News 6/17/11

Top News

The California Hospital Association files suit against the state public health department to block a requirement that hospitals report detailed information about surgical site infections starting June 1. CHA says most hospitals don’t have the information available electronically, so they would have to take time away from patient care to dig through records manually.

Reader Comments

From Ricky Roma: “Re: Dr. Jayne’s IT comments. Doctor, we live in a world that has networks, and that network has to be guarded by men with decreased budget and staff. Who’s gonna do it? You? The executive staff? We IT guys have a greater responsibility than you could possibly fathom. You weep for your iPad, and you curse IT. You have that luxury. You have the luxury of not knowing what I know. Denying iPhones, while tragic, probably saves PHI. And my existence, while grotesque and incomprehensible to you, saves PHI. You don’t want the truth, because deep down, in places you don’t talk about in the doctors’ lounge, you want me on that network. You need me on that network. We use words like governance, security, encryption. We use these words as the backbone of a career spent defending something. You use them as a punch line. I have neither the time nor the inclination to explain myself to a physician who sees patients under the blanket of the very security that I provide, and then questions the manner in which I provide it. I would rather you just said thank you and went on your way, Otherwise, I suggest you log on to a PC like everyone else. Either way, I don’t give a damn what device you think you are entitled to.” Brilliant as always from one of my favorite (but seldom heard) contributors.

From Mile High Club: “Re: WSJ article on use of corporate jets. It includes a searchable database, finding that destinations often coincided with the vacation homes of executives. McKesson had 41 flights to Martha’s Vineyard and Laconia, NH (probably someone’s house on Lake Winnipesaukee).”

HIStalk Announcements and Requests

This week on HIStalk Practice: additional background on the RWJF report that found diabetics treated by practices with EHRs received significantly better care than those treated at paper-based offices. Turns out the paper-based offices also had almost five times more non-insured or Medicaid patients than the EHR-based practices and twice as many non-white patients. Also: Julie McGovern of Practice Wise shares tips for creating a disaster recovery plan. A new organization is launched to certify medical scribes. Less than one-third of physicians are expected to remain independent by 2013.  Dr. Gregg shares HITECH support woes and wins. If you like the ambulatory world (and who doesn’t?) then you’ll want to make sure to sign up for the HIStalk Practice e-mail updates.

In almost totally unrelated to HIT news: a couple of girlfriends and I stayed at a upscale hotel recently for a little getaway. All three of us came home with what I have diagnosed to be bed bug bites (you know, I did the Internet research thing and compared my bites to the online photos.) Which leads me to wonder: are bed bugs the latest work hazard for HIT road warriors? It’s a totally disgusting topic, I realize, but it’s an issue I never really worried about in my traveling days. FYI, I complained to the hotel; they checked the room and told me they found no evidence of bed bugs. BFFs and I are thus considering whether we’d be better off visiting a dermatologist or simply seeking a psych consult.

Listening: Black Joe Lewis & The Honeybears from Austin, TX, recommended by a reader. Here’s what I e-mailed to her: “I’m doing hideously uncoordinated chair-based dance moves to Booty City, thinking I’ve gone back in time to the 60s to listen to Edwin Starr doing 25 Miles from Home. Now I’m going to want to accentuate everything I say with an emotional ‘HUuaaH’ just like this guy (and James Brown) I’m making that ‘white man trying to be funky’ look by scrunching up my nose, sneering, and and squinting as I bob my head out of time with the music and do some walking bass on the air guitar.”

On the Jobs Page: Solutions Executive – Virtual Office, Technical Marketing Engineer – Work from Home, Healthcare IT Technical Recruiter. On Healthcare IT Jobs: Allscripts Test Manager and Test Resource, Implementation Consultant, Meditech PCM Implementation Analyst.

First, do no harm. Once that’s done, (a) sign up for e-mail updates in the box to your upper right (unless your display is set to low resolution, in which case it could be just about anywhere); (b) send me news, rumors, and anything that would tickle my sophomoric humor; (c) find Inga, Dr. Jayne, my sites, and me on your favorite social not-working tool and make the appropriate electronic connections so we can feign mass appeal; (d) accept my personal challenge to randomly inspect five of the admittedly large number of ads to your left and click them, waiting excitedly as in the presence of Monty Hall to see what’s behind Door Number 3 and knowing that you are thereby supporting us keyboard-clackers who work absurd hours after our day jobs; and (e) don’t worry, be happy.

Thanks to Bulletin Healthcare, new to both HIStalk and HIStalk Practice as a Platinum Sponsor. The publishing company sends out electronic newsletters to 400,000 doctors every morning by 8:00 a.m., working with two dozen leading medical associations to meet the unique news requirements of their members  as a valued member benefit (American Medical Association’s AMA Morning Rounds, American College of Physician Executives’ ACPE Daily Digest, and American College of Cardiology’s CV News Digest, to name a few.) The Reston-based company is the medical division of Bulletin News, which provides executive news briefings for the President and most of the Cabinet. They’re happy to tell companies about their advertising programs, should yours have an interest. Thanks to Bulletin Healthcare for supporting HIStalk and HIStalk Practice.

Sales

The Regional Medical Center at Memphis (TN) purchases Carestream Health’s Vue RIS for radiology scheduling and reporting.

The University of Virginia Health System extends its licensing agreement for Streamline Health’s document workflow solutions and adds Streamline’s Correspondence Workflow application.

People

Press Ganey promotes Robert Draughon from president and CFO to CEO, replacing Richard B. Siegrist, Jr. Siegrist will transition to chief innovation officer and remain on the board. We reported this Monday, courtesy of a rumor report from South Bend Snoop.

PatientSafe Solutions names Joseph Condurso president and COO. He was a CareFusion VP and also spent time with Cardinal Health.

EnovateIT president Fred Calero wins Ernest & Young’s Entrepreneur of the Year award for Michigan and Northwest Ohio in the healthcare services category.

Vivek Kundra, the nation’s first CIO, will quit in August to take a Harvard fellowship. Like his boss, opinions vary on whether he has accomplished anything of positive significance. Nobody has said much about a possible successor, so I don’t know if Aneesh Chopra has the cred or interest.

Industry long-timer Rick O’Pry, founder of JR O’Pry Consulting and IntraNexus, launches a consulting company called HIT Strategists.

Announcements and Implementations

St. Michael’s Hospital (MN) will go live on Meditech on July 1.

Mayo-Austin (MN) apologizes to patients for long registration delays caused by the EMR it installed in April, saying it “has temporarily slowed down our registration process and phone response time as we check the accuracy of patient information and become more proficient with the system.” They’ve hired more staff. I bet decreased patient satisfaction and increased headcount to do the same work wasn’t in their business plan.

Omnicell’s OmniRX medication dispensing system wins Best in KLAS for hospitals 200 beds and over.

PDR Secure launches the RxEvent adverse event reporting service, which will allow doctors to report drug problems directly from their EHR. It was developed in conjunction with Greenway, the American Pharmacists Association, and athenahealth.

UPMC announces its HealthTrak mobile app for iPhones and iPads that allows patients to review their test results, history, meds, and appointments. It’s based on Epic’s MyChart.

Innovation and Research

Fujitsu works with a hospital in Japan to roll out a patient guidance system based on e-paper. Patients carry an electronic card holder that guides them to diagnostic departments, checks them in, and accepts their payment. They can wander around while waiting since the system calls them when it’s their turn (not that hospitals have anywhere interesting to wander around in anyway, but at least they could distance themselves from Unemployment TV).

Technology

Ottawa Hospital is deploying mobile technology in a big way, purchasing 2,800 iPads for its 456-bed facility. The CIO notes that its iPad and iTouch users include doctors, nurses, pharmacists, respiratory therapists, and even janitors.

Online physician networking site QuantiaMD finds that over 30% of physicians use tablet devices, 20% of them in clinical settings.

Panasonic announces that it will bring out an enterprise-grade, Android-powered Toughbook tablet in the fourth quarter.

Other

Sparrow Health System (MI) hosts a job fair in an attempt to fill 70 to 80 IT job openings. Analysts will support the health system’s $100 million Epic EHR implementation. Starting salaries are $50-80K.

The Missouri Hospital Association estimates that 90% of the state’s hospitals use an EHR for at least one of 24 functions. On average, hospitals use about nine EHR functions, though 44% use at least 13.

CapSite believes the ambulatory EHR and PM market will exceed $3 billion through 2013, with 63% of physicians replacing their current PM systems for an integrated PM/EHR and 38% upgrading or replacing their current PM. Capsite’s 2011 U.S. Ambulatory EHR and PM Study also predicts that 50% of physician will be investing in ambulatory EHR systems. In terms of current market penetration, Allscripts and Epic each have 16%, followed by eClinicalWorks, NextGen, and GE.

A tornado in Verona, WI left Epic powerless for most of last Thursday, forcing it to run on backup generators.

A California man is arrested for pretending to be a medical doctor. A patient got suspicious after he told her to treat her kidney disorder by eating watermelon in a hot tub.

Weird News Andy is speechless about this story: a woman in Sweden with fever, chills, and aches calls four times over four days for an ambulance, but is turned down because she is still able to speak. She dies. But WNA is tittering at this piece about English hospitals warning employees that their uniforms must not expose their midriffs or “excess cleavage” (whatever that means) after patients complained.

Sponsor Updates

• SCI Solutions posts a video describing its new Arrival Manager product and a cool flipbook of its annual Innovations in Access Management magazine.
• MEDSEEK wins the 2011 Frost & Sullivan North American Health Records Technology Leadership award.
• FormFast and T-System collaborate to integrate the print management portion of FormFast’s workflow software with the T-Sheets documentation system.
• CareTech Solutions announces that two of its clients won 2011 Aster Awards for their Web sites.
• AsquaredM is offering a June 23 Webinar on improving revenue cycle performance with Lean Six Sigma.
• Hanger Orthopedic Group will deploy NextGen Ambulatory EHR and PM at its 675 orthotic and prosthetic patient care centers in 45 states.
• The Tennessee-headquartered RegionalCare Hospital Partners selects Healthcare Management Services (HMS) to provide clinical and financial applications .
• McKesson VP and medical director David Nace, MD is speaking about bundled payments at this week’s AHIP conference in San Francisco.
• A health center customer of TELUS Health Solutions wins an Ingenious Award for using the company’s remote patient monitoring solution to increase nurse productivity, reduce home visits, and save $450 per patient.
• Humana will offer financial assistance to physicians adopting Allscripts EHR as part of is as part Humana Medical Home EHR Rewards Program.
• Pinehurst Dermatology (NC) contracts for the SRS EHR.
• API Healthcare hires Kathy Douglas, RN, MHA as the company’s chief nursing officer. She founded the non-profit On Nursing Excellence.
• TeleTracking Technologies will preview its new RTLS solution at the 2011 Association for Advancement of Medical Instrumentation conference being held June 25-27 in San Antonio.
• HHS’s Office of Minority Health and Quest Diagnostics announce a program to  donate 75 MedPlus EHR user licenses and one year’s subscription fees to physicians in small practices serving minority populations in Houston.
• Perceptive Software names Glenn Cross VP of Marketing.
• MED3OOO is offering an on-demand Webinar on Why ACOs Should Be Physician Led that features Amit Rastogi MD, president and CEO of PriMed LLC, a 70-provider medical group in Connecticut.

EPtalk by Dr. Jayne

Mile·stone (noun)

1. A stone functioning as a milepost.
2. A significant event or stage in the life, progress, development or the like of a person, nation, etc.

I believe in celebrating milestones. With the rapid pace that many of us run each day, it’s easy to overlook key events. We get used to doing the same tasks each day / week / month / year, falling into the cycle of “lather-rinse-repeat” and losing sight of the work that we are accomplishing.

I encourage my team to remember that, although this may be the 43rd time they’ve trained “E-prescribing 101,” this is the first time the users in their classes are seeing it. I remind them to remember the impact they are having on our end users and that completion of each class is an accomplishment.

We just took our 250th physician live on one of our clinical systems. The go-live wasn’t any different than any other go-live — the physician was aggravated that he had to be there and I was aggravated at having to deal with his surliness towards the IT team. However, calculating the number of times we’ve executed the same process multiplied by the number of people needed to work closely together to successfully get that physician live, it becomes significant. If you would have offered me a bet at the start of the rollout that we’d have this many physicians live on that application at this point, I wouldn’t have taken it.

We tend to take for granted the things that seem to be always present. Maybe we celebrate the beginnings and the ends — the new teammates and the retirements — but we forget to mark the events that happen along the way.

The five-year anniversary of an incredibly challenging project is passing without anyone in our organization other than those of us who were on the team at the beginning noticing. On one hand, maybe it’s good that the tool has become such a part of the organization that it’s not a big deal. But for those of us who still have flashbacks from the go-live (and probably a little post-traumatic stress disorder), it’s amazing.

Celebrating milestones helps us learn what others value and why it matters. Last Wednesday was HIStalk’s eighth birthday. Although Mr. H mentioned it, he tends to be the somewhat shy and retiring type, so it was pretty low key. I’d like to do my part to celebrate HIStalk and reflect on the impact Mr. H and company have had on me.

As a reader, HIStalk provides a reliable, humorous, and entertaining source of information that I could not possibly have uncovered without hours of sifting through the announcements, updates, and studies that come through my inbox and across my desk each week. It gives me tidbits of industry gossip that sometimes hit too close to home.

I’ve learned things about competing health systems that I could not have sleuthed out on my own. I’ve surprised vendor execs by asking them to confirm rumors about their companies that they haven’t even heard themselves. I’ve experienced HIStalkapalooza and the IngaTini.

As a member of the HIStalk team, I’ve had the opportunity to see different sides of vendors as Inga and I cruised the aisles at HIMSS, at one point switching badges to see if it made a difference in how we were received. One of the high points was meeting Mr. H for the first time in the HIStalk limo, changing into our doctor disguises and walking down International Drive with Inga in her amazing boots. We saw our sponsors, many of whom compete directly with each other, breaking bread together at the HIStalk luncheon.

I’ve learned that whether people like a particular piece I’ve written or whether they hate it, I don’t take it too personally either way.

This has been an opportunity to meet amazing people, make new friends, and learn that being anonymous can be a challenge. Using Dr. Jayne’s e-mail address, I’ve emailed people I’ve known for years — and have been ignored. I’ve socialized with key players in government and healthcare and have had to bite my lip to keep from saying, “OMG, if you knew you were talking to Dr. Jayne you would not have just said that.”

I’ve also built necessary career skills – namely the ability to keep coffee from coming out my nose when my co-workers quote HIStalk pieces that I’ve had a hand in.

Best of all, I’ve learned that what may seem like an insignificant event at the time can be a life-changing one. I’d like to thank a certain vendor exec for casually asking, “Do you read HIStalk?” over drinks on a certain day in 2009. At the time, I didn’t. But thanks to that simple question, along with the faith and support of Mr. H and Inga, as well as the camaraderie of Dr. Gregg and Dr. Travis (MD recently conferred!) I’m about to click SEND on Dr. Jayne’s 50th post. Here’s to milestones.

Contacts

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

News 6/15/11

Top News

Three Kentucky healthcare systems will form a single organization with a combined 91 hospitals, clinics, and home health agencies. The new system will include the University of Louisville Hospital, the James Brown Cancer Center, the six-hospital Jewish Hospital & St. Mary’s Healthcare, and the seven-hospital St. Joseph Health System. As part of the deal, Catholic Health Initiatives will make an incremental capital infusion of $320 million to support the system.

A new Robert Wood Johnson Foundation report finds that 51% of office-treated diabetics in Cleveland received all the care they needed from practices using electronic medical records vs. 7% from paper-based practices. A similar correlation was found for diabetic outcomes. I didn’t see study methodology so I can’t really evaluate it to determine if it adequately proved cause vs. effect, but it’s interesting.

Reader Comments

From Paula: “Re: Vince’s HSD piece. What about McDonnell-Douglas IHS? It was an innovative system for its time. When McAuto decided to get out of the hospital systems business, it was sold.” Here’s a reply from Vince:

Thanks for reading these dusty old bits of trivia! Yes, IHS (Integrated Health Systems) was one of many turnkey minicomputer systems that the shared giants offered in the 80s – which is going to be the next epoch in HIS-tory covered. McAuto bought IHS in the mid-90s as a DEC-based "total" HIS, to complement their wide array of other turnkey mini offerings, including HDC, MHS, LabCom, RXCom and RadCom. SMS offered a bunch of minis too: ACTIon 400, 700 & 1200, Spirit Choice, and MS4. Ironic the shared giants got into minis so big! Stay tuned for all the details in two weeks."

From Former TMISer: “Re: Commission on Professional and Hospital Activities (CPHA). Vince might want to do a piece on them since they were maybe the first to computerize healthcare data on a large scale. It was a grant-supported non-profit that collected, processed, and stored abstracted data on more than 50% of hospitals back in 1969, offering three products: Professional Activity Study, Medical Audit Program, and Length of Stay Study. All were paper-based printouts. CPHA was influential in the development of the International Classification of Diseases and its length of stay data contributed materially to the development of DRGs.”

 

From The PACS Designer: “Re: StartUp Health. In addition to HIStalk giving smaller companies a chance to succeed, the federal government has announced a program called StartUp Health. This new effort will help entrepreneurs create a long-term roadmap for success by providing education, support, and capital to build a health and wellness business.”

From augurPharmacist: “Re: American Society of Health-System Pharmacists. The Summer Meeting in Denver has lots of HIT content. Discussions include bar code scanning at each step of the intra-hospital supply chain such that ‘when a drug product changes hands, it gets scanned.’ There’s a growing awareness about the technologies required to enable intended pharmacist practice model change from inside the pharmacies to the patient side. Lots more information available on pharmacy’s professional initiative referred to as PPMI by searching ‘PPMI.’”

From J.U. Stice: “Re: nextEMR. Looks like they are the most recent ONC-ATCB certified EHRs to die on the vine. No employees, unpaid bills, empty promises. Classic story of underfunding and no marketing traction. If you build it, they will come? I don’t think so.” I contacted CEO and Founder Alan Faustino MD, who provided this response:

Reports of our demise have been greatly exaggerated. While we have experienced our share of growing pains, like most companies in this economy, we are still offering the same outstanding service and support that has help us survive in this turbulent and confusing HIT period. As a matter of fact, we have been vetted out by several organizations recently from a financial and technology point of view and have been successful in developing strong relations that will sustain this company today and into the future. As an example, we have been chosen as the EMR of choice for the McFarland group to implement and use EMR for research initiatives. We have weekly webinars and look forward to using our technology to better the overall success and increase influenza immunization to the under represented in this country. I can assure you that the NMA and the Cobb institute would no likely involve themselves with a company not in operation. As a matter of fact, we have in conjunction with the McFarland group a webinar tonight and welcome anyone to join and "feel our pulse" Like many businesses, we have had to let go of some employees for financial or performance reasons. However, we wish these people well and hopefully they will find more constructive things to do with their time. However, I do appreciate the "press." Hopefully, HIStalk will allow us to show a different perspective on our company and welcome the opportunity to let the physician community know how nextEMR, along with our partners, are giving physicians the technology to be frankly better physicians today.

From Chip: “Re: poll on giving patients a list of employees who accessed their electronic medical record. You have to do this to pass ARRA and EHR certification requires it, so vendors must have overcome any technical hurdles.”

HIStalk Announcements and Requests

I have to give a shout out to Best Buy for some superior customer service I just received. I bought a new Asus PC from them, but noticed it had integrated graphics rather than the advertised 1 GB ATI graphics card, which was almost certainly an error in the specs Asus gave them (or perhaps an Asus manufacturing mistake). It wasn’t a huge deal and it wasn’t Best Buy’s fault, but I called the local Best Buy store where I had picked it up (I had done ship-to-store) and they told me to bring it over. They gave me a brand new 2 GB card ($100) and for “my inconvenience” (basically, next to none), they had the Geek Squad folks install it while I waited – all at no charge. I felt bad for even calling since the graphics aren’t all that important to me, but Best Buy really came through. The new PC is working great and I’m finally off Vista and WinXP (except at work, of course, where the ten-year-old XP still reigns unchallenged).

Sales

Norton Healthcare (KY) purchases the Morrisey Concurrent Care Manager application to automate its care management processes

People

James Hauschildt EdD, MA, BSN, RN is named academic dean of Saint Luke’s College of Health Sciences (MO). He was formerly with Dearborn Advisors, Dell, Cerner, and the Air Force nurse corps.

Announcements and Implementations

Massena Memorial Hospital (NY) goes live on MEDHOST’s EDIS.

Shands Healthcare (FL) goes live on its $95 million Epic EMR at three facilities. A fourth facility will be added in September and several faculty practices will go up next year. The same article includes some interesting facts about Epic: the company has 240 customers; one-fourth of the country’s physicians use Epic software; and, 110 million patients (38% of all patients) will be in an Epic system once pending implementations are complete.

The School of Medicine at the University of Alabama-Birmingham starts its EHR implementation, which will be completed in five phases over the next 18 months. Stephen Stair MD, the physician executive sponsor of the project, provides an update above.

West Tennessee Healthcare System deploys BIO-key International biometric ID software within its Sentillion Vergence solution.

A nine-physician internal medicine group in Michigan sells itself to Oakwood Healthcare, saying it passed on aligning with Henry Ford Health System because HFHS couldn’t get its EMR installed quickly enough. HFHS says the EMR wasn’t a priority because they are replacing their McKesson system with a $100 million custom system from RelWare and didn’t see the point in installing a system that will be gone in two years. Oakwood uses NextGen, but signed a contract in April to implement Epic in its hospitals and practices at a cost of $60 million.

Philips will roll out its eICU system in India within a year.

Government and Politics

Maine legislators vote to allow residents to opt out of the state’s HIE database.

Mark your calendar: July 3 is the last day eligible hospitals and critical access hospitals can begin their 90-day reporting period in fiscal year 2011 for the Medicare EHR incentive program. Eligible Providers have until October 3.

The Boston Globe points out that the state still does business with IBM’s Cognos division even as one of the company’s former salespeople goes on trial for giving kickbacks to the speaker of the house of Massachusetts in return for getting software contracts without going through the required bidding process. Neither IBM or Cognos, which had not been acquired by IBM at the time of the alleged incident, have been charged, but it’s possible the SEC could get involved if evidence suggests that the sale boosted the acquisition value of Cognos.

The UK’s NHS says that even though the country’s “digital by default” policy requires citizens to communicate with government agencies by digital means, that requirement will not be imposed on those seeking health services. Instead, the government will meet whatever demand citizens have, with one of its technical leaders saying, “The idea that we should wait for everyone to agree before offering digital services is ludicrous.”

Innovation and Research

A study finds that implementation of healthcare IT had no effect on outcomes for nursing home patients, other than it seemed to make them more disruptive.

Other

HIMSS names Hudson River Healthcare (NY) as its single finalist for the Community Health Organization Davies award.

Mayo Clinic’s chairman of health policy and research says that the clinic won’t be participating in an ACO, at least based on the proposed rule. According to Douglas Wood MD, Mayo’s objections include the use of oversight boards to judge performance, the proposed anti-trust rules, the methods of measuring effectiveness of care, and the way patients would be assigned to ACOs.

maxIT Healthcare celebrates its 10-year anniversary by sending out its executives in an RV with a cool paint job, driving across the country to visit its consultants and clients in the field.

Weird News Andy noodles out a great story about a doctor and a diva (he clarifies they are not one and the same in this particular case). An opera singer (on the left above) shopping at a Manhattan Trader Joe’s gets annoyed at a teenaged boy who blocks her husband from grabbing a frozen Pad Thai dinner. Hubby complains loudly, so the boy’s mom (a doctor, on the right above), bellows out, “Get that pole out of your ass.” The opera singer admits that she then slapped the doctor, but adds that she needed slapping because the doctor was “getting into her personal space.” The opera singer is on trial for attempted assault.  

Here’s a great interview and character study of Bill Gates, who talks about global health and how his kids will need to find regular jobs because he’s not giving them much money (“much” meaning quite different things to Bill than to you and me). Trivia: he bristles when the reporter asks if his kids have iPhones, iPads, or iPods, saying, “They have the Windows equivalent … they are not deprived children.” You forget how young he was (21) when he and Paul Allen started Microsoft in 1975 – the photo above is from 1984, well into the company’s growth and the year that Windows was launched. He looks about 12.

I like this well-written and just-sarcastic-enough editorial by a physician and former president of AAPS, whose bio contains this wry observation: “As a life-long dog lover and trainer, she realizes that her dogs have better access to medical care and more medical privacy than she has, and her veterinarians are paid more than physicians in the United States for exactly the same types of surgery.” Among her unhappy but amusing observations (not all of which are correct) about medical practice is this:

Now there’s also “healthcare reform.” That includes the push for the EHR (electronic health record). Physicians are being bribed with $44,000 for installing one that meets the government’s desire to have your formerly private medical record on a government database. With this system, a keystroke can fill your medical record with mistakes, yet a physician can’t write a progress note without learning to navigate a computer program so obsessive that the detail required to order a simple test would do for a moon landing. The former head of CMS (Centers for Medicare and Medicaid Services), Nancy-Ann Min DeParle, made around $2 million dollars working for the company whose program it is, before she became an unaccountable “Czar” in the present regime.

A female visitor trips while walking out of the elevator at Louisiana Medical Center and Heart Hospital. She claims permanent injuries to her arm, shoulder, and neck that cause her pain and suffering, disability and mental anguish, loss of income, loss of earning capacity, and expenses. She’s suing the hospital for $600,000.

Sponsor Updates

• Highmark selects MEDecision’s collaborative health management solutions to support the management of its 4.8 million members.
• Practice Fusion hires Edwin Miller as its first VP of product management. He previously worked for Curaspan, Artromick, and athenahealth.
• Health Language is demonstrating its upgraded version of LEAP I-20 at booth #335 at this week’s AHIP conference in San Francisco.
• CareTech Solutions and its client, Central Maine Medical Center (ME) are chosen by the Ohio Hospital Association to present an IT security case study, Security Assessments: A Tool to Manage Risks and Achieve HIPAA Compliance, at OHA’s annual meeting this week in Columbus.
• The 49-bed Monroe County Medical Center (KY) contracts with Healthcare Management Systems for its EHR suite.
• The City Paper of Nashville and Nashville’s Entrepreneurs’ Organization name ICA president and CEO Gary Zegiestowsky as one of the top ten entrepreneurs in the Nashville area.
• ZirMed earns a #79 ranking on HCI’s 100 list of top HIT companies.
• Business Alabama magazine and Best Companies Group name MEDSEEK one of the 2011 Best Companies to Work For in Alabama.
• PatientKeeper releases its Charge Capture solution for Android.
• Nebraska Medical Center chooses Voalte’s integrated communication solution.
• Sage Healthcare Division announces that more than a dozen healthcare facilities have chosen Sage Intergy Meaningful Use Edition.
• Moses Cone Health System (NC) selects ProVation Order Sets for its five hospitals.
• Duncan Regional Hospital (OK) will implement T-SystemEV STAT to manage average length of stay in its ED.
• North Shore-LIJ Health System extends its enterprise agreement with Surgical Information Systems by choosing the SIS Anesthesia documentation solution.
• The entire recruiting team of Intellect Resources achieves Certified Personnel Consultant certification.
• NYU Langone Medical Center implements the PatientSecure palm scanning solution for biometric patient identification. A patient commented, “This technology makes you feel like a VIP. You just put your palm on the scanner and you’re done registering at your doctor’s office, no clipboard, no hassle of paperwork to check in, plus, it’s absolutely secure. It’s immediate and instantaneous. Never in my life have I experienced health care like this before. ”

Contacts

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

Monday Morning Update 6/13/11

From South Bend Snoop: “Re: Press Ganey. CEO Rick Siegrist is resigning. There are rumors of a possible sale of the company to GE, J&J, or 3M, which seem farfetched.” Unverified. I didn’t realize that he co-founded TSI, PatientFlow Technology, and HealthShare Technology.

From Mr. Roboto: “Re: Meditech. They’ve always steered clients to JJWild, now Dell. A former Meditech person told me that Meditech was getting financial considerations for every system sold by JJWild. I find it highly unlikely that Dell (like JJ) is doing anything technically proprietary for Meditech except throwing them a fee for each system sold.” Unverified.

From Komodo: “Re: Meditech. Dell and Meditech have a gentleman’s agreement that Dell will supply all 6.x hardware and therefore design consulting, leading to application and conversion consulting. Now that Dell is becoming cozy with Epic, Howard Messing may be re-thinking this position since his customers don’t like the no-choice solution. I hope you can get Howard to respond.”

Welcome to new HIStalk Platinum Sponsor The Advisory Board Company. I’ve been a fan of the DC-headquartered company for quite awhile since I’ve always liked their super-summarized best practice guides covering big hospital issues such as capacity management and medication errors (I made myself look like a star once by skimming their throughput document and applying its recommendations to my hospital’s particular bed management challenges). Other than best practices research and tools, the company also offers clinical research, leadership development, BI and analytics, and consulting services. The ABCO connection to HIStalk, however, is its Crimson Initiative, a physician performance management analytics solution that gives hospitals (and their physicians) a 360-degree view of physician performance measures such as patient satisfaction, compliance with order sets, and adherence to key quality and utilization metrics. Crimson is used by over 400 hospitals and contains physician analytics and benchmarking information covering 15% of the entire country’s admissions. Paul Roscoe, CEO of the Crimson business unit (and former president of Sentillion and GM of Microsoft Health Solutions Group) e-mailed me awhile back to say that his Sentillion experience with HIStalk was so positive that he asked ABCO’s marketing team to sponsor, saying that HIStalk is “insightful, thought-provoking, funny, and a great source of inspiration for my iTunes collection,” of which the latter is of course the most satisfying to me. You may recall that Advisory Board acquired University of Michigan spinoff Cielo MedSolutions in February 2011, which gives it capabilities in population management analytics and patient registries for physician practices that support risk-based arrangements by making sure patients are current on preventive care and screenings. Thanks to The Advisory Board Company and its Crimson Initiative for supporting HIStalk.

Speaking of Crimson, above is a video from Robert Wood Johnson University Hospital that describes a pilot study that reduced length of stay by 8% and cost per case by $276. Another study by Memorial Hermann found that it saved $358 per patient admission.

Larry Garber MD, medical director of informatics for Fallon Clinic (MA), sent over a press release indicating that as of May 23, Fallon doctors make up more than 10% of those who have successfully attested to Meaningful Use. An amazing 99% of Fallon’s doctors have achieved MU with their use of its Epic system.

Chris Rauber, a reporter for the San Francisco Business Times who I exchange information with fairly often, is writing a story about UCSF’s IT struggles and needs insider sources (anonymous is OK). If you can help him out with details and confirmation, he would appreciate an e-mail.

This week’s e-mail from Kaiser CEO George Halvorson talks about their control of hypertensive patients through use of a care team, proactive interventions, evidence-based medicine, and EMR tracking. The result: Kaiser went from 44% of hypertensive patients controlled to 80% (vs. the national average of less than 50%).

I’m not sure what to make of these survey results: 40% say it’s a good, technically reasonable idea to give patients a list of all views of their EHR information if they ask, while 32% like the idea but think it’s too challenging technically (which would have been my vote). A solid 28% think it’s just a bad idea in general, which puzzles me a bit since I’m not seeing the downside. New poll to your right, following up on all the discussion generated by Thoughtful CIO’s guest post about “why Epic?”: what factor is most responsible for Epic’s sales success?

My Time Capsule editorial that’s seeing daylight for the first time since April 2006: If You Want Testing For Usability, Reliability and Maintainability, Tell CCHIT. A sample: “CCHIT standards that address data management within the four walls will prepare organizations to feed the data demands that RHIOs will create. As I’ve said before, a RHIO without data-ready members is like TV cable with no programs.”

Vince Ciotti says he has received quite a few e-mails from his fellow memory lane strollers about his HIStory series, so his latest chapter should unleash golden memories from the sunny slopes of long ago: the story of McAuto, once a household word (in HIT-related households, anyway), but largely forgotten today.

Retiring Compuware co-founder and CEO Peter Karmanos Jr. says he has two goals to accomplish before leaving the company in two years: boost annual sales of the application performance management division from $250 million to $2 billion and to get an IPO done for Covisint, whose healthcare offerings include the Covisint ExchangeLink Platform for connectivity among hospitals, practices, and HIEs.

E-mail Mr. H.

News 6/10/11

Top News

ONC chooses ANSI for a three-year term as the Approved Accreditor (ONC-AA) of its Permanent Certification Program (ONC-ACB) that will replace the ONC-ATCB designation in 2012.

Reader Comments

From Cabrito: “Re: Meditech. I hear that customers upgrading to 6.0 are required to buy all hardware from Dell, pay Dell an enormous implementation fee, and pay ongoing fees to Dell for maintenance. If they choose not to do so, they have to pay Meditech to certify the hardware. This smells of the East Coast good ol’ boys club. Does 6.0 really require hardware that’s all that different from Dell or any other vendor?” I passed your inquiry along to Meditech and invited them to respond. The company’s response was, “No comment.” That made me think of the old Magic days, when you had to buy specifically programmed (and much more expensive) display terminals because it wouldn’t run on anything else. I would hope that’s not the case here.

From William Hanson MD: “Re: my book, Smart Medicine. Thanks for calling it out. I am indeed the CMIO at Penn now. I’m an avid reader of your blogs. Keep up the good work. Thanks, Bill.” I see Amazon has added “Look Inside” for the book and it’s an engaging read – Bill is a really good writer.

From the medical consumer’s standpoint, a generation of patients who grew up with Google, eBay, and Wikipedia will soon have access to comparably comprehensive, current information about medicine and its practitioners. They’ll be able to find best-performing doctors and hospitals in the same way they can now shop for best-buy electronics and credit card rates. The successful practitioner and medical systems of the future will be the ones that adapt best to the new patient, who was raised on universal information and immediate gratification.

From IT Director: “Re: HIStalk. Your site was instrumental these last few years to help me sort out the different HIS vendors and to see where the industry is now and where it is going. Our C-level has been mystified that I knew so much about the industry, largely thanks to you and Inga. HIStalk has a HUGE impact — don’t change a thing. Happy shoe wishes to Inga.” Thank you.

From Saul Revere: “Re: Paul Egerman, founder of eScription. Pretty strong language in claiming Republications are ‘incapable of simple arithmetic’ and ‘I have more money than I could possibly imagine.’ The problem is that his own math is perilously stupid — to plug the current projected deficit over the next five years by taxing those with more than $200K income, tax collections would have to triple.” The conservative site’s article makes a point that I somewhat believe: if a person or group wants everybody’s taxes raised to support some pet cause, why aren’t they voluntarily supporting that cause themselves by sending in their own extra checks to the Treasury? Still, these are liberals with huge incomes, so at least their proposal would hit their own personal bottom line. And Paul’s right: his windfalls from selling IDX to GE and eScription to Nuance have certainly given him all the money he’ll ever need and then some. He says the Bush-era tax cuts saved him over $10 million and he didn’t trickle any of it down, as was the case with most of the mega-millionaires joining him in the proposal. I don’t dislike their idea, but the problem is that politicians from both parties have pushed the country so far into the red that even the few billion dollars it would generate won’t help much, as you noted. I also see that Googling “Paul Egerman” still brings up my 2005 interview with him (one of my favorites) as #1 of 83,600 hits. I asked him about his Democratic politics back then and he gave a good answer (although in the interest of full disclosure, Paul sought me out at HIMSS years ago as Mr. H and he won me over with his friendly manner and by picking up the breakfast tab):

I grew up in a single parent home. We didn’t have a lot of money. In fact, it was before there was welfare, and I got my healthcare at a county hospital. Our family got by as a result of a lot of help from a lot of people, and I’m very fortunate that I’m to be a member of what I call the Winner’s Circle right now. It was a wonderful ride and I’m very fortunate that I’m able to do well. The reason that I have "blue state" political beliefs is that I personally know that I couldn’t have made it without the help of the government and lot of people. I think the Winner’s Circle should be expanded and other people should have that same opportunity that I had. I respect other people’s opinions and I keep politics separate from my business, but my involvement in politics is only because I’m interested in good government.

A representative from Dell e-mailed that the reader’s comment from Monday stating that Kootenai Medical Center’s Meditech system is hosted by Inland Northwest Health Services was incorrect. She says Dell is hosting that hospital on its MSite Meditech hosting solution, which has brought several hospitals live and has 40 more contracted.

From HIS Junkie: “Re: webinar. ONC is now competing with HIMSS, charging $100 for a webinar on HIT trends that other firms charge $1,000 for. I guess ONC is doing all they can to reduce the federal deficit. Maybe they should stick to fixing the mess that has been created with all the convoluted new MU regs.” The webinar is through National eHealth Collaborative. Most of their NeHC University offerings are free, but a few cost $100. If I ever leave my day job and free up some time, the first thing I’ll do is run some webinars and industry news and trends analysis. I have endless ideas, but zero time.

From Lula: “Re: AHIMA. I didn’t see that you ran the news about Alan Dowling.” I totally forgot since we had already run a solid rumor a week ago that the top AHIMA brass had quit and former CEO Rose Dunn had been brought back in some capacity. That turned out to be correct, as I expected: AHIMA CEO Alan Dowling exits after a little more than a year, along with COO Sandra Fuller. The “some capacity” for Rose Dunn is interim CEO. We heard some rumblings that the new folks had tried to implement some good ideas but stepped on toes in the process. Alan has impeccable credentials: master’s degrees in computer science and healthcare management engineering, an MIT PhD in health management and information systems, consulting experience with E&Y, and 35 years in the Air Force with a rank of colonel. Association work is probably quite a bit different than running a company, so maybe it just wasn’t a good personality fit.

HIStalk Announcements and Requests

This week on HIStalk Practice: new FAQs from CMS. The Louisiana Care Quality Forum REC designates Greenway’s PrimeSUITE EHR as a supported EHR product. Industry experts tell a Congressional committee that financial and regulatory barriers make EMR adoption difficult for small practices. IPAs could be coming back in vogue, thanks to the emerging ACO model. Take a tour of the HIStalk Practice site and make my day by  signing up for the e-mail updates.

Listening: new from Black Lips, fiercely independent, ragged Atlanta-based garage punk (think 1965 Rolling Stones with some Pixies and Dandy Warhols elements added). I wouldn’t want to be in the presence of either the band or their die-hard fans since I have a feeling both are seriously psycho, but the new CD is outstanding.

I mentioned that Mike Cemeno had been promoted from interim CIO to CIO at Waterbury Hospital (CT). That wasn’t the case: while the hospital’s newsletter introduced him with the CIO title, there was a line further down in the article noting that Mike and the executives featured with him were hired as interim management, which I missed. He and I have swapped some chatty e-mails — he hasn’t decided to apply and hasn’t been offered the job.

 Modern Healthcare is running its 100 Most Influential People in Healthcare poll. I keep hoping I’ll at least be nominated one of these days (especially given that Nancy-Ann DeParle is on the list and nobody’s heard of her since she took the supposedly high-profile White House health reform job), but until then, I found some familiar, HIStalk-friendly names that might be worth one of your five votes: Jonathan Bush (athenahealth CEO), John Halamka (CareGroup CIO), James “Kipp” Lassetter (Medicity founder), Ed Marx (Texas Health Resources SVP/CIO and HIStalk contributor), Deborah Peel MD (Patient Privacy Rights founder), Peter Pronovost (Johns Hopkins professor), Sunny Sanyal (T-System CEO), and Glen Tullman (Allscripts CEO). I’m sure I missed other friends of HIStalk in my quick skim down the list, but I’ll add them as I notice. I figure a tiny bit of Ed Marx’s influence can be attributed to his regular and well-received HIStalk posts, so Inga and I will bask in his reflected glory if he wins.

Thanks to Elsevier Clinical Decision Support for sponsoring HIStalk at the Gold level. The company is behind some well-known clinical content brands (Clinical Pharmacology, Mosby’s, OnFormulary, CPM Guidelines, and First Consult) and also offers Pinpoint Quality (clinical performance data analysis), Pinpoint Review (clinical surveillance), Clinical Measures (intervention and error documentation), Risk Navigator Clinical (predictive analytics), Risk Navigator Performance (provider care patterns for improved clinical and financial outcomes), Risk Navigator Provider (helps physicians analyze real-time patient information for care and communications), and quite a few more systems. The common thread is point-of-care technology and content that improves quality, safety, and cost-effectiveness. Thanks to Elsevier Clinical Decision Support for helping keep the HIStalk keyboards clacking.

Speaking of Elsevier, they’re accepting nominations for Mosby’s Nursing Superheroes, launched last month during Nurses Week. Four winners will be announced in October. 

On the Jobs Page: Meditech CPOE Consultant, Sales Executive – Medical Device Experience, Regional Sales Executive – NYC, Associate Regional Sales Executive. On Healthcare IT Jobs: Epic Lead Analyst, Ambulatory Clinical Analyst I, Director, Product Management, Clinical Healthcare IT Project Manager.

Acquisitions, Funding, Business, and Stock

Streamline Health reports a net loss of $281,000 ($.03/share) for the first quarter. That compares to a net loss of $1.18 million a year ago. Revenue was up 17% to $4.14 million.

A judge in Australia rules that iSoft will have to pay CSC $2 million US if the struggling company decides to sell to a different suitor. Former iSoft chairman Gary Cohen, who has said he wants to buy iSoft himself, says he is pleased with the judge’s decision.

Sales

LHP Hospital Group (TX) contracts with Conifer Health Solutions to provide patient access and business office services.

Wishard Health Services (IN) selects MedTouch to design, build, and integrate the health system’s patient portal and RelayHealth into a site. Patients can request appointments, view lab results, communicate with physicians, and access patient education content.

People

Former AHIMA CEO Linda Kloss joins the Precyse Advisory Council.

Announcements and Implementations

CliniComp completes a two-year installation of Essentris-EMR at 59 Military Health System inpatient treatment facilities worldwide.

Government and Politics

HHS and ONC introduce the Investing in Innovations (i2) Initiative to spur innovations in HIT. As part of the rollout, CMS awards Health 2.0 and the Capital Consulting Corporation $5 million to fund projects supporting innovations and to encourage HIT development using mechanisms like prizes and challenges.

The VA chooses Systems Made Simple and Technatomy Corporation to provide software development, support, and documentation for several projects of its EVEAH program (Enhance the Veteran Experience and Access to Healthcare).

Innovation and Research

Above is an interview with Orlando Portale, chief innovation and technology officer of Palomar Pomerado Health (CA), whose self-developed mobile patient information app was named one of 12 finalists in the I Awards for innovation in wireless and mobile healthcare. It’s an impressive app, judging from the screen shots above.

Technology 

WebPAX is awarded a patent for technology that allows a Web browser to display medical images stored in multiple geographic locations. The image management company holds several other patents that allow viewing diagnostic-quality images in a Web browser with full PACS capabilities. The Durham, NC company says its solution requires no client software, runs on any browser on either PCs or Macs, and is storing 180 million images online with 1,400 physician users. The technology is also used for clinical trials and physician training. I assume it was either developed for or used by Duke given the duhs.duke.edu address in the screen shot above.

Other

A report says that 76% of Fortune 50 companies are in healthcare or have health divisions. The same study predicts the health market will account for nearly nearly one-fifth of the GDP by 2019 and (optimistically) forecasts that 58% of small physician practices will roll out EHRs over the next two years. Perhaps more realistic: the mobile health market will grow from $1.4 billion in 2008 to $12.7 billion by 2014.

Weird News Andy can find no words to describe this story from England: a patient high on drugs and alcohol goes to the hospital ED for treatment. Employees decide he’s just drunk, so they leave him a corridor to sleep it off, with nurses stepping over him frequently. Ten hours later, a nurse finally checks on him and finds him dead. Security cameras captured video of employees dragging his uncovered body away like a sack of fertilizer.  

Nineteen people in western Pennsylvania are charged with high-tech oxycodone trafficking: they obtained doctor names, DEA numbers and license numbers from a Web site; created a computer prescription template; and put their own cell phone numbers on the prescription form so they could verify the prescriptions when pharmacies called.

Pfizer starts the first clinical drug study to be conducted over the Internet, with patient contact performed via Internet questionnaires, video, and Web pages instead of home visits.

Sponsor Updates

• Lehigh Valley Health Network (PA) will use T-System’s DigitalShare documentation system to support its on-scene emergency healthcare during this weekend’s 5-Hour Energy 500 event at Pocono Raceway.
• Siemens partners with Surgical Information Systems to offer the SIS Anesthesia solution to the enterprise healthcare clients of Siemens.
• Healthcare Informatics ranks MED3OOO 47th on its HCI 100 list of top HIT companies by revenue. Orion comes in at 64 and Capario earns the number 87 spot.
• Medicity is awarded a second patent on its Novo Grid technology for clinical information exchange.
• Tucson Medical Center and OptumInsight (Ingenix) announce plans to create a sustainable health community based on the ACO model.
• Central DuPage Hospital (IL) contracts with iSirona for its medical device connectivity solution.
• Sage hosts a June 28th webinar on Meaningful Use success, featuring two physicians who have already received incentive checks. Register here.
• KLAS ranks Encore Health Resources as one of the top two overall performers in the HIT advisory services segment.
• Nuesoft posts a video on FDA regulation of EHRs.

EPtalk by Dr. Jayne

Government Health IT reports that the Association of Academic Health Centers finds the HIPAA Privacy Rule’s disclosure requirements to be “excessive and burdensome” and requests an exemption for researchers.

Statistic of the week: fewer physicians filed address changes last year, possibly reflecting the impact of the economy on physician decisions to relocate or retire. American Medical News notes economic pressures and the state of the housing market as possible factors. Interestingly, plastic surgeons had the lowest move rate, approximately half that of family physicians. Although I do love medical data and working with it, sometimes working with statistics makes me crazy. It would be more interesting if they did it like baseball: left-hander Dr. Jones is 14 for 15 on successful colon biopsies with the Olympus scope, 15 for 15 with the Pentax. You could even have baseball-like trading cards for your favorite attending physicians.

Legislative Corner

Sometimes I get a little burned out on reading about healthcare legislation, specifically Medicare/Medicaid regulations, reimbursement, Meaningful Use, etc. Although it’s a key part of my job, it just gets a bit depressing. I decided to find out what other health-related activities our lawmakers are pursuing when they’re not trying to tell the IT department how to do our jobs. Here goes:

For my Southern friends, North Carolina lawmakers are debating the Youth Skin Cancer Prevention Act that would require minors to get a physician’s prescription for indoor tanning. It’s coming down to cancer prevention vs. parental rights. Since the pools are now open, what I’ve seen of the outdoor tanning habits of teenagers is extremely concerning. Makes me thankful that my “too much time at the computer” paleness will hopefully keep the wrinkles at bay.

Speaking of wrinkles, New Jersey may require a statement of medical necessity for Botox injections received by patients under age 18. Teens are seeking the injections in an attempt to prevent wrinkles. The issue “took on a new urgency” after reports of the so-called Botox Mom who injected her eight-year-old. Botox is a godsend for certain medical conditions; however, the cosmetic version is a big-time money maker. I’d like to see a requirement that anyone who wants to use Botox for wrinkle prevention has to demonstrate their commitment by slathering on SPF 50 every day (see above).

Not to be outdone by their neighbor, New York is considering a dress code aimed at reducing hospital-acquired infections. Neckties, jewelry, and watches would be banned under a “bare below the elbow” dress code. Although the evidence doesn’t seem to support their approach, I definitely worry about people who are less than great at handwashing because they are worried about getting their cuffs or watch wet. Personally, I’d like to see someone take aim at white coats — I’ve seen some nasty ones out there lately. Makes me want to keep coupons for the 99-cent dry cleaners in my pocket to hand out.

Finally, legislation with an IT twist. Florida’s new law to prevent physicians from asking about gun ownership in certain situations (HB 155) gets a new enemy: The Brady Center to Prevent Gun Violence. A lawsuit was filed this week that states the inability to ask about guns in the home prevents physicians from educating patients. IT staffers beware: even if the physician’s question is relevant to the patient’s care or safety, the law prevents the response from being entered into a database.

Contacts

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

News 6/8/11

Top News

Merge Healthcare acquires Ophthalmic Imaging Systems (OIS) for approximately $30.3 million in stock. OIS and its subsidiary Abraxas Medical Solutions offer EMR and PM products, as well as digital imaging systems.

Reader Comments

From The PACS Designer: “Re: Apple at WWDC. This week, Steve Jobs announced Apple’s next generation of products. The Apple iOS 5 will ship this coming fall and will support iPhone 3GS, and 4, iPad 1 and 2, and iPod touch third and fourth generation. Also of keen interest was Apple’s new LionOS operating system for iMacs, which will sell for $29.99.”

 From Roman DeBeers: “Re: Chuck Friedman. ONC’s chief scientific officer is leaving in July after four years.” Unverified. I e-mailed him to confirm, but he didn’t respond.

From Jim: “Re: speeding up HIStalk. I think you gave tips before. I’m a bean counter, so technically deficient. Any ideas? Love this resource!” Here we go: (a) I assume you are an IE user since it’s the most trouble-prone browser by far, so use the infinitely faster and better Firefox or Chrome browser instead, even if just for reading HIStalk; (b) if you can’t dump IE, upgrade it if you can since old versions (anything before IE8) are notoriously buggy and slow; (c) add the extension print to any HIStalk web address to view a bare-bones print layout that doesn’t include graphics, sidebar content, sponsor ads, etc. There are all kinds of browser options that can slow you down, which is another reason to like the non-IE ones – those browsers seem to work better without tweaking. 

From JC: “Re: Ingenix / Optum. Looks like they will be the winning bidder over GE to acquire HMS/MedHost. I hear it will become their EDIS of choice.” Unverified.

Acquisitions, Funding, Business, and Stock

Germany-based surgery software vendor Brainlab acquires Voyant Health, the Israel-headquartered vendor of the TraumaCad, OrthoWeb, and VoyantFlow specialized surgery planning tools for orthopedic surgeons. Voyant has also announced future availability of its VoyantLink cloud-based image exchange network.

CSC announces the launch of its Global Institute for Emerging Healthcare Practices with the stated mission of “monitoring worldwide trends, conducting regional and multi-country studies, and evaluating emerging operational practices and technologies that have the potential to improve performance of healthcare industries around the world.” I think all that marketing-speak is really just saying that CSC wants to be a bigger player in healthcare and having a name that includes Global Institute sounds very noble. Mr. H’s cynicism is clearly rubbing off.

Israel-based dbMotion builds up its presence in Australia as the government prepares to bid out big contracts for a new Personally Controlled E-Health Records system, which will allow all Australians to review their meds, immunizations, and lab results electronically. The program, announced a year ago, is a building block for the National Health and Hospitals Network and will cost $500 million US over two years.

Intel launches its AppUp hybrid cloud service that offers pre-packaged, subscription-priced applications to small businesses, but allowing those small businesses to store their data on their own local server. Allscripts was listed as a vendor whose applications will soon be added to the catalog.

McKesson gets sued yet again over claims that it conspired with Hearst Corp. to inflate average wholesale prices of drugs (AWP, also known as Ain’t What’s Paid since it’s a phony number of dubious value). This time, it’s Michigan doing the suing, claiming its Medicaid program overpaid pharmacy claims for eight years because of a secret McKesson-Hearst collusion to inflate AWPs via Hearst’s First DataBank drug database. McKesson has settled several related racketeering lawsuits for several hundred millions of dollars over this same issue, but an early estimate of the company’s exposure was $15 billion. Here’s my analogy: First DataBank published the equivalent of one of those baseball card price books that claim to survey card shops to find out what cards are selling for. Customers used the book for the unintended purpose of pricing their own cards (in theory, there would then be one universal price since all sellers would set the same price from the same book). States and other insurers, lacking a way to determine what drugs really cost but insistent on paying based on any kind of cost, even a totally phony one, latched onto AWP as a lazy substitute even though everybody knows that nobody pays AWP. The plaintiffs are like customers who bought baseball cards at the book price, only to find out that the book didn’t do their surveys very well, causing them to overpay for a Ken Griffey Jr. rookie card. McKesson’s role, if I’m remembering right off the top of my head, was minimal – FDB started surveying only McKesson to get the AWPs it published and McKesson says it was unaware of that fact, not to mention that there was no benefit to McKesson for inflating the prices anyway. My take: stupid buyers who overpay always blame someone else and expect to be reimbursed for their incompetence.

Sales

Health Management Associates contracts to deploy the MEDHOST ED solutions in 58 hospitals.

In Canada, CGI Group signs a seven-year, $50 million contract with University Health Network of Toronto to develop a shared diagnostic imaging repository.

People

Former national coordinator David Blumenthal is named chairman of the Commonwealth Fund Commission on a  High Performance Health System.

Former Yale-New Haven ACIO Michael Cemeno is named CIO of Waterbury Hospital (CT), removing the “interim” portion of his title.

Union Hospital (IN) promotes Kym Pfrank from VP of information systems to the newly created role of SVP and CIO.

Former WellSpan Health VP/CIO/CTO Buddy Gillespie joins infrastructure and hosting vendor Distributed Systems Services as director of healthcare solutions.

Dave Roberts, HIMSS VP of government relations and Solana Beach, CA city council member, is appointed to an HHS panel that will advise CMS and HHS on issues such as insurance outreach programs and helping consumers understand health plans.

Announcements and Implementations

Epic names Dell as its first Community Connect Certified Consulting Firm for EMR/PM services. The new designation is designed for service firms implementing Epic for affiliated physician offices and community hospitals on a shared EMR.

CAP, AHA, and Surescripts are recruiting hospital laboratories and critical access hospitals to participate in the Lab Interoperability Cooperative (LIC). It’s funded by a two-year CDC grant and aims to electronically connect hospital labs with public health agencies. It will be represented at the Healthcare IT Connect summit in Washington June 21-23.

Lee Memorial Health System (FL) goes live on its $70 million Epic system.

The use of AirStrip OB at Novant Health (NC) is profiled in an article in the Charlotte newspaper. The article also mentions AirStrip OB’s use in three Presbyterian hospitals in Charlotte, with an interesting angle: doctors are nicer to nurses when called in the middle of the night because they can immediately pull out their iPhones to look at the OB tracing in real time instead of getting impatient as the nurse describes what they’re seeing.

Government and Politics

Kentucky’s governor announces that two HIT-related companies have set up North American headquarters in Newton and will bring 20 jobs there: Arcron Systems (a Korea-based hospital information system vendor) and Meaningful Use Technologies. Despite the governor’s bragging, I think it’s actually one company with two lines of business. I couldn’t make much sense out of the Web site of the former (“With the help of our experienced professionals and years of reflecting clients’ opinions to our products, Arcron Systems strives to promote public healthcare and to facilitate understanding medical industries”) and the latter seems to be the implementation arm of the former. Arcron itself appears to be connected to the Hyundai Medis medical tourism company and the Hyundai Group conglomerate (shipping containers, securities, elevators, logistics, and other stuff, but not the carmaker, apparently).

HHS CTO Todd Park left his big athenahealth cash-out retirement in his 30s for government service because he was promised a role as “entrepreneur-in-residence.” He describes his job: “I have no budget. I have no formal team. I don’t control any government contracts. I don’t control any grants. It’s perfect, because it actually gives you the kind of freedom to maneuver, to really be a change agent.”

Innovation and Research

The Wall Street Journal covers Project RED (“Re-Engineered Discharge) that prepares inpatients for discharge and uses an animated “virtual discharge advocate” to provide instructions to patients and verify that they understand them. The program was developed at Boston University Medical Center, supported by grants from AHRQ, NIH, and NHBLI. Everything can be downloaded from its site.

Other

From last week’s e-Health conference in Toronto: the CEO of the Ontario Hospital Association makes waves by suggesting that physicians should be required by law to use EMRs and that paying physicians who don’t is an “unfair and inappropriate use of public money.” Meanwhile, the president and executive director of the Montreal Regional Health and Social Services Agency in Quebec blames poor technology for low EMR adoption rates, noting the systems are of little use to physicians or patients and that “we tried to create monsters and nobody wanted to use them.” Love those Canucks.

County-owned Singing River Health System (MS) gets approval to borrow $40 million to buy an EMR and to make unrelated improvements, although one county supervisor questioned why the two-hospital system would take out a 25-year loan for software that might last only ten years. I’m assuming its Epic since the hospital’s LinkedIn profile mentions an Epic project director.

A new book by William Hanson, MD of University of Pennsylvania School of Medicine went on sale Tuesday. Smart Medicine: How the Changing Role of Doctors Will Revolutionize Health Care discusses data mining, genomics, electronic medical records, telemedicine, and other technologies. I’m not clear on whether he’s CMIO there since it’s mentioned in some online bios, but not his own or that of Penn Medicine — those show him as professor of anesthesiology, critical care, surgery, and internal medicine.

The sheriff of Winkler County, TX (above left) goes on trial for helping a doctor (right) retaliate against two nurses who expressed anonymous concerns about the doctor’s performance to the Texas Medical Board. The nurses, who had worked at Winkler County Memorial Hospital for a total of 47 years, were fired and charged with felonies after the doctor asked his friend the sheriff to find out who sent the complaint letter about him. The medical board has placed the doctor on probation for four years; the nurses won a $750,000 settlement from the county, the hospital, and sheriff; and lawmakers passed a bill that protects nurses from retaliation when they are advocating for patients. The sheriff faces 10 years in prison if convicted of either of the two felonies with which he has been charged – misuses of official information and retaliation – plus a misdemeanor charge of official oppression. The county attorney and the hospital administrator were also charged and the doctor faces four criminal counts.

Sponsor Updates

• MEDecision will showcase is new Alineo and InFrame platforms at the 2011 Western EOC conference this week in Chicago and at AHIP June 15-17 in San Francisco.
• St. Joseph’s Health Center in Toronto selects Intelligent Forms Suite from Access for its electronic forms management system.
• Twenty-one Texas providers have received Medicaid EHR incentive checks for their meaningful use of the e-MDs EHR.
• Shareable Ink partners with Waiting Room Solutions to combine its digital pen technology with the EHR from Waiting Room Solutions.
• T-Systems will donate its T-Sheets documentation solution to the Texas Disaster Medical System, a collaboration of state and local public health agencies and providers that facilitates disaster planning and provides emergency response care.
• Jason Poteet joins Cumberland Consulting Group as director of business development.
• Cancer Treatment Centers of America selects Micromedex from Thomson Reuters for evidence-based drug, disease, toxicology, and patient education information.
• Radiology & Imaging Specialists (FL) contracts with GE for its Centricity OneView solution.
• Practice Fusion earns full ONC-ATCB certification from the Drummond Group.
• Ingenix announces that its transition to the OptumInsight name is complete.
• Wolters Kluwer Health releases a query tool to streamline the collection of quality data for the GI Quality Improvement Consortium benchmarking initiative.
• Spring Hill Primary Care (WV) contracts with Sage Healthcare Division for the Intergy Meaningful Use Edition.
• CHRISTUS Health picks MEDSEEK’s eHealth ecoSystem and ecoSmart solutions.
• UltraLinq Healthcare will donate an ultrasound machine and its UltraLinq solution to benefit Gift of Life International, an organization that coordinates surgeries for children with congenital heart defects. The donation is being made in connection with next week’s American Society of Echocardiography Scientific Sessions in Montreal.
• AnMed Health (SC) chooses Wellsoft’s EDIS to integrate with its existing McKesson suite of products.
• Nashville General Hospital will implement MyHealthDirect to connect its patients with appropriate providers.
• Danbury Orthopedic Associates (CT) chooses the SRS EHR. 
• Adena Health System (OH) chooses the eClinicalWorks EHR/PM and patient portal for its 150 employed physicians.

Contacts

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

Thomson Reuters to Sell Healthcare Business

News and information provider Thomson Reuters has announced that it will sell its healthcare business, which includes software and data products for clinicians, hospitals, and drug manufacturers. CEO Thomas Glocer said in the announcement that its healthcare business “lacks the integration with and global scale of our other units” and that proceeds from its sale will be reinvested in its core markets of financial, legal, media, and science.

Thomson Reuters is a publicly traded company with annual revenue of $13 billion and market capitalization of $31 billion. The company says the healthcare business generates $450 million in annual revenue, with a profit margin comparable to its consolidated 19.3%. Its products are used by more than 3,000 US hospitals.

Popular Thomson Reuters healthcare products include Micromedex (drug reference), CareNotes (patient education), ClinicalXpert Navigator (mobile patient information), CareDiscovery (benchmarking), CareFocus (clinical surveillance), Ascent (financial management), The 100 Top Hospitals program, and Clinical Performance Solutions (formerly Solucient and Medstat).

The company’s benchmarking database stores information from more than 750 healthcare organizations and is claimed to be the largest in the industry. Its MarketScan data warehouse contains information on more than 40 million unique patients. Thomson Reuters announced on May 25 that it had jointly developed a data and analytics solution with GE Healthcare to support population-based effectiveness and outcomes research.

The company says it expects the sale of the unit to close by the end of the year. Morgan Stanley and Allen & Co are its financial advisors.

We interviewed John Loyack, the company’s director of healthcare product management, in December.

Monday Morning Update 6/6/11

From Cop Rock: “Re: Meditech 6.0 multi-facility. Steward Health Care was set up by Cerebrus Capital Management to run the six Caritas Christi hospitals it bought from the Archdiocese of Boston. Their Meditech 6.0 implementation will encompass all six hospitals, surely the largest implementation to date of 6.0.”

Another reader mentioned that the first multi-site 6.0 install may have been Kootenai Medical Center (ID), whose systems, he points out, are hosted by HIStalk sponsor Inland Northwest Health Services. That organization, via its Information Resource Management subsidiary, performs HIT work that includes an HIE, all kinds of Meditech services, and consulting related to ARRA, infrastructure, revenue cycle, and clinical processes. Not to mention the services they provide to physicians throughout the Northwest that include hosted GE Centricity apps, help desk, networking, desktop management, and e-mail services. Their latest newsletter is here. I figured I might as well mention them since I haven’t said too much about them lately and I keep forgetting that they’re doing cool stuff.

From Portnoy’s Complaint: “Re: Georgetown. Georgetown Memorial / Waccamaw Community Hospital is running Meditech 6.0, now live for one week at two hospital campuses about 30 miles apart. A few minor bugs remain to be ironed out, mostly with running reports from secondary report writers; also old scanned images from MT 5.0 are not viewable, but should be fixed soon. Some one-time patches run to fix problems at go-live with patients not crossing over have unfortunately resulted in those patients still appearing on rounding lists though they’ve already been discharged. No major meltdowns from physician staff during the transition. Meditech support staff were reportedly helpful and senior Meditech administration came on site to learn about the problems with implementation and they seemed genuinely interested in creating a better product. Kudos to CIO Frank Scafidi and his team for managing the transition.” Unverified.

From Mike: “Re: free PDFs from the National Academies Press. Here’s the press release. Everybody can now download their 4,000 reports for free.” Mike, who runs Meaningful Use Rule Consulting, listed some now-free HIT-related titles (the first thing I thought of was using them as texts for online courses):

• Digital Infrastructure for the Learning Health System: The Foundation for Continuous Improvement in Health and Health Care: Workshop Series Summary (2011) Institute of Medicine (IOM)
• The Future of Nursing: Leading Change, Advancing Health (2011) , Institute of Medicine (IOM)
• Innovations in Health Literacy: Workshop Summary (2011)
• Preliminary Observations on Information Technology Needs and Priorities for the Centers for Medicare and Medicaid Services: An Interim Report (2010)

From The PACS Designer: “Re: Windows 8. Microsoft has released details of their upcoming introduction of Windows 8, which is rumored to be available in the fall. The Windows Start screen will now be the method to access your most important features by using tile graphics and the touch feature everywhere instead of the icon clicking available currently for your existing applications. Additionally, it looks like Microsoft ported many of the Windows Phone 7 User Interface graphics to this new release to compete with the Apple iPhone.” My take is this: every other Windows release sucks. Think about the dog upgrades people paid good money for, like Windows 98 Second Edition, Windows ME, and Vista. Windows 7 was good, therefore history suggests being wary of Windows 8. I hope MSFT surprises me. I’m finally taking the plunge to Windows 7, replacing my two-year-old desktop PC with a model on sale at Best Buy for a price I couldn’t resist (my current one is a $349 barebones kit that I did myself, adding in the extra parts and Win XP from its predecessor). I hate to replace a relatively new PC, but I’m having odd lockups and the hassle and cost of reformatting to install Win 7 makes the replacement option attractive. I’ll keep the old one as a spare or maybe raid the good parts I added in, like the Thermaltake power supply. 

From Todd: “Re: CIO salaries. I remember seeing it on the site, but couldn’t locate it. Can you provide the link or tell me how you found the salaries? Thank you (as always) for your great site. I’m not sure why you keep your day job or how you pull off doing everything you do, but your work is sincerely appreciated wide & far by the HIT industry.” I really like my day job – not only is it interesting and challenging, I get to see what I do have a direct impact on patient care, patient safety, and clinician satisfaction and I would miss that. Plus, I work for a non-profit hospital employer I really admire, not like when I worked for the uber-sleazy for-profit hospital (that didn’t last long) or the clueless vendor (that lasted way too long). In both cases, I wanted to wear a paper bag over my head to work each day so nobody would recognize me. The CIO salary information (old) is here. You can look salaries up by finding the 990 form for a non-profit hospital – I use GuideStar or Foundation Center (sign up for a free account for the former). Search by organization name, choose the most recent 990, and then look under two sections: Part VII (highly compensated employees) or in the appendices. Sometimes the CIO isn’t listed because they aren’t on the highest paid list, or sometimes they’re listed by name and not title, or sometimes they pull a UPMC and form a separate management company to keep the public from knowing what they’re paying. Above is one from WellStar, which I randomly chose (I blurred the names because the CIO in question is an HIStalk reader, so I figure I owe him that). Sometimes you can find how much a hospital paid an IT vendor if that vendor is among their highest paid. In WellStar’s case, McKesson is #1, with $10 million in payments over one year. If a vendor’s 990 isn’t listed, they are required by law to provide you one if you ask (the same goes for HIMSS and any other non-profit).

Speaking of sticking with healthcare as a profession, two-thirds of survey respondents would. New poll to your right: is a proposed HHS rule that requires EHRs to log all access to patient records and providers to make those logs available to the patient on request a great idea that’s technically reasonable, a great idea that’s technically unreasonable, or just a bad idea?

Say hello to new HIStalk Gold Sponsor Ignis Systems of the ultra-cool city of Portland, OR. The company’s EMR-Link gives its 4,000 physician users an efficient way to enter lab orders, which is important since docs do that almost constantly. They don’t need to enter orders once in the EMR and again in the lab ordering system. In fact, they don’t need an EMR at all. EMR-Link does medical necessity and insurance checking, prints order sheets, prints ABNs if needed, and routes orders automatically to the correct lab based on insurance and location. Repeat what I just said about radiology orders, since EMR-Link also integrates radiology ordering into the EMR. Meaningful Use is all about interoperability and connectivity, while physician acceptance is about workflow — EMR-Link connects EMRs to lab and rad providers, but also connects orders and results to any HIE. Setup is in hours, not weeks, docs just work like they’ve always worked, and everybody gains efficiency and saves money. I found an excellent and surprisingly unbiased presentation from January on their site that talks about EMR expectations, ARRA, and integration. I was also amused at the fun executive bios (the CEO’s history: “Working for a 600-person company was too big; a one person company was too small. This seems just right.”) Thanks to the folks at Ignis Systems for supporting HIStalk.

My Time Capsule editorial from 2006 for this time around: Small Vendors With Good Ideas Can Carve a Niche In Healthcare. Other than a now-outdated reference to Myspace, here’s an amuse-bouche: “Build something that supports what healthcare users themselves want to do, not what someone else wants them to do. Sounds obvious, but think about CPOE, nursing documentation, and other software that forces change on users who don’t want it, often leading to fierce resistance and vendor acrimony.”

Reading the long-forgotten word Myspace makes me think of another former technology darling that’s now a head-scratching trivia question: Second Life. Remember when Cerner and all those “visionary” hospitals wasted time, money, and press releases sticking virtual worlds out there with no apparent awareness of how utterly ridiculous that was? Nobody was using the dog-slow Second Life except nerds living in their parents’ basement and pervs hoping for creepy simulated hookups. I criticized Second Life in 2007 and proclaimed it a goner a year ago: “I said in 2007 that I thought Second Life was clunky and pointless despite all the hospitals and webheads raving about how transformative it was going to be for business and consumer commerce. Maybe in a virtual world, but in the real one, Second Life parent Linden Labs is tanking. Predictably, Second Life proved to be as pointless for corporations as it was for everybody else.” I predicted the same outcome for Twitter in that post, so we’ll see if I’m as wrong about that as when I proclaimed Epic as irrelevant back in 2003.

I ran the first of several Innovator Showcase pieces this weekend. My volunteer panel of investment bankers and a provider chose a handful of companies from dozens that applied to be featured, looking at those that were small and innovative. Logical Progression was the first and I’ll follow that format for the others: company info, a quick read about what they do, a pitch video made specifically for the HIStalk Showcase, a customer interview, and an executive interview. It’s like being at a venture fair, but with the ability to research the company and product in a more leisurely fashion. I’ll follow up with Chris from Logical Progression in a few weeks to find out if anything has changed.

HIStalk turns eight years old on Wednesday. It’s hard to believe it’s been that long. I figure I work on HIStalk at least 40 hours per week, so that’s about 16,000 hours (and counting) that I won’t be getting back.

We ran a reader comment about e-prescribing vendors being pushed by practices to get them running by June 30 so they can bang out their 10 Medicare e-prescriptions to avoid a 1% Medicare penalty, while doing 25 electronic prescriptions will earn them a 1% bonus. e Interactive Universe is capitalizing on that rush, offering a system they say can be running in just a few hours, including online training. The company guarantees that the required volume can be met in less than one business day.

Shareable Ink sent over an advance copy of a press release going out next week that announces its partnership with Waiting Room Solutions. Shareable Ink’s digital pen and paper has been paired up with WRS’s ONC-ATCB certified small-practice EHR. Three customers of the package have already received Medicare incentive payments, one of them being Lawrence Gordon MD of ENT Specialty Care, who credits both companies with getting him to MU attestation so quickly (April 20) and with improving the health of his patients.

Here’s the latest HIStory from Vince Ciotti, with a personal history of the biggest name in HIT for decades, Shared Medical Systems (they were cloud before cloud was cool).

The use of AirStrip Cardiology at several Broward County, Florida hospitals is profiled by the local CBS TV station.

St. Luke’s Episcopal Hospital (TX) implements GE Healthcare’s Patient Care Capacity Management, developed at Mount Sinai in New York. From the announcement, it appears to be a combination of consulting services and the AgileTrac RFID tracking system for employees, patients, and equipment. St. Luke’s expects to save $10 million by using it.

The Institute of Medicine will hold its second health data forum this Thursday, June 9 in Bethesda, MD (it will be simulcast as well). The event will feature 50 companies that are building tools around government databases. Speakers include HHS Secretary Kathleen Sebelius, HHS CTO Todd Park, the CEO of Walgreens, the CTO of the VA, Aneesh Chopra, Tim O’Reilly, and others.

Rock Health, the cool new accelerator for Web-based and mobile health applications, chooses its inaugural class of 11 startups. Three are in stealth mode, but announced were (a) Brainbot – mental performance; (b) CellScope – home diagnosis; (c) Genomera – personal health collaboration; (d) Health in Reach – procedure marketplace; (e) Omada Health – clinical treatment social networking; (f) Pipette – patient monitoring and education; (g) Skimble – mobile fitness; and (h) WeSprout – connecting health data and community.

Florida Governor Rick Scott changes his mind about the proposed doctor shopper database he promised to kill just a few weeks ago, signing a pain clinic bill that will start it up on October 1. The bill also prohibits doctors from selling meds directly from their offices, calls for an automatic six-month suspension for doctors who overprescribe, and requires pharmacies and drug wholesalers to report suspicious drug usage. Interesting stated fact: 85% of national sales of oxycodone occur in Florida, often bought by middlemen who resell it to drug-stupored Appalachian hillbillies. Right after the bill was signed, federal authorities raided the office of an Orlando doctor who prescribed 303,000 oxycodone doses in one year, more than the entire state of California. Given the rampant Medicare fraud that Florida is also known for, perhaps the feds should just move all of their agents there in an Iraq-like surge.

Beth Israel Deaconness physician informaticist Shane Reti is conducting a New Zealand trial of the iPad 2 as a kiosk at which patients complete an allergy form and check the accuracy of the clinic’s allergy records. The information is sent to the doctor’s smart phone for review during the visit.

Citrus Valley Health Partners (CA) hires Paveljit Bindra as CMO/CMIO. He brings impressive credentials: cardiologist, Harvard undergrad and MD, Fulbright scholar at Oxford, Mass General and Penn residencies, and a Wharton MBA in both finance and healthcare management.

Bizarre: a teenager in China sells a kidney to buy an iPad 2 and an iPhone. The hospital in which the illegal surgery was performed said it wasn’t responsible since it had rented out its urology department to the businessman who arranged the transaction.

E-mail me.

HIStalk Innovator Showcase – Logical Progression 6/3/11

Company name: Logical Progression
Address: 125 Edinburgh Drive, Suite 210, Cary, NC 27511
Web address: www.logicalink.com
Telephone: 919.655.1970
Year founded: 2005
FTEs: 8

Elevator pitch
Logical Ink is a tablet-based documentation software solution that helps healthcare organizations improve their documentation and replace paper-based workflows with interactive, mobile, pen/touch-friendly electronic forms.

Business and product summary
Our core competency is providing healthcare organizations a patient and provider-friendly way to capture documentation in a mobile setting. We’ve been focused on the pains providers are having with the adoption of electronic medical records and the pains hospitals are having with eliminating paper in patient-centric settings such as registration and consents. Traditional approaches such as desktop and Web-based software have a miserable track record of success because of a number of factors. We address this with years of research, guidance from a number of physicians/providers in the industry, and a balance of technologies: our interactive forms platform, digital ink, handwriting/voice recognition, mobile tablet devices and sophisticated integration with existing clinical systems.

We provide a simple, monthly subscription pricing model that is based on the number of forms you submit through our document portal.

Who is your target customer?
Hospitals and medium to large clinics.

What customer problem do you solve?
We help hospitals fill the gaps in their EMR and more easily transition to electronic medical records with a provider- and patient-friendly solution. We eliminate paper forms while introducing eforms intelligence to validate at the point of care, capture clean documentation, feed the completed documents to the enterprise content management (no more manual scanning/indexing) and feed the captured discrete data to the clinical repository.

Who are your competitors?
Topaz SigPad solutions, Digital Pen solutions like Shareable Ink, Salar, Phreesia are all in our space (patient/clinical documentation and patient check-in) and doing good things. But paper and the status quo (traditional approaches to the EMR interface) are our biggest competitors.

Why are you better than your competitors?
In short, our technology, our approach (pen + tablet), and our people. We offer things you can’t do on paper, sig pads or digital pen: interactive forms with video playback, image capture and annotation, colored ink for emphasis, zoom in/out, in-place editing/erasing, drop-down lists, dynamically hidden form sections based on answers (e.g., mark pregnancy question as read-only/hidden if patient is male), dynamic form content (populate informed consent risks based on selected procedure), and popup instructions/tooltips.

Real-time validation at the point of care for missing dates, signatures, and values. We can lock down parts of a document based on security roles. We provide real-time integration with the EMR or clinical repository via HL7/ODBC to keep demographics, vitals, medications, allergies and orders current in the documentation. We’re active in CFR Part 11 compliance because of our work in clinical trials.

We are the only vendor focused on using tablets (Windows, iPad, Android) and pen-based input (along with traditional keyboard and voice). That means no paper and no wires so providers can remain bedside. We have over 30 years combined experience with enterprise eforms and mobile technologies. We’re experts in everything tablet.

Pitch video created specifically for this Showcase

Customer interview (the HIM manager for a large, prestigious academic medical center)

What problems have you solved using the Logical Ink technology and what has been the overall impact on the hospital?

As we were making the move to a fully electronic health record, we did an assessment of all of our documents within the record. We realized that we had several types of documents that our major systems could not support. The documents were in different care settings and completed by different role groups, but they all had a common denominator – they were documents that required a patient signature. Some of those documents were being scanned, but we knew that this was an interim step and were looking for something that could truly move us from a paper to an electronic record. 

We were additionally challenged with a highly decentralized environment where our clinicians have offices in several locations throughout the campus (or the state). When we we made changes to forms based on policy or regulatory requirements, it was very difficult to ensure that we had appropriate version control. Inevitably someone would still be using an old version of a form.

Finally, we wanted to make sure that documents were available when they were needed. Our environment meant that forms were sent via interoffice mail or faxed to the correct office after being completed. This inevitably led to delays in availability which led to bottlenecks in our workflow. 

The initial feedback has been quite positive from both the front end clinicians and the back office staff. The technology is easy to use and mimics paper. The output is crisp, clear, and the patients seem to love it. The decision support has been very helpful in ensuring that documents are completed before they are filed in our repository

If you were talking to a peer from another hospital, what would you say about your experience with Logical Progression?

The Logical Ink team has been great. From the start, they were constantly thinking about solutions to our concerns. We chose the procedure consent as our document to pilot. One of the key issues that we needed to resolve was how to provide our physicians with the flexibility and freedom to complete the document as they felt was appropriate while maintaining structure around document classification and content. Logical Ink worked with us to provide an innovative solution to the issue that made our physicians, our IT department, and HIS happy. They are still developing ways to innovate within our project parameters, the most recent example is embedding a video into a form to assist with patient education.

How would you complete this sentence in summarizing for them: "I would recommend that you take a look at Logical Ink under these circumstances:”

I would recommend that you take a look at Logical Ink if you need a flexible solution to complete your EHR migration which is capable of capturing patient signatures, handwriting, and integrating multimedia.

An interview with Chris Joyce, founder and president of Logical Progression

Tell me how your solution is better than digital pens.

We have really embraced a paperless forms platform that’s more interactive than the forms platform that you’d get with digital pen. We do share a lot of the natural user experience with writing your notes in the margins, capturing discrete data, just the familiarity that the physicians and the patients would have immediately when they see the interface. But obviously, when we put our forms on the tablet, we’re paperless, there are no wires attached, so that’s the immediate thing you notice.

Once you’re completing a form, we provide validation at the point of care. The forms platform will highlight required fields that have to be signed or filled out. If you try to save a form and you’ve got incomplete data, it will tell you there at the point of care, “The patient forgot to sign this,” or, “They forgot to date this” and you can correct it on the spot. You’re not having to wait until you’ve docked the pen and you’re receiving an alert after the fact. We think that’s pretty important for just cleaner documentation in general. It really doesn’t disrupt the physicians because they can quickly correct that and move on.

There are some little things like drop-down lists that can be dynamically populated from the clinical repository, pop-up tool tips for help instructions, color ink annotation on diagrams that can be pulled from a static library or even the camera on the tablet. Those are some of the major differences.

I believe overall, as you just get off of paper, the better off you are when it comes to archiving as well. Our electronic form in the source document. I’s the original source and we know when we archive that that we don’t have any extra pieces of information that have to go along with that.

I’ll ask you an investor-type question. Are any parts of your offering patented?

They are not.

You said you compete mostly with paper and traditional EMR interfaces. How hard do you think it will be to get customers to spend money on your product to replace those?

We have had some pushback historically because people expect our user experience to be baked into their EMR solution. Ultimately, that’s one of the reasons why we want greater exposure. I believe that they’re correct in a lot of ways that if you’re going to provide a mobile, physician-friendly module to your EMR, you should have an experience like Logical Ink in your product. We are, however, complimentary to that investment.

In practice, even though hospitals are investing a lot of money in electronic clinical systems, there are a lot of gaps that are left over. Not all physicians are created equally, so some will have weaker areas than others, but particularly in the areas where we’re extending the EMR to the patient in their documentation in intake and registration, in questionnaires — there are big holes there — but in the physician areas of the ED and the clinical documentation and the anesthesia record, those are just areas where the conventional approach is so frustrating and weak for the physicians that it’s a non-starter.

We get calls from ED physicians a lot that are looking at our solution because they’re very concerned about their productivity loss if they were to switch to a traditional-based system. We certainly recognize that we are providing something that a lot of the larger vendors should be providing just as general sensibilities for mobility and user-friendliness.

Do you think it will be hard to convince hospitals to trust a small company to provide and support technology that in many ways could be mission-critical?

We haven’t had that big of a problem there. Historically, IT and healthcare is risk-averse. The same could be said for clinical trials and the life sciences folks. It seems like the consumer tablet market and the Meaningful Use legislation has really reached a critical mass with that sort of forcing them to take greater chances, to get meaningful progress toward electronic records.

I think that the EMR vendors have been around long enough and their traditional approaches have been tried out. It’s not due to lack of money. I’s not due to the lack of not trying. It’s just there are some fundamental problems with their approaches and I think that there are going to be some vendors and some hospitals that will take those risks to go ahead and make progress.

What is the next level for the company and what will it take to get there?

We’ve been fortunate to have an explosion of tablets in the last year and that has obviously forced us to innovate. We were initially supporting Windows tablets only. With the introduction of the iPad and the Android devices, you’re finding that the platforms are very fragmented.

The software development platform is what I’m speaking to. We will continuously support the new, emerging devices and it will force us to also re-think some of our approaches. Traditionally we’ve been looking at a pen-based interface, whereas the new tablets don’t always come with a stylus. In some cases we’ll introduce Digital Ink to those platforms and use third-party styluses or we’ll make the forms platform more flexible for additional types of input, like touch, soft keyboard, that type of thing.

As far as business, what does it take to advance?

Our goal in participating in HIStalk and in this discussion is really to raise awareness. We want to, in the short term, get more hospitals to adopt solutions like ours just to be aware that they exist and just see the benefits of them.

I think ultimately from a business standpoint, we would like to partner with a large EMR vendor that’s ambitious and wants to address the mobility and the user-friendliness of their documentation solutions and integrate Logical Ink into that experience.

News 6/3/11

Top News

Primary care providers treating hepatitis C patients via videoconferencing achieved results identical to those of specialists at a university medical center, according to a NEJM-published study. The program was Project ECHO at the University of New Mexico Health Sciences Center. I interviewed Sanjeev Arora MD, the project’s director, in October 2009. I was impressed.

Reader Comments

From DrLover: “Re: DrFirst. Looks like DrFirst is being inundated with requests for people to enroll in eRx before the submission deadline of the end of June. What normally took them three days is up over a week. Thirty days left for providers to write 10 Medicare scripts to prevent 1% penalty, 25 scripts to get 1% bonus.” 

 From Kramer: “Re: AHIMA. Just about everyone at the top has left. What’s going on?” I haven’t heard much, although one source says there were internal conflicts after CEO Linda Kloss stepped down a year ago. Former CEO Rose Dunn has been brought back in some capacity (note: I erroneously originally assumed it was Linda Kloss who had returned, but not so). All unverified. I have to admit that the first reaction that both Inga and I had when we got your question was that HIMSS was taking over AHIMA, which isn’t the case as far as I know (but isn’t exactly a far-fetched scenario given the historically acquisitive nature of HIMSS).

From N.S. Sherlock: “Re: IBM’s Watson in healthcare. Did you see this? Very interesting.” Above is a video featuring Eliot Siegel MD, professor of diagnostic radiology and nuclear medicine at the University of Maryland School of Medicine. It’s one of two universities working with IBM’s Watson computer to identify potential healthcare applications. They say that Watson can, like a medical student, learn and then apply that knowledge through experience.

From Pogo: “Re: Healthcare Informatics top 100 vendors list. I bet you have more companies supporting HIStalk as sponsors than they do as advertisers.” Maybe. I eyeballed the list and counted at least 35 of the 100 that sponsor HIStalk, HIStalk Practice, or HIStalk Mobile (some haven’t been announced yet, but are coming soon). Thanks to my sponsors and congratulations to those who made the list. If I ever get the time to reflect, I’m sure I’ll be amazed that so many companies support some hospital guy’s part-time blog – it is truly humbling and there’s no precedent that I know of in Internet-land.

From Maia: “Re: ‘spurred’ customer. Perhaps their previous EMR vendor was Dude Ranch EMR.” An EMR vendor’s press release headline leads off with “After Being Spurred by Previous EMR.” Awkward phrasing for sure and there’s plenty more in the remainder of the release (the verb tense wanders aimlessly throughout). The practice mentioned is an OB/GYN clinic, so maybe they should have worked in an accompanying stirrups pun.

From Klara: “Re: six important letters. Something for you to make fun of.” And I shall: an unfortunate Logicalis press release touts the freshly earned CPHIMS credential of one of its managers as “like a PhD in HIT.” Like a mail-order PhD, maybe — you just have to pass a multiple choice test. No coursework, research, teaching, or real-life competence is required. The odd thing is that their employee, according to her LinkedIn profile, holds a master’s degree that’s worth a lot more than a CPHIMS certificate and they don’t even mention that fact.

From Sharky: “Re: Stage 1 MU. IDC Health Insights just put out a list of vendors who have helped customers achieve Stage 1 and Epic isn’t on it. Everyone assumes Epic has customers who have cleared the bar, but why haven’t we seen evidence of this?” I assume because Epic doesn’t do press releases. Note the highlight from the article you mentioned. It’s totally lame, even more so coming from a research company. Attestation started just over a month ago and I doubt many hospitals were ready (compared to small practices, anyway) and especially Epic shops since so many of them signed on in the past year or two. If you run Epic at your place (inpatient or outpatient) and have successfully attested, e-mail me and I’ll set the record straight. UPDATE: Sharky responder points out that the HHS Web site lists several Epic facilities that have already received checks: “Epic customers who have checks in hand include Univ of Wisconsin, Texas Health Resources, Rush in Chicago, Northshore in Chicago, Beaumont in Michigan and many EPs associated with them. Most of them for multiple hospitals. I’ve heard as much as 50% of the money went to Epic sites (that would need to be verified, but worth checking).” Ed Marx of Texas Health Resources confirms that they attested on the first day (April 18) and received their check quickly. I found the the CMS list of providers who have received checks here.

Some unverified responses to HITuser’s question about running Meditech 6.0 in a multi-facility environment: (a) two-hospital Georgetown Hospital (SC) went live a couple of weeks ago; (b) Steward Hospital (MA) is going live late this month on 6.0 and claim their Meditech people are telling them it’s never been done; (c) TheScoop says he knows of just one and it’s in Hawaii. Thanks to those who replied.

HIStalk Announcements and Requests

Listening: Green Carnation, because I’ve always liked them and I needed a shot of Norwegian prog metal.

Thanks to Lawson Healthcare of St. Paul, MN, joining our merry band of sponsors at the Platinum level. If you work in a hospital, you probably know about the company’s financial management, human capital management, customer relationship management, and supply chain management systems. Maybe you haven’t heard about their other offerings: the Cloverleaf line of data integration products, the Initiate patient and provider identity management tools, the MediSuite clinical system for Canadian customers, the recently announced Lawson Analytics for Healthcare, and the Lawson Enterprise Exchange HIE component line (clinical document exchange, clinical portal, and results delivery). Lawson’s healthcare-specific enterprise management products focus on critical hospital resources – people, supplies, and finances. A recent entry on the company’s Simplifying Healthcare blog mentions that its supply chain customer, the hard-hit St. John’s Regional Medical Center of Joplin, fully stocked its temporary hospital within 12 hours. Thanks to Lawson Healthcare for supporting HIStalk.

Your “things to do before or shortly after you die” list: (a) sign up for e-mail updates to your right, ensuring that you’ll get at least something potentially useful among all the spam; (b) cement our symbolic and symbiotic social media relationship by friending Inga, Dr. Jayne, and me on Facebook, liking HIStalk while you’re there, and connecting with us on LinkedIn; (c) send me news and WikiLeaks-like rumors; (d) treat the sponsor ads to your left with click-worthy admiration rather than jaded contempt since these companies not only see you as the powerful, influential thought leader and desirable demographic that you are, they also keep Inga in shoes; and (e) observe my offered high-five for being a loyal HISalk reader and don’t leave me hanging.

Jobs on the Job Board: Certified Epic Ambulatory Builder, Meditech Project Director, QA and Testing Specialist. On Healthcare IT Jobs: Healthcare EA Architect and Developer, Healthcare Software Product Manager, Implementation and Account Manager, ICD-10 Project Manager.

Acquisitions, Funding, Business, and Stock

The co-founder of Citrix Systems starts VirtualWorks, which sells technology that finds all versions of a file on any kind of storage system via a Universal Index. He says small hospitals are particularly affected by “data sprawl” due to virtualization, cloud computing, and use of mobile devices, but no affordable solution was available previously.

Sales

Health Sciences South Carolina signs an exclusive, sole source agreement with HalfPenny Technologies to participate in a demonstration project to share clinical lab data between members of the state’s REC.

Kingman Regional Medical Center (AZ) contracts for Craneware’s InSight Denials to manage its denied insurance claims. The product was developed by ClaimTrust, which Craneware acquired in February.

People

Quality Systems CEO Steve Plochocki is profiled in a Smart Business cover article titled How Steve Plochocki built a new operating model for Quality Systems. It’s pretty fascinating, especially if you’re interested in what was on the minds of EMR vendors as HITECH was being put together.

Patient outreach technology vendor Phytel names Patrick Flynn as CTO.

TELUS Health Solutions promotes Michael Guerriere, MD to chief medical officer, a newly created position.

Announcements and Implementations

Vital Images announces its VitreaView universal image viewer.

TELUS Health Solutions announces its partnership with Carefx to create TELUS CareShare, a set of cloud-based provider services that includes results distribution, electronic referrals, medical reconciliation, and care coordination.

Fujitsu’s annual technology symposium this week had a theme of consumerism in healthcare, featuring speakers from the VA, Stanford, Mayo, West Wireless Health Institute, Kaiser, Continua, and others. The company displayed its PalmSecure biometric solution, document scanners, electronic wait time signage, mobile monitoring, mobile phone wellness management, and Slate PC.

Government and Politics

OptumInsight (formerly Ingenix) CEO Andy Slavitt testifies to members of the Congressional Small Business Committee’s Subcommittee on Healthcare and Information Technology and presents low-cost recommendations to help small practices adopt HIT. He suggests creating standards for EHRs and HIEs, providing federal support for HIEs, providing legal protection for physicians in regard to privacy issues, extending small business loan guarantees for physicians, and continuing support of RECs.

HHS’s Office of Inspector General says it will recover $3.4 billion in the first half of the fiscal year as a result of its audits and investigations.

Four legislators introduce a bill to provide Meaningful Use EHR incentives to individual hospitals within a multi-campus system.

CMS designates June 15th and August 24th as National 5010 Testing Days, encouraging participation by all providers, clearinghouses, and vendors.

Other

 
 

 

A reader sent a report describing the work done by Mercy’s IT department when the tornado hit their St. John’s Regional Medical Center in Joplin, MO. Here’s a summary, beginning on Sunday, May 22.

• Sunday 5:41 PM – the tornado hits.
• 6:00 PM – Mercy Technology Services establishes two conference bridges, one for leadership and one for technical issues. Nobody at the hospital could be reached by telephone.
• 7:00 PM – servers were failing even though the network was up. Power had been shut off to the buildings, generators didn’t kick in, and the UPS finally died. A phone tree was set up to locate employees. Patient charts and a census were printed from Epic at the Washington data center (the hospital had just gone live with Epic three weeks before and none of that information was lost). Kronos time clock data was cross referenced to Lawson to get contact information for employees who had clocked in.
• Monday 8:00 AM – all 183 patients were accounted for and matched to their printed charts. Five patients and one hospital employee had died.
• Tuesday evening – satellite-based voice and data communications were in place at temporary treatment locations at a local auditorium and hotel. Epic was running in the auditorium. Groups from HR, finance, and other areas worked in assigned areas with IT support, including network access, printing, and applications.
• Friday – the tent hospital was in place.
• Saturday – 54 mbps radio-based connectivity was in place in the tent hospital. PCs and multi-function devices were in place on mobile carts. A network was running in the tent hospital, with three drops every four feet.

Thomson Reuters releases its third annual study identifying the top 10 US health systems based on quality of care, efficiency, and patient satisfaction. The list includes three-time winners Advocate Health Care (IL), Kettering Health Network (OH), and OhioHealth (OH).

The average clinician spends 122 hours per year trying to access various forms for EMR, according to a study sponsored by a single sign-on vendor. Without SSO, users require an average of 6.4 passwords to access clinical systems.

The MUSE conference is underway in Nashville. If you are attending and run across anything newsworthy, let me know.

Students at UC Merced are creating a telehealth program to address gestational diabetes, hoping to find sponsors to cover the cost of glucometers and software.

Mobile device management software vendor AirWatch gives Inova Health System $100,000 to fund three projects: a telestroke program, a study of how mobile technology affects inpatient physician productivity, and a pilot that will equip home health nurses with tablets. I mentioned the company in February after getting an impressive HIMSS booth pitch from a co-founder – their tools should give hospitals a lot of comfort in allowing mobile devices (including the always troublesome Apple ones) into the enterprise.

Strange: a company called Medical Justice gets doctors to put a “mutual privacy agreement” in the clipboard full of forms that patients sign, which then gives the practice ownership of any reviews the patient posts about it on sites like Yelp. The company claims it exists to give doctors a way (at $625 per year) to have fraudulent reviews taken down, but another critique suggests that the company also posts its own glowing reviews of its practice customers. The company says it’s not posting fake reviews, it’s just helping patients post their genuine reviews (the article claims all of those they post are five stars and the company won’t provide proof of their authenticity). I can’t imagine any other type of business trying to control reviews posted by its customers, not to mention that phony reviews would probably be posted by non-patients who would not have signed the form anyway.

Sponsor Updates

• Allscripts President Lee Shapiro joins the board of Medidata Solutions, a provider of development tools for clinical trials.
• AirStrip Technologies names former CliniComp president Alan W. Portela its new CEO. He replaces founder Gene Powell, who will remain as chairman of the board and a senior advisor.
• The University of Texas Medical Branch selects ProVation Order Sets as its electronic order set solution.
• ICA’s chief marketing office John Tempesco writes about cutting hospital administrative waste in a recent Business Edge post.
• St. Luke’s Hospital & Health Network (PA) chooses CareTech Solutions to provide remote 24/7/365 IT infrastructure monitoring.
• iMDsoft is reviewed in the recent KLAS anesthesia documentation report, which notes that 100% of surveyed customers said its MV-OR system is part of their long-term plans, with seamless interfacing with clinical and surgical systems being a strong factor.
• Nemours Children’s Hospital (FL) hires Orchestrate Healthcare to install Epic in its new Orlando facility.
• MED3OOO is hosting a free Webinar discussing Why ACOs Should be Physician Led that features Amit Rastogi, CEO and president of PriMed. Sign up here for the June 8th session.
• The Public Health IIM Syndromic Surveillance Interface olf Iatric Systems earns ONC-ATCB certification.
• University Health Systems (NC) wins Concerro’s 2010 Client of the Year ward for optimizing labor management through its use of Concerro technologies.
• Siemens Healthcare certifies BridgeHead Software’s BridgeHead MediStore as a medical imaging and full disaster recovery solution for Siemens SYGO uses.
• NCR Healthcare chooses EPX as its preferred payment provider, planning to integrate its payment processing functionality into NCR’s kiosk and patient portal self-service offerings.
• Awarepoint VP Chris Doran spoke at the VA-sponsored VHA Real Time Location Systems Conference this week in Atlanta, with a talk entitled “RTLS Technology Appropriateness.”

EPtalk by Dr. Jayne

Lots of buzz about cell phones this week. First, multiple media outlets, including the Wall Street Journal, covered the World Health Organization’s conclusion that cell phones potentially increase cancer risk. The agency’s International Agency for Research on Cancer reviewed existing studies looking at the effects of radio frequency fields, classifying phones as “possibly carcinogenic” and increasing the incidence of certain types of brain tumors. Other agents in the “possibly carcinogenic” realm include DDT, car exhaust, lead, and pickled vegetables. Bad news for most office types: coffee is on the same list.

Next, the Los Angeles Times reported that “cell phones used by patients and families are twice as likely to contain potentially dangerous bacteria compared with the mobile phones used by healthcare workers.” Samples collected included drug-resistant staph and other bacteria associated with hospital-acquired infections. A sassy comment on the Web site poses this question: if cell phone radiation can cause cancer, why doesn’t it kill the bacteria? I like the way he/she thinks. In the mean time, folks, wash your hands before using the phone!

More 5010 news as CMS schedules National 5010 Testing Day to be held June 15. For those of you who are close to ready for testing activities, this is your chance to work with clearinghouses, insurance plans, and Medicare contractors to make sure things go smoothly. For those of you who might be a tad behind, I found the Get Ready 5010 Web site to be helpful. Available webinars highlight action plans for both small and large practices and also cover how to work with clearinghouses and payers. The site is sponsored by the AMA, WEDI, HBMA, and AHIMA.

HHS has posted what some are calling a Wall of Shame that lists nearly 300 organizations (including payers, physicians, and hospitals) that have reported breaches of medical privacy affecting more than 5,000 patients each. I take comfort in reading that they weren’t all laptops, hard drives, or other IT-related issues — several organizations were cited for issues involving (gasp!) paper records. Check out the list – lots of prominent organizations appear and it specifies the type of breach whether it was theft, loss, unauthorized access, or hacking.

American Medical News reports that CMS is finally putting their money where their mouth is, unveiling three new Medicare ACO options to aid in the transition to this new care model. This “pioneer” ACO program would provide cash advances for organizations to set up and fund the care coordination needed for viability, assuming that the investment would be repaid through cost savings. It’s unclear what would happen if organizations gamble with the cash and don’t save any money. CMS will hold four training sessions, the first being June 20-22 in Minneapolis. A public comment period is open and you can weigh in at advpayaco@cms.gov and let them know what you think.

For those of you who are always looking for the “next thing,” keep in mind that we’re only a month away from the National Committee for Quality Assurance (NCQA) publishing their version of ACO rules. Due out in July, it will give those of us who have to digest, summarize, define, compare, and forecast some additional beach reading.

I’ll close by mentioning a piece I saw in Medical Economics. The print version was heartwarmingly titled What a rock star taught me about the practice of medicine (the online version unfortunately titles this Brief encounter with rock star influences physician’s career, an editorial.) Internist Gregory A. Hood of Lexington, KY talks about meeting Roger Daltrey of The Who and how being a physician played into his experience. It’s mostly a feel-good piece, but my favorite part is when he talks about being “an extremely fast typist” who can fly through the Ticketmaster screens while purchasing tickets. He attributes his success in scoring front row Daltrey seats to his EHR-honed typing, stating that “EHRs have redeeming features.”

That’s enough to warm my little CMIO heart (as if the heat and humidity across most of the country wasn’t enough). Do you have a story about your EHR’s redeeming features? E-mail me.

Contacts

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

Healthcare IT from the Investor’s Chair 6/2/11

Ask the Chair

 

My broker has found nothing other than the usual suspects and none of them are rated all that good. Would be interesting to have your investment banker dude weigh in on investing in a fund or a reasonable combination of individual stocks, with no promises or guarantees, of course.

I’m guessing that would be me, as both a former analyst-dude and I-banker dude. 

Here’s my view. While I used to make my living recommending stocks, I’ve come to the conclusion that buying individual stocks is nearly an impossible game to win. Why? There’s a theory known as Market Efficiency, which basically postulates that all information known about a company and its prospects is already reflected in its share price.

Now clearly the readers of this blog know more about this sector than the average stock market participant (and are probably better looking and more fun to party with), but we’re talking about the market as a whole, ranging from little old ladies’ investment clubs to the likes of Raj Rajaratnam (the Galleon hedge fund owner recently convicted of insider trading).

As readers of my debut column will recall, buy-side and sell-side analysts spend their time scouring for “market inefficiencies.” In other words, seeking out stocks that don’t fully reflect their value. They do this by attending HIMSS; reading financial statements; talking to users, consultants and company management teams; and other forms of fundamental research.

Now clearly these market inefficiencies do happen for a number of reasons. Sectors go in and out of favor, companies miss (or exceed) their Street forecasts and are over-penalized (rewarded) as a result, or you just might really believe in what a company you use or saw at HIMSS is doing and so want to bet on them. (The key word here is “bet,” so please behave accordingly.)

Now that I’m done flaming about market efficiency (there’s no zealot like a convert), here’s what I do:

• First, my personal investment strategy is based around a core and diversified portfolio of low-cost index funds. That said, sometimes I just can’t help myself. That’s what a “satellite account” is for. If you want to “play” the market (again, notice the word we use), consider allocating 10-15% for that purpose. Mine is in my IRA so I don’t have tax consequences to worry about.
• Next, do your homework. You presumably have an investment thesis beyond just wanting to own HCIT stocks (e.g., love Cerner / athenahealth / Allscripts’ product at my hospital / medical group; Jonathan Bush has a great sense of humor; I use ePocrates every day; etc.)
• Watch the stocks you’re interested in and look at their valuations relative to other sectors, each other, and their history. I’ll note that these stocks have had a great run over the past few years and, in my view, the easy money might have already been made.
• If you can, try to obtain some analyst reports. At the very least, check the company’s SEC filings.
• If you determine that there’s a good buying opportunity, for whatever reason, place your trade and hope for the best! I’ve traded these stocks for my own account a few times, with generally good, but occasionally horrid results – your mileage may vary!

If you’re bullish on the entire sector, one idea might be to divide your HCIT portfolio across a number of stocks to diversify away some of the company-specific risk. As I used to say to portfolio managers who asked me to choose between two different competitors: remember, you’re not selecting the best system for your facility / practice, you’re buying pieces of paper that trade. There’s no reason you have to pick just one.

That diversification reduces risk is something even most economists agree on (though there’s the counter-view: “no guts, no glory”). Just don’t put next month’s mortgage payment or your kid’s college tuition into these stocks — they’re volatile at best! As an aside, the best book on investing I’ve ever read is A Random Walk Down Wall Street, by Burton Malkiel.

Did you attend the Health Evolution Partners’ Leadership Summit? What was it like?

For the second year, I was invited to attend this event in Dana Point, CA. While the conference began years ago as a Versant Ventures event, Health Evolution Partners took it over a few years ago. HEP is a billion-dollar private equity fund focused on healthcare, with CalPERS as its lead investor. As readers of this blog likely recall, the fund’s chairman is David Brailer, MD, PhD, the first “Healthcare IT Czar.”

(In the interest of disclosure, I should mention that I’ve known the good doctor since he was the T.A. in a class I took at Wharton while he as earning his PhD over 20 years ago. He’s been a friend and supporter ever since.)

I view this as one of the best work-related events I attend each year. As Dr. B said in his opening remarks, he asked his staff to find the best one hundred minds in healthcare, and about 400 showed up. The event included a number of panels on topics ranging from the future of for-profit hospitals to innovations in primary care, the emerging super-consumer, personalized medicine, risk-bearing medical groups, and more.

The speakers ranged from such luminaries as Michael Dell and Todd Park (athenahealth co-founder, now CTO of HHS) to CEOs of corporations of varying sizes to policy wonks and, truthfully, ranged a bit in quality (as is ever the case). I’d give them a B+ (as high as I ever grade panel events, btw).

Beyond the panels, however, were several other aspects of the event that made it extremely worthwhile. Friday afternoon had two noteworthy components. First, was “strategy sessions,” where senior executives from companies ranging from Kaiser and Optum (fka Ingenix) to Pfizer and Oracle shared their visions and strategies in a small, boardroom-type setting. This was the first time I’d heard the Optum viewpoint and strategy actually expressed, and I walked out nodding my head in agreement with much of it (though the devil and valuations are clearly in the details).

Finally, the event concluded with a round of “speed dating,” where a number of innovative companies were given short sessions with a range of sponsors, including large vendors, health systems, and funders. In effect, HEP is trying to use this “Innovation Network” to bring the smaller (often more creative) companies together with the execs of the larger (always better capitalized) companies to find some areas of potential common interest and, hopefully, accelerate the pace of progress.

As an observer, it appeared to be an outstanding opportunity for both sides, though I do wish there’d been a way for people in neither group (such as this author) to participate.

Best of all, the quality of the attendees and the networking events were simply outstanding, really the best of its sort I attend. There was a great deal of card swapping, as well as reconnecting going on. A highlight for me was a casual introduction I made between two ST Advisors’ clients and learning that one was on the board of a hospital which was in need of the type of solution the other’s company provided! That kind of serendipity can’t be beat. I’m already looking forward to next year.

Ben Rooks is the founder of ST Advisors, a consultancy which has worked with dozens of HCIT companies and investors typically on issues around strategy, financing, and outcomes/exit planning. He enjoys food and wine, debating market efficiency, discussing healthcare, and most especially, reader comments!

News 6/1/11

Top News

 

HHS issues a proposed rule requiring healthcare providers, health plans, and their business associates to maintain an access report detailing all disclosures of patient information within an EHR or accounting system. Providers must also record every EHR chart access, including details on who opened the patient chart, the date, and the time. The access report must be made available at the request of patients.

Cerner announces a two-for-one stock split, with a June 24 distribution date. Shares closed Tuesday at $120.10, valuing the company at just over $10 billion. Neal Patterson holds $512 million worth. Above is the one-year CERN share price (blue) compared to the S&P 500 (green).

Reader Comments

From All Hat No Cattle: “Re: HHS’s HIT certification. Seems like another needless scam.” ONC announces availability of six Health Information Technology Professionals examinations: (a) clinician / practitioner consultant; (b) implementation manager; (c) implementation support specialist; (d) practice workflow and information management redesign specialist; (e) technical / software support staff; and (f) trainer. ONC is offering vouchers to qualified applicants; otherwise, it’s $299 for the first exam and $199 for each additional. ONC pre-nicknamed the exams HIT PRO, which is trademarked for some reason. I’m not entirely sure what the point is – in the “Why Take the HIT Pro” explanation, they talk about a shortage of qualified HIT workers, implying that passing the test makes someone qualified. There are no educational or occupational prerequisites for taking the 125-question tests, although the target audience is the folks who have finished one of those short, ONC-funded HIT programs that community colleges offer.

From MadCow: “Re: Loma Linda University Medical Center. Pulling an EMR swap, from Cerner to Epic.” Verified. LLUMC’s board approved Epic last week, which will be rolled out through their entire system. Epic will replace Cerner for inpatient and ambulatory clinicals, GE for faculty practice management, and a homegrown registration and billing system. LLUMC will keep their Cerner lab apps because Epic’s Beaker is a few years away from having the capabilities needed for an organization of that size.

From HITuser: “Re: Meditech 6.0. Have they implement any sites running multiple facilities?” A good question, which I will open up to those HIStalk readers who surely know. I’d have to guess yes.

HIStalk Announcements and Requests

A reader asked if I could interview someone from St. John’s in Joplin about their emergency preparedness lessons learned once things settle down there. If anyone is reading from there and would be willing at some point, let me know.

Watching: Life on Mars, a quirky one-season sci fi/cop show in which the lead character is sent back in time to 1973. Harvey Keitel is excellent in it, former Cosby kid Lisa Bonet has a role, and the pop culture (hair, clothes, music, etc.) are cool. Lots of Bowie tunes. It’s the American remake, predictably inferior to the original British version, they say, so I’m hoping the original hits Netflix streaming.

Welcome to new HIStalk Platinum Sponsor Impact Advisors of Naperville, IL. The company’s service offerings include strategic advisory (IT performance assessment, strategy, system selection, contracting, ROI, HITECH readiness, governance, and facilities planning) and strategic implementation (planning, readiness, project leadership, staff augmentation, project oversight, interim management). Impact Advisors has won several awards,including Best in KLAS for Planning and Assessment for three straight years. They’ve also bagged some “Best Places to Work” recognition in case you’re looking for opportunities (I see they need implementation specialists for Epic and Cerner at the moment, as well as HIT strategy folks). Founders Andrew and Peter Smith are HIT long-timers and have boatloads of experience working with hospitals and physician groups and are on the speed dial of quite a few big-name CEOs and CIOs as their trusted advisors. Former FCG President Steve Heck is a VP there, so you can catch up with him when you contact the company. Many thanks to Impact Advisors for supporting HIStalk.

It’s a quiet week by all appearances, which is a relief since I’m trying to catch up after a few days of being semi-off. It seems like about half of the 7,359 HIStalk e-mail subscribers are kicking back an “out of the office” reply this week, so good for everybody who is getting away a bit for the unofficial beginning of summer. It’s a great time to send in your news, rumors, guest articles, or whatever goodies you have that might interest others.

Acquisitions, Funding, Business, and Stock

A London newspaper says that Sage is reviewing its healthcare business and will likely sell it, although it did not provide details or sources.

A Chicago Tribune story on excessive executive pay speculates that McKesson shareholders may push back on the compensation of CEO John Hammergren at this summer’s annual meeting. He’s California’s third-highest-paid CEO at $54.6 million for the year ended last March (the company hasn’t released his FY2011 take).

Announcements and Implementations

IBM announces the expansion of its Dallas-based Health Analytics Solution Center, including the addition of new technology and the doubling of its solution architects and technology specialists. Mobile technologies, remote patient monitoring, and analytics are some of the areas IBM says the Center is addressing.

Health information network provider Availity earns EHNAC recognition for achieving the requirements for the 5010 Readiness Assessment program.

MIM Software introduces the VueMe App for iPad, iPhone, and iTouch. The app allows patients to view diagnostic images that have been sent them from their doctors, or to share those images with a specialist.

Government and Politics

Your tax dollars at work: as of May 19th, the Medicare EHR incentive program had paid providers $75 million; the 15 state Medicaid programs paid an additional $38 million. Including HIT training programs and RECs, HHS says it has doled out a total of $1.7 billion to promote EHR adoption. ONC coordinator Farzad Mostashari also notes that EHR use among primary care physicians increased from 20% in 2009 to 30% in 2010.

ONC publishes a proposed rule that addresses how the agency can remove an approved accreditor of the permanent EHR certification program. The ruling establishes a process to deal with situations where the ONC-AA engages in misconduct or does not perform its responsibilities.

Weird News Andy notes that the Feds are cracking down on healthcare fraud by threatening to file criminal charges against corporate executives whose companies are caught in wrongdoing, even if the executive had no direct knowledge of the illegal activities. Instead of just accepting a fraud settlement from big companies who treat it as a cost of doing business, Uncle is pulling out previous precedents that it says allow it to hold executives personally responsible, noting that several Fortune 500 companies have bought their way out of Medicare fraud several times (can I get an amen?) A quote from HHS’s chief counsel for the inspector general:

To our way of thinking, the men and women in the corporate suite aren’t getting it. If writing a check for $200 million isn’t enough to have a company change its ways, then maybe we have got to have the individuals who are responsible for this held accountable. The behavior of a company starts at the top.

Maybe the government should have cracked down on this guy: a man who used patient information to charge phony narcotics prescriptions to a federal employee insurance plan gets off with a six-year sentence and a fine. He had pleaded guilty to charges of healthcare fraud, HIPAA violations, and identity theft in obtaining the drugs to sell.

In the UK, a member of Parliament says NHS should fire CSC from its $5 billion NPfIT contract since it has implemented only three hospitals in nine years. MP Richard Bacon, always a great source for quotes, says NHS CIO Christine Connelly’s assertion that it would cost more to fire CSC than to let them finish the work is “incredible,” saying if that’s true then everybody involved with Connecting for Health should be fired. Tony Collins reports on a leaked memo that says CSC is proposing to cut the number of trusts it will implement from 220 to 80, but at a rate per trust that’s double what the current contract specifies.

Other

Bizarre: 53% of surveyed teens say they would rather lose their sense of smell than their personal technology, while 47% say they want to be remembered for their social network connections.

 Sponsor Updates

• Carlos A. Labrador, MD (FL) is named as one of 15 eClinicalWorks clients to receive EHR incentive checks from CMS.
• Dell InSite One is managing over four billion diagnostic imaging objects and associated reports with its managed cloud enterprise archive.
• Fujitsu names Perceptive Software its Central Region Premier Partner of the year.
• T-System partners with Isabel Healthcare to integrate its T-SystemEV EDIS with Isabel’s diagnosis decision support content.
• Lawson Healthcare recognizes five provider organizations with its 2011 Customer of the Year Awards.
• maxIT Healthcare will provide consulting services for Meditech Magic users who are implementing the OrderEase software from Iatric Systems .
• Twenty Meditech hospitals have selected Imprivata OneSign in the last six months, bringing Imprivata’s Meditech client base to 150.
• HMS DIRECT, HMS’s remote hosting service division, expands it data center capacity to accommodate the growth of the company’s ASP business.
• Molina Healthcare picks GE Centricity Practice Solution as its primary EMR/PM platform.
• A Gateway EDI/LarsonAllen study finds that physician practices that have adopted RCM tools have higher revenues and collect more patient payments at the time of service.
• NCR is holding a June 16 Webinar called Revenue Cycle: Why Self-Service is Key, featuring Elmhurst Memorial Hospital.

Contacts

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

Monday Morning Update 5/30/11

From Pericles: “Re: Allscripts outage at Allegheny General. The article refers to the company’s ‘New Jersey headquarters’ instead of Chicago. Could they have named the wrong vendor?” I assume the problem was with a hosted version of the Sunrise application, which is run from the former Eclipsys hosting center in Mountain Lakes, NJ. That operation and service was turned over to ACS/Xerox just over a month ago in a 10-year, $500 million outsourcing deal.

From Nosmo King: “Re: Nuance. As result of the Nuance partnership with 3MHiS that created CAPD (Computer-Assisted Physician Documentation), there are rumors that Nuance might buy the troubled document creation and management business of 3MHiS, formerly known as SoftMed.” Unverified.

From Mercy IT Gal: “Re: St. John’s Regional Medical Center, Joplin. It’s been a crazy week here at Mercy. A lot of time and effort is going into making sure the patients are taken care of, making sure our co-workers are OK, and securing the assets that were in the hospital. The mobile hospital is pretty wild – looks like a MASH unit (picture attached). The mobile hospital is an attempt by Mercy to show the community of Joplin that we’re not going anywhere. Mercy is committed to the Joplin community and will not abandon them in their time of need, even if it means setting up a temporary structure until we can get something new built. The frustration at work can get pretty high at times, but I can tell you that this week I’ve been pretty proud of working at Mercy. It’s amazing how people have come together looking for a way to help. Probably one of the best stories I’ve heard is from someone who volunteered to answer the hotline assigned to checking to make sure our Joplin co-workers were safe. She said she got a call from someone who had some damage, but was overall OK. She was concerned about her job and stated that she didn’t want to go to Freeman because Freeman is a for-profit hospital.  She said her heart was at Mercy and that’s where she wanted to be. I didn’t mean to turn this into a propaganda e-mail touting the virtues of Mercy, but as you can guess, this has been an emotional week and I guess it’s getting to me. Thanks again for all the hard work you do to keep us healthcare geeks informed and entertained. In case you don’t hear it often enough it really is appreciated. I hope you take some time to relax over the holiday weekend with Mrs. HIStalk.”

Update 5/29: the temporary hospital was scheduled to open Sunday afternoon in time for the President’s visit. Above are additional pictures from St. John’s – the photo album is here. The one with the printer in the lower left is what’s left of the data center.

From Sy Alice: “Re: abstract from the American Urological Association meeting. I imagine the good doctor could have phrased this better: “Good treatments are available for all patients and, depending on what the patient is willing to do, every man can get an erection if he sees a physician specializing in sexual dysfunction.” I’m not touching that with a … well, I’m just not touching that.

From The PACS Designer: “Re: CloudFoundry. CloudFoundry is the world’s first open Platform as a Service (PaaS) offering. The CloudFoundry.org Web site is a community-driven open source project that is led by VMware. With the CloudFoundry Beta, you can try for free the VMware Horizon App Manager, which is an open, user-centric management service for accessing cloud applications.”

From Lab Rat: “Re: Epic Beaker. I wouldn’t even think about implementing it until Epic gets back to work on it, especially in a larger hospital. Label printing is way more complicated to set up than with Cerner or Meditech and instruments were having troubles with the labels.” A Beaker site contact I asked agrees that it needs work.  

Photo: Patriot Guard Riders 

Monday is Memorial Day, a day to honor those men and women who have died in military service to the United States. Try to squeeze in a few minutes among picnics, car races, and the beach this long weekend to remember the fallen who earned that one day of honor the hard way (many of them barely old enough to vote). It’s perfectly fine to be anti-war and anti-military and still be supportive of those in the service – most of the fallen didn’t get to pick the cause they died for, so you can’t hold that against them. I ran one of my favorite poems on Memorial Day 2005 and a time or two since. My flag is flying and I hope yours is too – it’s the (very) least we can do.

Listening: Lez Zeppelin, an all-girl Led Zep cover band (not as weird as it sounds since Robert Plant shrieked like a girl most of the time anyway and cute girl rockers are always better). I’m not a fan of cover bands or even Led Zeppelin in general, but somehow I like their albums (yes, they’ve done two) that are note-for-note covers of the originals. I’m air guitaring to Dazed and Confused right now, wishing I was watching them live. Also: Manchester Orchestra, Atlanta-based emo-ey indie that veers into hard-rocking territory every now and then and sounds just fine.

About two-thirds of provider respondents aren’t so sure their employer has good enough security practices to keep their medical records private. New poll to your right: how loyal are you to working in healthcare?

I was going to run a poll on CHIME’s CIO credential, but I remembered that I did that two years ago. The opinion then was 91% negative (13% said it’s a vanity credential, 33% said it has no connection to competency, and 43% said it’s just another way for CHIME to make money).

Six-employee MobiuSoft of Flint, MI says they’ll hire up to 144 more folks in the next 18 months if their HIE product earns certification (that’s what I’m inferring from the newspaper article, anyway). Former Genesys PHO VP Jerry Van Horn formed the company in 2009.

Quality Systems (NextGen) announces Q4 numbers: revenue up 24%, EPS $0.64 vs. $0.45, beating analyst expectations for both.

Thanks to new HIStalk and HIStalk Practice Platinum Sponsor Gateway EDI of St. Louis, MO. The 30-year-old company’s 85,000 physician users trust its fully integrated tools and proactive service team to monitor their claims, catching and fixing issues before they cause problems for their practices. The fast-growing company’s founder was a physician who created new solutions when existing claims processing tools weren’t doing the job. Users rave about the personal support they get from the customer service department, with one happy physician customer calling them “the Nordstrom of EDI.” Providers get paid faster, big practices enjoy the customization capabilities of the Web-based software, and vendors offering Gateway EDI’s solutions with their PM software give customers an all-in-one solution. Thanks to Gateway EDI for supporting HIStalk and HIStalk Practice.

ED doc Kevin Kitka, DO of Mercy/St. Johns Regional Medical Center of Joplin, MO describes what it was like to be working in the hospital as it was severely damaged by the recent tornadoes. He’s an excellent writer:

A small child of approximately 3-4 years of age was crying; he had a large avulsion of skin to his neck and spine. The gaping wound revealed his cervical spine and upper thoracic spine bones. I could actually count his vertebrae with my fingers. This was a child, his whole life ahead of him, suffering life threatening wounds in front of me, his eyes pleading me to help him. We could not find any pediatric C collars in the darkness, and water from the shattered main pipes was once again showering down upon all of us. Fortunately, we were able to get him immobilized with towels, and start an IV with fluids and pain meds before shipping him out. We felt paralyzed and helpless ourselves.

Speaking of St. Johns, nearby hospitals accepting its evacuated patients had a heavy OB load. The hospitals credit GE Healthcare for rushing a team of employee volunteers to get fetal monitoring set up, one of them driving four hours to get to the hospital and another doing configuration from her laptop while hunkered down in her pantry because her own Dallas neighborhood was under a tornado watch.

Allscripts fires PwC as the auditor of its financial statements. I don’t really understand the reasons or the impact from the SEC filing, but maybe someone can enlighten me.

It looks like Cerner has a new logo and a tag line of “Health care is too important to stay the same.” I like the new one much better – it uses green (my favorite color, and everybody wants to use green these days) and it ditches the robotic-looking, all-caps-shouting CERNER in favor of a cute, non-threatening rounded font that everybody uses when trying to look Web 2.0.

Cerner’s just-published 2010 annual report has a chatty letter from president, chairman, and co-founder Neal Patterson with some fun quotes:

• Thirty-one years ago, had we known exactly how hard, how long and how costly it would be, we might have chosen a different industry. I am thankful today for how youth and ignorance can sometimes prevail over conventional wisdom.
• In my professional experience, vision is the thing you as a leader use to give your organization the courage and motivation to invest in new ideas years before they produce economic returns.
• We view our work over the past 30 years as analogous to building the foundations and laying the electrical grid for a great city that hasn’t been built. Reaching the place where we can actually start to build on top of that foundation is inspiring for us and our clients. Things are starting to get fun.
• In the past several years, we have made changes to our health plan, fired our third party administrator (we prefer to think of it as eliminating our first insurance company), launched an on-site new age clinic and pharmacy, incorporated biometric measurements for our population, realigned the economic incentives for associates in our health plan price tags and rolled out a data-based wellness management program that
  provides personalized health profiles for our associates.
• The Cerner of today is known for care; we expect the Cerner of five or 10 years from now will be recognized for health as much as care. As I mentioned, we can see a plausible scenario where health actually becomes the bigger portion of our growth.
• This is the start of my fourth decade at Cerner. This is the first decade that I will not finish—at least not in the role of CEO. Unfortunately, there is a direct correlation between years of experience and chronological age. Often when I share Cerner’s age (31 years), I make the offsetting remark that Paul, Cliff and I were all in our 20s when we started Cerner. In my case, I was 29. If you add thirty-something to any age, the numbers start getting large. I don’t intend to end this decade as Cerner’s 70-year-old CEO … which is frustrating because this is going to be the most exciting decade yet.
• [This is an entry on his personal to-do list, referring to his sister-in-law Linda, who died of sepsis due to lack of care coordination] Save Linda’s life. Make it systematic that preventable events that harm people are exposed to the appropriate caregivers and eliminated. This will not bring back Linda, but it may prevent the next 50-year-old schoolteacher from rural America from dying unnecessarily from the uninformed, sometimes inadequate, sloppy, delay-ridden thing we call a healthcare system.

Here’s Vince Ciotti’s latest HIStory, which points out the parallel of a 1960s government program that drove financial systems development and sales much like ARRA is doing for EMRs today.

McKesson’s lawsuit against Epic isn’t over. A federal court will rehear McKesson’s case, which claims that Epic’s MyChart infringes on a RelayHealth patent covering patient-doctor communication via the Web. The previous ruling let Epic off the hook, saying that Epic’s customers and not the company itself set up MyChart. The issue at hand is whether Epic encouraged its customers to do so, and if so, whether that constitutes patent infringement.

Rennselaer Polytechnic Institute is awarded a $1.2 million NIH grant to develop patient-specific “phantoms” that can model the organ-specific radiation exposure involved in CT scans.

The new management team at Guam Memorial Hospital finds financial irregularities that include paying $25K per year for software that generates a form that they say could easily be photocopied instead.

Interesting: Regenstrief doctors are developing software that will use EMR data to determine which warnings and side effects are relevant to individual patients, creating dynamic prescription labels.

High-powered venture capital firm Venrock adds Bob Kocher, MD as a partner, expanding to three partners who will focus on healthcare IT companies. He was previously with McKinsey, Brookings, and the Obama administration. Venrock’s previous investments include athenahealth, RelayHealth, Awarepoint, Castlight Health, Coderyte, and Vocera.

Hospital and population health applications vendor Healthways outsources its application development and technology management services to HP in a 10-year, $380 million deal.

GE Healthcare and Thomson Reuters will offer drug companies and other researchers a database that combines de-identified patient EMR data from GE with de-identified claims and prescription data from Thomson Reuters.

A study of 17 physicians in a clinic moving from an old EMR to a new and more powerful one finds that prescribing errors dropped, but mostly because use of unapproved abbreviations was reduced. The total number of other errors increased at the 12-week mark and was identical to baseline at 12 months, suggesting that EMR implementation may cause errors early on and have little effect after a year. Most of those same doctors said the alerts weren’t useful, it was too slow in handling prescriptions and refill requests, and the more sophisticated system wasn’t any safer than the old one.

England’s NHS Direct hotline launches a free mobile app that allows patients to assess symptoms, get self-care advice, and contact NHS’s telephone nurses. It’s Android-only for now, with an iPhone app coming in a few weeks.

Population and risk management software vendor MedVentive raises $1.5 million in convertible promissory notes and warrants. I interviewed Nancy Ham (president and CEO) and Nancy Brown (chief growth officer) last August. I asked some reasonably good questions about technology support for ACOs and whether providers are fixated on EMRs while ignoring potentially more important solutions.

Sponsor Updates

• The use of AirStrip OB by Lovelace Health Systems (part of Ardent Health Services, which uses it in all of its hospitals) is profiled in the New Mexico business paper.
• Billian’s HealthDATA is hosting a June 8 Webinar called Providers’ Perceptions: Mobility in Healthcare. They’re also offering a free white paper titled Social Media Strategy for Healthcare Vendors.

E-mail Mr. H.

A Reader’s Response to HIStory 5/23/11

In Mr. HIStalk’s Monday Morning Update (5/23/11), Vince Ciotti’s HIStory slide show installment focused on the former Lockheed / Technicon … / Alltel / Eclipsys companies and their health information systems. However, this installment is full of factual errors.

Ron Johnson was NOT one of the original Lockheed engineers. Ron was hired at the Technicon company (1980?) as director of marketing, and he was let go after a brief stint.

In addition, the late George Kennedy was NOT one of the original Lockheed engineers. At Technicon, compared to others, George’s role was thin and short-lived. 

Ralph Korpman, MD was involved as a pathologist for the Technicon laboratory information system and famously sold a version of it to the then-HBOC (lawsuits followed; settled out of court).

Jack Whitehead, who owned Technicon Instruments, a laboratory system company (Tarrytown NY), bought the original Lockheed system (along with many of its engineers) and named the company Technicon Medical Information Systems (TMIS), as it was called when I joined the company in 1978. TMIS was set up to take the Lockheed system and commercialize it. 

It was pretty clear who drove that vision in those early days. Unsung heroes, such as Sam Virts, Ralph Boyce, Dick Kortum, Chuck Tapella, Bob McCord, Mel Hodge, Stan Grahams, Bob Williams, Dave Brown, Carole Widener, RN, Shirley Hughes, RN, ……….. (and forgive me for leaving out so many who deserve to be included here).

Around the same time that TMIS started, Spectra 2000 Medical Information Systems was started by another group of former Lockheed engineers and initially financed by Transamerica (LA). This company was later bought by Medicus; Richard Jelineck, PhD, et al. The two competing TMIS and Spectra systems obviously were similar. What set the systems apart functionally was Spectra’s MIS provided the first colored screen text. However, Technicon’s MIS was fully installed and used in a hospital based on documented cost / benefits.

In 1975, two reports were written about the TMIS system: One was written by Battelle Columbus (OH) Laboratories – Final Report on Evaluation of the Implementation of a Medical Information System in General Community Hospital. The other was Demonstration and Evaluation of a Total Hospital Information System – El Camino Hospital, Mountain View CA.

El Camino Hospital has never employed physicians nor have physicians ever owned the hospital. ECH was and still is a community-based, district facility. The community physicians from the Sunnyvale Clinic and the smaller Mountain View Clinic were key supporters of the TMIS. Other, key, physician leaders, such as Ralph Watson, were part of smaller physician practices / groups. The fact that these community physicians were not employed and there was success in gaining wide-scale adoption of CPOE during the 1970s is an accomplishment that other companies and products required 25+ years and paid incentives to achieve.

In 1981, Jack Whitehead sold TMIS and the lab system division, Technicon Instruments, to Revlon. TMIS became Technicon Data Systems (TDS). In 1984-85ish, Revlon sold TDS back to Jack Whitehead’s son, John, who again took the company private and renamed the company TDS Healthcare Systems. Technicon Instruments was sold to a number of companies after Revlon, with its legacy now part of the medical division of Siemens. The name “Technicon” was bought by Bayer and cannot be reused.

In 1996-97, John Whitehead sold TDS Healthcare Systems to Alltel. This lasted 2-3 years before Alltel sold it to Harvey Wilson (formerly of SMS) who started Eclipsys with the idea that he would take the Brigham & Women’s home-grown HIS, put it in a “box”, and take the market by storm.  Harvey lasted awhile at Eclipsys, but his vision never even came close to fruition. 

Yes, a handful of those old Technicon, TDS, … systems still chug away.  On the other hand, Mr. Ciotti writes that he is a frustrated English major, and he can’t even use / spell the word "it’s" correctly! Thankfully he wasn’t a frustrated history major, because he really would have had no excuse for all the “HIStory” errors in this installment (and others?).

This reply was composed by the following, former TMIS / TDS / Alltel /……employees, who remain proud having been able to work with the above, early system, company, and exceptional engineers and clinician developers … and who remain alive and well working in today’s world of healthcare IT:

Jane Baseflug, RN
Connie Berg, RN
Edith Caesar (retired)
Ann Farrell, RN
Deborah (Debby) Kohn, RHIA
Elizabeth West

News 5/27/11

Top News

St. John’s Regional Medical Center (MO) may not be salvageable, according to hospital’s president Gary Pulsipher. He says St. John’s, which is part of Mercy Health System, will open a 60-bed mobile hospital by Sunday and will rebuild. The hospital went live on EHR less than a month ago, but will soon be back online to connect the mobile hospital with other Mercy sites.

Reader Comments

From Easily Amused: “Re: magazine typo. A finance newsletter described a vendor as ‘provider of elf-service and revenue cycle management applications.’ I had visions of Santa’s helpers pitching in to improve collections.” At least they aren’t involved in elf gratification.

From Meaningless User: “Re: attestation. Do you have any info regarding which hospitals have attested to MU and what their success has been? I have not yet heard any announcements or rumors of a hospital achieving MU yet.” I doubt there’s a publicly available list, but some have met the Stage 1 requirements. It would be interesting to know if any have been turned down, but that’s not the kind of news that makes vendor press releases (not to mention that hospitals probably wouldn’t apply unless they were pretty sure they qualify).

HIStalk Announcements and Requests

In case you missed it this week on HIStalk Practice: Kareo lends advice on how to handle medical billing after a zombie apocalypse. Massachusetts eHealth leads the nation in enrolling primary care physicians for its REC. AMA reports a 45% increase in profits for 2010.  Dr. Gregg reflects on egos in the industry. And my personal favorite: the fake doctor who used toothpicks to treat his patient.  None of this news appeared on HIStalk , so if you follow the practice side of technology and aren’t signed up to get HIStalk Practice e-mail blasts, then you are getting left in the dust.

I’m taking a few days off for fun family stuff and trying to spend minimal time on the laptop, so I’m a little bit disengaged at the moment as I struggle to resist the gravitational pull of work and focus on non-work. I’ll be happy to get back to endless HIStalk hours in a few days.

Acquisitions, Funding, Business, and Stock

 

Standard Register enters a definitive agreement to acquire 100% ownership interest in informed consent provider Dialog Medical. Terms of the deal were not disclosed.

Resilient Network Systems raises $5 million in Series A funding, led by Alsop Louie Partners. Resilient’s technology facilitates the electronic transfer of health records.

People

Former Healtheon/WebMD CEO Mike Long is named president and CEO of EGHC, of which he was already board chair. The company’s businesses include a health plan, the Lumeris quality management software line, and ClearPractice EMR.

Announcements and Implementations

HIMSS introduces the ICD-10 PlayBook to educate providers on the transition to ICD-10

Allegheny General Hospital (PA) resorts to paper recordkeeping Wednesday after shutting down its Allscripts EMR. The hospital says it upgraded the system over the weekend and began having slowdown problems Monday and Tuesday. The hospital voluntarily shut down the system for about 12 hours while Allscripts fixed the issues.

CHIME reports that 109 individuals have earned Certified Healthcare CIO designation since the credentialing program was launched in July 2009. I said it was a dumb idea then and I’ll stand by that opinion now. Obviously the credential hasn’t exactly gone viral if only 109 out of thousands of hospital CIOs have signed on over two years, voluntarily jumping onto the hamster wheel of spending hospital money on renewals and going to CHIME meetings to earn CE. To each his own, but I’d be embarrassed to use a non-educational  credential earned by passing a multiple choice test of job-specific knowledge (designed by asking CIOs what they do on the job, then testing them to see if they theoretically know how to do it). My theory has been that CHCIO appeals to CIOs who feel inferior to their better educated C-level peers because they never expended the minimal effort required to earn a graduate degree by any of a zillion inexpensive, flexible, geography-indifferent programs that are out there.

athenahealth releases its sixth annual PayerView Rankings and awards Aetna the top spot among major players. BCBS-RI was the best overall performer, while state Medicaid providers were the worst in terms of days in AR and denial rates. Compared to last year, payers averaged payment one day faster with 5% fewer denied claims.

RCM provider RealMed announces its integration with Epic’s billing software.

Medicomp Systems announces that its Quippe electronic documentation system SDK is available for licensing to EMR developers. The browser-based, iPad-friendly system (which Dr. Gregg, Inga, Dr. Jayne, and I all raved about after working with it at HIMSS) uses the company’s MEDCIN-powered patented prompting technology to create and present EMR information in an amazingly intuitive way that even a non-doctor like me could use immediately after a ten-minute overview.

NCO Healthcare Services earns the “Peer Reviewed by HFMA” designation for several products related to eligibility, bad debt, and and extended office services.

Government and Politics

More grumblings about the proposed ACO regulation, this time from seven US senators. The lawmakers send Secretary Sebelius a letter urging HHS to withdraw its proposed ACO rules, saying, “the proposed ACO regulation will fail to accomplish its purpose” of better quality care and lower costs. The senators claim the proposed rules do not align incentives and accountability and include requirements that are too complex and an ROI that is uncertain.

CMS clarifies financial incentives for ACOs in rural areas, saying participants would be eligible for a savings exemption. CMS says that ACOs with fewer than 10,000 assigned beneficiaries would be exempt from the 2% savings threshold required of larger ACOs.

Add BIDMC to the list of hospitals claiming to be the first to receive HITECH money, $2.57 million in its case.

Other

Emergency physicians claim the biggest challenge to cutting costs in the ED is fear of lawsuits. An American College of Emergency Physicians poll finds that 53% of ER docs say the main reason they conduct the number of tests they do is fear of being sued.

Sponsor Updates

• SCI Solutions is attending and exhibiting this week at the National Association of Healthcare Access Managers conference in San Antonio, providing their traditional “Stress Free Zone” that features massages and cocktails.
• ESD heads to MUSE later this month (booth 910) as well as the Canadian E-Health Conference (booth 203). The ESD folks also shared that their KLAS ratings are up should you be interested in taking a look.
• Oklahoma Surgicare picks Provation MD software for gastroenterology documentation and coding.
• NextGen announces that Springfield Center for Family Medicine (OH) received federal funds for demonstrating Meaningful Use under the Medicare incentive program.
• Tim Reiner, VP of revenue management for Adventist Health System, describes that organization’s use of self-service technology from NCR for patient collections in a YouTube video.
• Yavapai Regional Medical Center (AZ) contracts for several applications from Lawson Software.
• Prime Healthcare Systems, California’s largest for-profit system at 14 hospitals, expands its use of document management technology from FormFast  to improve health information, revenue cycle, and patient registration.
• Self Regional Healthcare (SC) chooses RelayHealth as its HIE partner to improve care and support the Meaningful Use efforts of its eligible providers.
• Tele-Tracking releases Patient Flow Dashboard for monitoring enterprise-wide patient flow and getting more efficient use of existing capacity.

EPtalk by Dr. Jayne

I’ve been fairly critical of the federal Meaningful Use program lately. For the record, I want to mention one piece of the program (even if it did get relegated to the Menu Set) that I’m absolutely in favor of: increasing the number of providers who report syndromic surveillance data to public health agencies.

We’ve seen huge benefits to the field of epidemiology with increasing availability of health-related data. I still like the Google Flu Trend site as an idea even if it’s only search data. And “old school” diseases aren’t going away – the number of measles cases reported across the US just hit a 15-year high. 

The ability to track, trend, and prevent killer diseases is one of the cooler things we can do with healthcare IT (and one that’s proven to work, mind you). Can you imagine the TV show Quincy ME  if Jack Klugman had population-based aggregate data to work with?

In that same vein, a throwdown to my favorite elected officials. Hey Congress, how about putting together a true “Menu Set” of information technology interventions that have been proven to be effective and incentivizing them individually so that providers aren’t faced with the “all or none” problem with Meaningful Use? Any of us who have had to fill out the awful paperwork from the county health department to report a sexually transmitted disease would be happy to interface it directly from our EHR at the click of a button.

The American Medical Association offers a new app to assist with CPT codes. Only available for Apple users at this point, it allows you to search for, track, and e-mail selected codes. The first problem I had with it is that it apparently ignores the iPad’s gyroscope – it can only be viewed in portrait mode, which is a bummer for those of us that like to prop the iPad on our desk landscape-style so we can stream Netflix while we multi-task.

Navigation to the various sets of codes was pretty easy, but there wasn’t enough information on the screen to make a decision about the right code. The user would have to select each code and read the description. It would be more helpful to have a quick blurb visible on the screen rather than having each entry on the list say “office consultation,” which isn’t very helpful. (It was particularly unhelpful in the preventive codes section, but I couldn’t get a screenshot off my iPad to show, so I clipped this from the AMA Web site.)

I didn’t receive any IT-related checklists for a potential Zombie Apocalypse, but Inga did turn up Kareo’s thoughts on handling medical billing after the fact. I hadn’t really thought about Web-based telecommuting as a strategy to prevent employees from being eaten, but it does make a lot of sense.

Rest assured that due to our decentralized, multi-state virtual office architecture, the HIStalk staff is at significantly lower risk for being decimated by zombie attack than most health IT vendors.

Although Kareo’s piece mentions they didn’t know the code for having one’s brain eaten, I can propose (courtesy of IMO’s Problem IT product): E968.7 Assault by human bite and E979.8 Victim of crime or terrorism.

The Journal of the American Medical Association reports on Navigating the Challenges of In-flight Emergencies. There are apparently minimal standards for emergency medical kits, but kits and employee training vary from carrier to carrier. Airlines also have their own reporting systems and protocols, often relying on physician passengers rather than employed medical control officers on the ground.

The article proposes standardized reporting to the National Transportation Safety Board; expert recommendations for first aid kits (and eventually evidence-based kits based on the data gathered through reporting); enhanced training for flight attendants; and enhanced ground-to-air medical support.

Having had to respond to “Is there a doctor on board” more than once, I’m in agreement. Plus, it looks like an excellent opportunity for vendors to go after another potential customer base. Anyone want to hire a sassy CMIO to write your content for airline medicine? I’d be happy to travel all summer and write code for the most common airline emergencies I encounter along the way.

Contacts

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

News 5/25/11

Top News

The market for anesthesia information systems is predicted to increase 50% by 2012 and be valued at $4 billion by 2017. Vendors battling for market share include Picis, GE Healthcare, Draeger, IMDsoft, Merge, and Philips.

Reader Comments

From Baywatch: “Re: UCSF. The CIO is leaving involuntarily. Looks like the board finally figured out that the Centricity debacle was as much of a leadership problem as a software problem. The Epic project is floundering and bleeding money, with poor direction and an incompetent staff.” We asked a UCSF press contact, who replied: “Mark R. Laret, CEO of the UCSF Medical Center, today announced that ‘Last Friday, CIO Larry Lotenero notified me that he will retire at the end of June, completing 10 years of service to UCSF.’”

From TopCrush: “Re: AAOE meeting. I’m at the American Association of Orthopaedic Executives in Orlando this week, along with a few hundred other folks and about sixty exhibitors. ACOs are definitely a concern for these guys. Orthopedic docs are scared of being left out and worried about the financial ramifications. Kind of funny but they have a VIP entrance for participants that have been coming for years or on a chapter board.  AAOE set up a fun Sports Lounge in the middle of the show floor – shuffle board and fuse ball included.” Thanks for the update from the field. I wish I had a special door I could walk through every once in awhile, just to make me feel more important.

HIStalk Announcements and Requests

Mr. H semi-left me on my own tonight, just in case you were wondering why there are fewer smoking doctor images that usual. Mrs. H deserves a date night every once in awhile and I hope he is taking her somewhere special.

People

Community Health Network (IN) appoints Ronald Strachan CIO. Strachan is the former CIO for WellStar Health System and for HealthEast Care System.

Shared Health names Hedge Burt VP of sales. Burt has served as SVP of business development with Entrada, as well as VP of provider sales for Kryptiq.

PACSGEAR names Eli Rapaich CEO. Rapaich succeeds company co-founder Brian J. Cavanaugh, who will assume the role of COO. Most recently Rapaich served as VP of sales at Philips Healthcare.

Announcements and Implementations

The DoD awards SAIC a $53 million contract to provide IT and EHR system support to the TRICARE Management Activity MHS.

Gulf Coast Medical Center (FL) will move to Epic EMR next month.

CMS notifies Jefferson Regional Medical Center (AR) that it has met Stage One Meaningful Use requirements and will receive approximately $3 million. Jefferson uses Allscripts’ Sunrise Clinical Manager EHR.

Catholic Health Initiatives selects Beryl to provide outsourced patient experience solutions, including physician referral services.

Hospital EHR vendor eCareSoft, the US subsidiary of Mexico’s largest HIT vendor, embeds task-oriented tutorials and collaborative e-learning tools into its application. Hospital users can share shortcuts and workarounds and provide feedback to the vendor’s support team right from the application.

Trinity Health (MI), Baycare Health (FL), and Jackson Health System (FL) go live on the LegacySuite solution from Legacy Data Access. LegacySuite provides data storage and Web-based solutions for retired HIT applications.

The Federal Health Architecture (FHA) awards CGI Group a one year contract for $5.7 million to support FHA’s CONNECT NHIE Gateway solution.

Swedish Medical Center (WA) picks PRISM contact management software from Aegis Health Group to automate its physician relations management process.

Jefferson County Hospital (MS) selects Custom Software Systems to provide ChartSmart EMR, document management, and lab modules.

Texas Health Resources, where Ed Marx serves as CIO, receives over $19.5 million in Medicare EHR incentive payments for the meaningful use of its Epic system. THR has invested more than $200 million on its EHR initiative.

Innovation and Research

A new study concludes there’s no consistent association between EHRs and clinical decision support in ambulatory patient visits. Researchers looked at data from 2005-2007 so perhaps newer decision support tools might paint a different picture. However, only one of 20 indicators showed superior quality with EHR visits versus non-EHR visits.

Other

The video above is from St. John’s Regional Medical Center in Joplin, MO, heavily damaged after taking a direct hit from a tornado. Its 183 patients were evacuated, but five patients and a visitor died and several employees were injured. Hospital x-rays were found 70 miles away, with the hospital asking anyone finding hospital records to hold them while they figure out a way to collect them. Missouri’s disaster medical team has set up a makeshift 30-bed hospital in a tent, staffed by 40 doctors, nurses, pharmacists, and support staff.

Health IT ranks among the top 10 most popular career path for college graduates, according to a University of CA-San Diego study. Top jobs include healthcare integration engineers, system analysts, clinical IT consultants, and technology support specialists.

Sponsor Updates

• DIVURGENT will host a CHIME College Live session June 8th entitled Accountable Care Organizations: Overview and the Role of Information Technology.
• Thomson Reuters’ Meaningful Use Quality Manager 1.0 earns ONC-ATCB modular certification from CCHIT.
• Voalte signs up to resell the Epocrates Essentials premium clinical suite with Voalte’s communications solution.
• CynergisTek CEO Mac MacMillian and Ohio Presbyterian Retirement Services CIO Joyce Miller-Evans will present at the Colorado Health Information Management Association’s Long Term Care Spring Meeting this week.
• Geisinger Health System (PA) picks Orion Health Rhapsody Integration Engine as its integration platform.
• Vocera CEO Bob Zollars is named a finalist for the Ernst & Young Entrepreneur Of The Year award for Northern California.
• The Redwood Falls City Council (MN) approves the $50,000 purchase of Provation software for the Redwood Area Hospital. The hospital will interface the software with its Meditech EMR.
• Awarepoint is awarded a patent for its wireless interaction-based tracking system.
• MED3OOO announces the general availability of InteGreat V6.4, which includes the components required to meet Meaningful Use standards.
• University Hospitals Bristol NHS Foundation Trust implements Imprivata OneSign for its 5,100 users.
• Baylor Health Care System (TX) affirms its plans to implement GE Centricity EMR across its entire HealthTexas Provider Network of more than 500 physicians.
• Prime Healthcare Services (CA) expands its rollout of FormFast document management technology to its recently acquired facility, Alvarado Hospital.
• BridgeHead Software celebrates the 10th anniversary of its partnership with MEDITECH.
• Lakeland Healthcare (MI) selects the ChartMaxx Epic integration package to integrate their physicians’ ChartMaxx EMR with the health system’s Epic program.

Contacts

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

Monday Morning Update 5/23/11

From The PACS Designer: “Re: SlideRocket. Microsoft PowerPoint has been the dominate force in the presentation arena for business applications, but there are new ideas surfacing that could challenge their market share.  One is a Web-based application called SlideRocket, acquired by VMware last month. You can try it by importing an existing PowerPoint presentation to see what a Web-based format can do to enhance your creative abilities.”

From Little Birdie: “Re: [SVP name omitted]. Fired from Ingenix last week.” I’m leaving the name off since nobody likes seeing themselves in unflattering headlines, but the source is a good one.

From Lawdy Mama: “Re: Ford’s in-car medical monitoring. The target is much larger. Truckers include a large population of diabetics and, since they live on the road, have problems managing their disease. It can also be dangerous for diabetics to drive while suffering dizziness or other symptoms.” I’m always fascinated by trucker health since I talked to a guy once who runs a company that provides healthcare services from truck stops – it was truly fascinating to hear about their particular risk factors and the challenges of delivering healthcare services to them when every minute off the road costs them money. I guess I can see the value there, although Ford didn’t mention trucks in their announcement. As long as the built-in device doesn’t require drives to interact with it (or drivers exercise reasonable caution by pulling over when doing so), then there may be some medical value.

My Time Capsule editorial this time deals with missing clinical information, even in supposedly advanced IT systems. A snip: “I can think of only two reasons: (a) command and control is so fragmented within our episode-based system of revolving door specialists that everyone assumes that someone else is watching the big picture, or (b) providers are too busy to do anything more than patch and mend, buried in piles of disjointed facts that are difficult to comprehend and act upon.”

I got a nice e-mail that I need to anonymize quite a bit, but here’s the gist. The author said reading HIStalk for years taught him/her two major lessons that he/she will use directly in his/her new vendor leadership role: (a) move your products up the value chain via application and technology integration, and (b) if your product enhances expensive hospital information systems, then price it accordingly based on the value it delivers. The conclusion: “Your blog sure cut down my learning curve for many things healthcare. I thank Dr. Jayne the newcomer, Inga, and yourself for your commitment to the industry.” I really appreciate that.

CMS may not show a lot of confidence in providers, but the feeling is apparently mutual. New poll to your right, for providers: are you confident that your employer’s security practices will keep your medical records private?

I found this installment of Vince Ciotti’s HIStory to be his most interesting so far, in which he also mentions the EMR that’s 40 years old and still running today (and it’s not Meditech).

Welcome to new HIStalk Platinum Sponsor Kony Solutions of Orlando, FL. They help companies (more than 35 Fortune 500 ones, in fact) get their message out to every mobile device that’s out there, providing a highly configurable out-of-the-box solution that allow companies to put mobile-rich apps (smart phone, mobile web SMS, etc.) in the hands of consumers in as little as a few weeks and at a lower cost than any other solution. These are not cookie cutter templates. Healthcare examples of what they can do: generate outbreak alerts, manage appointments, do prescription refills, and create provider-finder apps. Like their ad says, just putting an iPhone app out there is missing a bunch of consumers who use other technologies. I interviewed Aaron Kaufman, VP of the company’s healthcare and life sciences solutions division, just a few weeks back. Thanks to Kony Solutions and Kony Healthcare for supporting HIStalk.

Thanks to the readers who sent over new Annals of Internal Medicine articles on RHIOs and EMRs. Talking points: (a) only 13 of 179 RHIOs reported that they could meet Stage 1 Meaningful Use requirements, and (b) two-thirds of RHIOs won’t survive financially once their grant money runs out. The RHIO article points out that it’s not surprising that RHIOs can’t wean themselves off the taxpayer teat since free-flowing HITECH money encourages them to start up, but nobody wants to pay for information exchange except for directly beneficial transactions such as lab results. It also mentions that RHIOs are being held back by low EHR adoption (the accompanying editorial says RHIOs struggle “in exactly the same way as a cable company would if no one owned television sets.”) Here’s all you need to know about the article, which comes from its summary: “No RHIO in the nation met our expert-derived criteria for the comprehensive HIE needed to substantially improve care quality and efficiency.” The article had some unintentional humor in the footnotes: the authors who concluded that RHIOs are pretty much a failure were, like the RHIOs themselves, supported by ONC grant money. Doh!

Even Epic’s contractors get big new buildings. The company working on Epic’s never-ending construction projects figure they’re never going to be finished at this rate, so they build a 22,000 square foot building to hold their 65 on-site professionals that oversee several hundred construction workers. The construction company says they will have up to 700 people on site next year as they ramp up work on Epicenter 2, a second on-campus Epic auditorium that will seat up to 13,000 people.

A book detailing the 2004 murder of Cerner nurse Julie Keown by her husband (he poisoned her Gatorade with antifreeze), has been published.

A study finds that hospitals are over-promoting their robotic surgery gadgets and, in 73% of their Web sites, are using word-for-word questionable information provided to them from the manufacturer who sold them the equipment. According to the Hopkins surgeon who led the study, “To me, this is exactly what is wrong with American health care.  We are adopting technology without being up front about the outcomes to consumers. And we adopt technology before we properly evaluate it.”

Bizarre lawsuit: a woman sues an Ohio hospital, claiming it mailed her picture of her premature baby who died there. She says she received 154 pictures of her dead baby propped into a variety of poses, including some of his body being held by an unknown hospital employee, even though the mother told the hospital she didn’t want pictures taken.

Sponsor Updates

• DIVURGENT’s latest newsletter addresses activation management. The ACO book by partner Colin Konschak is now available on Amazon.
• Practice Fusion is hiring at its San Francisco headquarters, looking for talent in account management, marketing, engineering, legal, customer engagement, and executive management.

E-mail Mr. H.

News 5/20/11

Top News

The UK’s National Audit Office (NAC) says that the billions spent so far on the country’s National Programme for IT has been poorly used and the project needs to be reassessed. The NAC concludes that the investments don’t represent value for the money and officials are not confident that spending more will be any different. The NAC believes the project’s core aim of having an electronic record for each patient will not be achieved.

Reader Comments

From Frank Mac Court: “Re: study on operational RHIOs. Here’s more information on the study.” Earlier this week, I mentioned the report that found only 13 of 75 operational RHIOs met the basic criteria for Meaningful Use. The information was collected in early 2010 and the authors admit that “data exchange could have accelerated in the interim.”  It’s likely that today there are more than 13 HIEs exchanging Meaningful Use-caliber data, though admittedly it’s still a pretty small club.

From Certs Two Mints in One: “Re: [vendor name omitted]. One of our sites is under siege by these folks, whose product holds only Modular EHR certification. They told the customer in writing that they ‘will be ONC-ATCB certified as a complete EHR for Meaningful use by July 1st, 2011.’ Vendors are supposed to be prohibited from pre-announcing their status and clearly they are saying something they can’t know is true. Maybe they failed and have made software changes that they assume will earn them certification.” That’s at least a poor choice of words – swapping ‘will’ with ‘hope to’ would have removed all grounds for complaints from either customers or the certifying body.

From Sarah: “Re: ONC and security awareness. If you heard and met some of the so-called IT consultants that standalone providers hired, you would think they needed some awareness. Many of the providers we deal with have IT people that can’t even set up a domain or workgroup correctly without leaving gaping security and permission holes, let alone manage security at a level we implement internally to protect their PHI. In some areas, the only option (no joke) is Geek Squad. They need step-by-step list for the techs and automated verification tools that providers can run themselves during annual security audits.” I think those are great ideas. Hospitals are reasonably good at basic security, but physician practices often don’t even know they need it, much less how to make it happen.

HIStalk Announcements and Requests

Listening: the just-released Rome from Danger Mouse, spaghetti western-style music mixed with a little R&B and played on vintage instruments (the keyboards are amazing) recorded straight to tape, some by the original musicians from The Good, the Bad, and the Ugly and similar movies. Mellow 60s hip with that shimmery, sharp, echoey movie soundtrack sound that makes you think that a guitar-carrying Claudine Longet could wander in looking wide-eyed and pensive in a mini-dress at any moment. Guest Norah Jones sounds sweet and Jack White is pretty good. If you’re in the right mood (and I’ll leave you to decide what that mood is), it’s transcendent.

This week on HIStalk Practice: the irreverent Joel Diamond, MD resurfaces and ponders what HIStalk would be like if it offered with some quaint, Andy Rooney-style observations. Don Michaels, PhD and VP of Hayes Management Consulting makes his premier on HIStalk Practice and offers tips to determine if one’s organization is ready for an ACO. Julie McGovern with Practice Wise shares insight into the high quality talent to be found in the country’s HIT programs. Massachusetts governor Deval Patrick helps eClinicalWorks celebrate the opening of its new office. Computer trumps doctors in detecting acromegaly. The AMA Board of Trustees argues against EMR standardization, claiming it would stifle product innovation. Participants in an ACO demonstration project contend that CMS’s proposed ACO framework is too risky. While you are paying a visit to HIStalk Practice, check out some the Web sites of some of our sponsors and learn more about their nifty products and services.

On the sponsor-only Jobs Page: Program Manager, Data Implementation Engineer, Healthcare Informatics Analyst, Systems Engineer. On Healthcare IT Jobs: Clinical Nurse Analyst, Regional Business Development Manager, Clinical Project Manager, Director Technical Infrastructure, Allscripts Report Writer.  

I had a routine doctor’s office visit this week. I observed perhaps 10-12 employees of the university-owned practice as I waited my turn, ranging from the front desk people to assistants to nurses. Every single one of them, other than my doctor, were somewhere between significantly to massively overweight, while all the patients in the waiting room were pretty much of normal size. I wondered how effective those employees are at convincing patients to change their dietary and exercise habits? That reminded me of the two respiratory therapists I’ve known who smoked constantly, with their cigarette packs prominently sticking out of their shirt pockets as they counseled patients on good pulmonary health. Healthcare is a funny business.

Acquisitions, Funding, Business, and Stock

Israel press reports that Reed Elsevier is in talks to buy Israel-headquartered dbMotion for $250-$300 million. dbMotion officially told me they could not comment. In February, dbMotion and Elsevier announced a partnership to integrate Elsevier’s analytics solutions into dbMotion’s interoperability platform.

Proof that Irrational Exuberance II is upon us even amidst a recession and smothering national debt, only this time limited to just a handful of darling companies. LinkedIn share prices more than doubled in their first day of trading Thursday, opening on the high end of their range at $45 and closing at $94.25. That values the company, which lost money for years until finally eking out a $15 million profit last year, at almost $9 billion. Hopefully the huge ranks of the unemployed will somehow benefit from the trickle-down effect of millionaire secretaries and trade-in VC wives buying Ferraris and McMansions. I hate everything about LinkedIn except that just about everyone is on it.

People

   

HIMSS runs a bio and interview of its 1990s CEO John Page. Interesting: he says his greatest achievement was splitting HIMSS off from AHA, which he said was essential for its survival. He also mention his greatest challenge – trying not to disenfranchise the management engineers that formed HIMSS as the IT side of the house started invading and eventually pushed them out like greedy European settlers marching red-skinned Americans off their land and into concentration camps called “reservations.” It must be lonely being among the tiny ranks of folks making up the MS part of HIMSS.

Announcements and Implementations

Detroit Medical Center anticipates receiving $40 million in Meaningful Use incentives, including $16-$17 million this year.  Meanwhile, Beaumont Hospitals is planning for $26 million, including $10.3 million this year.

Verizon Wireless and Medco Health Solutions release a mobile app to guide patients and doctors to the lowest cost prescription drug. The app gives information on out-of-pocket costs and lower cost options, based on a patient’s specific insurance plan.

Ford will expand its Sync in-car automation to create “the car that cares,” planning to roll out allergy alerts and connected medical devices to monitor blood sugar with the help of its partners Medtronic, WellDoc, and SDI. I don’t get the point, not to mention that the last thing we need is a bunch more marginally skilled drivers screwing around with yet another electronic device instead of paying attention to the road. Maybe Ford can add monitors for bladder distension and grumbling stomachs and fund the whole project by running GPS-localized restaurant and gas station ads.

Government and Politics

CMS announces that the first Medicare EHR incentive payments will be issued this week. Greenway Medical says their client Childs Medical Clinic (AL) was among the first to receive funds Thursday, as was Cerner client Dr. Juan Salazar (TX).

Innovation and Research

An upcoming study in an economics journal claims that higher usage of EMRs would save a lot of babies. You can guess what they did: combined old (2006) data from several sources that include that of HIMSS Analytics, taking a guess at when those systems went live (since HIMSS Analytics reports products bought but not yet installed), did some kind of county-level breakdown, and found that EMRS are “associated” with lower infant mortality (leading to the dramatic title, “Can Healthcare IT Save Babies?”, that in my mind is a question left unanswered.) I would have been more convinced had they looked at infant mortality at individual hospitals pre- and post-EMR, also ruling out related OB-specific systems that don’t really require EMRs. I don’t doubt that hospitals with the ambition and money to buy EMRs may well have better outcomes with newborns (possibly because they aren’t usually in poor, inner city neighborhoods), but its a stretch to say it was the EMR itself that made them better (or to assume, even with everybody and his brother installing EMRs, that we’ll be seeing a drop in infant mortality anytime soon). It’s a free PDF download if someone wants to critique it in more detail.

Other

Officials with Saint Elizabeth Regional Medical Center (NE) say they will hold off on plans to form an ACO, following the release of proposed ACO rules. The hospital fears potential financial risks may not be sufficient to cover high initial investment costs, including IT-related expenses.

KLAS looks at partial and extensive IT outsourcing and concludes that CareTech, Dell, and Siemens rank high in both categories. CTGHS topped all firms for partial IT outsourcing and CareTech led for extensive IT outsourcing.

In the under-200-bed community hospital market, 80% of organizations report confidence in their vendor’s ability to ultimately satisfy Meaningful Use requirements. The other 20% are looking to replace their vendor. All of the Cerner clients participating in this KLAS survey expressed confidence in Cerner’s ability to meet Meaningful Use; at least three customers from each of the other seven vendors felt achieving Meaningful Use with their current vendor would be a long shot or probably won’t happen.

Weird News Andy likes this quote about NPfIT from UK MP Richard Bacon: “This turkey will never fly and it is time the Department of Health faced reality and channelled the remaining funds into something useful that will actually benefit patients. The largest civilian IT project in the world has failed.”

A NEJM editorial says the provider payment system based on CPT and E&M codes forces EMR vendors to modify their programs to create reams of repetitive and clinically worthless documentation instead of doing something useful, like improving clinical decision support. It points out that payments encourage upcoding and over-documenting, but nobody has come up with a better alternative.

Alan Cremer, founder and acting CEO of drug database search application vendor IntelliDex, e-mailed to ask me to mention that he’s looking for a president and CEO for the company. If you have startup leadership experience, preferably in a medical informatics company, check out the job description and consider throwing your hat into the ring.

Sponsor Updates

• iSirona demonstrated its integration technology at last month’s Vision User conference in Salt Lake City. The company used its software to upload patient vitals from a Stryker Bed InTouch and a Fukuda Denshi bedside monitor, which were then verified and uploaded into the Siemens clinical suite.
• H/P Technologies, which provides staffing and consulting for all Meditech modules, will exhibit at MUSE May 31–June 3 in Nashville.
• The MSO Mississippi Health Partners selects RelayHealth to provide health information exchange for its 800 physicians and 13 hospital members.
• ESD hires Dan Oberle as VP of business development. His previous employers include Santa Rosa Consulting, CTG, and ACS.
• Orion Health and NextGate partner to include NextGate’s  MatchMetrix EMPI and Provider Registry products in the Orion Health HIE solution.
• Dossia partners with Health Language Inc. to embed HLI’s language engine into the Dossia Health Management System.
• API Healthcare announces that it achieved its highest number of deployments ever during the first quarter of 2011.
• Ovum, part of Wolters Kluwer Health, introduces OvidMD, a clinical tool that incorporates medical research with Wolters Kluwer’s UpToDate resource tools.
• Children’s Hospital of Orange County (CA) selects MobileMD to provide HIE services to its 800 physicians and 1,000 referring physicians.
• Healthcare Innovative Solutions co-sponsors a Victoria Era fashion show, which raised over $1,000 for the Seville Food Pantry (OH).
• Hayes Management Consulting unveils a partnership with The Coding Network to provide audit and remediation services to physician practices using MDauditComplete.
• Capario says it is now processing inbound 5010 claims (Errata version) and providing 5010 ERAs with submitters.
• Sage SVP Tony Ryzinski offers up 10 areas for improvement when managing the revenue cycle.

EPtalk by Dr. Jayne

WebMD reports this week that even mild exercise with the Wii Fit game can improve fitness for COPD patients. Big surprise: patients are more likely to stick with exercising at home if it’s fun. I have to admit, the Wii is one of my guilty pleasures and its price point is more realistic for people than some of the other game consoles. If it gets people off the couch for even 10 or 15 minutes a day, I say go for it — although I’m not sure I want to know what my blood pressure looked like when I was trying to find the last three i-points on Island Flyover. But then again, there’s something therapeutic about crashing your biplane into the ocean repeatedly after a long day listening to physicians complain about computers.

I keep getting e-mails from the American Medical Association about their AMAGINE physician portal ,which “offers a low-cost approach to meet the needs of your practice and achieve each level of meaningful use.” If you’re a provider or someone who works closely with a provider, have you checked this out yet? I’d be interested to hear what you think. Featured products on the site when I stopped by included NextGen, Ingenix CareTracker, and Care360 EHR.

I’m still a bit in awe of being a minor Internet celebrity. I wonder if Centers for Disease Control spokesman Dave Daigle was ready for his brush with fame? The normally sleepy Public Health Matters blog featured a new topic this week: Preparedness 101: Zombie Apocalypse. The site has been so popular after being named a Twitter “Top Tweet” that it’s intermittently crashing, so be patient. I’m not sure of the specific impact of zombie apocalypse on IT infrastructure (my medical training was more in dealing with the brain-eating aspects of zombie behavior) but it’s always good to be prepared and make sure you have a disaster plan for each of your critical systems. If anyone has a good zombie preparedness checklist for enterprise EHRs, please share!

I agree with Inga, it was feeling like a bit of a slow news week, at least until I came across this headline: Don’t forget! Your computer job is still killing you. Based on the multitude of upgrades our organization has to complete in order to be ready for Meaningful Use attestation, I was sure the author had been following me around. I’m not sure about their level of medical fact-checking, but I do like their graphics. It’s a good reminder for those of us who have traded walking the clinical halls of academic medicine for a more desk-jockey lifestyle that we need to get up and move.

Finally, having spent some time attending a renowned Southern institution famous for matriculating Mrs. degree candidates, I learned that there are a few things that aren’t fit for discussion in mixed company if one wants to catch a good husband. Since I’ve turned into a grizzled IT veteran (although I do know how to identify a fish fork and exactly how to use it) I’m going to break that rule today. Last November, Mr. H mentioned a UK team that was working on a smart phone app that would instantly diagnose sexually transmitted diseases after urine or saliva was … ahem … applied to a chip that would then be attached to the phone, leading to a quick diagnosis. It seems this product will have an expanded target market after June 1 since Apple has approved a “prostitution-friendly” app aimed at pairing “sugar daddies” with willing companions. I was going to say something pithy about Adam, Eve, and an Apple until I read further to find it’s compatible with Android and BlackBerry devices as well. Instead, to the App Store, I say — “well bless your little heart.”

Contacts

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

News 5/18/11

Top News

HHS’s Office of Inspector General spanks its fellow agency ONC for pushing interoperability without mandating security controls or encouraging standards. Examples of what it wants to see: requiring portable media to be encrypted, requiring two-factor authentication for remote access to PHI-containing systems, and mandating timely OS patch application and antivirus updates. OIG based this work on a previous project that looked at providers, in which it found unsecured wireless networks, lack of application vendor support for OS-level changes, poor antivirus practices, lack of event logging, allowing shared user accounts, and giving too many users administrative rights over their PCs.

ONC’s response to this report: (a) we turfed security work off to HITSP and incorporated some of its specs as HHS policy and in EHR certification requirements; (b) Stage 1 of Meaningful Use requires providers to fix their own security problems; (c) our job is to convince providers to use EHRs and we will worry about security later in the process; (d) our chief privacy officer is drafting a plan. It sounds to me like the typical external auditor’s report: their job is to find stuff to make sure you keep hiring them, while yours as the IT shop is to balance their sometimes ivory tower observations with your own realities. My only takeaway is that ONC should spend some of its billions to push security awareness, which you would think highly paid hospital and vendor IT people wouldn’t need, but apparently they do.

Reader Comments

From Mia: “Re: CompuGroup. Big layoffs at Noteworthy Medical (last week, I think) and other of their companies. Will be interesting to see how many of the 420 ONC-ATCB certified EHR companies are around five years from now.” Unverified.

From CPOE Zealot: “Re: medication error. Incidents such as these give CPOE a bad rap.” The parents of a five-week-old premature baby who died after being given 60 times the ordered dose of IV sodium chloride sue Advocate Lutheran General Hospital (IL) for wrongful death. Like most fatal medication errors, CPOE was a non-factor here: — most in-hospital medication error deaths are caused by incorrect IV preparation or administration. In addition, the doctor ordered stat labs and then a re-test after getting a high sodium level back, but nobody drew it, leaving the baby on the hyper-concentrated fluid for 20 hours. There is one good reason CPOE gets a bad rap in cases like these, though: vendors sell and hospitals buy the seemingly logical argument that CPOE prevents patient harm, when what it mostly does is prevent lots of errors that were being caught anyway (like poor handwriting, in which somebody just calls the doctor for clarification). The risk of harm doesn’t change much unless you work at the sharp end of the stick where EHRs fear to tread – medication preparation and administration. The best IT systems in existence (including bedside bar-code checking) couldn’t have saved this baby’s life when hospital employees, despite experience and best intentions, are just as prone to distraction and carelessness as the rest of us humans, especially when they are overwhelmed and tired (sometimes because their peers were laid off to help pay for CPOE systems).

From Wireless Observer: “Re: Cerner. Word on the street is that Cerner is getting ready to announce some big organizational changes and these are not good kind of changes for the employees (may be good for Wall Street, however). This is supposed to hit the CareAware division pretty hard.” Unverified. CareAware is Cerner’s solution for connecting medical devices to EMRs (video above).

Acquisitions, Funding, Business, and Stock

FairWarning will hire 70 employees over the next 24 months.

Salt Lake City-based MediConnect Global announces plans to hire 100 employees across multiple departments.

Cerner names SenSage its “Accelerate Partner of the Year” for demonstrating speed to value for Cerner and its customers. SenSage also an expanded alliance with Cerner to offer a SaaS-based version of P2Sentinel, Cerner’s enterprise clinical system auditing program.

CareCloud partners with Xpress Technologies to launch a combined EMR/PM solution for urgent care facilities and hospital ERs.

Sales

Sharkey Issaquena Community Hospital (MS) selects Custom Software Systems ChartSmart EMR.

Onslow Memorial Hospital (FL) contracts with Language Access Network  to provide hospital video language interpretation services.

People

 

Awarepoint names Ralph Keiser (MedeAnalytics) EVP of sales and Jaime Ojeda (PCTS) EVP of marketing and business development.

Government and Politics

CMS announces plans to release applications for “mature ACOs” interested in participating in its new Pioneer ACO Model and taking part in shared savings. CMS is also seeking input on the idea of an Advance Payment ACO Model, which would give certain ACOs access to their shared savings up front so they could build the required infrastructure. For providers wanting to learn more about ACOs, CMS is offering four free Accelerated Development Learning Sessions beginning in June.

Innovation and Research

Of the 75 operational RHIOs in the US, only 13 meet the basic criteria for Meaningful Use (e-prescribing, clinical data exchange, quality reporting) according to Harvard researchers. I don’t have access to the study, but apparently the findings are based on data from 2009 (so old they use the term RHIOs, apparently). Surely there’s been some improvement since 2009. If you’ve seen the full report, please share your insights.

JAMA reports that the use of telemedicine in ICUs reduces mortality rates and length of stay.

The New Zealand government awards a $252K grant to Vensa Health to conduct further research related to its mobile health reminder system. The company recites an impressive list of technology features, but like just about every mobile health vendor, they have no evidence showing that their product is effective in improving health. Like Bill Gates told me at lunch once (well, OK, me and a huge ballroom full of people at the mHealth Summit), reminders and education don’t necessarily work when it comes to wellness – plenty of fat people own bathroom scales.

Other

I got another “urgent news” e-mail blast today from one of the rags that reinforces my argument that most industry publications either (a) can’t distinguish real news from press releases, or (b) don’t care as long as it draws readers and advertisers. Today’s hot news: a bond rating agency issued a press release claiming their study correlated use of advanced IT to hospital profitability and quality. I downloaded the “special report” from Fitch Ratings and it was, as I expected, not worth the excitement, being even less methodical (and therefore even less useful) than the Most Wired survey. Here’s a summary.

• The bond ratings company looked at only the 291 hospitals that use its services. That’s out of maybe 6,000 US hospitals – a tiny, non-randomized, non-representative sample that excludes for-profit and government facilities.
• They checked Leapfrog, Baldrige, and Healthgrades and found that 75 of their clients had won a quality award (all awards are created equal in drawing room studies like this that just match Readily Available Data Set A with Readily Available Data Set B).
• They checked with HIMSS Analytics and found that 24 were at EMRAM Stages 6/7 (ignoring all other forms of IT except inpatient clinical).
• Apparently disappointed to find that only 12 of the 24 EMRAM 6/7 hospitals had won quality awards, they invented an excuse related to “the evolution and maturation of how quality is measured.” (maybe that should have been the headline – that half the hospitals who reached IT Nirvana haven’t won even one major quality award as a result).
• They found that richer hospitals won more quality awards and had more IT (neither of which necessarily has anything to do with patient outcomes).
• They looked at utilization trends and concluded that higher IT hospitals (meaning richer ones) are improving, although they did not look at their absolute performance (meaning a hospital could still be terrible as long as it’s less terrible than before).
• The bottom line: even if the bond ratings firm had conclusively proved any kind of relevant correlation (which they most definitely did not), that still wouldn’t have proved causation. The implicit message in running this yawner of a study as real news is that everybody now has the justification to buy more IT, which is an absurd conclusion for an industry that somewhere down deep is supposedly based on science.

Speaking of questionable studies, here’s another one: do seven percent of doctors really use video chat in patient care? I’m not interested enough to buy the company’s report to evaluate its methodology, but I would have to bet that they surveyed a disproportionate number of telemedicine physicians or tele-ICU intensivists. Most docs won’t even e-mail patients, much less fire up a Skype session for a leisurely and probably unreimbursed Webcam chat.

Quality IT Partners, Inc. announces its Facebook launch featuring a dedication to the Scott Hamilton Cares Initiative, including a song and video written and produced by the company.

Sponsor Updates

• Sonoma Valley Hospital (CA) picks ProVation Order Sets.
• BridgeHead Software will exhibit at the 2011 International MUSE Conference May 31-June 3 in Nashville.
• Emdeon introduces Emdeon Audit Advantage, which will provide real-time prescriber eligibility and patient coverage alerts to pharmacies. The company also wins a five-year GSA contract that allows it to offer products to  over 90 government entities.
• Healthwise Patient Education EMR module earns ONC-ATCB certification.
• Imprivata announces GA of OneSign Anywhere for authentication and single sign-on for remote and mobile users.
• Delta Health Alliance, one of the country’s 17 Beacon Health communities, collaborates with Medicity to connect participating physicians and hospitals.
• Daughters of Charity Health System (CA) expands its partnership with Passport Health Communications and adds three additional RCM solutions from Passport’s eCare Patient Access Suite.
• McKesson medical director David K. Nace, MD is named first vice chairman of the board of directors of the Patient-Centered Primary Care Collaborative.
• Practice Fusion says it has grown from a team of four in 2007 to 75 today. The company is expects to reach 150 employees by the end of the year and is seeking new office space.
• MyHealthDirect assumes a silver-level sponsorship for the 19th Annual Medicaid Managed Care Congress this week in Baltimore. CEO Jay Mason will also participate in a panel discussion on ACOs and patient-centered medical homes.
• API Healthcare publishes a whitepaper entitled Achieving Quality of Care and Controlling Costs, which includes best practices for workforce automation.
• Concerro creates a Mac versus PC parody that compares healthcare scheduling solutions with paper-based systems.
• The City of Philadelphia selects eClinicalWorks to provide an EHR/PM solution for the Department of Public Health, which includes 230 providers and 20 primary care and correctional clinics.
• JEMS Technology announces a rental program that allows hospitals to provide smart phone video consultation capabilities (JEMS Consults) to their physicians starting at under $1,000 per month.
  

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Contacts

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