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.

Healthcare IT From the Investor’s Chair 10/12/10

Health 2.0 2010 – Two Perspectives, One Attendee

I attended my second Health 2.0 conference in San Francisco last week and find myself suffering from multiple personality disorder as a result. My multiples (only 2) are the geeky, health policy, propeller-head Ben; and the Investor Chair Ben. Allow me to share both views.

What an amazing ecosystem (or is it an incubator)!:

Health 2.0 is easily the most forward-thinking conference I attend, and the sense of energy and excitement there amazes me. I even started following a Twitter feed for the first time! Yes, it’s a bit like the Internet conferences I attended in the dotcom days, but there’s much more of a focus on empowering patients, improving decision making and making healthcare better.

Unlike the e-health conferences of yore, while investors do attend, they’re not throwing money around. With over 1,000 attendees and close to 50 sponsors this year, the conference is clearly a success. Kudos to Matthew and Indu (who I actually think might be the best entrepreneurs in the room) for putting it together and creating a bit of a sandbox in which people can play.

Another industry veteran and I were musing that it has a similar feel (albeit smaller scale and way hipper) to the Microsoft Healthcare Users Group (MS-HUG) conferences we used to attend about a decade ago. That is to say, it’s an outstanding networking and business development venue. Yes, the term ecosystem was way overused, but there’s a degree of earnestness that I find alternately annoying and endearing.

As expected given the 2.0 theme, many of the “companies” are focusing on social networking and “user generated healthcare”. I’m not sure if tweeting what I eat or posting how many steps I take will change my behavior, but a number of the other attendees seemed to think so.

Bottom line for this Ben is, as a very smart entrepreneur turned venture capitalist observed, “Health 2.0 is a great chance to catch the vibe and see what people are thinking about five years out.” He went on, however, to say he’d likely invest elsewhere for the next few years as he waited for the market to catch up. This brings us to what did Investor Chair Ben think.

Let the Angels Sing (Because the VCs Aren’t Likely To)

All of the above notwithstanding, I saw few, if any, investing opportunities.

Yes, some of the sessions had interesting ideas, but I couldn’t shake the 90s Internet conference feel. Too many companies were more into showcasing how edgy and disruptive they were, then how lucrative, proprietary or sustainable they were. There’s this tone of self-congratulation that I find off-putting (but maybe I’m just old!).

While I wasn’t able to attend the DC to VC conference the day before (another part of Health Innovations Week), chatting with some folks from a major publisher who did, I was told that none of the pitches they heard talked about a business model or how they’d make money. Of the companies I saw or spoke with that did have a business model, as with last year, too many were focused on advertising revenue or were just too small in scale to attain institutional financing. That, perhaps, is part of the appeal and charm of Web 2.0 in general. It allows someone to develop a website or app in their loft or garage and perhaps make a few hundred thousand dollars a year doing it, quit their day jobs working for the Man and, best of all, in this case, improve the health status of a sizable number of people in the process.

This shoestring/boot strap ability is great and exciting, but it typically does not create something an institutional investor who wants to generate returns for their funds’ investors (and themselves) is likely to care about, hence my conflicting viewpoints. Did I see a few companies that were likely institutionally backable? Yes, but with the criteria of having reasonably high entry barriers and/or capable of generating $10-20 million in EBITDA (earnings before interest, taxes, depreciation and amortization – a key financial metric used by investors), I’d say less than five. It not being a venture forum event, I will decline to name them, but I’d be surprised if they were EMRs solely for iPads (how long will it take NextGen, Sage or AdvancedMD to develop their own?) or a service that allows me to get a text message of my last STD status to prove I’m healthy before I hook up (though the founder of Qpid.me did a great pitch).

Trying to integrate my two personalities, I’ll observe the following about Health 2.0 and its eponymous conference:

Health 2.0 is real and becoming mainstream. Sponsors included Cerner, RelayHealth (aka McKesson), OptumHealth (part of United, sister of Ingenix), and Sage (fka Medical Manager). These aren’t companies jumping on the bandwagon or trying for some gloss either; for the most part they have a commitment.

Part of the power and excitement are the low entry barriers and the ability to bootstrap on a shoestring (Inga, just which is the right footwear metaphor here?) For minimal cost and time, a developer or entrepreneur can make a difference in people’s health status/quality/access…

…but raising capital will be a challenge and a home run (or even a triple) exit isn’t a likely outcome.

There were some innovative ideas and great, exciting and high energy people…

…but more features and products than companies.

I’ll close with a link to a very worthwhile Forbes article written by some of the best HCIT VCs in the business. In addition to athenahealth, they’re currently invested in four private companies that I personally find fascinating. Their lessons learned are well worth noting.

Ben Rooks spent ten years as a sell-side equity analyst covering HCIT and related sectors before spending six years as an investment banker where he closed transactions ranging from $40 to 365 million. Seeking to make an honest living, he then founded ST Advisors, LLC where he works with healthcare companies and their sponsors, most often on issues around strategy, financing, and outcomes/exit planning. After all this time, he still can’t wait for HIMSS!

Monday Morning Update 10/11/10

From The PACS Designer: “Re: Windows Phone 7 launch. Microsoft has scheduled the Windows Phone 7 launch for October 11. If Windows Phone 7 is as good as Win 7 in combination with Bing, then we’ll see some interesting apps that could start to be used by healthcare providers and patients.” I’m not a big fan of the name for sure, and I don’t know how many people care about the Zune Hub. The Windows Phone Live cloud service seems cool. Overall, I don’t think it’s exaggerating to say that lines of would-be purchasers Monday morning (or lack of them) will tell you a lot about the odds that Microsoft will return to innovation relevance. I can’t imagine anyone giving up a recently purchased iPhone or Droid to get one — they’ll have to energize the fence-sitters. You don’t want to be slow to a market involving long-term contracts.

From Five Grand, Here: “Re: Harvard. Capitalizing on fear and anxiety, they’re going to the bank after promoting them. Even with a visit to the Harvard Faculty Club, am I the only one who thinks this is a rip-off?” The Harvard School of Public Health offers two-week program on HIT leadership for $4,995, not including hotel and dinners. Faculty includes Glaser, Halamka, and Middleton. Hospital people are so insecure and indecisive that I’m sure the mid-levelers with budget money show up (and probably add an intentionally vague note about their new Harvard “education” on their resume, which is part of what the $5K buys in their minds, I’d bet). The site says the attendee satisfaction is high. I’ll reserve judgment until someone who has been tells me their outcome, i.e. everything else aside, did their employer, who is likely quite different from Harvard, get their money’s worth in sending them? Sometimes expensive is worth it.

From Paisano: “Re: GE. I heard they’ve restructured the sales force. Any insights?” I don’t usually follow sales force restructurings, but anyone who wants to chime in can. I’m bored easily by endless territory realignments, new management bringing in recycled ideas already tried and failed elsewhere, and messing around with the sales function instead of fixing the real problem of underperforming products or executive management.

From Mark Wagner: “Re: HIStalk article EMR: One Size Does Not Fit All. Evan Steele made some accurate observations in his recent physician practice EMR post. There are many variables that influence the eventual success or failure of an EMR deployment at a practice. Practice specialty is absolutely one of them. Since HIMSS10, KLAS has been compiling a report that drills down on EMR vendor performance by specialty. As the need for more information by specialty was raised in this forum, it seems appropriate to also announce here that KLAS is releasing a first-of-its-kind ambulatory EMR specialty report on Tuesday. Beginning October 12, providers will be able to download a complimentary copy of the KLAS EMR specialty report and vendors can purchase a copy of the report. Mr. Steele correctly points out that KLAS only accepts evaluations from live users of a system. KLAS feels that live users are best equipped to report on current release quality, vendor responsiveness. and the level of customer support. Former users often share comments about failed experiences and KLAS reports that feedback when it is offered. KLAS welcomes research topic suggestions and questions about what we do and how we do it. Please contact us at info@KLASresearch.com.” Mark is the director of ambulatory research at KLAS.

From Mark: “Re: Meditech’s history. I love telling this story. Beverly Hospital was the beta when Meditech was introducing color terminals. Their controller and CIO went to visit Neil in the development building in Cambridge, which was actually two buildings, one old and one new, joined on a few floors. When you walked from the second floor of one to the second floor of the other, there was still a step because the floors weren’t the same height from the street. They went into the room where Neil was putting the final touches on the EPROM that was going to become the master for the new color terminals. All that was left to do was to pick out the colors that would be used for certain menus and pop-ups. Neil let the people from Beverly choose the color palette for hundreds of thousands of color terminal users.”

From John Smith: “Re: Ingenix. Layoffs in the payer and government group (the division that acquired AIM Healthcare). Rumor is about 100 people this past Wednesday.” Unverified.

HIE vendor Halfpenny Technologies gets $2.6 million in VC funding.

Thanks and welcome to North Highland, supporting HIStalk as a Gold Sponsor. The company, based in Atlanta but with 45 offices all over the US and elsewhere, does things differently. Instead of flying consultants out from a central location at the client’s expense, they have experienced consultants who work out of the same cities as their clients, or as they say, “Our consultants trade hotel rooms and security checkpoints for dinner at home and Little League practice.” Their results are real and measurable and their work is guaranteed. Thanks to North Highland for supporting HIStalk.

I was thinking about the impending Siemens layoffs, scheduled to start in early December. I know the Thanksgiving to New Year’s holiday season is long (15% of the year, basically), but companies could at least appear to be more humane by whacking their previously valued associates after January 1 instead of during the holidays. Cutting people loose right before Christmas means executives either don’t care or have let the situation become so desperate that the only answer they have for their own poor planning is to decisively overreact.

Carol from RelayHealth, who describes her specialty as “all-around-helping-providers-get-paid products”, offers a new white paper for readers interested in the point-of-service payment question asked earlier. You can download it here.

It seems that the IS department is going to be doing the Meaningful Use attestation work in most hospitals, although many clearly haven’t decided for sure. New poll to your right: how well will the Windows 7 phone compete against the iPhone and Droid?

If you’re an HIStalk sponsor and didn’t get your invitation from Inga for out little get-together in Orlando at HIMSS, e-mail her. We look forward to seeing you there.

Nuance and IBM are collaborating to develop Clinical Language Understanding, a healthcare-specific natural language tool to extract discrete data from clinician narrative.

Bon Secours Health System will use medical error tracking tools from Quantros.

BCBS of Nebraska chooses NaviNet’s provider communications portal for real-time eligibility checking and claims status and remittance.

I’ll leave you with one of the many amazing moments (this one from 1987) from St. Elsewhere, the best hospital drama ever. This is the memorable scene where Dr. Westphall expresses his opinion of the hospital administrator sent in by Ecumena, its new for-profit owner.

E-mail me.

News 10/8/10

From Rickie in the Shadowlands: “Re: Siemens layoffs. 475 jobs in Managed Services and Professional Services (including Soarian support) will be transitioned to India and Romania, with the first wave of layoffs 60 days from last Thursday. The VP emphasized that no job is safe.” Rickie included the internal e-mails from both the VP (I don’t know his name) and from CEO John Glaser (still feels funny to think of him as vendor CEO and not hospital CIO). John’s seemed sincere and personal. The VP used every contrived buzzword and trite phrase known to man, coming across as smug in leading off with the “clarity and applicability” of his memo, moving to “evolve our delivery model,” “drive value to our customers and position for mutual success,” and finally in artfully finding a soothing phrase to describe trucking off 500 American jobs overseas, “introducing additional geographic diversity.” It’s bad enough to lose your job without having to hear brain-numbing Management Muzak as the soundtrack.

From Hot Nurse: “Re: nurses. The IOM released a report Wednesday recommending that nurses take leadership roles in healthcare redesign as physician partners. Within hours, the AMA issued a rebuttal, saying that nurses don’t have the education and training that doctors have and they should not assume an equal role. The IOM had science in its hand in saying that nurse practitioners have outcomes equal to or better than MDs. Seriously, the best they can come up with is ‘nurses aren’t our equals?’ In fact, physicians don’t want this low-paid work and we can’t recruit enough primary doctors anyway. The physician image has gone from gods to captains of ships to pathetic in my career. They have not supported IOM’s patient safety initiatives (checklists, handwashing) or embraced IT. They don’t want to do primary care, but don’t want anyone else to, either, and they have no plan for the coming tsunami. Nurses excel at patient engagement, communications, and education, which MDs avoid since they can’t bill for it. Their last big proclamation was that they won’t read PHRs for patient histories because nobody will pay them to do it. The poor economy is bringing out the worst in them.”

From Capitulator: “Re: Meditech’s database. We have a data repository, but given the latency in populating it, would like to access Meditech’s database in real time. Can you enumerate the companies that provide tools to do this? I gather that Blue Elm is one of these but we were hoping for something less expensive.” I need some help from Meditech experts on this one. If you have some advice, click the Add Comment link at the bottom of this post and fire away. Thanks.

From Dr. Love: “Re: patient estimation tools or eligibility software used by hospitals. Would you consider this as a topic for the future? We are interested in products that we can use in our application with simple imports and exports.” I’ll have to punt on this question, too. Little help?

From Picka Penny: “Re: Iowa HIE announcement. The scope was changed by the state to 40 hospitals, meaning ACS’s winning bid is less than $3,000 per hospital per month. I don’t see how they can even buy hardware and pay the expenses of the employees who will have to work free.” Unverified.

From Beantown MD: “Re: your list of reasons that hospitals buying physician practices won’t work this time around, either. You are absolutely correct. It will not work for the reasons you describe, which were the same reasons for the failure in the 1990s. Since then I have not seen any real change in how doctors view this issue. And for the record, these reasons are about the same for why Disease Management works so poorly.” Thanks, Doc (he really is a doc – I just didn’t give his name).

Listening: new from Canadian grunge rockers Finger Eleven, a little softer than their older stuff, so I went back to The Bluest of Gray Skies. All of it’s good, though.

I’ll be mostly incommunicado next week as I take a slightly-deserved hiatus with Mrs. HIStalk in a tropical locale, so the fabulous Inga will be wo-manning the helm in my absence. I’m hoping for none of those “it was better without you” comments when I come back.

My pal Lyndsey from Nuesoft (she friended me on Facebook and Liked HIStalk, so that makes her my pal) sent over some pictures of their sales folk at AAP last week, dressed in vintage clothing representing client-server technology compared to today’s cloud computing. That’s one hideous leisure suit (I’m having disturbing Mr. Furley flashbacks) and a couple of cute Trekkie outfits. You have to be fearless to be in sales, evidently.

Adobe wins the Blue Button Developer Challenge, sponsored by Markle Foundation and the Robert Wood Johnson Foundation. The challenge was to create a Web-based tool that downloads information from the VA or Medicare to help patients manage and improve health. Adobe’s Blue Button Health Assistant extracts immunizations, allergies, meds, health history, labs, and military service histories.

Terry Ketchersid MD, VP and chief medical officer of Health IT Services Group, suggests the 2010 book above in response to the reader’s interest in a book about HIT and the future. I see chapters by familiar names Don Berwick, Don Detmer, Bill Stead, and Jon Perlin. Terry’s company sells the Acumen EHR for nephrologists (a very small group, apparently) and they produce an EHR blog for them, including Meaningful Use information. Terry also marvels that I have time to write HIStalk, which was exactly what I was thinking Tuesday evening when I came home from work, ate in approximately 120 seconds, and didn’t leave the chair for the next five hours until I was finished writing Tuesday’s post. Tonight was a breeze at just 4.5 hours.

Voalte gets a writeup in their local Sarasota paper for implementing its iPhone-powered voice, alarm, and text system at Wahiawa General Hospital (HI).

Inga mentioned the new Allscripts Homecare Mobile. Above are a screen shots I found on their site. It will run on Windows Phone 7-based smart phones.

The VA puts its previously mothballed pharmacy re-engineering IT project back on track after redesigning the project structure.

The Technology Association of Georgia and other groups are sponsoring an all-day HIT Leadership Summit on November 9 at the Fox Theatre in Atlanta. I had to dig and scroll to find pricing, but it looks like $39 for members and $59 otherwise.

IntraNexus will integrate PatientSecure biometric patient identification into its SAPPHIRE Patient Access Manager and Advanced Clinical Manager solutions. Registration or clinical staff will direct the patient to place their palm over a scanning sensor, which will retrieve their records if they’ve been seen previously. My first thoughts were addressed in the fourth paragraph: it can be used to identify John Doe patients and can validate the bearer of an insurance card.

Stockholm-based Elekta boasts of the #1 KLAS rating of its MOSAIQ Radiation Oncology/MOSAIQ Medical Oncology systems among oncology information systems. You may recall that the company acquired IMPAC Medical Systems in 2005, making it the world’s largest oncology software vendor.

Both Davies Award winners in the ambulatory category are e-MDs clients, the company says. I like this: The Diabetes Center of Ocean Springs, MS is the first non-physician provider to win the Davies — it’s a nurse practitioner clinic. I’m shocked that Inga offered no commentary about their attire, which I think is quite fetching and possibly deserving of an award in the clinical couture category.

Jobs on the HIStalk Sponsor Job Page: Management Consultant for Clinical Workflow, Project Manager, Regional Director of Centergy Sales. On Healthcare IT Jobs: Data Extraction Architect, IT Systems Analyst, Implementation Specialist, Product Manager.

I like this: Meditech quietly supports the Lesley University New Teacher Community. They got Neil Pappalardo, Larry Polimeno, and Howard Messing to talk about teachers who made a different in their lives and took the great pic above, which I’m appropriating with full credit to their site because I think it’s an excellent shot of some pretty amazing guys. Sounds like a man crush, I know, but you cannot believe the business accomplishments and social contributions made by the Meditech founders and executives over the years. Neil Pappalardo’s story would be a Hollywood hit, I’m convinced. I’ll willing to write it.

Among the Phoenix-area companies presenting at a December investor conference: ClearData Networks (healthcare cloud hosting) and WebPT (a Web-based EMR for physical therapy clinics). I figured I’d give them a shout out just to be nice.

A Microsoft executive proposes that PCs be blocked from connecting to the Internet if they don’t have a health certificate, drawing an analogy to vaccinations. A security expert, referring to Microsoft’s endless security updates, said, “There may be some who would say that Microsoft shouldn’t be on the internet until they get their own house in order.” I think Microsoft is right in identifying a need to protect the Internet a bit better, although the devil is in the details.

This might be a record: 24 laptops are stolen in a Troy, MI pain clinic break-in.

An MIT graduate student develops a health monitoring system that uses a webcam built into a mirror to determine heart rate. It measures variations in facial brightness, a technique that the student thinks will also work to determine respiration and blood oxygen levels.

A free Internet tool developed by a UK-based non-profit research group predicts the drug regimen response of AIDS and HIV patients with 80% accuracy, better than any other method.

Former national coordinator (back when the government wasn’t spending much on HIT) David Brailer is elected to the board of Walgreens. I will have to drop him a note to recognize my local store, where I stopped the other day to buy Halloween candy and found a delightfully garish and well-made Hawaiian shirt perfect for vacation for $6.99. That’s healthcare in America: the same store that sells prescriptions and medical supplies also carries heavily discounted Hawaiian shirts, cigarettes, and motorized Halloween skeletons.

E-mail me.

HERtalk by Inga

Robert Wood Johnson University Hospital (NJ) selects ProVation Medical MD software for gastroenterology procedure documentation at is ambulatory surgery center.

Medicity secures contractual commitments with five new health systems representing 12 hospitals.

RemCare, developer of a care coordination software product, raises an additional $1.9 million in equity and warrants, bringing its current round funding to $3.3 million. RemCare’s CEO is Ben Albert, a former VP of client services for PatientKeeper.

The Health Information Partnership for Tennessee selects Axolotl’s Elysium Exchange platform for its state HIE project.

RelayHealth introduces MedGift, which sounds like a cool departure from its typical RCM and HIE connectivity services. MedGift is a patient gift registry and social network that facilitates communication between patients and their friends and family members. In addition to providing communication tools, MedGift allows patients to register for personal needs, wants, and wishes based on their individual circumstances. MedGift was actually founded by a cancer survivor is a free service for patients and their families.

AT&T partners with eCario machine-to-machine wireless data and mobile connectivity for near real-time, remote monitoring of cardiac patients.

The Ohio State University Medical Center names Phyllis Teater CIO. She’s been serving as interim CIO since January.

Starting this weekend, downtown Kansas city will be packed with 6,000 Cerner health conference attendees. If you are one of them, send us a picture or a report from the front lines.

iMDsoft introduces MVdashboard, an ICU tool that displays clinical and administrative metrics graphically.

Emmi Solutions, a provider of Web-based patient communication tools, names David Pearah CTO and SVP of product management. He was previously VP of the e-prescribing business unit of Allscripts and the former director of product management at Nuance-Dictaphone.

Trey Lauderdale of Voalte sent me a note this week saying he’d be presenting at the DC to VC: Investing in Healthcare IT Summit. Even though US CTO Aneesh Chopra and HHS CTO Todd Park were featured speakers, I told him it probably wasn’t worth a mention — unless he could get a picture with one of those guys in the (in)famous Voalte pink pants. Todd Park obviously has a sense of humor.

Halfpenny Technologies secures $2.6 million in VC funding, which it will use to deliver its Lab Hub platform.

A compliance analyst at UW Medicine Compliance warns providers of these patient documentation shortcuts in EHRs that might raise concerns during an audit: (a) cloning (cutting and pasting) form previous encounters; (b) templates that include pre-filled “negative” terms for each organ system, and (c) macros. CMS is especially concerned when they suspect templates are doing the bulk of the documentation.

Ninety percent of CHIME CIOs participating in a recent survey believe their organization will qualify for Stage 1 stimulus funds by September 30, 2012. They expressed concerns, however, that staffing deficiencies could affect their chances at implementing an EHR and receiving stimulus funding. The release of the survey results coincides with CHIME’s annual Fall Forum. Now what will be really interesting is to revisit these same issues over the next couple of years.

Speaking of the CHIME meeting, Ed Marx tells me he won the CHIME Charity 5k. Ed also sent over this photo of David Blumenthal, who spoke in front of 600 attendees and stressed the need for the government and healthcare providers to address consumers’ privacy and security concerns.

When reality is crazier than TV: Actor Brando Eaton files a suit against a prop company, charging it failed to inform actors that a defibrillator on set was a “real working device.” A fellow actor on Miami Medical (a show I’ve never heard of, but that Mr. H says he’s seen filming at Warner Brothers in Burbank) applied the defibrillator to Eaton’s chest during a scene and it sent electrical charges through his body. Eaton was taken to the hospital and later needed treatment and counseling for “anxiety, flashbacks, and apprehension.”

Several employees at a Michigan hospital are reprimanded over a photo taken during a break and later posted on Facebook. One picture was of a nurse removing a splinter for another nurse while in an empty operating room. The pair were part of a group written up for “unprofessional” behavior. Unless I am missing something (like patients were left unattended or a patient’s photo was posted), I’m thinking we are getting a bit overly sensitive about policing social media.

E-mail Inga.

News 10/6/10

From StateHIECoordinator: “Re: Iowa. The state has issued a Notice of Intent to Award to ACS for the Iowa Statewide Health Information Exchange.” SHIEC sent over the award letter that went out to the eight bidders. It includes technical scoring and prices, but I’m not sure if I should run that since it may not be public information. The selection went down to frontrunners ACS and Medicity in the “best and final offer” round, with ACS winning on price.

From Maladroit: “Re: book. You mentioned a book on healthcare IT and the future sometime in the last ear. I don’t remember much about it except it seemed like a great book to help me understand a CIO’s perspective as he/she thinks about maturing their tech org. Do you remember the book?” Hmm. I’ve mentioned a few books, but I don’t remember this one particular. It might have been Ed Marx, too, since he’s well read. Readers, if you know the book or have others to recommend on that topic, let me know and I’ll run a list.

From Wax On: “Re: medical transcription acquisitions. The big buzz among the MT community at the recent AHIMA convention in Orlando was about Nuance acquiring both OSi and Encompass Medical Transcription. And in another deal, Keystrokes acquired Chartnet.” I’m appreciating the irony that the hottest technologies in healthcare IT appear to involve transcription. Voice and paper are hard to kill for good reason.

From Ex-Employee: “Re: CareTech Web Division. All sales staff let go last week. Management plans to eliminate the Web division and focus solely on outsourcing.” Inga contacted the company for a response:

On the heels of significant growth in its Web products and services segment, CareTech made the decision to adjust its go-to market approach for the Web business with an emphasis on balancing its growth with providing the best delivery service. The decision involved a shift in resources, including a reduction in the area of Sales, and an increase in technical resources for the Web Development and Account Management areas. The company remains committed to its Web products and services business, and is especially looking forward to the opportunity to see current customers and meet new ones at the 14th Annual Healthcare Internet Conference where CareTech will have an exhibit and speaking engagement.

From Long Time Reader, First Time Writer: “Re: MU. Several CIOs I work with are gnashing their teeth because their vendors are telling them they’ll only apply to have their latest software version certified. Clients on the now-current version will have to pay the vendor for an upgrade and service fee to get on a ‘certified EHR’. Some have said they are being quoted months to get the upgrade because customers that signed lucrative contracts with the vendor’s service arm are moving to the head of the line. Love the blog BTW.” I guess I’m seeing it through the vendor’s eyes – ONC made them jump through hoops to get their products certified and to get them implemented by a firm date, so somebody has to pay and not every customer can be the first to go live. I’d blame the government for trying to tie something as complex as EHR adoption to something as desperately made up on the fly as economic stimulus. But if you have a particularly egregious vendor example, tell me since I’m sure some are milking it hard.

Ingham Regional Medical Center (MI) helped start and fund the Capital Area RHIO, but won’t participate in it. The hospital and its parent company will instead join Michigan Health Connect, explaining that, “A lot of the larger systems decided to go that route so they wouldn’t have to participate in different RHIOs and repeat the investment over and over again.”

Inga trumped Weird News Andy on this article, although she kept it at arms’ length when she sent it my way, saying it’s “a bit icky for my taste.” It’s a little raw for me too, but if you’re fascinated to know the “Strangest Foreign Bodies Removed From Patients”, many of which seem to involve unusual sexual practices, feel free to check it out. I did, but I think I regret it now.

ONCHIT puts up a Certified Health IT Product List page. It doesn’t include the CCHIT-certified products yet.

The Government of Queensland will implement (warning: PDF) the MetaVision Clinical Information System from iMDsoft in the ICUs of 14 hospitals.

Blessing Health System (IL) will implement Patient Condition Tracker from Rothman Healthcare Corporation within Allscripts Sunrise Clinical Manager. Their nursing school will also participate in research studies involving the system, which turns 26 measurements and observations from the EMR into a single number called The Rothman Index that allows early detection of patients going bad. I’ll have an interview with the co-founder up shortly.

Jack Kowitt, SVP/CIO of Parkland Health & Hospital System, e-mailed to say he was happy that I was puzzled by an ARRA comment attributed to him by the Dallas business paper since he was misquoted. The article said the hospital “won’t seek federal stimulus funds because its electronic records upgrades started before the stimulus bill was passed,” which I thought was odd since HITECH payments aren’t linked to spending. I indicated probable reporter error, which was the case according to Jack: “The question was whether we were using any stimulus funds to implement the EMR. The response was, since we have already implemented, we would not. It wasn’t about MU money, which we are aggressively pursuing.”

It appears that CCHIT’s initial press release that listed certified products was incorrect. ChartAccess from Prognosis Health Information Systems was listed under EHR Modules in the hospital domain, but the current product list shows it as a certified complete EHR in the hospital domain, the only one other than EpicCare.

I got an e-mail blast from a seemingly desperate free HIT magazine today, urging me to post five comments to their online articles to be eligible for a giveaway (so much for highfalutin’ journalistic integrity – what’s The New York Times paying for sending in letters to the editor these days?) Since it mentioned their expert bloggers, I thought I’d check out the competition for the first time. All the blog entries I saw except one seemed to come from other sites – they’re just reprinting them on their own site like they were written for the dead tree people. Maybe I’m an amateur purist, but both the comment bribe and the reposted blogs strike me the wrong way.

Inga contacted the folks at Infogard to get pricing information for their ONC-ATCB certification services. Drummond and CCHIT are pretty transparent about what they charge and were very nice to give Inga the information so she could put a comparison together for readers. Infogard sent her a curt reply: “Unfortunately, we will not be able to provide our price list.” We’ll make sure to help keep their secrets when their press releases come out by not mentioning them.

A Forbes blog riffs on a New York Times article about EMR vendor ClearPractice, which I didn’t realize was run by big-time VC guy John Doerr (Google, Amazon) and his brother. They also oversee a Medicare Advantage insurance plan. The Forbes writer isn’t impressed with ClearPractice or its iPad version called Nimble, although he’s focusing on the business success and not the innovation or potential:

While electronic medical records are a promising tool, the piece lacks context. For a company like Dr. Doerr’s to have been around for a decade and only have 500 doctors using the software basically means it’s failed. Check out this list of EMR vendors by market share based on physician usage. In a rapidly consolidating market there are at least 10 and probably 50 different vendors with more than 500 licenses. The idea that the Apple iPad will somehow, with an assist from stimulus funds, revive the fortunes on an individual EMR company is optimistic to say the least … The other thing that struck me is that the piece made no mention of the history of hubris when Silicon Valley tries to cure health care’s ills. Remember when Netscape founder Jim Clark devised Healtheon on a piece of paper? Or AOL founder Steve Case’s mostly expired Revolution Health?

Meditech got specific about its expansion plans Monday, announcing its intent to purchase 135 acres in a Freetown, MA business park and to build a 180,000 square foot office building for 800 new employees. A local politician estimates the company’s investment there at up to $100 million.

The University of Louisville School of Nursing gets a $792K HHS grant to develop nursing informatics education. They’ll buy simulation lab equipment that includes a patient simulator, iPads, and EHR simulators.

Interesting: a company uses Salesforce.com to deliver and analyze patient EEGs, looking for similarities in a database of known EEG irregularities to suggest psychotropic medications to doctors treating mental illness.

MedAssets is holding its Business & Technology Forum this week in Orlando.

Weird News Andy’s contribution this time around: “1/3 off healthcare ‘reform’ … I wish.” A report (warning: PDF) finds that HHS has already missed a third of the deadlines mandated by the Patient Protection and Affordable Care Act, with another 29 coming due in the next three months.

And speaking of government efficiency, health insurance premiums for 8 million federal workers will go up 7.2% in 2011, which the government spins by saying that’s less than increases in the private sector because of savvy negotiating.

A company brings social networking to crutches, allowing Facebook friends of the injured to create custom “skins” for their crutches. The company will offer advertising materials in the ED and expects to co-brand with healthcare systems.

The Institute for Healthcare Improvement releases a white paper to help hospitals manage serious clinical adverse events.

An interesting analysis: hospitals are buying up primary care practices to prepare themselves to become Accountable Care Organizations, which could be the end of the line for small, independent practices. Hospitals are looking at increasing PCP salaries like a Wall Street analyst looks at price-to-earnings ratios, knowing that internists and family practitioners generate hospital revenues at nine times their average salaries, while expensive specialists generate a multiple of only five times their salary. For industry noobs, it’s time for hospitals to get taken to those 1990s cleaners all over again, because:

1. Docs sell out precisely because they don’t want to work  as hard for their new hospital employer as they did for themselves (duh).
2. Hospitals are notoriously bureaucratic and inefficient managers, making them particularly unsuited for running a low-overhead medical practice in every way from EMRs to personnel policies to regulatory compliance.
3. Private practice docs hate and distrust everything about hospitals except the money they have and don’t usually change their opinions or behaviors just because they sell them their practices.
4. Doctors resent taking orders and being told how to practice medicine, especially from suit-wearing hospital MBA-types who fancy themselves business experts despite always having worked for a paycheck instead of themselves, making it likely all these deals will fall apart in 4-5 years like they did last time around, with the docs scrambling to start up new practices without the benefit of a location, an EMR, or patients that they sold away to the local hospital in a frenzy of co-opetition.
5. Patients aren’t much more enthused about hospitals than doctors are, so they aren’t exactly thrilled to see the big sign go up over their friendly little doctor’s office knowing it’s the same folks with ED waits, bad cafeteria food, and terrible parking.

E-mail me.

HERtalk by Inga

From RDU Dude: “Word on the street is that Vern Davenport has left Allscripts.” Portly Gentleman sent us a note on October 1 suggesting Allscripts would soon announce some executive changes. He named names (Vern’s being one of two), but we didn’t run them since it didn’t seem right until it actually happened. The company confirms that the former Misys president and Allscripts exec has indeed moved on.

Over 50 practices in Tenet Healthcare markets select MED3OOO’s InteGreat PM and EHR as part of a Tenet/MED3OOO community-based EHR partnership.

Hearst Corporation appoints Gregory H. Dorn MD, MPH president of drug database provider First DataBank. He most recently served as EVP at another Hearst company, Zynx Health, and replaces Donald M. Nielsen, MD, who becomes chairman of the First DataBank Advisory Board.

Omnicell acquires Pandora Data Systems, a provider of analytical software for medication management. The Pandora solution is used by several HIT companies, including CareFusion, McKesson, Cerner, and will continue to be operate as a stand-alone product. Omnicell’s comparable product is about twice as expensive, so there goes your cheaper alternative, most likely.

Epic wins a five-year,  $14 million EHR contract from the US Coast Guard, replacing a version of the Department of Defense system. That could be a notable Epic foothold in government down the road.

Penn State Hershey claims its use of CareAware technology has contributed to a 90% decrease in manual charting during surgical procedures. Providers now average one minute of charting during surgery, compared to 10 minutes before the CareAware implementation.

I love and appreciate all our sponsors, but this is funny. I received a note from one today (someone in accounting who has probably never heard of HIStalk) asking us to re-issue an invoice. The reason: they had asked to pay their sponsorship over several invoices, so dividing the total led to a per-invoice amount of xxx.1666 (infinite decimal). We invoiced xxx.17. They’re asking to correct the remaining invoices to xxx.16 so that the yearly total hits the amount exactly instead of being four cents over. Who else wonders how that accounting department handles client issues?

The Institute for Health Technology Transformation publishes a new report that examines the current EHR landscape. I can’t say I gleaned much new information, but was struck by the authors’ comment that the EHR “landscape” is still in its “infancy.” Given that I was selling EHRs (or EMRs as we called them in the old days) years ago, I’m thinking there must be some inverse relationship between EHR-years and dog-years.

North Kansas City Hospital deploys Cerner’s P2Sentinel auditing solution to address the hospital’s Meaningful Use Stage 1 access requirement.

Miami Children’s Hospital will spend $67 million to implement Cerner Millennium. The hospital will also extend a 50% discount to community physicians who wish to implement PowerWorks EHR in their offices. The hospital expects the government to provide $7-$8 million in stimulus funds once Millennium is fully operational.

Here is some not-so-pleasant news: at the current rate, 2010 could be one of the worst years ever recorded for mass hospital layoffs. Blame the increased demand for charity cases, the decline in reimbursements, and a reduction in elective procedures. As of August, 8,233 employees lost jobs in 102 separate layoffs, according to the Bureau of Labor Statistics. At the current rate, 12,349 jobs would be cut by December 31st, compared to 11,757 last year.

Six Texas pharmacies file a lawsuit alleging CVS Caremark of violating patient privacy laws and unfairly competing with its rivals. The complaint highlights Caremark’s plans to establish a data warehouse that includes the names, demographics, and drug histories of patients, plus Caremark’s Rx Review program that is designed to use patient data for direct marketing to patients and physicians.

Sponsor Updates:

• Allscripts introduces Mobile Homecare, a smart phone application for physical therapists, nurse assistants, and other clinicians caring for patients in their homes.
• API Healthcare signs up Halton Healthcare Services as its first Canadian client.
• Quest Diagnostic partners with HP to offer a preconfigured solution that includes Quest’s Care360 EHR and HP hardware, services, and financing.
• Wahiawa General becomes the first facility in Hawaii to implement Voalte’s iPhone solution.
• Detroit Medical Center selects the iDoc document imaging system from CareTech Solutions for its eight facilities.
• The Nashville Chamber of Commerce names Informatics Corporation of America to its Future 50 Award list for the third consecutive year. The award is presented to the 50 fastest growing companies in Tennessee.
• Catholic Health Initiatives expands its partnership with Allscripts to include Allscripts EHR and PM for all of its 1,200 employed physicians and 7,000 affiliated physicians. CHI is also adding Sunrise EPSi Performance Management solution for its 73 hospitals and will develop its own HIE with the Allscripts Community Exchange solution.
• PatientKeeper deploys its new physician documentation product, PatientKeeper NoteWriter, to Mercy Medical Center (IA) and Alegent Health (NE).

E-mail Inga.

Equifax Acquires Anakam

Equifax announced after the market close Monday that it has acquired authentication management vendor Anakam. The San Diego-based Anakam has a significant healthcare presence, with products addressing online identify verification, credentialing, two-factor authentication, inoperability authentication, and secure collaboration. Former HHS privacy and security advisor Bill Braithwaite MD PhD is the company’s chief medical officer.

Equifax had chosen Anakam this past January to provide authentication for its I-Card product. Anakam’s solution was chosen last month by Buffalo-based HEALTHeLINK as part of HHS Beacon Community demonstration project.

The Atlanta-based Equifax says it will market Anakam’s Identity Suite with its IDverifier service as a single, integrated two-factor authentication solution. Rajib Roy, President, Equifax Technology and Analytical Services was quoted in the announcement as saying, “With Anakam, Equifax will become a premier provider of cloud-based authentication solutions.”

Monday Morning Update 10/4/10

From D.B. Platypus: “Re: ACO. The NorCal HIMSS chapter sponsored a CIO forum on October 1. A speaker showed this video. It had everyone rolling on the floor in a fit of hysteria.” I like it, although someone sent Inga a similar video that we posted on HIStalkTV that I like even better. My newest oft-repeated monotonic mantra from that one involving orthopods: “There is a fracture. I need to fix it.”

From CPAhole: “Re: Allscripts/KLAS. I’ve worked with numerous Allscripts/A4 reps and they did as they were instructed, sitting next to their clients as they completed the survey. KLAS outed the company. Of course Allscripts will take the high road and say they have a better system, but what else would they say?” Unverified.

From Lemmy: “Re: another stolen unencrypted laptop. Here’s the CIO’s internal e-mail from Harvard Vanguard Medical Associates.” I don’t recall seeing this previously, but the purported e-mail says that a vendor-owned laptop containing urodynamic testing data was stolen on August 3. It contained minimal information (name, date of birth, physician, MRN, and testing data). Massachusetts law required encryption starting March 1, 2010 as I understand it, so that might be a problem.

From Elaine: “Re: HIEs. I’m a new HIE manager within our health system and am interested in any data sources regarding interoperability discussions or lessons learned.” I’m sure people are reading who know a lot more than me, so add a comment to the bottom of this post if you can help Elaine.

From The PACS Designer: “Re: iPad’s little sister. Apple is working on a smaller 7" iPad for release early next year. This little sister iPad weighs only 1.1 pounds and will have front- and back-facing cameras. This smaller sized iPad may be of interest to our heathcare colleagues if they can produce it with a case that can be disinfected.”

Listening: Delain, female-led Dutch symphonic metal. Also, reader-recommended Pretty Lights, Boulder-based electronica (two guys doing something between DJing and playing) with some impressive live performances that mix several genres, mostly hip-hop and and synthesizer. Not something I usually like, but it sounds good (probably even better as a soundtrack to romance, I’m thinking without much credibility).  

Meditech says it will expand again, adding hundreds of new jobs to be housed in newly built Fall River buildings. Sales in 2009 were $234 million, up 38% from the year before.

This week’s internal e-mail blast from Kaiser chairman and CEO George Halvorson says the company has donated its internally developed clinical terminology translation engine to the US government, accepted by HHS Secretary Sebelius, CTO Chopra, and National Coordinator Blumenthal. From the example he gave,the Convergent Medical Terminology utility can convert 75,000 terms back and forth, for example between ICD-9, ICD-10, and SNOMED. It will be distributed as open source by the National Library of Medicine. 

Drummond Group issued the first ONC-ATCB EHR certifications, but CCHIT trumps them on quantity, announcing Friday that it has certified 33 EHR products (19 complete systems, 14 modules) in the 10 days since its program started. I’m not sure that will instill confidence in folks who have always questioned the rigor involved since they can apparently crank out three per day including weekends, but there you go. HIStalk sponsors that have newly certified products are Allscripts, NextGen, eClinicalWorks, T-System, and Wellsoft.

Transcription service outsourcer iMedX acquires FORE Transcriptions. And transcription software and services vendor MedQuist gets $310 million in financing, mostly from GE Capital, with the resulting announced dividend causing shares to hit a three-year high (strictly by investors looking to get the dividend – otherwise, borrowing money to pay a dividend isn’t exactly a robust growth engine). What’s with all the sudden interest in transcription companies?

Nearly two-thirds of respondents say KLAS reviews aren’t useful to providers, although I’m sure many of those respondents work for vendors ranked by KLAS as lower than #1. New poll to your right, requested by a reader: providers, which department will conduct and submit your Meaningful Use self-attestations?

Longmont United Hospital (CO) says VHA’s PriceLYNX vendor price comparison tool paid for itself immediately when a vendor was caught overcharging the hospital by $120K and returned the money. The materials manager says the software will allow him to negotiate price reductions of 8-20%, saving the hospital up to $4 million over the life of the contract.

This BBC article on real-time computing is interesting and scary. It says 50 to 70% of banks use it to perform algorithm-based trading of stocks and complex financial instruments. The example given is in trading stocks of two oil companies whose share prices usually follow each other closely. The software can check prices every 10 seconds and blindly buy Stock A shares if Stock B moves up even a tenth of a point. SAP says that kind of situational analysis may be useful in medicine, such as in monitoring the blood glucose of diabetics. Let’s hope the medical application is dissimilar from that of the money changers, whose computer-assisted self-destruction may yet take us all down with them.

Speaking of SAP, HP and “The Most Inept Board in America” choose the former CEO of SAP to be HP’s next CEO. SAP fired the Germany-born Leo Apotheker after a disastrous seven months as CEO, although some say he was the scapegoat for a terrible company strategy that predated him. HP is paying him like he’s a star: $1.2 million in salary, incentives of 200-500% of that with $2.4 million guaranteed, $72 million in options, a $4 million signing bonus, and $4.6 million in moving expenses (that’s a lot of U-Hauls). I’ll go with the summary of Oracle CEO Larry Ellison: “I’m speechless. HP had several good internal candidates…but instead they pick a guy who was recently fired because he did such a bad job of running SAP.” Their pre-Hurd CEO pick was an ultra-expensive termination, too: HP’s value dropped in half after Carly Fiorina orchestrated the company’s merger with Compaq. She was let go in an ugly fight about the time the company admitted that it spied on the personal phone records of journalists and its own board members trying to find out who was leaking information about its strategy.

The Dallas Business Journal summarizes the “long, expensive, and full of twists” EMR implementation projects of local hospitals. The hospital costs and associated taxpayer-funded EMR bribes: Texas Health Resources, $200 million, $70 million; Baylor, $200 million, $45 million; Parkland, $70 million and no stimulus funds. Parkland said they won’t go after ARRA money because their upgrades were underway before ARRA was passed, which seems puzzling since HITECH money doesn’t require spending anything, just demonstrating Meaningful Use (unless the reporter or I misinterpreted).

University of Virginia Medical Center goes live with Epic in its 140 clinics, with the big house going up in the spring. Cost: $122 million.

You, looking at the monitor – sign up for e-mail updates, Friend or Like us on Facebook, send me rumors. That would make me happy.

The VA will test 20,000 thin client devices using desktop virtualization, hoping to reduce maintenance and energy costs of its 325,000 PCs.  

In Spain, Andalusia will require hospitals to record birth records electronically within the first 24 hours of life, giving the child full health benefits that are independent of the mother and allowing pediatricians immediate access to the records. The centrally maintained information will support monitoring of infant morbidity and prenatal mortality.

The Canadian Medical Association says the $500 million that the Canadian government will give Canada Health Infoway in 2010 to goose EMR adoption isn’t enough. CMA wants another $423 million, which it says will increase adoption to 100%, apparent embarrassed over the high EMR adoption rates of other countries (Netherlands 99%, UK 95%, Australia 95%). I guess they weren’t consoled by US adoption, which comes in at anywhere from 4% to 40% depending on whose definition and survey you like.

My Health Care Manager gets a $1.2 million NIH grant to develop a search engine for geriatric health issues.

The bailout-happy federal government agrees to throw taxpayer money in the general direction of Massachusetts hospitals, especially Boston Medical Center, giving them $335 million. Cynics like me might point out that Massachusetts leads the nation in healthcare (percentage of insured citizens, use of electronic medical records, fancy hospital buildings housing bowtie-wearing academic doctors) and yet (or more likely, because of) has the highest healthcare costs. According to the article, Sen. John Kerry strong-armed CMS and Don Berwick to use our money without consulting us first, which I guess we might as well get used to as healthcare “reform” starts tapping an already wildly indebted Uncle Sam, who gets a lot of his healthcare ideas from Mass, even the fantasy that reform will somehow lower costs while insuring dozens of millions of new people. Maybe Uncle should be looking at the sensible, practical middle of the country instead of the extremes on the ends. From its most recent federal tax records, BMC paid its previous CEO $1.3 million and she got another $3.5 million when she left last year right before the hospital’s big profit turned into a loss. Somehow, that doesn’t make me feel better about my involuntary donation.

E-mail me.

News 10/1/10

From Allscripts: “Re: the note from Clinical Wisdom on KLAS. We agree that there is a conflict of interest in having vendors pay large fees to the same company that is producing the ratings. We reached the same conclusion a few years ago and discontinued the practice. After our recent merger with Eclipsys, we inherited an existing Eclipsys contract that was in place with KLAS, so the information reported by the writer was technically correct. However, we have now canceled that contract and we do not currently pay KLAS anything. We realize that is counter-intuitive as we currently are and have consistently been highly rated across many product categories by KLAS, but ultimately we didn’t feel it was right to pay a firm that was also rating our products. Over the last two years, we have re-invested those dollars in a ‘Net Promoter Score’ process, which is widely considered across many industries to be the ‘gold standard’ for measuring customer loyalty. Using this rigorous, statistically valid methodology (developed by Satmetrix and Bain & Company), we get client feedback directly in a very methodical way and then act immediately on what we learn. The bottom line is that we agree with the Consumer Reports analogy from the writer – KLAS should provide a full accounting and disclose what they receive from every vendor. In that same light, we would encourage other vendors to disclose how much they are paying KLAS – complete transparency is critical when you’re talking about the core technology that providers use to make decisions vital to every American’s health.”

From Ben Cannoli: “Re: IOM’s study of HIT best practices. The IOM report is incredible even after a decade. I’m glad they are leading. HIMSS has been weak, negligent, and pathetic on this issue, but I don’t believe they can strong arm the IOM.” Inga mentions it below. The IOM gets an ONCHIT grant to look at how HIT affects patient safety. It will cover some industry hot buttons: surveillance and reporting of HIT-related patient safety issues, discussion of the possible roles of federal agencies like FDA or AHRQ, and impact of certification bodies and trade associations (HIMSS, you’d expect). I’d bet that Don Berwick made this happen. I don’t know how much they’ll get done for $1 million, but I’m interested to find out.

From Digital Bean Counter: “Re: real-time claims adjudication. Is it taking off yet? Any big players?” Little help, if you know.

From VaHooGirl: “Re: Martha Jefferson Hospital. No longer a rumor – they are merging with Sentara to become its 10th hospital.” Verified.

From TuTu True: “Re: Mrs. HIStalk. A source tells me that Inga is Mrs. HIStalk. Be honest – true or false?” False. And to answer the other occasional rumors: (a) yes, there really is an Inga – it’s not just me pretending to be her;  (b) yes, she really is a woman, and (c) yes, the Inga picture at the end of her posts really does look like her since I paid some offshore artist $15 to draw it from a photo.

From Luke O’Scyte: “Re: correction about the Canadian government spending $500 million on EMRs. Please replace ‘spending’ with ‘wasting.’ I’m highly skeptical of the value that will be generated from that half a billion dollars.”

From Portly Gentleman: “Re: Allscripts. A couple of executive suite offices are about to become vacant.” PG provided credible names and I’m sure his information is correct, but I feel funny about mentioning names of people leaving jobs. Watch for announcements early next week.

From MSFTGUY: “Re: McKesson Paragon. Just went live at 391-bed Lake Charles Memorial. Several big hospitals have gone live on Paragon this year. Maybe folks have a choice between a system that doesn’t work and is only 1/3 of an HIS (Cerner) and one that’s ridiculously irresponsible to purchase (Epic)?” I did some work at that hospital once. Nice folks. None of the systems you mentioned are for everybody, so it’s hard to criticize their choice, especially if it was a lot less expensive.

From Perineal Flowers: “Re: [name omitted] is one of two finalists to be CIO of Tenet.” I’m expunging the name since I’d sure hate to get someone fired if they don’t land the rumored new job after all, but I did manage to contact them. They humorously (or so I assume) told me the rumors also have them going to Allina, Duke, and Partners, all of which have open CIO jobs along with Tenet. I’m pretty good at reading between the lines, so I think there’s fire underneath that smoke. We’ll see from which direction soon, I’m betting.

Listening: The Tyde, obscure, Byrds-like LA jangle surf. 

A scrappy Austin-based non-profit investigative publication runs a pretty good story on the ongoing sale of de-identified hospital patient data by the Texas Department of State Health Services. Among their customers: GE and a company that runs background checks for border security. Deborah Peel MD was quoted as saying that a HIPAA loophole allows selling patient data to any entity that claims to be doing “research”, which isn’t defined. Now this is funny: the only parties that stay anonymous aren’t the patients, but rather the people who download the free data files covering 1999-2003. The article wanders all over the place and is predicated on your believing that de-identified data can be re-identified (which it definitely can to some reasonably high percentage, but some people refuse to believe that fact). If newspapers weren’t going broke, they should fund a re-creation of that experiment where patient data was re-identified by linking to common fields from other government-sold databases, such as driver’s license records.

Here’s another fun tidbit from the Austin article, even though I don’t believe its accuracy. The guy who wrote The Long Tail estimates that free EMR vendor Practice Fusion takes in $250 million per year from selling the de-identified patient data stored in its systems, dwarfing any possible revenue it could make by selling software. It cites a Practice Fusion job ad on Craigslist for a Data Sales Director, someone with experience creating “an aggressive data monetization strategy” who can pitch to “pharmaceutical companies, medical device companies, insurance carriers, government entities …” and “establish a fair market price for EHR data and negotiate effectively with buyers.” That position is still being advertised on Practice Fusion’s site, but the language has been dialed back a lot.

Cerner caves in to patent trolls Acacia Research (“research” meaning “writing threatening lawsuit letters to companies to see who will pay up”) and will pay that organization for the privilege of selling PACS, which Acacia’s often-waved patent claims they invented. Acacia’s strategy is smart: they threaten to sue, but offer a license for less money than it would cost to mount a legal defense. Most companies pay up and the threatened suits rarely go to court, although Epic mounted a swift legal counterstrike for being threatened. I never heard how that turned out, but it doesn’t matter – I still admire their willingness to fight for what’s right.

This is brilliantly funny: You may know Ross Martin, MD as the guy behind the HITECH Operetta and Meaningful Yoose Rap in his role as President of The American College of Medical Informatimusicology, although he has a less interesting but probably much more lucrative HIT consulting job. He writes a hilarious letter to the editor of The New York Times for not publishing a previous letter of his, threatening a class action suit by rejected would-be authors and signing it, “Yours in the quest for wealth creation through victimization, President, Literary Mediocrity Association.” They whittled his piece down to a paragraph, but they did run it. I think the HIStalk audience is more appropriate for his type of humor than that little New York paper.

WorkflowOne, which claims to be “the nation’s leading name in healthcare document management,” puts that leading name on a Chapter 11 bankruptcy filing. Premier just renewed its contract with the company, claiming that “no one is better prepared to help Premier members reduce costs and gain efficiencies across their entire print lifecycle than Workflow One.” Doh! Still, the company has big revenue and EBITDA, so I’m sure they’re not going anywhere. It seems odd that they even filed, frankly.

Lots of good jobs on the HIStalk Sponsor Jobs Page: Eclipsys Pharmacy Consultant, Natural (Software AG Product) Programmer Analysts, McKesson Workflow Clinician. On Healthcare IT Jobs: Product Manager, Lead Epic Analyst, Senior Clinical Systems Analyst, Solutions Marketing Specialist.

Sharp Healthcare chooses Aternity Frontline Performance Intelligence to monitor application user experience.

Vanderbilt launches its first preventive genetic screening program, testing all cardiac cath patients for clopidogrel metabolism problems and storing the results in their EMR so that a different blood thinner can be used if needed, avoiding expensive and dangerous blood clots. Several other drug-affecting genetic traits will be tested as well. Now that’s just cool.

Several national pharmacy organizations launch the Pharmacy e-Health Information Technology Collaborative, which will work to get pharmacist-needed functionality into EMRs.

CMIO interviews one of my favorite CIOs, Denni McColm, from 74-bed Citizens Memorial Healthcare in Bolivar, MO (the only one of very few HIMSS EMRAM Stage 7 hospitals, a standout on the list dominated by big, rich health systems). CMH has a bi-directional CCR interface with Google Health that Denni says will meet Meaningful Use requirements, saying interoperability doesn’t necessarily required an HIE. They’ll use Google Health to make sure patients who ask get a copy of their medical record within the MU-specified timeframe.

ChartLogic earns EHR certification from Drummond Group.

iSoft convinces its bankers to reorganize the company’s debt. Shares are still at 13 cents. You would think those two events might attract takeover interest, but the company’s chair says conditions remain “challenging.”

A Chicago cardiologist will pay $20 million and spend five years in prison for defrauding Medicare and private insurance of $13 million, turned in by another doc who gets $3.5 million as the whistleblower. The cardiologist submitted 14,800 false claims that added up to more than 24 hours a day of work from 2002-2007, so he enjoyed a lavish lifestyle until the case finally ended. When the Feds raided his house, they found $6.7 million in uncashed insurance company checks.

E-mail me.

HERtalk by Inga

The Allscripts/Eclipsys crew sent over an invite to EUN 2010 Outcomes Through Innovation, which is the user meeting for Eclipsys clients. Wish I could go because it’s in one of my favorite cities, San Diego. The event is October 10-13 at the Manchester Grand Hyatt.

The board of governors of Good Samaritan Hospital (IN) approves the $400K purchase of McKesson’s PACMED and MedCarousel pharmacy packaging systems. At the same board meeting, the director of IS says the hospital is on target to earn nearly $7 million in ARRA incentives over the next six years.

St. Vincent’s Healthcare (FL) extends its seven-year partnership with TeleHealth Services. The health system will implement TeleHealth’s TV and interactive patient education solution at St. Vincent’s and St. Luke’s hospitals.

I noticed that Intellect Resources posted this article about the current shortage of IT professionals in the Nashville area. Middle Tennessee is home to a number of large HIT employers, including HCA, HealthSpring, Cogent Healthcare, and ICA. Several companies are working with on training initiatives at area colleges to help increase the pool of professionals with both healthcare and IT expertise.

Merge Healthcare adds two new perioperative solution clients: Exempla Saint Joseph Hospital (CO) and Kalispell Regional Medical Center / The Surgery Center of Northwest Healthcare (MT).

If you are headed to the American Academy of Pediatrics show this weekend in San Francisco, say howdy to HIStalk Practice’s Dr. Gregg Alexander. He’ll be directing the Pediatric Office of the Future exhibit, which will showcase technologies available for pediatricians. Dr. Alexander is pretty darned excited by the project, as evidenced by his  latest Intelligent Healthcare Integration post.

ONC awards the Institute of Medicine a $1 million contract for a year-long study of HIT’s effect on patient safety.

The Tiger Institute for Health Innovation celebrates its one-year anniversary and provides an update of its work to date. The Tiger Institute is a partnership between Cerner and the University of Missouri Health System to create new technologies. So far UMC has implemented bar-coded medication administration and is rolling out CPOE in a couple of months (not sure why that would be considered innovative) and is working on several prototype projects, including a mobile app that allows physicians to review clinical data and give orders via smart phones.

CIGNA and St. John’s Mercy Medical Group (MO) launch a 12-month accountable care organization pilot program. The pilot will target patients covered by a CIGNA health plan and receive care from one of St. John’s 165 primary care physicians. Physicians have the potential to earn bonuses for meeting quality improvement targets and lowering medical costs.

Mayo Clinic and five other health systems form the Mayo Clinic Center for Social Media, dedicated to the use of social media to promote health, improve healthcare, and fight disease. The Center will offer educational conferences and webinars and develop social platforms to share training and resources. The website www.socialmediahealthnetwork.org will launch October 25.

Baptist Health (FL) partners with Vitalz to provide provider-to-provider portal services between 13 Solantic Baptist urgent care centers and 40 Baptist primary care offices.

Texoma Medical Center (TX) implements Skytron’s RTLS to track and manage 200 hospital assets. When reading the press release, I was amused that either the hospital or vendor thought it was noteworthy to mention that Texoma is also using the RTLS technology to monitor vendor sales rep visits.

This week on HIStalk Practice: BlackBerry thumb, cell phone elbow, and Facebook depression; medical students say having an EHR is a very important factor in their decision what to practice; Phreesia and a few first impressions.

Sponsor Updates

• Fred Castillo, VP of healthcare mobility sales for AT&T and Eleanor Chye, executive director healthcare mobility product management at AT&T will participate in separate panel discussions at the CTIA Everywhere Healthcare event next week in San Francisco.
• Methodist Hospital of Southern California goes live with API Healthcare’s Human Resources and Payroll solution.
• Sharp Memorial Hospital (CA) selects GetWellNetwork’s bedside education/entertainment system. GetWellNetwork’s patient education and communications tools will be interfaced with Sharp’s Cerner EMR system.
• Susquehanna Health (PA) plans will add the perioperative information management system of Surgical Information Systems to its three-hospital system. Susquehanna will integrate the SIS solution with its existing Siemens Soarian applications.
• Albemarle Hospital (NC) selects the Access Intelligent Forms Suite to bar-code patient forms for auto-indexing via a document management system into its Meditech EHR.
• Ingenix CareTracker earns CCHIT Certified 2011 Ambulatory EHR certification.
• Zac Fritz joins My Health Direct as SVP of sales and marketing.

Here at HIStalk, we love well-intentioned works of charity. Thus, I applaud Cincinnati Bengals wide-receiver Chad Ochocinco for promoting contributions to Feed The Children. Ochocinco has his own personalized “OChocinos” cereal and includes a Feed the Children phone number on the box. At HIStalk, we’re also about getting the little details right, so bummer that Ochocinco didn’t get Mr. H to proof the cereal box. Perhaps he could have caught a certain typo before the box it hit the production line. Mr. H likes the occasional smut reference, so I’ll mention that the Feed the Children phone number listed was actually a phone sex hotline. Oops.

E-mail Inga.

News 9/29/10

From Waterkeeper: “Re: CPOE reality. Another example.” A study finds that electronically preventing entry of CPOE orders for concomitant use of warfarin and sulfa drugs did great at preventing the potential drug interaction, but also delayed treatment in patients for which the simultaneous use was appropriate, causing Penn researchers to stop the study early as being unethical. Says the lead author: “[It] worked extremely well, but putting it in place actually hurt people … it’s naive to think that CPOE 1.0 is going to be perfect. This is a clarion call for continual evaluation of whatever we’re doing in terms of electronic interventions.” You’ve read it here in various interviews, but it’s worth reiterating: CPOE isn’t done just because it’s live and doctors are using it. That’s where the scientific work should begin, but unfortunately usually doesn’t as everybody declares mission accomplished and moves on to some other fire du jour that requires extinguishing.

From EMR Salvage Here, Can’t Bill There: “Re: downtime in Pittsburgh.” Included was an August e-mail to providers purportedly from Medical Service Associates, apologizing for problems in which a network failure led to the discovery that backups couldn’t be restored from either their own two backup systems or the two of their vendor. At the time of the late August e-mail, they still hadn’t restored anything from before the downtime. All unverified and most likely not the final word on the situation there, but my takeaway from experience is the same as always: backups don’t work at least half the time.

Inga e-mailed our sponsor contacts today about a little get-together we’re having for them in Orlando at HIMSS, separate from our Monday night HIStalk reception (nothing too fancy since it’s on a blogger’s budget, but sincere nonetheless since we really appreciate our sponsors). Response has been brisk, so if you’re the boss and haven’t heard about it, check with your internal person before we run out of space. If your company is on the fence about sponsoring HIStalk, we can probably make room if you sign up soon. Plans for the Monday night reception are progressing nicely as well. Expect a big evening that will go a bit beyond our usual food, drinks, and HISsies (running until late, so pace yourself). Stay tuned.

New readers sometimes get confused about who writes what on HIStalk, e-mailing the wrong one of us about something the other wrote. Here’s the deal: Inga writes the part starting with “HERtalk by Inga.” I write all the rest. I do most of the interviews, but I should mention that Inga did the most recent one with Doug Ardoin. And it’s all Inga on HIStalk Practice. Clear as mud, right? She and I are kindred spirits anyway, so we’ll figure it out.

Medical office patient check-in vendor Phreesia completes a $20 million Series D equity financing round. Jumping in is Ascension Health Ventures, the $325 million strategic healthcare venture fund of Ascension Health. 

Strange: a hospital trauma nurse gets a 2 a.m. call on her cell phone from the California Donor Network, with which she’s familiar because of her job. They tell her that her brother has died and they need her permission to harvest his organs. Agitated, she goes to her other brother’s house and they call their sister-in-law to console her, only to hear the sleepy voice of her I’m-not-dead brother asking what they want. The hospital had given the donor group the wrong contact information, that of a patient with the same name but spelled differently. The hospital can’t explain the mistake except to say that the information was wrong when they switched computer systems in 2005. The coroner’s office claims they would have caught the mistake before taking the organs of decedent with the wrong family’s permission.

HHS’s open source CONNECT program wins the 2010 Wall Street Journal Technology Innovation Award for health IT. Runners up are diagnostic image sharing platform vendor lifeIMAGE (I interviewed CEO Hamid Tabatabaie a couple of weeks ago) and Disease Precursor Identification from Ingenix, which identifies people at risk for chronic diseases. 

Munroe Regional Medical Center (FL) says it dropped ED-door-to-balloon time for heart attack patients to 48 minutes, below the national average of 62, by using incident command management software from LiveProcess to manage the Code Blue calls.  

A Weird News Andy find: NewYork-Presbyterian/Columbia University Medical Center admits that someone accidentally opened up a server containing ICU patient information to the Internet. A patient’s family ran across the information via a search engine and told the hospital. I can’t decide which is more annoying about the hospital’s name: that it’s absurdly long with dashes and slashes or that they insist on conjoining New York into a single word for no apparent reason. 

RIM previews its BlackBerry PlayBook tablet device. Like the Torch, I doubt it will generate much consumer interest, especially since it may work only on WiFi, not 3G/4G. That’s speculation since it’s not coming out until next year, making the video a bit premature in its lost cause of convincing iPad prospects to hold off. Businesses will probably like it, though.

The National Quality Forum endorses performance measures and preferred practices for care coordination. Among the latter is electronic medical records.

Ed Marx has updated his Tool Time post with responses to your comments.

Here’s another bad HIT press release, replete with enough odd phrasing, incorrect punctuation, and bizarrely missing information (like the names of the company’s president and the customer who are both quoted) to make it seem highly unlikely that the writer speaks English as a first language. Not that there’s anything wrong with that, but the company is in Minneapolis, where English is pretty common (albeit with a cute accent, like in this horrible, sappy movie that I just played from Netflix for Mrs. HIStalk while I pretended to watch while daydreaming).

The Canadian government will spend $500 million on EMRs in the next fiscal year, with $380 million of that going toward implementation.

ClearPractice announces GA of Nimble, which it says is the first comprehensive EHR for the iPad. It connects to the company’s cloud-based system by WiFi or 3G. Or maybe it’s not the first after all: an updated press release omits the “first” reference and fixes other unspecified errors in verbiage. The release came from a PR company, but it’s never encouraging (in a “Quality Is Job 1.1” kind of way) for a software company to let obvious mistakes get out the door. And in another tactical error, there’s a beautifully made demo video on their site (where I grabbed the screen shot above) that you’d be watching right now if they were smart enough to make it embeddable like everybody else does who wants widespread exposure for free (it’s called YouTube, people). Now I’ve lost interest.

Deborah Peel, MD of Patient Privacy Rights comments on an Information Week article about healthcare data breaches.

I don’t need a cell phone, but I’m thinking about getting the new model of the iPod Touch for running apps, checking e-mail where there’s a WiFi connection, and playing music and video. Good idea or not? I thought it was perfect until I read that Apple had to downsize the camera resolution from 5 megapixels to one to fit into the slim case. Still, it seems like a good deal for $299 for the 16 GB model.

Mohit Kaushal, MD joins West Wireless Health Institute of EVP of business development and chief strategy officer. He was a key player in developing the healthcare portion of the FCC’s national broadband plan, which includes mobile health, when he worked for that organization.

Bob Mitchell, former editor of the dearly departed ADVANCE for HIE, interviews John Glaser about his new job as Siemens Healthcare CEO.

Deaconess chooses Omnicell for medication management.

The Greater Dayton Area Hospital Association (OH) signs up with the HealthBridge HIE.

It’s funny today how many car problems are fixed with a software update. The same is true for implantable defibrillators, for which a new upgrade checks for electronic problems that indicate wire integrity problems that could cause patients to be shocked inappropriately.

Costs of Care, a Boston-based non-profit whose goal is to reduce healthcare costs by giving providers pricing information as they make medical decisions, announces a national essay contest. The best anecdotes from doctors, nurses, and patients illustrating healthcare cost awareness will earn $1,000 prizes. The judges are former HHS secretary Mike Leavitt, Atul Gawande, Tim Johnson of ABC News, the dean of the Harvard Medical School, and Mike Dukakis. Entries are due by November 1. The group, founded in 2009 by medical resident Neel Shah MD, plans to create smart phone and Web apps to provide pricing transparency.

A nurse at Seattle Children’s Hospital kills an ICU baby by mistakenly administering a tenfold overdose of calcium chloride. A 15-year-old died from a narcotic overdose at the same hospital last year.

InterSystems announces Cache’ 10, which adds database mirroring and a high performance solution for Java applications.

I’m totally behind, so be patient if you’ve e-mailed me. I’ll be vacating soon, which will dig the hole I’m in a week deeper, and then attending the mHealth conference to make the backlog worse, but my lack of timely response doesn’t mean I love you any less (that’s my go-to excuse when Mrs. HIStalk catches me paying insufficient attention to her or her movies).

E-mail me.

HERtalk by Inga

From Jellico Jerry: “Re: reality check. Loved your point today about Cerner and Epic, and which deals Cerner won vs. Epic. Cerner won sites with no $$ (UHS, Tenet). Although they are still significant wins, they are very different client bases.” In case you aren’t up to speed, KLAS recently reported that nearly 70% of 2009 hospital EHR purchases were for Cerner and Epic. A reader then noted that if one were just reading HIStalk, you’d think Epic had “cleaned everyone’s clock.” We countered saying Epic got the bigger, more lucrative deals that really count. Anyone who’s dealt with either or both companies knows that Cerner will darn near give the software away to avoid losing a deal, while Epic won’t discount a penny.

The Ohio Health Information Partnership (OHIP) names its five preferred EHRs from the 40 that were considered: Allscripts Professional; eClinicalWorks Unified EMR/PM Solution version 8; e-MDs Solution Series 6.3.0; NextGen Healthcare EHR; and Sage Intergy suite 6.0. Interestingly, OHIP requires that the selected vendors conduct all technical support within the United States.

Quality Systems, NextGen’s parent company, strikes a deal with Pricedoc.com to incorporate PriceDoc’s online search marketing tool into the NextGen Practice Management system. Pricedoc.com is basically a medical version of the travel site Priceline.com, giving patients the chance to name the cash price they are willing to pay for particular procedures or services. Sounds like the deal gives Pricedoc.com access to NextGen’s PM client base and Quality Systems gets a spiff when physicians and patients connect.

T-System releases DigitalShare, a new solution made possible through a strategic partnership with Shareable Ink. DigitalShare allows clinicians to document patient encounters on T-Sheets using Shareable Ink’s digital pen to capture the data. I first saw the technology at MGMA a year ago and made the Mr. H-esque observation/prediction that it would be great technology for the ER.

Lehigh Valley Health Network selects QuadraMed’s Quantim computer-assisted coding solution to help prepare for its ICD-10 transition.

Confer Health Solutions acquires MediHealth Outsourcing, an HIM and clinical revenue cycle company.

Providence Health & Services hires Summit Healthcare to provide dictionary management and data migration services as it moves to Meditech 6.0. Providence also purchases Summit InSync and Summit Scripting Toolkit technology.

GE was the overall leader in the US ultrasound market last year, according to Millennium Research Group. GE increased its lead over Philips and Siemens and now holds about 27% of the $1.2 billion US market.

Former Cerner Eastern US general manager Greg White is promoted to VP and managing director of the company’s Middle East, Africa, and India region. He replaces Rich Berner, who returns to KC as VP of client development.

Axolotl introduces Elysium Discover, a suite of reporting and analytic tools for HIEs.

Northwestern Medical Center (VT) goes live this week on its first phase of Meditech.

ChartWise Medical Systems signs a strategic agreement with 3M Health Information Systems to integrate 3M’s Grouper Plus Software the clinical documentation tool ChartWise:CDI.

Frederick Jelinek, one of the pioneers in the field of voice recognition, died earlier this month. I had never heard of him before reading this article, but he’s credited with enabling computers to understand English. While that accomplishment is significant in and of itself, Jelinek’s challenging background makes his work even more laudable. He was born in what is now the Czech Republic and his dentist/physician father died in a Nazi concentration camp. After his death, Jelinek’s mother moved her family to the US. He graduated from high school and took a job working in a factory to help support his family Jelinek later enrolled in night classes, studied engineering, and eventually earned a doctorate from MIT. He spent his career with IBM and Johns Hopkins University, creating the bones for today’s voice recognition systems. Isn’t that a great story?

Friday marks the first day of the hospital payment year for implementing certified EHRs and using them meaningfully. Guess it would help to have some certified EHRs out there.

Sponsor Updates

• eHealthAlign selects ICA as a strategic partner to technology and infrastructure for its multi-state HIE.
• maxIT Healthcare earns a spot on Modern Healthcare magazine’s list of Best Places to Work in Healthcare.
• Voalte VP Trey Lauderdale will participate in a panel discussion at next week’s CTIA Everywhere Healthcare event in San Francisco.
• MEDecision announces that its Nextalign iEXCHANGE 8.0 solution is now generally available.
• BridgeHead Software wins a contract with The Rotherham NHS Foundation Trust for healthcare data and storage management.
• Picis and The Sullivan Group (TSG) will integrate TSG Clinical Rules risk management solution with Picis ED PulseCheck.
• HealthEast Care System (MN) implements Ingenix Web.Strat medical coding technology, integrated with its McKesson HealthQuest billing system.
• EDIMS announces that its ED EMR clients can access the admission review service of Proven Healthcare Solutions, which offers a 30-minute guarantee.

E-mail Inga.

Healthcare IT from the Investor’s Chair 9/28/10

Capitalizing a New Venture: So Many Choices…

I appreciate everyone who reads, especially those who leave comments. A comment on my previous post asked, “Isn’t it ALL about the patient?” 

As I pointed out in my response, for better or worse, healthcare in America is all about entrepreneurship — from medical spas to physician-owned hospitals and imaging centers to million-dollar salaries for hospital execs (I agree wholeheartedly with Mr. H on that topic, btw) to software entrepreneurs like Neal Patterson (Cerner), Judy Faulkner (Epic), or Randy Lipps (who realized that supply storage could be improved while his child was in the hospital and so founded Omnicell).

Anyone in the healthcare system, from physicians to business people to lab managers, who realizes that the current system they are using or experiencing just isn’t working as well as it could or should can decide to take the risk and form a company, develop a product, and go to market. Even before ARRA, HCIT attracted more than its fair share of entrepreneurs. That’s what makes this sector my favorite playground.

That said, I think it’s more like the playground of my youth. Before safety was the law and springy floors and safety teeter-totters came into being, it has historically been an area where start-ups thrive, but a disproportionate amount of investment dollars have been lost. Never a dull moment.

Hopefully someone reading this has started or is thinking of starting a new venture. Let’s explore their options along the continuum to finance it.

Friends and Family

Just what it sounds like. It’s going to Mom and Dad, Rich Aunt Joan, Crazy Cousin Bill, your stoner college roommate who was employee #55 at Google, and all the other friends you ask to put money into your new venture.

This is clearly a mixed bag. While their terms will likely be the most generous and they’ll likely value your new venture at the level you think is fair, these shareholders can be demanding in a psychic way. Family gatherings could turn into business updates. You’ll get calls on nights and weekends.

There’s the risk of that feeling in the pit of your stomach that if it goes wrong, you’ll have to face these people for the rest of your life. Hmm, sounds like a more expensive form of capital then I originally thought.

Angels

“Angel” typically refers to high net worth individuals who invest in private companies for themselves, as opposed to within a fund.

Angel investing has been on an upswing over the past few years for several reasons. First, with the stock market’s mixed performance over the past five years, this class of investor is looking to enhance their returns with some non-traditional investments. More importantly, angels are filling a gap that has resulted from the decreased popularity of traditional venture capital (discussed below).

Angels are typically much closer to the friends and family investor. They also have some of the same pros and cons.

On the positive side, they’re typically easier on valuation and they’ve often been entrepreneurs themselves. On the other hand, they’re not professional investors and so might lack some of the dispassionate views that a VC can bring. While they might have run companies, they might not know healthcare or software at all and might insist that their great success running a plumbing supply business obviously translates to your venture.

Their lack of a traditional venture fund (and its limited partners) cuts both ways as well. Where a VC might care only about an ultimate sale (or IPO), an angel might care more about receiving cash distributions. If you want to invest for growth, that could be a source of conflict.

If you have a choice of angel investors, as the knight in Indiana Jones and the Last Crusade said, “Choose wisely”. Do they bring experience and industry knowledge and contacts, or are they just a source of funds? Whichever it is, would they answer that question the same way that you would? How active do they want or plan to be? Will they want a board seat? Even if not, what will they require for ongoing communication as well as general care and feeding?

The importance of clarity and alignment of goals, vision, and timing here simply can’t be overstated. More than ever before, angels are starting to organize around their activities. Many top-tier business schools and tech associations have formed quasi-official angel groups.

Venture Capitalists

Traditional venture capitalists (VCs) are professionals at investing in private companies. Typically structured as a partnership, the investors (limited partners) tend to be foundations, pension funds, endowments and often high net worth individuals.

Research (and my observation) shows that VCs can bring much more than capital to their portfolio companies. They typically have strong networks in the sector and a great ability for pattern recognition, often having seen similar companies grapple with similar issues.

One of the most successful HCIT entrepreneurs I know once told me that, after herself, she attributed her company’s success most to the VC involved. This clearly suggests that valuation (and even terms) shouldn’t necessarily be the key factor in selecting one’s financial partner.

Beyond that, however, I’ve observed a huge continuum of both personalities and skills. I’ve seen VCs add tremendous value and insight. I’ve also seen VCs where I’d suggest the entrepreneur sell a kidney on eBay before taking their money.

Another factor to consider is that different funds tend to invest at different stages of a company’s life cycle. Loosely defined, these stages range from: (a) a good idea and founder (Seed Stage); (b) great team and product (Series A); (c) proven product and critical mass of customers (Series B); and business seems to be working, but needs growth capital (Series C and beyond).

While topnotch venture capital funds are continuing to fund early stage companies (and HCIT is no exception), for multiple reasons (to be discussed in a future post), fundraising has become more of a challenge to earlier stage companies than ever before. Hence the significant growth in angel investors to fill the gap.

None of the Above

What other options might exist for funding early stage ventures? I’ve seen companies of all stages think creatively to help bridge funding gaps. Government grants (especially lately) are a source of capital. Sourcing expertise from academia can help reduce the burn (many business schools and engineering schools have programs for students to consult).

One of my favorites is customer or partner financing. Perhaps a distribution partner or a few customers will pre-purchase software licenses, allowing you to combine a revenue and capital event. This win-win scenario serves to both build a customer reference and development partner and help your balance sheet.

Many hospital systems now have internal venture funds as well. These range in terms of stage of company they invest in (some are more risk-averse than others), but can also provide an appealing imprimatur to the marketplace of both customers and ultimate investors.

As I said, even though I don’t guard the Grail, my best advice here is to choose wisely. From my research days to now, when I’m looking at a company, one of the first things I do is see how they’re capitalized and who their investors are. Whether it’s shallowness or just a lesson learned, I find that it can tell me a great deal about a company. Is this a fund with a reputation for thoughtful investing and management, or an investor that typically throws companies to the public before they’re ready to maximize their own returns? Are there angels involved with experience and reputations for success?

While perhaps not the best way, assessing the backers is sometimes an efficient way of coming up with preliminary judgments about companies and their management teams.

Thanks for reading, but I’m afraid I’ve run out of space before even getting to Private and Growth Equity investors (who are sometimes also known as leveraged buy-out investors). While I touched on this in my Take Private post, it probably warrants its own, so let me know if there’s interest.

In the mean time, I’ll be attending the Health 2.0 Conference in San Francisco. That will be the topic of next month’s Investing Chair post. If you’ll be there and would like to chat, drop me a note.

Ben Rooks spent ten years as a sell-side equity analyst covering HCIT and related sectors before spending six years as an investment banker where he closed transactions ranging from $40 to 365 million. Seeking to make an honest living, he then founded ST Advisors, LLC where he works with healthcare companies and their sponsors, most often on issues around strategy, financing, and outcomes/exit planning. After all this time, he still can’t wait for HIMSS!

Monday Morning Update 9/27/10

From Sara Dippedy: “Re: crass KLAS. Our company suffered for years under KLAS ‘extortion.’ If we didn’t pay to belong, we were relegated to an asterisked account, insinuating that we were hiding something. All it took was one ticked off IT underling to nail you with an anecdotal crack, even though they were often happy as a bird 24 hours later. Opinions vary due to overambitious vendor guarantees and unrealistic customer expectations. We need an independent, not-for-profit testing authority, like Consumer Reports.”

From EHR Geek: “Re: proctologist. Did I beat Weird News Andy to the punch?” You did. A New York proctologist is arrested at his oceanfront condo for submitting $3.5 million in false Medicare charges, including charging for 85 hemorrhoidectomies performed on the same patient and procedures adding up to more than 24 hours in a single day. My mind immediately offered several witty comments, but I’m sure yours has already done the same.

From Me So Corny: “Re: eHealth Align. The Kansas City HIE’s board approved signing with ICA’s CareAlign as its HIE solution on Friday. It will be announced this week.” Verified, apparently, since it’s on ICA’s Twitter feed.

From The PACS Designer: “Re: ResolutionMD Mobile. The reading of image files on the iPhone is getting easier with ResolutionMD Mobile. The app is free from the iTunes Store. One of the key features is the DICOM processing, and storage stays on the server with window and level manipulation residing on the iPhone.”

Listening: a 1995 CD from obsolete harmonic Canadian power poppers Zumpano. Sounds great.

The California Academy of Family Physicians will use (warning: PDF) a $145K grant from The Physicians Foundation to create an online EMR resource for physicians, including a readiness assessment and tools for EMR selection. “We liken it to changing the tires on a moving car. Our physicians struggle every day to keep the doors open and keep patients healthy. Look, the office doors are open, patients are coming in, it’s flu season — and at the same time you have to adopt an EMR?”

I ran across a cool open source laptop security app called Prey Project. You install its invisible client on your laptop or mobile phone. If the device is stolen, the app phones home via the Internet or text message, sends you its location determined from geolocation services, takes the thief’s picture via webcam, grabs a screenshot of whatever the thief is doing, and locks down the PC. It will look for any open WiFi hotspot if the device isn’t connected to the Internet. If you’re feeling vengeful, you can annoy the thief by remotely triggering an alarm or an onscreen warning.

Doctors in Australia are warned by the New South Wales medical board not to make “flippant and derogatory” comments about patients after a patient complains. Related: the Australian Medical Association questions whether it’s a good idea for doctors to accept the Facebook friend requests of their patients, saying it’s inappropriate for them to blur the professional-social line.

This week’s company-wide e-mail from Kaiser chairman and CEO George Halvorson makes the point that by collecting ethnicity information in HealthConnect, Kaiser can uncover important ethnicity-specific health risks. He makes an interesting point: since every Kaiser patient has the same coverage, treatment, and providers, the only variable is often ethnicity.

Lisa Busby, CIO of Inter-Lakes Health, is named interim CEO after Kevin Haughney quits.

A couple of readers offered software alternatives for mind mapping. Luke O’Scyte recommends for the iPad and iPhone Headspace ($3.99) and iThoughtsHD ($9.99). For the desktop, he’s trying the open source Freemind, which Les also recommends. Ben suggests the free XMind. 

The Health 2.0 conference will be held October 7-8 at the Hilton San Francisco. Companies sending speakers include O’Reilly Media, Microsoft, HHS, Executive Office of the President, Wired Magazine, The New York Times, Cerner, Google, Kaiser Permanente, and WebMD. Other events during Health Innovation Week include a developer’s challenge at the Googleplex, a REC/HIE summit, and HealthCampSFBay. Early bird registration ends Thursday. You can save an extra $100 by using code “HIStalk” when you sign up. I have no financial interest – I’m just being nice in mentioning it.

Epic UGM photos from Wisailer.

Hyland Software, the OnBase document management company, acquires Computer Systems Company of Cleveland, OH. CSC offers document imaging, revenue cycle, and OB/GYN workflow and EHR tools.

Northern Ireland electronic document management vendor Kainos wins its third NHS contract in the last few months.

The Government Accountability Office appoints 19 members to its Patient-Centered Outcomes Research Institute, which was authorized under the Patient Protection and Affordable Care Act. It’s a big deal: this group will get $500 million per year of the $1.1 billion in ARRA money set aside for comparative effectiveness research, including setting research priorities and overseeing clinical trials. CMS can use its results for what sounds like setting co-pays that will encourage more effective treatments. The dean of UCLA’s medical school will head the group.

A patient sues Medical City Dallas (TX) for mishandling her electronic medical records after being called by collectors claiming she owed money for psychiatric treatment. The hospital had mistakenly chosen her medical record for that of an uncooperative psych patient with the same name, then merged the two accounts. Afterward, the hospital sent her a letter saying they would fix the problem, she got more collector calls, and she found the same patient had been admitted again and the same mistake had been made.

Greenway announces the start of its two-day, regionally-offered Meaningful Use training sessions for customers.

It would be fascinating to know why (heavy vendor response?) 75% of readers wouldn’t use a free, ad-supported EMR. New poll to your right: are the product ratings offered by KLAS representative of product performance in a way that’s useful to providers?

An ISMP survey finds that providers are exasperated with never-ending drug shortages. For those unfamiliar, let me explain why that’s a big deal for hospitals. Sometimes there’s only one source of a given drug, meaning doctors are forced to order alternatives they don’t know much about, often drugs that are less effective or more dangerous. Nurse are suddenly looking at unfamiliar drug packages, increasing the chance of medication error. From an IT standpoint, systems have to be changed: automated dispensing cabinets have to be set up for the new item, CPOE and pharmacy systems may require modification, and any systems that read drug bar codes must be re-programmed. Imagine being a high-acuity patient and finding out that your anesthesiologist or surgeon can’t have his or her critical drug, which they know inside and out from years of predictable use, and instead will be rolling the dice on some alternative they’ve already judged inferior, all because a drug company is mysteriously out of the A-team product. Nobody seems to know why shortages happen, but speculation usually runs to the cynical in my hospital: scumbag pharma tactics, wholesaler market fixing, and hoarding by other facilities who hear shortage rumors (that hoarding is often by us, I should add, since we’re just as unhappy about running out of drugs as anyone else and we don’t hesitate to use our clout to jump the line).

The FCC opens up “super WiFi”, the white space airwaves formerly taken up by analog TV signals, a boon for wireless device and service vendors (including those selling hospital technology). An early adopter is rumored to be Microsoft, which supposedly needed only two towers instead of thousands of routers to cover 500 acres on its Redmond campus. Strange: country singer Dolly Parton filed a complaint – she’s worried about the effect on wireless microphones.

This should fuel the usual HIT takeover rumors: Oracle’s Larry Ellison says the company’s string of acquisitions will selectively continue with semiconductor companies and vendors of industry-specific software.

This is scary, especially since it’s probably true here: the #1 organization that graduating college students in Canada would most like to work for is the federal government.

E-mail me.

News 9/24/10

From Clinical Wisdom: “Re: KLAS. A friend told me that Eclipsys paid KLAS $300K per year. Can KLAS accept mega-bucks from vendors they evaluate without being influenced by their cash? Imagine Consumer Reports taking money from car companies. I think they owe those who buy their reports a full accounting of what they earn from vendors and what those vendors are promised.” We’ve been around and around the KLAS business model over the years. Providers don’t usually pay KLAS for the reports; they get them free in return for providing data, so they would not be surprised to find that vendors pay big bucks (i.e., it’s the HIMSS “ladies drink free” model). I asked Adam Gale in my 2007 interview if the company would be willing to have its survey and ranking process audited by an outside expert. He said yes, but that hasn’t gone anywhere as far as I know. He offered this comment when I asked if being paid by vendors is a conflict of interest:

I would say we have one of the world’s strangest business models, where internally, if you ask anyone at KLAS who our customer is, they’d tell you it’s the provider. That sometimes irks the vendors because they pay a reasonable amount of money to have access to the subscriber data. One vendor, as a mistake, sent us an e-mail intended to be internal that said, “Doesn’t KLAS understand who the customer is based on how much money we spend?” We hold that up and cheer. The vendor is not our key customer. The provider is. We frame every vendor question in terms of, “Will it help providers make a better decision?”

From Spell Czech: “Re: CareFusion Pyxis. Are they really struggling against Omnicell? I hadn’t heard that. Love the blog — been reading for a couple years now!” I’m sure Pyxis still holds most of the market, but it wasn’t long ago that they never lost customers. Both my current and previous hospital employers reconsidered whether Pyxis was worth keeping (clunky software, arrogance, bad support). In one case, we begrudgingly stuck with them because McKesson’s product wasn’t fully baked and Omnicell was struggling. In the other, we dumped Pyxis and never looked back. My conclusion is that, finally, Pyxis has some real competition from both of those now-acceptable alternatives and the market is reacting at least somewhat to that, even though those competitors share some of the same flaws (too many engineers making design decisions and worrying about moving parts instead of nurse-friendly software). I haven’t heard anything about Cerner’s entry into that business. Competition is good for everyone, especially the customer and patient.

From Mighty: “Re: ED denominator for Meaningful Use. CMS has finalized it, though I don’t see it mentioned in many places.” The CMS clarification says that only ED patients who are admitted as inpatients or who are treated as observation patients count toward the CPOE requirement and other parts of MU.  

From Computer Giant: “Re: UPMC. Can the EMRs not solve this problem?” That was tongue in cheek, in case you couldn’t tell. UPMC howls when a state report finds that flagship UPMC Presbyterian-Shadyside has a higher-than-expected mortality rate for CHF, septicemia, respiratory failure, and stroke. Their excuse is the standard: “our patients are sicker,” but when the state responded that everything was severity-adjusted, UPMC then commented that their younger patients throw off the stats. I’ve yet to see a hospital that took the news constructively that it’s underperforming. Be comforted: in their own minds, every hospital is above average.

From Peggy: “Re: Epic co-op. I love your site. I read it religiously! Our hospital is evaluating vendors to replace our clinical core and Epic is (of course) one of them. I’m interested in the consulting co-up you mentioned. Would you mind sharing more information?” I don’t have details, but I’m sure they will emerge publicly at some point.

From Slidell Computer: “Re: executive director of Physician Hospitals of America. She’s leaving. Rumors are circulating that changes will force physician-owned hospitals to sell out or close. Maybe she sees the writing on the wall.”

From Not Quite: “Re: GOP’s Pledge to America. It returns the country to the 2008 budget, ARRA stimulus money for EHR systems will end, and according to polls, the GOP will take over Congress. Shouldn’t all EHR purchases stop now since they won’t get their incentives?” I’ll stay out of the political debate since I distrust all politicians equally (except maybe Chuck Grassley and Ron Paul), but I would say that anyone buying an EHR solely because of Uncle Sam’s promised largesse should think twice even without the Pledge to America. CMS is like a devious cat owner waving a laser pointer around: they love to see providers jump around in reaction to ever-changing and mind-bendingly complex policies that address what initially seemed like simple, good ideas to make sure no payouts actually occur.

Wisailer, a reader attending Epic’s UGM, shared some of the interesting aspects from the meeting so far (his or her words, not mine):

• According to Judy, one of Epic’s goals is "to improve health care for the world," based on their estimate that 30% of the US population is covered by an Epic EMR.
• She says “do what Epic says" and your implementation will succeed.
• Epic has spent 66,000 hours on Meaningful Use, which Carl Dvorak seemed to imply has slowed down their transition to Web-based applications.
• The customer base is 224, up from 190 last year, and many of the sessions were oriented to new installations.
• 200,000 physicians use Epic.
• Vendor ally — boring. Lots of suites and pretty smiles. More consultants, fewer device and service providers.
• Swag consisted of pre-washed, BPA-free water bottles with special refill funnels at water coolers.
• The Haiku iPhone app will be extended to the Droid soon.
• Canto, a new Epic iPad application, will be released in the near future. LOTS of buzz about this product.
• Horse-drawn carriages are giving tours of the campus and bikes are available directly across from Epic Farms, thought by many to be the production source of Epic Kool-Aid.

The pic above of some of the Epic festivities, which looks like a more affluent, less crowded, and much colder (highs in the 60s this weekend) version of Woodstock, is from Dave Yost’s blog.

As Inga told me, we’ve been outed by Google. I set up HIStalkTV a few months back on a slow Sunday afternoon just to play around with posting HIT-related videos that I found amusing or useful. The site is suddenly popping up on search engines for some reason and readers are e-mailing us about it. It’s definitely beta and I haven’t really decided what to do with it if anything, but feel free to send me your thoughts. We even had one of our favorite PR people ask about sponsorship opportunities, which I appreciate even though I’ve given that zero thought.

I was motivated by Ed’s CIO Unplugged post about his use of MindManager for mind mapping, list making, etc. (maybe because he featured HIStalk prominently in the picture). I tried some of those programs years ago and lost interest, but figured I would look again since I really like the concept for creativity. I lost interest in MindManager again when I saw that it has become Visio-ized (tons of overly complex functionality added for corporations and priced accordingly — $349), so I found a simpler alternative that seems to work great: MindVisualizer ($79). I’m running the free trial and will probably buy it because it’s pretty darned slick. I used it today to make a few plans for the HIStalk reception at HIMSS and the tool didn’t get in the way of my thought process, which is the most important criterion.

This seems remarkably open minded considering the source: on the HIMSS blog, the senior director of federal affairs (Tom Leary) asks for comments on the federal government’s role in ensuring the safety of HIT products. Supposedly the only reason the FDA doesn’t regulate HIT today is because of some fancy, long-ago behind-the-scenes political footwork by various groups and vendors, so maybe HIMSS is considering taking an official position. Why not chime in?

A fun Medgadget post: the National Space Biomedical Research Institute has developed an astronaut EMR that combines a mobile monitoring device with software. The EMR is iRevive from 10Blade, which was designed for EMS users (you mean astronauts don’t enjoy the benefits of a certified EHR?)

Continuing my rant on badly written press releases, this HIE one speaks for itself. For the love of God, doctor and press release writer, take a breath! In addition to the hopelessly dense text, it starts off with (1) a mini-editorial; (2) a snooze-inducing history lesson; (3) a ton of quotes, apparently all so equally significant that none could be omitted to make it readable; and (4) in the VERY LAST paragraph, one long sentence that contains the only real news in all that fluff. There is a reason that companies pay experts to craft their communication instead of doing it themselves.

Precyse Solutions will unveil its new Automated Clinical Documentation software and Computer Assisted Coding software engine at AHIMA in Orlando next week.

Weird News Andy entitles this as “Half a woman is better than none.” Doctors in Canada take a drastic step to save a 31-year-old woman with untreatable bone cancer: they cut her body in half by removing her leg, lower spine, and part of her pelvis, then do a “pogo stick rebuild” in fusing her remaining leg back to her body. I wish I had her positive outlook: “I have no problem getting around. If I need to, I’ll crawl (up stairs) or scooch like a kid.” The most bizarre aspect of the story in my mind, however, was how the doctors described the size of the tumor: they said it was the size of a calzone.

Welcome and thanks to brand new HIStalk Platinum Sponsor T-System of Dallas, TX, which created and sells what is surely one of the most effective, well-accepted, and ingenious paper documentation solutions ever devised: the famous T-Sheets, on which over 30 million ED visits are documented each year. The company offers other versions for ED nurses, order sets, urgent care, and primary care, but I’m sure they would also want you to know about T SystemEV, the company’s emergency department information system (with modules for patient tracking, status board, nurses, physicians, and CPOE) that’s used by 240 hospitals. It offers comprehensive physician and nurse documentation, clinical content, a short learning curve (often just one shift, they say), status board, prescription writing, discharge instructions, CPOE, lab integration, real-time coding capture, and patient satisfaction and reporting tools. All are important for Meaningful Use, of course. Former McKesson MPT President Sunny Sunyal recently joined T-System as CEO, so I’d say he did his due diligence and liked the company’s performance and potential. Thanks to T-System for supporting HIStalk — Inga and I appreciate it.

All adult hospitals in Milwaukee County, WI will use My Health Direct for ED referrals to community health centers, courtesy of an agreement signed with the Wisconsin HIE. I interviewed Jay Mason, the chairman and CEO of My Health Direct, in June.

I was checking up to see what’s happening with long-time HIStalk bestie Scott Shreeve MD, formerly of Medsphere and now building Crossover Health, a member-based medical practice that will provide individualized urgent, primary care, and online health services from clinics in California (Newport Beach, Foothill Ranch, and Aliso Viejo). I didn’t think I’d be interested in the construction video above, but it’s pretty fascinating to see how that company and others are taking a very different approach to healthcare delivery for those who can pay for it themselves.

Some unusually juicy jobs on the HIStalk Sponsor Job Page: Sales Director, VP of Solutions Marketing, McKesson Consultants, Head of Quality Systems, Sales Director. On Healthcare IT Jobs, Senior Account Executive for VA, Sales Professional – North Carolina, Clinical Systems Analyst III, Epic Project Managers, Eclipsys Documentation Consultant.

Home care mobile solutions provider CellTrak Technologies announces the latest version of its smart phone system, which includes Android capability. It’s also sold in Canada by TELUS Health.

The US Army awards a research grant to InterSystems to look at its HealthShare platform to exchange data between Madigan Healthcare System (WA) and South Sound HIE.

Medical College of Wisconsin spinoff Imaging Biometrics gets an $800K NIH grant to develop its software that helps clinicians distinguish tumors from healthy tissue.

Odd: a woman’s iPhone is stolen while she is hospitalized and in labor.

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HERtalk by Inga

From Hamlet: “Re: KLAS, Epic, etc. KLAS found that nearly 70% of new 2009 hospital EMR purchases were for an Epic or Cerner integrated solution. Reading HIStalk, you would think Epic cleaned everyone’s clock.” They cleaned a lot of the clocks that counted, i.e. the big, influential hospitals with lots of beds and big dollar volume.

From A-Rod: “Re: on the move. Long-time healthcare CIO Bob Kaplan has been appointed EVP and CIO of Audax Health Solutions in Washington, DC. Bob has been CIO of WebMD, NCQA, IFMC, National Preferred Provider Network, and PHP Healthcare Corp.”  According to the Audax Web site, the company is an early-stage startup developing products that “change how patients and providers interact.”

From Sunshiney: “Eclipsys wins. Mercy Memorial Hospital System in Michigan is replacing McKesson with Eclipsys and Sidra Medical and Research Center in Qatar picks Eclipsys’ inpatient EHR.” Both verified.

Capario promotes sales and marketing VP Jim Riley to president. He replaces Andrew Lawson, who will be moving to another company within Martin Equity Partners, the entity that owns Capario. Riley was previously VP of sales and marketing for Payerpath, where he also worked under Jim Brady, Capario’s executive chairman.

Saint Barnabas Health Care System (NJ) picks EDIMS and its EDIS software for its six-hospital system.

Scribe Healthcare Technologies introduces Scribe Mobile, a new dictation app for the iPhone, iTouch, and iPad.

Yet another entity announces its ICD-10 conversion strategy. Global IT service provider HCL Technologies will use Health Language’s Language Engine solution as part of its end-to-end ICD-10 conversion solution.

Central Jersey HIE Project selects Advanced Data Systems, Greenway Medical, and MDTablet as its recommended EHR vendors. Well, at least that is what I think was said in the HIE’s very rambling press release.

Holy Redeemer Health System (PA) will implement MobileMD and its 4D HIE technology to provide connectivity among the hospital, community physicians, and other area care providers.

This week on HIStalk Practice: InfoGard provides an update on when they’ll begin EHR certification and testing. A medical office janitor lands in jail after selling patient charts to a recycling company for $40. Theories on why medical office hiring is up despite declining revenues. A new study reveals the top EHR/PM companies in the ambulatory world.

A sign of the times: San Juan College (NM) says it will shut down its medical transcription program at the end of the school year. School administrators admit that computers are increasingly taking the place of traditional medical transcription, so the school will instead focus on modernizing its coding and HIT degrees.

The local press highlights Rapid City Regional Hospital and its migration to Meditech. The hospital has implemented bedside medication verification and is now moving to physician documentation. The transition is not without its opponents, including one neurologist who is apparently not a big fan of EHRs:

They are good for insurance companies and good for controlling data, but it’s not necessarily good for patient care. The travesty is, so far the systems are bad. You’re not talking to the patients. You’re talking to the computers. If the doctor has to type, they’re not going to add very much information. Either you input data or you take care of patients, but you can’t do both well.

KLAS finds that the oncology market has been mostly ignored by enterprise software vendors, with best-of-breed vendors dominating the market. Enterprise vendors are more focused on the medical, rather than radiation oncology market, and often vendors are less interested in functionality and more focused on integration with other systems. Epic is named the closest enterprise system to delivering an oncology solution. Cerner, Eclipsys, GE, Meditech, and Siemens offer varying functionality as well.

E-mail Inga.

UnitedHealth Group To Acquire A-Life Medical

UnitedHealth Group announced after the market close Tuesday that it will acquire computer-assisted coding vendor A-Life Medical of San Diego, CA. Terms were not disclosed.

UnitedHealth Group will add A-Life Medical to its Ingenix Health Care Delivery business, extending a strategic alliance formed between the companies last year to develop advanced coding solutions.

A-Life Medical’s products include the LifeCode natural language processing solution, which analyzes clinical documentation to identify diagnoses and procedures and recommend ICD-9 and CPT-4 codes to coders. Its Actus computer-assisted coding product will allow Ingenix to market services to providers transitioning to ICD-10 by the mandatory October 1, 2013 date.

The acquisition is UnitedHealth’s fourth technology-related buy so far this year, having previously absorbed Picis (high acuity systems), Executive Health Resources (medical necessity and compliance), and Axolotol (health information exchange systems).

News 9/22/10

From Medicament: “Re: Epic UGM. Announced attendance is 5,500 vs. 3,800 last year. Surreal. This panorama is from the auditorium just after Judy’s keynote.” If you are there, send me a report of any newsworthy developments. Sorry the pic is small, but that’s the point: the meeting isn’t.

From Neils Bohr: “Re: Accenture. I heard they got the HHS contract for use case for the Standards and Interoperability Framework last Friday.”

From Epic CoOp: “Re: Epic consultants. Given the huge demand, 20 of them are forming a consulting co-op to keep the cut that temp agencies take.”

From Blue Danube: “Re: video. Even though it’s an ad for Centricity, it paints a pretty accurate picture of primary care and the need for EMRs.”

Listening: new (released just today) from John Legend and The Roots, a collaboration between the modern R&B/hip hop singer (John Legend) and the Philly funk band (The Roots), updating socially conscious soul songs from the 60s and 70s. I can’t describe just how awesome this album is, sounding as fresh and uncomplicated as Motown circa 1968. If you don’t like soul or hip hop music because it’s over-produced, non-melodic, and fixated with trite subjects like lust or fame, let this rekindle your hope for the genre. I usually condition my recommendations knowing they aren’t for everyone, but this one’s for everyone.

UnitedHealth Group makes another buy, announcing plans to acquire coding vendor A-Life Medical. I covered it in a news blast here. UnitedHealth Groups is obviously on an HIT tear, bagging four companies so far this year. That’s a good reminder to sign up for updates using the Subscribe to Updates box on the upper-right of this page and/or to Friend/Like us on Facebook since I usually post new stuff there too.

The San Diego office of the FBI announces that El Centro Regional Medical Center (CA) will pay $2.2 million plus interest to settle Medicare fraud allegations brought forward in a former employee’s whistleblower lawsuit.

Rothman Healthcare hires Richard Sommer as CEO. I hadn’t heard of the company, so I checked it out. It markets products based on The Rothman Index, an automated system that collects 26 observations and results for each patient every hour and graphs the score so caregivers can quickly see who’s crashing. The trial was at Sarasota Memorial (FL). The Rothman brothers found the company after their mother died after post-surgical complications that were subtle and therefore undetected in the hospital. According to the company’s site, nurses at its first hospital site identified a patient going bad within five minutes of bringing the system up in test mode, reacting to a patient whose pulse-ox had dropped from 98% to 85% over two days without alarming anyone.

Jewish General Hospital of Montreal, Quebec will use education and clinical image sharing tools from Aurora Interactive to create an online pathology education network.

McKesson, HP, and Intel launch a site that mixes HITECH resources with preconfigured EHR hardware/software packages.

Transcend Services announces BeyondAlerts, which extracts clinical data from transcribed narrative to trigger provider alerts.

Panasonic will offer data encryption from Mobile Armor in its Toughbook notebooks and mobile clinical assistants. That includes self-encrypting Seagate drives, centralized management, pre-boot authentication, and auditing. Smart.

I made fun of a Brainware sales announcement a few weeks back because it didn’t name the customer (for contractual reasons, no doubt, but I still questioned the newsworthiness of an anonymous customer sale). They sent me their latest announcement this week, joking that this one names names, that being Gundersen Lutheran Health System (WI). Brainware and Ascend Software are providing the Brainware Distiller intelligent data capture tool along with business process automation for the health system’s Lawson accounts payable system. Brainware’s tools pull data out of unstructured sources such as invoices without templates or indexing. For AP, that means speeding up processing and providing a near real-time view into liabilities. It uses fuzzy search to assign GL codes and vendor numbers to non-PO invoices. Its Gateway product is a portal for vendors to check the status of their invoices online.

Since I shamed Brainware, let’s move on to the next poster child for bad press releases. Does this headline roll off your tongue? The Institute for Transfusion Medicine(SM) (ITxM)(SM) Deploying BIO-key(R) Fingerprint Search and Identification Solution for Donors and Patients. Marketing people can’t even introduce themselves without holding up little trademark and service mark signs. I guarantee that nobody could read this even 2-3 times and have the slightest clue what it’s about with all the unnecessary, lawyer-paranoid clutter.

Covisint, the portal vendor owned by Compuware, acquires DocSite of Raleigh, NC, which offers PQRI, registry, decision support, e-prescribing, progress notes, and integration tools. Roger Sterling tipped us off in the 9/1 HIStalk, although Inga couldn’t get Covisint to confirm.

Children’s Boston will use Allocade’s On-Cue Operations Management software in radiology. It pulls data from existing systems to create a rule-optimized patient itinerary and provides caregiver collaboration tools and business intelligence.

New Jersey’s HITREC contracts for physician practice consulting services from Nit Health. Being a hospital guy, I couldn’t help but think of small combs and Kwell shampoo.

Maimonides Medical Center (NY) goes live with InterSystems Ensemble for rapid integration and development, using it to develop new interfaces to/from Sunrise Clinical Manager.  

An interesting debate at the VA: should tech-savvy doctors be allowed to store limited patient information using cloud-based Web tools if they appear to be secure and if the VA’s systems can’t meet their needs otherwise?

A study finds that a heart attack risk calculator used by consumer health sites is not very accurate, misclassifying 15% of patients as needing medications when they really don’t (check out the screen shot I took above from the American Heart Association’s version of the calculator to see why that’s not too shocking). Epocrates is mentioned as offering physician treatment applications based on the flawed formula.

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HERtalk by Inga

From Heresay: “Re: certification pricing. I’ve heard CCHIT is charging $40-$60,000 for EHR certification compared to Drummond’s $20K.” If anyone thinks they have a solid handle on the pricing from the three ONC-ACTBs, please step forward. InfoGard has yet to publish any details, but here is how I am interpreting the pricing from CCHIT and Drummond:

• Complete EHR Ambulatory: CCHIT $34,300; Drummond $19,500.
• Compete EHR Inpatient: CCHIT $32,550; Drummond $19,500.
• If you don’t need testing for the full EHR and just need individual modules tested, CCHIT has assigned a per-module fee for testing that ranges from $650 to $2,000, depending on the module’s complexity, plus a $7,000 base fee that includes the mandatory security criteria.
• Drummond charges $11,500 for up to 19 modules, include the mandatory measures, or, $16,000 for 20 or more modules, including the mandatory items.

To summarize: Drummond is less expensive if you need complete EHR certification and testing. If you need module testing only, CCHIT could be less expensive. The CCHIT folks would probably add that their fee includes a comprehensive testing and certification toolkit for vendors, which they will sell to non-applicants for $1,000. Also, vendors with CCHIT 2011-certified products will not need to pay additional fees for the ONC-ATCB certification through CCHIT, though additional testing is required.

I happened upon this blog post by an Epic User Group Meeting attendee. He shares details of Sunday night’s round-the-campfire wienie roast, complete with s’mores, dogs, and employee-provided entertainment. Very cool. Epic is expecting over 5,300 customers to hit Verona this week for this year’s theme, “UGM: The Musical.” In addition to 300 educational sessions, the meeting will  feature Epic staff singing Broadway tunes, Les Feud game show, and a tug-of-war tournament.

KLAS finds that nearly 70% of new 2009 hospital EMR purchases were for an Epic or Cerner integrated solution. Overall EMR sales nearly doubled last year in the 200+ bed hospital market. Meditech and Siemens saw limited growth and McKesson’s Paragon product outsold McKesson’s Horizon solution.

RCM company NHPN appoints David Garber SVP of managed care. Garber has held leadership positions in a number of managed care organizations, including CompServices and Coventry Health Care.

A third of office-based providers are now e-prescribing, according to Surescripts. However, only 12% of all prescriptions were written electronically last year. The number of providers using electronic prescribing grew significantly from 2008 to 2009, from 74,000 to 200,000, while the total number of e-prescriptions jumped from 68 million to 190 million. Massachusetts had the highest e-prescribing rate at 57%, followed by Rhode Island and Delaware.

Corey Hall joins REACH Call as EVP of medical informatics, coming over from the College of American Pathologists.

Sponsor Updates

• iMDsoft and Medical Web Technologies (MWT) partner to integrate their technologies. iMDsoft will offer MWT’s One Medical Passport pre-op workflow solution as part of its MetaVision AIMS product.
• Greenway Medical Technologies introduces its Allergy Module for PrimeSuite EHR, which includes injection record tracking, allergen testing, serum development, and lot administration and reporting.
• API Healthcare says that 35 provider and contingent staffing clients have gone live with its workforce management solutions this year.
• NextGen Healthcare provides VHA members special pricing on its clinical and financial software.
• Vanguard Health Systems deploys Medicity’s Novo Grid HIE technology to 850 physicians across four states.
• Parkview Medical Center (CO) selects RelayHealth’s RevRunner to improve its revenue cycle performance.

E-mail Inga.

Monday Morning Update 9/20/10

From Tobias Funke: “Re: interesting billboard. This is from Avera Health in Sioux Falls, SD.” That’s pretty cool – the billboard has a smoke machine behind it to extend the smoke into the sky. It drew lots of attention, both from passers-by who checked out the site afterward and the local fire department, who shut it down.

From The PACS Designer: “Re: Windows 1E9 beta. Just like Mr. H, TPD loves Firefox and avoids Internet Explorer. Well, now we have the Windows IE9 beta release, but you won’t be able to use it for Windows XP! It looks like a move by Microsoft to push more of us XP users to upgrade to Windows 7.” I’m still holding Vista against them. The decades-old Windows pattern is obvious: one really OS good release alternating with a bad one that causes endless frustration. My preferred browsers, in order, are Chrome, Firefox, Opera, and then IE (I don’t use Safari, so I don’t know where it would fit). Windows 7 is a winner, though, which is still not great consolation given that I paid for Vista instead of jumping right from XP to the next good version. I don’t think anyone would complain about moving up to Windows 7 if it didn’t require starting over for XP users — you have to have wasted your money on Vista to do a simple upgrade, or at least that’s what I recall when I last considered it. I suspect I’m like the typical XP holdout — not cheap, just not finding a good reason to risk problems knowing that Microsoft offers no help (in other words, have lots of time and a second computer to Google your problem just in case the first one is trashed because you’re on your own).

Former McKesson Provider Technology CFO Craig Niemiec is named EVP/CFO of US Preventive Medicine. I checked out that company’s prevention program and it sounds pretty cool: you pay $229 for the first year, complete an online health risk questionnaire, and then go to a local lab to have a panel of blood tests. The company sends your lab results to a PHR, you and your doctor get a custom prevention plan, you gain access to online dashboards and action programs, and a nurse advocate is available to help with health maintenance. Since it’s not tied to insurance or employment, nobody sees the information without your approval.

Job candidates with a CPHIMS credential would impress one out of five HIStalk readers if they were hiring. New poll to your right: would you use an free, ad-supported EMR?

Sonney Sapra is promoted to CIO of Tuality Healthcare (OR).

iOptimal announces the beta of iPad Hospital Toolkit, which it says requires no iOS programming and connects to standard databases to convert legacy apps to run on the iPad.

A third organization is approved by HHS to certify EHRs as an ONC-Authorized Testing and Certification Body: InfoGard Laboratories of San Luis Obispo, CA. They have many certifications and list extensive internal expertise (cryptography, security, systems architecture, etc.) that makes CCHIT’s credentials look a little anemic in comparison.

St. Edward Mercy Medical Center (AR) will go live on Epic September 26. The local paper’s article says Sisters of Mercy Health System, of which St. Edward is part, spent $450 million on Epic.

Siemens will make its IT Solutions and Services unit a separate company on October 1, having previously announced plans to cut 4,200 jobs there to set up a spinoff. That business covers a bunch of industries including healthcare, but I wasn’t familiar with the healthcare parts: content management, PACS data storage, identity management, and RFID. I assume this has nothing to do with Siemens Healthcare.

Cardinal Health sells its remaining shares in its CareFusion spinoff for $706 million. Some of the CareFusion medical device and technology brands include Pyxis, Alaris, AVEA, Jaeger, SensorMedics, V. Mueller, and MedMined.

England’s Connecting for Health wants NHS trusts to report their inventories of Microsoft licenses by October 1. Since CFH didn’t renew its Enterprise Agreement and their license count is fixed, that means trusts are own their own to budget and pay for their Microsoft licenses.

I’m not sure how this qualifies as defense funding, but Assistant Senate Majority Leader Dick Durbin brings home the Illinois bacon in getting $3.6 million in funding through the Senate Appropriations Committee for Children’s Memorial Hospital of Chicago to study regenerative genes. It’s great for wounded soldiers, so I guess you could squint a little at the tumescent federal budget and make it so. The Senate has to approve, but I think they are battle-weary themselves from approving endless federal handouts that, if you continue squinting, only slightly resemble a robust economy.

An interesting and cheap idea for practices interesting in reducing missed appointments: sign up for a Web-based virtual phone service and use it to send SMS reminders to patients.

Vecna Technologies signs a marketing deal with Cycom Canada to sell its QC PathFinder real-time hospital infection monitoring system to hospitals in Canada. The company, whose offices are in the DC area and Cambridge, MA, also offers a Web portal and patient self-service kiosks. Also, the medication delivery robot above. Their stuff looks pretty cool.

Former treasury secretary Paul O’Neill questions David Blumenthal after the latter’s EHR-love keynote speech at a patient safety meeting, asking him (I’m paraphrasing): if the government is so hot to spend billions on EMRs, then why not design a prototype and then refine it, creating a national standard? Blumenthal’s answer, also paraphrased: there’s a debate about whether the ideal approach is like the Internet, where competition took the basic structure of the Internet and turned it into something amazing, or should someone just set detailed standards centrally? He also touted certification. An interesting quote from the excellent Mass Device article, from Atul Gawande at an August meeting talking about reducing medical errors: “Ignorance remains, but we have a new kind of human failure that has emerged as important and that is what the philosophers call ‘ineptitude,’ meaning that the knowledge is there, but the individual or group of individuals fail to apply that knowledge correctly.”

A former Medco pharmacist nears the 80th day of his hunger strike protesting the mail order pharmacy’s requirement that pharmacists fill at least 50 prescriptions per hour, saying it causes medication errors.

The VA and DoD launch a fourth records-sharing pilot, this one involving the Spokane VA, Fairchild AFB, and Inland Northwest Health Services. The first three are in San Diego, Norfolk, and Indianapolis.

California Attorney General Jerry Brown wants to review the salaries of hospital executives, among several public positions that he thinks are overpaid. The healthcare example he gave was the CEO of Washington Hospital, who makes $847K. The hospital gave the stock answer about having to pay market salaries for the best hires, which always sounds lame to me. First, some of healthcare’s hires are clearly not the best people. Second, by that logic, you’d be paying teachers and ministers huge dollars if only they were lucky enough to have higher-paying alternatives. And third, I like the idea of offering less than market salary and seeing who really wants to help patients vs. themselves. If you can’t stand the idea of running a non-profit hospital for a paltry $500K, then don’t let the door hit you on your way out.

E-mail me.

Sponsor Updates

• T-System announces the six winners of its 2010 Client Excellence Awards.
• Medicity announces that Carolinas HealthCare has selected the company as its partner to build a multi-state HIE.
• Nuance will be at AHIMA next week.
• Baltimore-based clinical documentation vendor Salar is recruiting for a number of positions to support its growth: software engineer, RVP of sales, implementation specialist, marketing specialist, and others. I like these guys – their crew was having a blast at the HIStalk reception at HIMSS in Atlanta.
• A good Facebook to follow – NPC Creative Services. I read a lot of Facebook posts and theirs is always on point about HIT.
• HIS vendor IntraNexus will be at HISpro’s seminar for buyers in Dallas on October 13-14. That’s Vince Ciotti, who keeps the registration fees and hotel costs way down ($295 to register).
• I don’t remember if I’ve mentioned this: Quest Diagnostics and Surescripts will work together to create a service that will make lab and prescription information readily available to physicians. Quest is the parent company of HIStalk sponsor MedPlus, which offers the Centergy data exchange, ChartMaxx document-based EHR, and Web-based Care360 EHR that is used in more than 70,000 practices.
• Holon is offering downloable overviews of its offerings: central order entry pharmacy, results notification, workflow scheduling, pharmacy solutions, and others. The company offers the Holon Framework that includes solutions for data exchange, workflow, interoperability, and document management, all designed to enhance rather than replace existing systems.
• International informatics and medical terminology vendor Apelon will be at AHIMA, where Kathy Giannangelo will present on the state of standardized terminologies. The company’s expertise is in terminology asset management, data interoperability and integration, and data warehouse content and consulting.
• If you’re going to the Virginia MGMA fall conference in Virginia Beach next week, check out DIVURGENT’s presentation on tactical approaches to HITECH, delivered by partner Colin Konschak and client services VP Shane Danaher. The healthcare consulting firm will also be at the CHIME Fall Forum and VAHIMSS in October.
• Stockell Healthcare Systems offers several success stories about its InsightCS solution for patient registration, ADT, and revenue cycle management.
• Precyse Solutions will oversee transcription, medical records processing, coding, and storage for Benefits Health System (MT), taking over its 60 employees.
• Rechargeable workstations from Enovate are highlighted on the Web page of Children’s Hospitals and Clinics of Minnesota, which shows the amenities and benefits of its patient rooms. Cool idea: each room has a caregiver window so that nurses can check on the patient and perform documentation from the hallway without barging in.
• UC Irvine Medical Center gives credit to Surgical Information Systems for its best practices in patient handoff and communication that led to a successful Joint Commission survey.
• Order Optimizer has added a very well laid out Web page on Meaningful Use. It says its SaaS-based CPOE can be live in nine weeks with no capital investment and no impact on legacy systems, making it feasible to meet Stage 1 incentives within 90 days.
• MED3OOO offers free electronic newsletter subscriptions covering coding and compliance, clinical tools, and developing healthcare news.
• SRSsoft publishes its online EMR Straight Talk, with the latest entry being EMR Purchase – Caveat Emptor.
• Cumberland Consulting Group is growing and therefore looking for candidates at these levels: consultant, managing consultant, and executive consultant.
• Regulatory compliance consulting firm The Anson Group will present at the 2010 RAPS Annual Conference in San Jose next month. The company also offers technology commercialization services that can include licensing, sale, and partnerships, particularly with regard to products involving FDA approval and the resulting regulatory risk.
• I like the people at electronic forms management experts Access, being among the very few sponsor folks I’ve actually hung out with non-anonymously here and there. I’m still trying to get them to bring their award-winning Texas barbeque team to HIMSS in Orlando for your benefit as an attendee, since that part of the world struggles by with pathetic chain barbequed chicken of no particular regional specialty and therefore is generally unaware of the glories of Texas brisket and sausage (although I do like that of Cecil’s Barbeque on Orange Avenue even if they smoke it over hickory instead of post oak and/or mesquite). Anyway, Access has a blog here, which coincidentally gives HIStalk a shout-out in the latest entry.
• Informatics Corporation of America is offering an October 21 Webinar entitled Sustaining HIEs Through Leveraged Infrastructure – A Multi-Community Approach.
• Sunquest is at the pathology informatics conference in Boston this week and will head on over to CAP ‘10 in Chicago immediately after. Stop by and tell them you saw it on HIStalk.
• API Healthcare launches its Client Connections site, providing easy access to support materials, manuals, and training materials. It also offers clients the ability to network with each other and with API’s experts on workforce management technology. Clients can search the support database, review and enter support tickets, and receive e-mail updates when the status of their ticket changes.
• Enterprise workflow vendor FormFast offers a Webcast library covering EMR maturity and adoption, RAC audits, workflow applications, prescription printing, and others.
• The Sentinel RCM application 340b drug pricing application from Sentry Data Systems will be integrated with Omnicell’s WorkflowRX 7.0 software.
• EDIS vendor EDIMS will be at ACEP 2010 in Las Vegas next week. I’m sure they would appreciate a howdy from HIStalk readers also at the Mandalay Bay.
• Culbert Healthcare Solutions just won a “fast growing” award, so it stands to reason that they might want to talk to you if you’re an ace consultant (Allscripts, Epic, GE, integration, revenue cycle, PM, etc.) Info here.
• Interesting in outsourcing revenue collections? AdvancedBiller, a service of AdvancedMD, will match you with up to three AdvancedBiller partners, who will provide needs analysis and price quotes. Register here.
• TELUS Health offers an online demo of Telus health space, its HealthVault-powered consumer platform for Canadians that is the first to achieve Canada Health Infoway pre-implementation certification.
• SCI Solutions is making customer reviews of its access management services freely available online via Customer Lobby, including KLAS-like commentary and star ratings. I believe you can infer that they have little to hide about their ordering, patient scheduling, and revenue cycle applications. SCI was one of the first HIStalk sponsors and doesn’t really advertise much, so thanks to John Holton, Cindy Dullea, and Hans Morefield, some of the folks there that keep in touch regularly.
• Wellsoft announces that CCHIT has certified its EDIS v11 emergency department EHR, making it one of the first.
• EHR consulting experts Enterprise Software Deployment (Allscripts, Cerner, Epic, McKesson, Meditech, Siemens) brings on David Tucker as national sales VP. The company is growing like weeds and is on the lookout for both salaried and contract consultants – check out their job board.
• Software Testing Solutions has posted fun photos from their creative booth activities at SUG 2010. You can sign up for a variety of demos and classes for their application testing solutions for Sunquest, Eclipsys/Allscripts, and Epic.