will cost them an additional $100 million. A quarter billion dollars seems like a lot for an EMR considering that Aurora showed a $50 million loss two years ago and a $116 million loss last year. For that performance, the CEO was paid $2.3 million last year (including a million-dollar bonus), the COO made $2.2 million (another million-dollar bonus), two other VPs made more than $1 million (both with >$500K bonuses), and the CIO took home $739K (including a $250K bonus). All while laying people off, of course.

That article about Epic values the company at $2.6 billion, or just 3.3 times revenues. That seems about right given that Cerner’s market cap is just over 4x sales and is better diversified, although Cerner is probably less profitable for the same reason.

Gary York, the founder of patient visibility vendor Awarix that was bought by McKesson in 2007 (and who was also founder of imaging vendor Emageon, since acquired by Merge Healthcare) is named board chair of Emergency CallWorx, an Alabama-based 911 and incident management software vendor.

A Florida business paper does a nice profile on nurse communication system vendor Voalte, mentioning its rapid growth (20 clients expected by the end of 2011) and its legendary pink pants. Trey Lauderdale told me that Inga gets some credit for those since he asked us for advice before the company’s first HIMSS exhibit awhile back and joked about needing to stand out among the larger and better located ($$$) booths. I don’t recall the details, but Inga either dared them to wear pink pants or picked up on Trey’s joke that they were thinking about it and she ran it in HIStalk before he could change his mind. The rest is history, as the pink represents the company’s fresh culture. Shockingly, we don’t get asked for advice all that often despite having other colors on reserve for those occasions.

GE reports bad Q3 numbers as it tries to shed its GE Capital baggage. Net income dropped 18% and sales fell short of estimates, although Jeff Immelt says orders are picking up (I’m always wary when the audited numbers are bad but the unaudited anecdotes are rosy). GE says its performance was dragged down by the $1.1 billion it had to pump into a Japanese finance division. GE Healthcare’s performance was the only bright spot, with revenue up 4% and profits up 14%.

Speaking of GE Healthcare, it announces a CCD-powered tool for Centricity that allows exchanging basic patient information with non-GE EMRs.

A veteran is denied his request to return to active duty in Afghanistan when a Pentagon doctor using DoD’s AHLTA EMR sees his post-traumatic stress treatment records from the VA’s VistA system. The VA is treating the incident as a data breach since the AHLTA-VistA interface isn’t supposed to exchange information of that type. VA CIO Roger Baker actually suggested that doctors not enter progress notes into VistA if they can’t figure out how to keep it from being viewed in AHLTA. On the other hand, the VA wants to rewrite/replace VistA at huge taxpayer expense, so that kind of warning would help the argument, I’m just saying.

Speaking of DoD, the GAO says the $2 billion AHLTA EMR (double that cost by many accounts, up to $20 billion by some estimates) is mediocre at best (limited capabilities and performance problems) and will be replaced by 2015 with something called "EHR Way Ahead,” with $302 million requested for FY2011. Northrop Grumman got billions to develop and maintain AHLTA (the EMR formerly known as CHCS II before it was rebranded in a PR-company led attempt to hide its many warts), so I’m sure they consider themselves an obvious choice to take a second uber-expensive swing at the ball. In any case, regional droughts are being relieved by vendor and fat cat contractor salivation. I love these AHLTA comments from student doctors:

• My favorite are the contractors who keep explaining how much easier it is to use than a real chart. I wonder how much medicine they practice.
• They tell you that all you need to do to fix the system, is keep sending trouble tickets in. since when did software testing get added to my job description? i want out, and as far away from AHLTA as possible.
• I remember watching the PGUI instructor (similar to AHLTA) show us how "wonderful" that system was. He pretended the pt was there for an asthma appt. I kept track of the time it took just for him (the specialist) to enter the info and the time the computer was "thinking" (hourglass sign). It took 7 1/2 minutes.
• I was the last holdout and management basically had to come down and hold a pistol to my head to get me to stop writing 600s. I still order things in CHCS and document it later in AHLTA when I get around to finishing notes in the evening. This is the biggest turd of a program I’ve ever seen.
• I haven’t met an AHLTA contractor yet that I would hire to help anybody program their VCR.
• For new users, if you’re trying to add a consult and it keeps kicking it out, 95% of the time you can fix it by adding a med first (I like rectal Tylenol), then adding the consult, then go and delete the med. Ha ha of course the fact that I have to do this to work around the bug lets you know how screwed up AHLTA is in the first place.
• What I hate is that, while psych notes are require a "break the glass" thing to access, the actual psych/counseling diagnoses appear on the front of every note created. Thus some poor kid talks to a social worker about problems with his wife, and every subsequent note has "MARITAL PROBLEMS" plastered to the top of it.
• It’s funny, I think AHLTA is the most universally despised part of military medicine. Anything else: GMOs, Base Locations, volume of procedures, whatever, you’ll find someone who had a good experience. AHLTA the opinions just seem to vary between ‘it’s pretty bad’ and ‘I’m armed and hiding outside the programmer’s house’.

When anesthesiologists talk about patient safety, I listen, because that group is the only one of all medical disciplines that admitted their own problems and went off on their own to reduce surgery-related mortality by a huge percentage (see: Peter Pronovost). The Anesthesia Patient Safety Foundation has new recommendations (warning: PDF) for medication safety in the OR, indicating its willingness to surrender anesthesiologist independence in the interests of patient safety: (a) put pharmacists in the OR; (b) use high-alert drugs only as premixed products and administered by smart pump; (c) bar code check meds before administration and with decision support and documentation built in; (d) use case kits whenever possible and do not let providers prepare their own drug doses; and (e) establish a just culture for error reporting. Not to perpetuate a stereotype, but if surgeons weren’t collectively such pouting egotistical cowboys, they might save more patients instead of arrogantly standing in the huge patient safety shadow cast by their anesthesiologist colleagues.

Verizon expands its Medical Data Exchange beyond simple dictated notes to include images and lab results. It also announces new partnerships: MD-IT for applications, Alert Notification for communication, Amaji for clinical documentation, Tolven for applications, NLP for natural language processing, ZyDoc Medical Transcription for transcription. I’ve never heard of MD-IT, but I was interested that one of its founders and board chair is an MD/PhD who founded the company that claims to have developed the first antivirus software, later sold to Symantec to become Norton Antivirus. He also founded Cybertrust, which Verizon Business bought in 2007. I guess he didn’t need to practice medicine.

Nurses at Children’s Hospital of Oakland go on strike after management makes them pay 15% of the cost of their healthcare benefits, which have risen 80% in the past five years. The hospital says the nurses all make at least $136K per year and the benefits will cost them only $4,000. Can they really be paying staff nurses $136K?

E-mail me.

News 10/15/10

HERtalk by Inga

From: JimmyJoe “Re: UW Warning on Cut and Paste. In my prior life I became increasingly concerned about the quality and safety ramifications of mindless cutting and pasting. The practice also causes progress notes to grow and grow (due to cut and paste and add), making the record increasingly unwieldy and less useful. I informally polled a number of people in my position and all of them were equally concerned. None of them had an answer other than policies around not doing it without paying attention. It is important to remember that cutting and pasting is not really an EHR function, it is a Windows function. What to do, what to do?” I don’t have an answer either but it’s good to know you can always blame Bill Gates, should an auditor raise concerns about cutting and pasting in your EHR.

From: Bama Bubba “Re: RFID tracked hospital workers. I wonder if RFID-tracked hospital workers feel like cattle, too. Personally, I never bought the ‘inventory tracking’ rationale (excuse) for tagging workers.” Two Houston-area school districts, hoping to monitor the whereabouts of their students, implement “the same technology used to track cattle.” Despite parental concerns about potential health risks, administrators are pleased attendance is up.

From: Weird News Andy “Re: Medicare fraud-biggest ever. Leads me to wonder. . . Medicare get hits with fraud ALL THE TIME. Do private firms get hit with fraud as often and we just don’t hear about it, or is there something about people looking out after their own money that makes them more vigilant?” WNA asks a compelling question, prompted by news of a $100 million Medicare fraud case. In reading details on this case, it sounds as if the art of cheating Medicare isn’t rocket science. Maybe it’s not as easy in the private sector.

When I first read details of this same Medicare fraud case, I thought it had the bones for the perfect modern day Godfather saga. Federal prosecutors have charged a band of 40+ Armenian-American gangsters for billing Medicare over $100 million in fraudulent claims (Medicare paid $35 million of them.) The enterprise has been led by Armen Kazarian, whose role is similar to a Mafia godfather. He came to the US in 1996 and was granted political asylum based on a fabricated story that involved his father being doused with gasoline and burned to death.The fraud operations started with the identity theft of doctors, including their medical license numbers. The accused group then stole the identity of Medicare patients. From there, gangsters created 118 fake clinics across 25 states and began churning out fake claims. In most cases, Medicare was happy to pay. The story includes plenty of infighting, threats of violence for not paying debts, and  untraceable money transfers back to Armenia. The US attorney handling the case calls it the “single largest Medicare fraud ever perpetrated by a single criminal enterprise.”

Not a moment too soon: HHS awards TerraMedica a contract to assess fraud, waste, and abuse in Medicare claims using predictive modeling technology.

The St. Charles Health System (OR) selects Allscripts EHR and PM solutions for its employed and affiliated physicians. The Oregon Community Health Information Network’s (OCHIN) REC will provide implementation and training support for independent physicians. Allscripts, by the way, also announces its 2010 President’s and Circle of Excellence Hospital awards, which recognizes customers with documented strategies and superior outcomes using Allscripts technology.

eHealth Ontario awards CGI Group a $46.2 million contract to develop a new chronic disease management system. The solution will operate on AxSys Technology’s Excelicare platform.  AxSys, by the way, also just secured contracts with North American Management California and MSO of Puerto Rico to develop HIEs running on the Excelicare platform.

The Denver paper highlights the University of Colorado Hospital’s migration to Epic. The hospital says data integration is one of the major benefits of the $67 million project, which is expected to be completed mid-2012.

Halfpenny Technologies, which recently secured $2.6 million in VC funding, appoints four new execs to its management team, including Mitch Fry as EVP of business development, Daniel O’Brien as CFO, Roger W. Newbury, Jr. as SVP of sales, and Jim Sheils as VP of sales. Individually the group has worked for such employers as Sunquest, Misys, TELCOR, Touchstone Health, United Healthcare Group,  US Laboratory and Radiology, and dbMotion.

DB Technology and BridgeHead Software partner to offer a joint content and storage management solution. The combined solution leverages DB Technology’s document imaging component and BridgeHead’s data and storage management tools.

MEDecision earns accreditation from URAC for meeting URAC’s Vendor Disease Management, Vendor Case Management, and Health Content Provider standards.

Vocera Communications acquires voice technology vendors Clinical Health Communications (makers of OptiVox) and Integrated Voice Solutions (maker of VoiceCare.) Vocera also reports a 39% y/y growth for the third quarter.

Catholic Health Partners (OH) claims its saved over $8 million using Kronos’s time and attendance and productivity solutions. CHP attributes the savings to reduced agency and overtime use.

A reader tells me that Advocate Healthcare (IL) is now live on SAPPHIRE for patient registration and accounting in all nine of their facilities.

A class-action lawsuit filed in Arkansas accuses HealthPort of charging patients an illegal fee when requesting copies of their medical records. The lawsuit is not challenging the legality of HealthPort’s basic charge to retrieve/copy/send medical records. However, the lawsuit contends that the $1.71 sales tax imposed by HealthPort is illegal and in-state providers do charge sales tax for similar services.

St. Barnabas Medical Center (NJ) picks Merge’s AIMS, medication management, and patient portal solutions.

UMass Memorial Health Care announces plans to eliminate 350 jobs, or almost 2.6% of its workforce. The seven facility system expects to lay off 130 workers, freeze another 120 vacant jobs, and eliminate the equivalent of 100 jobs by reducing overtime and move employees from full to part time.

Hiring: the Cincinnati Business Courier reports that healthcare systems in tri-state area expect to add more than 100 people to help set up various EMR systems.

Verizon releases plans to expand its Medical Data Exchange platform beyond its core transcription exchange services; members will soon be able to share X-rays, lab results, and other digital records. Verizon will also begin offering IT consulting services for its Exchange members.

This week on HIStalk Practice: KLAS publishes a new report rating ambulatory EMRs by specialty; the Rhode Island Quality Institute picks several pre-qualified EHR and technology vendors for its REC; Ohio State Medical Association publishes a new social media toolkit for providers.

API Healthcare says it’s recently signed up more than 30 healthcare clients for its workforce management technology.

The Chesapeake Regional Information System for our Patients (CRISP) announces its statewide HIE is now live.

Pemiscot Memorial Health Systems (MO) selects Prognosis Health Information Systems’ ChartAccess EHR.

Despite taking some well-deserved vacation, Mr. H did manage to check in with me a couple times this week. Mrs. H apparently took this shot of him taking a moment to ensure the HIT world was still on track.  Maybe he’ll post a few more pics when he posts the Monday Morning Update this weekend.

E-mail Inga.

News 10/13/10

HERtalk by Inga

From: Penny Chenery “Data Innovations.” Data Innovations is taking on a huge amount of capital from an unknown venture capitalist. It is either an outright sale, or a large infusion of cash.” Investment firm Battery Ventures announces it just purchased the maker of software for managing clinical lab data for an undisclosed sum. Data Innovations also appoints former Lawson VP Mike Epplen as the company’s new CEO.

From: WALL-E “Re: Most Wired. I heard AHA is discontinuing the Most Wired award. Maybe all the commentary on HIStalk made them see the light.” Unconfirmed but I am sure that just reading the rumor will make Mr. H smile for a second or two. WALL-E wasn’t clear if AHA is no longer going to be associated with Most Wired or if the Most Wired award as a whole is going away. Send a note if you know.

From: Bertha Lindau “Re: Moses Cone. In case you’re interested, here’s a PDF where the Moses Cone COO talks about replacing GE with Epic.” The internal newsletter includes details from a brown bag lunch with COO Terry Akin, who has a number of interesting things to say about the transition. He points out that the health systems was unable to develop a fully integrated health record after their “big investment with GE” five or six years ago.  Akin calls Epic the “one company that has emerged head and shoulders above the rest” and claims that 99% of their physicians were favorably impressed with the Epic demo.

As WisconsinBiker shared June 23rd, Aurora Health Care (WI) is replacing its 15-year old Cerner system with a $100 million Epic solution. Aurora CIO Philip Loftus says that one the biggest advantages of Epic over Cerner is Epic’s fully integrated solution for both hospitals and clinics. Epic, by the way, is expected to end the year with $780 million in revenue, compared to $650 million last year and has an estimated market value of $2.6 billion.

Cerner may not be feeling the love from Aurora, but I bet the Kansas City Convention & Visitors Associates are big fans. This week’s Cerner Health Conference will generate $4.5 million for hotels, food, fuel, and related expenses as 6,000 users descend upon the city. Cerner took advantage of the event to announce several new alliances:

• A reseller agreement with SearchAmerica that includes the integration of Cerner’s revenue cycle offering with SearchAmerica’s financial services
• An alliance with Ingenix to  integrate Ingenix’s medical coding and prospective payment system (PPS) solutions into Cerner’s Millennium product
• A reseller agreement with MedAssets to market MedAssets’ web-based revenue cycle services

Here was an odd observation from one of the local papers: Cerner closed many of the leadership forum sessions to the media. Of course now the whole HIT world wants to know what Cerner was hiding.

Also meeting this week: nearly 1,500 Sunrise Enterprise users in San Diego. Attendees had a chance to see the new Sunrise Mobile MD iPhone application, which enables physician to access the Sunrise system. Allscripts also introduced Allscripts Developer Program, which allows clients and third parties to natively integrate their applications with Allscripts’ solutions. In December, clients will be able to search the Allscripts Application Store & Exchange to select or share applications developed through the Developer Program.

QuadraMed’s former SVP of corporate development Steven V. Russell joins digital pathology vendor Aperio as VP of corporate development.

A longtime HIStalk reader asked us to mention the upcoming HIT Leadership Summit in Atlanta November 9th. Silicon Valley venture capitalist Bob Bozeman (of Google fame) is keynoting the event, which aims to highlight Georgia’s leadership in HIT, plus drive statewide HIT revenue and job growth. There’s a pretty impressive list of HIT companies, universities, and medical schools participating in the event hosted by the Technology Association of Georgia (TAG), the Georgia Department of Economic Development, and the Metro Atlanta Chamber. I am happy to make the mention for Marty Mercer, who is on the TAG advisory board and a faithful reader. Plus I have a soft spot for attractive bald men.

So, Mr. H is vacationing this week, leaving me solo. I’m sure I have left out some earth-shattering HIT news, so give me a break and shoot me an email if you have some juicy news to share.

The Camden HIE (PA) goes live this week, connecting Cooper University Hospital, Lourdes Health System, and Virtua Health. Each of the three health systems is contributing $50,000 a year, plus the Merck Company Foundation is donating $50,000.

Vincent Marin joins Huron Consulting Group as CIO following 16 years with McKinsey & Company. Marin most recently served as director of IT services for the Americas region.

Novella Clinical hires Charles Lambert as its new CFO. Lambert had previously served as CFO for RCM provider Capario and Misys Healthcare before that.

Sponsor Updates

• CynergisTek CEO Mac McMillan, who also serves as Chair of the HIMSS Privacy and Security Steering Committee, will be a presenter at the Midwest HIMSS 2010 Fall Technology Conference next week in Minneapolis.
• e-MDs is playing an integral role in the creation of the HIT Certification program at the University of Texas. e-MDs’ CEO Dr. Michael Stearns serves on the curriculum committee and the company has donated their Solution Series EHR/PM system. Of the 34 students eligible for employment from the first graduating class, 21 have secured HIT jobs and seven have been hired by e-MDs.
• Medical Hills Internal Medicine and Pediatrics (IL) selects SRS Hybrid EMR for its 14 provider practice.
• Healthcare Coalition of Texas awards EDCO Group a contract to give its 17 healthcare system members to EDCO’s document management solutions.
• Sunquest Information Systems expands its international operations with the hiring of Dr. David Rossitter as director of customer operations in Norwich, UK. Rossitter most recently served as Interim Head of Operations for Astron Clinica.
• Frisbie Memorial Hospital (NH) contracts with Voalte for its integrated communication solution for the iPhone.
• Lourdes Hospital (KY) is working with Informatics Corporation of America (ICA) and Ulrich Medical Concepts to provide a bi-directional CCR for providers. Lourdes providers currently have access to the ICAare Clinical Portal;  bi-directional capabilities are being introduced for practices utilizing the Ulrich Medical EMR.
• PatientKeeper reports that its customers are processing more than 10 million physician charges annually with its Charge Capture application. PatientKeeper also just added US Memorial Health System (IL) as a new client and expanded agreements with Alegent Health (NE), Boston Medical Center, and the Robert Wood Johnson Medical Group (NJ).
• University Health System (TX) signs an agreement with iSirona to use iSirona’s technology to automate the delivery of patient medical devices to to the hospital’s EMR.
• Memorial Hospital (IL) selects Access Intelligent Forms Suite to complement its MEDITECH 6.0 Advanced Clinical/EMR system.

How does this happen: a Pennsylvania paramedic is charged with multiple counts of felony theft for stealing and re-selling as many as 15 ultrasound machines. Over the past few years, Juan Torres worked for a private ambulance companies and several ERs where various ultrasounds equipment was  reported stolen. The units,  some valued at around $35,000 each, were being offered on eBay for under $7,000.

E-mail Inga.