News 7/21/10

From News This Week: “Re: sale. One of your quoted CEOs will announce the sale of his company on Wednesday and hold an all-employee meeting on Thursday. A solid acquisition that will give the company extensibility internationally, although you will scratch your head for 3-4 months on what the purchaser is doing until the strategy emerges over the fall of 2010.” That’s Picis, I assume, although I don’t have solid information on the acquirer if it’s them (one reader says Ingenix, another says it’s a less obvious but unnamed player).

From Htx: “Re: Tim Thompson, CIO at The Methodist Hospital of Houston. He’s leaving to return to Florida.” Unverified. UPDATE: verified – he will be announced as the new CIO of BayCare (FL), Lindsey Jarrell’s old job.

From Cabrini Green: “Re: HIMSS Analytics Europe. HIMSS Analytics staff visited Germany to meet their new colleagues. The picture is funny — it looks like Steve Lieber and Jeremy Bonfini are holding hands.” It does, even though they aren’t.

From Elsie EHR: “Re: IBM. Who remembers ten years ago when IBM (along with Pfizer and Microsoft) sunk a chunk of change into an EMR called Amicore? Amicore was acquired by Misys in 2006, and of course Misys was acquired by Allscripts last year, which will merge with Eclipsys this year. Golly, I can hardly keep my dance card straight!”

Also from Elsie EHR: “Re: Aprima, formerly iMedica. I wonder if they will go after the Allscripts MyWay customers since MyWay and Aprima are the exact same product?” Careful … I don’t have confirmation on the rumor that Allscripts will sunset MyWay in 2012, so I assume it’s not true. Also, just to clarify, MyWay was the same product as Aprima only when that deal was originally signed in August 2007 (see my interview with Michael Nissenbaum, president and CEO, for more background). Since then, Aprima has continued to develop and sell the product separately from Allscripts, so they are no longer the same product even though much of their DNA is identical.

From UK Horlicks: “Re: British Medical Association. It has recognized Horlicks, the drink for HIT, with the slogan, ‘A drink other than Kool-Aid for HIT.” BMA demands that the government suspend access to Summary Care Records, saying it is unreliable since doctors aren’t keeping the uploaded patient records current.

From Anesthete: “Re: University of Michigan Hospitals. Recently signed with Epic to provide enterprise clinicals and financials in a plan to achieve MU.” Unverified. I mentioned that Hurley, which is affiliated with UM, had signed on, but that’s all I know. UM used to have a homegrown system that someone was trying to sell as I recall, but I never heard much about it.

From Zooey Rice: “Re: Amalga. A user of the Microsoft Amalga HIS says the company will exit the HIS market to concentrate on other things, like HealthVault or UIS. Love reading you every morning — smells like … victory.” Verified. Microsoft will announce Friday that its Health Solutions Group will discontinue sales and development of Amalga HIS to focus on Amalga Unified Intelligence System (the former Azyxxi). I didn’t really understand why they bought it in the first place considering it was a Thailand-based product with one notable customer, medical tourism hospital Bumrungrad International in Bangkok. Hanging the Amalga name on it was just plain confusing since in the US, Amalga was just the former Azyxxi product. My comment in 2007: “I don’t know why Microsoft wants to be in this business either, although maybe Azyxxi needs a little brother.” More from the company:

Amalga HIS, based on technology acquired from Global Care Solutions in 2007, is a traditional hospital information system designed to address all of a hospital’s transactional and reporting needs. Working with customers over the past three years, we’ve learned that an all-encompassing solution is not optimal for meeting the varied and dynamic needs of health organizations around the world. As a result, this approach is not well aligned to Microsoft’s broader health IT strategy moving forward. We will continue to develop and sell a RIS/PACS solution based on Amalga HIS and will look at other opportunities to leverage Amalga HIS functionality on the Amalga UIS platform.

HSG will continue to support our customers’ use of Amalga HIS through sustained engineering and support services for at least five years. We are working with each Amalga HIS customer to address their short and longer-term needs – moving them forward to HIS version 6.0 or identifying partner solutions that, together with Amalga UIS, could meet their requirements. Amalga UIS, based on the Azyxxi technology, is a highly flexible solution that enables healthcare organizations to reengineer workflows and get information to professionals when and where they need it.

From Cassie: “Re: St. Luke’s Health System in Boise. They’ve had a data breach in which a significant number of employee records, including SSNs, have gone missing. They are trying to squash the news report, especially given the other recent news from them.” Verified, but it wasn’t the health system’s fault. Mercer, the HR consulting people, loses a St. Luke’s backup tape when moving to a new office. St. Luke’s was in the news last week when its data center lost power, forcing clinicians back to paper.

Listening: Built to Spill, Boise-based, mature, Northwest-style indie rock.

Allscripts’ Q4 numbers: revenue up 14%, EPS $0.10 vs. $0.09, guiding up. The company beat expectations on both revenue and earnings for the quarter, but fell just short on consensus yearly revenue. CORRECTION: Allscripts actually slightly beat yearly revenue expectations – it was the company’s 2011 guidance that came in slightly low in the range of expectations, an announced $780 to $790 million vs. estimates of $787 million. All of these numbers exclude the impact of the Eclipsys acquisition. The conference call transcript is here.

Apple’s Q3 numbers: revenue up 61%, EPS $3.51 vs. $2.01, handily beating estimates. The company sold 3.3 million iPads, 9.4 million iPods, 8.4 million iPhones, and 3.5 million Macs in the quarter. Market cap is $229 billion, $6 billion more than Microsoft, and shares are naturally up on after-hours trading.

Iowa’s HITREC names e-MDs as a preferred EHR vendor.

ONCHIT is looking for a policy analyst to focus on consumer e-health.

Weird News Andy is reduced to puns in describing medical technology put to a seedy use — MRIs of food. Obviously fixated, he adds, “The one I found most interesting was the watermelon. The way the seed groups spiral puts to rest my sleepless nights wondering about their seemingly random distribution.”

HCA Midwest names Sarah Bloom as CIO.

Kingman Regional Medical Center (AZ) chooses SIS for periop.

Another backup tape mishap: South Shore Hospital (MA) determines that backups with 800,000 patient records were lost by the shipper on their way to destruction.

Epocrates files for a $75 million IPO, the same amount it planned to raise in its aborted 2008 attempt. Sales are at $100 million, but the company lost money in the most recent quarter. It plans to bring out some kind of EMR application for small practices this year.

Confirmed, thanks to a reader’s forwarded company e-mail: Kate Kervin joins NextGen as  SVP of marketing and product management, leaving Siemens. Brad Block of IBM (and former Doylestown Hospital CIO) is hired as VP of NextGen Consulting.

Minneapolis-based HealthPartners will use a mobile healthcare communications platform from Toronto-based Diversinet, starting with a two-way secure messaging system for discharged patients with chronic illness and women with high-risk pregnancies.

New Hanover Regional Medical Center (NC) chooses Perceptive Software’s ImageNow for scanning and approval of invoices, integrated with Lawson.

SAP partners with a consulting firm to develop financial and logistics applications for under-400-bed hospitals.

Jersey City Medical Center (NJ) rolls out the Isabel diagnostic checklist system.

Iron Mountain announces its EMR Enablement Solution to help hospitals organize and digitize paper records. It sounds like a marketing repackaging of existing offerings.

Small practice EMR vendor Patagonia Health gets a startup grant from a technology accelerator in its home state of North Carolina. Its product went GA on March 31. Former Misys software director Ashok Mathur is a co-founder.

This fun article profiles some doctors who write medical smart phone apps.

MedPATH Networks announces a marketing agreement with a digital rights vendor to commercialize security technologies that are used for military EMRs, including a secure information exchange based on NHIN standards. I haven’t heard of any of this, but it sounds interesting.

E-mail me.

HERtalk by Inga

HIMSS names three additional finalists for the Davies Awards, including Open Door Family Medical Center (NY) in the Community Health Organization category and Sentara Healthcare (VA) and Nemours (DE) in the Organizational category.

Beaufort Memorial Hospital (SC) says the installation of MEDHOST in its ED increased gross revenues by $1.3 million increase and saved $240,000 annually by replacing dictation with electronic charting. And, Tenet Healthcare has contracted with MEDHOST to add the Care Clock application, which enables hospitals to automatically post current ED wait times to their Web sites.

New from KLAS: a report on homecare finds that three of the top four rated homecare systems are sold by best-of-breed vendors. The top-rated vendors were Homecare Homebase, Delta, and CareAnyware. Meanwhile, Meditech clients find that PTcT is outdated and difficult to use, with 40% saying they’re considering a switch.

HHS wants to use ARRA money to develop a national inventory of research on the most effective treatments and medical interventions. The information would be available as a searchable online tool for physicians and the public.

Huntington Memorial Hospital (CA) selects the Allscripts Community Solution to power its HIE. The Community Record solution is powered by dbMotion. Centra (VA) also plans to implement the Community Exchange platform as well as provide Allscripts EHR for 70 staff and affiliated providers and Allscripts Homecare for its home health nurses.

Globally, wi-fi technology in healthcare grew 60% last year. The US healthcare market will add more than 500,000 additional networks this year, representing a 50% jump over last year.

Giant Mr. Whale has apparently found a new home at Epic’s headquarters, according to the artist. He (Mr. Whale) looks like a happy guy. The artist has a link on his Web site to more attractions on the Epic campus. I think my favorite is the subway.

ITalagen and Medificiency form a partnership to promote a physician practice solution that includes Allscripts EHR and ITegen’s medical billing services and IT support.

No surprise here: an survey finds that EHR implementations are the top priority among the HIT crowd, with 85% saying they are in the  midst of an EHR project or plan to start one within 18 months. More surprising: of the 110 professionals surveyed, 13% reported using Epic, 11%  Cerner, and 8% Siemens. How “random” are these results if Meditech or McKesson weren’t named?

I must ask Matt Holt if this qualifies as Health 2.0. A 64-year-old Pennsylvania woman avoids dialysis after finding a donor kidney via Facebook, getting 197 responses to her plea.

Philips Healthcare’s second-quarter sales were up 4% over last year and second quarter earnings were $280 million, compared to $198 million. CFO Pierre-Jean Sivignon said the US healthcare market was “bouncing back” after a period of financial crisis and regulatory uncertainty.

E-mail Inga.

Monday Morning Update 7/19/10

From Friend of Tim: “Re: Yale New Haven. They’ve signed with Epic and the CIO is out.” Verified. Health system SVP/CIO Mark Andersen confirms that YNHH signed a contract with Epic this week (no surprise there – I said months ago that they were going Epic if they could find the money and Mark confirmed). They just brought up Eclipsys Sunrise CPOE and pharmacy a couple of years ago and were also running nurse and physician documentation, so Eclipsys loses a high-profile customer. With the Epic deal done, Mark will be leaving in a couple of weeks after 13 years there. He’s always been gracious and quick in responding to my questions. I wish him the best.

From CP Uh-Oh: “Re: Chicago CPOE error detailed in a Friday happy hour e-mail blast.” The purported e-mail from a Chicago hospital radiologist:

We have discovered a systems issue that may convert CPOE orders for CT examinations without IV contrast into CT examinations with IV contrast in Radiant. I have asked all Radiology Faculty and trainees to be particularly cautious in protocoling CT contrast examinations, and would like to enlist your assistance in carefully checking contrast CT orders. In addition, until the problem is solved, it would be prudent to call CT to verify that contrast will not be administered to at risk patients. Your support is appreciated.

From CPAhole: “Re: Allscripts MyWay. I heard they’ve said they won’t support ICD-10 in MyWay since it will be sunsetted in 2012.” Unverified. I’ll be incognito at the Allscripts user meeting August 5-7, so if I don’t hear anything before then, I’m sure I will there in Las Vegas. Inga and I speculated when the merger was announced that MyWay was the square peg in a round hole, but we were just guessing then, too.

From A Once-Burned Skeptic: “Re: IBM’s $100 million healthcare investment. This strikes me as funny. Didn’t IBM invest roughly the same amount a few years ago by buying Healthlink, which had doctors and nurses focusing on healthcare transformation? If IBM would have simply retained the talent they had from that acquisition, they would be well positioned to do exactly this right now. Call me a skeptic on IBM’s interest in healthcare.” Everyone should be skeptical since companies like IBM and Oracle are always immersing themselves in healthcare for a couple of years, then losing interest after spending a ton of money with little to show for it. IBM couldn’t keep Kaiser as a customer for its expensive custom software development once Epic got traction, blowing through $400 million of Kaiser’s endless fortunes before they were replaced with Epic for $2-4 billion. I’m not sure how its $400 million deal with UPMC turned out. Healthcare IT is one of those things that seems to work backward from nearly every other product: the bigger and more diversified the company selling it, the less impressive the result.

HIStalk readers would have voted Don Berwick into his CMS administrator job given the chance, but only barely. New poll to your right: are the final Meaningful Use requirements for providers too easy, too hard, or about right?

Ed Marx has added his responses to your comments on his Strategic Plans – Getting to 2.0 post from last week. Want him to write about something specific? He would be pleased to hear from you.

CapSite will announce Monday that Saint Like’s Health System (MO) has subscribed to its service, which offers line-item pricing breakdowns from healthcare IT contracts and proposals in 60 categories.

Everybody, me included, is sick of hearing about Meaningful Use now that the regs are final. I think a few more practices in the 1-5 doc range might be interested with the bar lowered a bit, but I’d still bet most of them will run the numbers and pass, at least for now. The final MU requirements, as flexible and less demanding as they may be, still aren’t worth meeting in strictly financial terms, so that means hospitals, large practices, and tech-savvy small practices will get most of the checks. The great majority of practices and hospitals are small (1-5 docs and <100 beds, respectively) and I expect they’ll look at the ambitious timeline, the cost, and the stress on already-stressed doctors and simply say no to Uncle’s strings-attached cash (I’ve always called that my “Free Kittens” theory). We’ll see how accurate all those surveys have been that claimed the only thing holding docs up was upfront EMR cost.

Another new Epic site: Hurley Medical Center (MI).

Apple’s response to its embarrassing Antennagate iPhone 4 problems have been quite un-Apple like. I can imagine an HIT vendor faced with angry customer backlash over a CPOE bug reacting the same way in sequence: (a) it’s your fault for using our product incorrectly; (b) it’s actually not a problem, but a minor bug that makes it look like one and we’ll fix that eventually; (c) we’re not really sure if it’s a problem, but the best option is for you to spend your own time and money adding on a third-party solution; (d) OK, it might really be a problem, but it hasn’t been reported much, so it’s not a big deal; and (e) OK, it’s definitely a problem, but it’s the entire industry and not just us and everybody needs to do a better job.

GE’s Q2 numbers: revenue down 4%, EPS $0.30 vs. $0.27. Jeff Immelt says healthcare orders, along with oil and gas, were “particular bright spots.” GE Healthcare’s revenue and profit were up, at $4.1 billion and $661 million, respectively.

Verizon announces the Verizon Health Information Exchange, offering a clinical dashboard, patient index, and secure messaging. The MedVirginia RHIO has signed on, presumably meaning that its original (struggling) vendor Wellogic is out. Verizon’s offering runs on the Oracle Healthcare Transaction Base, which I thought had fizzled out years ago after the usual big splash followed by corporate indifference. Just in case it isn’t obvious, Verizon’s healthcare interest surged recently when taxpayer wealth was redistributed to make it more lucrative. Since HITECH, the company has announced services for security, telehealth, and physician data sharing.

A fun story: the guy responsible for killing a proposed Anthem Blue Cross 39% medical insurance rate increase in California is a work-from-home actuary who did part of his analysis from a hospital bed. California law requires the state to accept insurance rate hikes as long as the company proves it’s spending 70% of the premiums to pay medical claims (obviously that idea contains endless misaligned incentives that help keep healthcare costs rising). Hired by the state to double-check the insurance company’s numbers, the actuary found obscure mistakes in some of its inflation projections. Anthem and its corporate parent WellPoint claim appreciation for his diligence and express their relief in being able to hit the state up for less money (anybody buying that?) They resubmitted an increase request for half the original amount and then tried to hire him. A consumer group said, “He slew the giant. It was David versus Goliath, except David was armed with a calculator rather than a slingshot.” His tiny company also offers hospital services, including provider contracting and medical management reviews.

More only-in-California goofiness: 1,000 nursing union members picket the $3 million house of billionaire Meg Whitman, former eBay CEO and current candidate for governor. They’re upset at her promises to cut the state’s budget (including their pensions) even though it’s running a $20 billion deficit. She’s even in the polls with Jerry Brown even though she’s never held office and doesn’t even vote all the time. She’s spending up to $120 million of her own money to gain the seat.

St. Luke’s Health System (ID) loses power for 24 hours, forcing it to go to paper when its backup power systems also fail. My experience with backup generators is about the same as with data backups: they work about 80% of the time, which means IT is going to look really stupid in 20% of the unexpected disasters.

E-mail me.

News 7/16/10

From Lumpy Rutherford: “Re: Kate Kervin. Moved from Siemens to NextGen as SVP of marketing and project management, started this past Monday.” Unverified. Neither her LinkedIn profile or the NextGen executive page says so, but that doesn’t mean much.

Listening: Margot and the Nuclear So and So’s, polished, sweeping indie rock (or Indy rock, since that’s where they’re from). They are amazingly good.

IBM will spend $100 million over the next three years on healthcare transformation projects: creating evidence-based protocols, simplifying healthcare delivery, and studying the shift to an outcomes-based reimbursement model. The company says it will hire new people, among them doctors and nurses working on the front lines.

Fujifilm will commercialize the iPhone-based stroke diagnosis application developed by a hospital in Japan. Physicians are using it to review CT scans remotely.

I was talking to the new crop of residents at my hospital, most of whom were unimpressed (justifiably) with our clinical systems. I asked three of them which systems they had used that were better. Two said Epic and one said Eclipsys. I didn’t disagree.

OB-GYN EMR vendor digiChart brings on former McKesson sales VP Bob Allen (sales) and former Healthgate CTO Stephen Faris (R&D).

The number of Americans who support President Obama’s healthcare reform package: 36%.

Camden-Clark Memorial Hospital (WV) signs up with Eclipsys for what sounds like all Sunrise modules plus EPSi. Camden-Clark is also connecting its 70 owned or affiliated physician practices, which run the Allscripts Professional EHR, using Eclipsys HealthXchange (which is Medicity).

Scottish charge master software vendor Craneware says its sales reached a record $54 million in the year ended June 30.

Healthcare Growth Partners releases its Q2 report covering HIT-related capital markets, mergers and acquisitions, and capital funding.

Weird News Andy delivers this story about a woman pregnant with two babies that aren’t twins. She has two uteruses (uteri?). Or as WNA says, quoting Homer Simpson, “It’s uterus, not uterme.”

Dan O’Neil let me know that he’s taking a job with consulting firm Arcadia Solutions, leaving his CIO slot open at Quincy Medical Center in Boston just in case you’re interested.

Eclipsys shareholders will vote on the company’s planned acquisition by Allscripts on August 13.

Jobs: Senior DBA and Storage Engineer, Web Application Developer, Lab Systems Project Manager, Project Manager – Meditech Conversion.

Australia’s Lingo Systems will give away $1 million worth of software licenses as a promotion for its SMS message-based hospital staff scheduling system. Nurses indicate their availability on a Web page and are texted when the hospital needs one of those shifts covered. The first nurse to text back “yes” gets the shift.

Disciplined nurses are using multi-state licensing agreements to keep delivering care after misconduct. Recordkeeping isn’t up to date, so nurses disciplined in one state sometimes have clean multi-state licenses. One Wisconsin nurse who was fired and later convicted of stealing Dilaudid said, “When I went to go for the job in North Carolina, looked at the status of my license, and it was still active. That kind of surprised me, so I figured I would take it."

HHS launches a Meaningful Use Web site that includes the final EHR incentive details and final EHR standards and certification criteria.

Hospitals in Greece were overcharged for medical equipment by Siemens, prosecutors say, with some hospitals paying more in annual maintenance than the equipment was worth.

The iSoft tailspin continues: two of its Australian executives quit and the company downgrades its expected revenue based on NPfIT delays. Market cap has shrunk from $1.5 billion to $170 million and an Australian publication says iSoft has cut 600 jobs and will eliminate another 500 by the end of the year. Private equity firms are poking and prodding, of course (who wouldn’t at that price?)

Announced this week and darned cool: Google’s App Inventor for Android lets non-programmers build apps for Android phones using predefined controls. Some of the available tools can access a GPS sensor, automatic texting, and interact with Web sites. Brilliant. Somebody build something cool for healthcare and write up your experience – I’ll run it here.

E-mail me.

HERtalk by Inga

From Ed Marx: “Re: final Meaningful Use regulations. I am pleased with the compromise reached by CMS/ONC. The program remains as designed, an incentive, not a give-me. It strikes a strong balance between a stretch goal while being realistic with industry current state.” I had asked Ed to share his initial, high-level impression of the final rules. It’s interesting to note that several months ago, Ed expressed concern over the preliminary measurement requirements, believing they represented a “high hurdle” for many organizations. 

From Really?: “Re: final regs. They lowered the bar so much that my four-year-old could achieve Meaningful Use! The government might as well hand out money to everyone.”

From Chicago Skyline: “Re: The fine print. In talking to a few folks, vendors seem to worried that they will need to include in their software the reporting tools for the meaningful use metrics. In other words, the software must have a report that shows what percentage of all meds were electronically prescribed. What do you understand?” Just when I thought I was nearly an MU expert, I have to punt. I didn’t have time to look through the fine print today, but maybe someone who has can chime in.

From CheerLeader: “Bravo! Hurrah! Well done, Inga! Great work on your synopsis — I actually have something to pass along to by C-levels that they will understand.” You would think that after 3-1/2 years of doing this I would no longer be surprised that people really do read what I write. If you are more interested in how the final regs affect Eligible Providers, check out the summaries posted yesterday on HIStalk Practice.

Wellsoft wins a couple of EDIS deals in Canada. Kingston General Hospital and Hotel Dieu Hospital, which share hospital information systems and IT support, will jointly implement Wellsoft.

Westbury Hospital (TX) is implementing ChartAccess EMR from Prognosis for is new 137-bed facility.

Healthcare providers are generally still confused about certification requirements for ambulatory EHRs, according to a recent CapSite survey. Two-thirds of providers consider certification to be a very important element in their EMR evaluation process and more than half think that CCHIT certification is a requirement to receive stimulus funds. Sixty-nine percent weren’t aware the feds would be accrediting other organizations beside CCHIT. If I handled marketing for CCHIT, I’d figure out some sneaky way to leverage this last data point with vendors. Nothing like a little fear to scare a physician away from an otherwise good purchase decision.

Sharp Healthcare (CA) selects Allscripts Community Record, which is provided in partnership with dbMotion. Sharp uses Allscripts EHR for its employed physicians and has deployed Allscripts’ Care Management and Referral Management applications. The Community Record will connect the Allscripts systems with third-party clinical applications to create a single community patient record.

CAP STS signs a collaboration agreement with the Barcelona-based healthcare consulting firm Gesaworld. The two organizations will provide consulting, training, and implementation services for HIT standards.

Trace Devanny won’t be unemployed more than a weekend. The former Cerner president is taking over as CEO for The Trizetto Group, effective July 19th. Trizetto founder and current CEO Jeff Margolis will remain chairman of the board. Devanny will be based in Greenwood Village, CO, which will also become Trizetto’s new headquarters.

Home health and hospice software provider HealthWyse partners with ZirMed. HealthWyse will combine ZirMed’s claims management tools into its clinical and financial information system.

IOD Incorporated, a provider of release of information services, is infused with $35 million of growth equity from LLR Partners, a PE firm.

A reader sent over a note suggesting he had some “scoop” from the AMDIS Physician-Computer Connection Symposium, which is going on right now in Ojai, CA. Unfortunately he was in a hurry (something about a blackberry martini reception) and so far all I’ve gotten was this picture. I’m not sure who the speaker is, but the crowd looks totally engaged. I await rumors and/or martinis.

E-mail Inga.

News 7/14/10

From CernerDoesItToAnutherExec: “Re: Trace Devanny. He’s leaving Friday. He was shipped by Neal to France early this year, which is like getting dead fish in the Sopranos. Unlike the last 5-7 execs, it looks like Trace left on his own.” Too bad I don’t usually post news on Monday since that’s when this came and I’d have had a scoop. As I said on February 12 when Cerner announced his transoceanic relocation, “It seems curious that Cerner would allow its president to live and work overseas when only a tiny bit of its business comes from there, so I’m guessing there is more to that story.” It was nice timing to release not-so-positive company news on the day of Meaningful Use’s rowdy debutante ball (and not only just ahead of the earnings announcement, but “to pursue other opportunities” that apparently start just three days from now – hmmm). They’ve already removed him from the Web site. Neal will now hold all the Cerner titles – president, CEO, and chairman of the board. His Pie is secure.

From Jacob Black: “Re: Daniel Barchi interview. I guess Epic has a very closed system like Apple, but the similarities stop there. I think one of the problems with HIT today is that there are too many Microsofts raking in the implementation fees and we desperately need an Apple to shake things up. I think we’ll see one arrive in the next 24 months, and when it does, it will be a game-changer.”

From Dr. Boogie: “Re: Gibson General Hospital, Indiana. Medicare fraud.” The fired hospital CFO goes whistleblower.

From Ms. MarCom: “Re: Meaningful Use. All I can say is WOW. You have totally blown away any publishing competition this morning, both from a posting standpoint and from a speed of analysis standpoint. WOW! Great job!” I replied back to Ms. M that I would treasure her nice words, especially if I got fired for spending a couple of hours digging through the MU rule instead of working for the hospital whose clock I was on at the time. I don’t know if my employer would buy the industry service argument that I had rationalized. Our only plan for the day was that Inga would sit in on the Webinar, so it was impromptu.

From Ivo Nelson: “Re: consulting company life cycle. I’m going to take offense to your comments regarding your life cycle for consulting firm buy-outs. What you failed to mention was that some of us build our businesses on delivering for clients. That delivery creates trust that leads to more business. It takes years, if not decades to build the level of trust needed to be in the ‘inner circle’ of the CIOs. Most of them aren’t stupid and don’t just buy the current consulting fad; rather, they hire firms they trust and respect knowing these decisions can be career-limiting if it leads to a bad implementation. The reality of our business goes well beyond the spin. In my world, there’s an intermediate step that few of the hundreds of consulting firms that start up in this space ever achieve — that is widespread respect and trust that only happens through the grind of delivering on projects year end and year out. Trust doesn’t happen through spin.” Ivo knows I was being tongue-in-cheek. He’s right that a consulting company doesn’t grow enough to be an acquisition target unless they do things very, very well, like he did with Healthlink and is doing again with Encore Health Resources. My ribbing was aimed more at the companies (usually hardware vendors) that buy them thinking it looks like easy, high-margin money compared to moving iron.

And now, the obligatory Meaningful Use news and reaction.

Notice that during the press release (video above) that Kathleen Sebelius started off by botching the name of CMS, calling it the Centers for Medicaid and Medicare Services (backwards). That makes about as much sense as making its acronym CMS instead of CMMS, but I can’t swear I’d say it right either if facing a ton of cameras.

Inga has collected some thoughts and comparisons about the proposed vs. final Meaningful Use rule. She’s Meaningfully Used up, so help her out by adding a comment to that post with anything she missed.

Everybody with skin in the Meaningful Use game will be cranking out press releases extolling their love or hatred for what’s been passed. Thos who love it so far: Allscripts, AARP, UnitedHealth Group, Medsphere, AHIP. Those who hate it: American Hospital Association. I’m sure PR people are proofing a lot more press releases yet to come. In fact, CHIME issued a press release that said they are “actively reviewing the changes” and will publish its summary “once CHIME has thoroughly reviewed the 864-page rule.” I shall alert the media. Oh, wait, they already did.

Don Berwick’s first day on the job involved participating in the Meaningful Use press briefing. He reminded everybody about President Obama’s goal to for every American to have electronic medical records by 2014, which was probably a mistake since, like a lot of other ambitious administration goals, it’s clearly not going to happen just because of some stirring oratory. Inga speculates that the President rushed Berwick’s confirmation through so DB could look authoritative on his first day and use the opportunity to meet and greet. To me, he comes across as likeable and sincere.

Announced: the House Ways and Means Subcommittee will review the guidelines next Tuesday.

Check out Page 34: “We expect to update the meaningful use criteria on a biennial basis, with the Stage 2 criteria by the end of 2011 and the Stage 3 criteria by the end of 2013.”

My reaction to the rule: it’s a nicely done compromise. The really contentious areas were scaled back, and even in areas that weren’t, thoughtful rationale was provided. Breaking out the requirements into the mandatory vs. elective requirements was a great idea. CMS was smart to start tough in the proposed rules and then ease up after taking public comments into account. Some folks will still think the bar is set too high, but nobody’s putting a gun to anyone’s head to take the thousands to millions of otherwise free taxpayer dollars. If you don’t like the gift horse, don’t ride it.

What’s the biggest surprise in the final Meaningful Use guidelines? That doctors don’t have to actually enter any orders to meet the CPOE requirement. Anybody allowed to write orders can do it for them. That should goose the medical scribe job market. I think CMS got a little too user-friendly with that change since the next most important number other than overall percentage of orders entered via CPOE is the number that are entered directly by the physician instead of entered on their behalf as verbal or written orders by nurses (which opens the door right back up to transcription errors – the whole “readback” thing is lame). Also, anybody who implements clinical decision support thinking that the nurse will sift through the on-screen warnings and pass the important ones to the doctor knows how poorly that works.

I loaded the government’s PDF to Scribd as soon as a reader sent me the link this morning (thanks!) I see that file has received 2,177 reads so far. I don’t think HIStalk will set a one-day reader record, but it’s had 6,000 visitors so far (early Tuesday evening Eastern time). Needless to say, MU interest was high.

I e-mailed John Glaser to get his thoughts since he was instrumental in putting MU together. He thinks the best part was that they listened to industry concerns about flexibility and setting the bar too high. I told him he should get a completion bonus of the billions, of which he humbly suggested 1%. He also offered this piece:

The Big Day

On Tuesday (7/13/10) the final Meaningful Use regulation was released as was the final Standards and Certification Criteria regulation.

Arriving at the release of these regulations took time and an impressive amount of work. The regulations appeared 17 months after the passage of ARRA and 14 months after the first meetings of the Policy Committee and Standards Committee. Hundreds of hours were spent by volunteers of the Policy and Standards committees and their workgroups. Thousands of comments were written by organizations and individuals and read by dozens of federal staff. Some very large number of blog comments, articles and white papers were prepared by consultants, academics, vendors, practitioners and others. And an incalculable number of hours were devoted by staff at ONC, CMS, OMB and other federal agencies and departments.

All of this resulted in over 1,000 pages of regulations. Regulations that will bring tens of billions of dollars into healthcare and promise to significantly improve the care of patients. Healthcare in this country was forever changed on Tuesday. Those of us who work in the industry have not seen a day as momentous as this and may not see one again.

There are many individuals whose efforts brought us to this point. David Blumenthal. Farzad Mostashari. Tony Trenkle. Paul Tang. Jon Perlin. John Halamka. But I wanted to single out one person – Janet Marchibroda.

Janet was the founding CEO of the eHealth Initiative (eHI). For many years the eHealth Initiative has brought together a diverse group of stakeholders to develop strategies, author example policies, compile lessons learned and provide education to further a vision – significant improvements in care through the adoption and effective use of interoperable electronic health records. Years before there was an ARRA, eHI and Janet were relentless in their pursuit of this vision and they were remarkably effective in bringing their ideas to Congress, the Executive Branch, state governments and the industry. While not the only voice in the early days of this undertaking they were an exceptionally effective voice. You could clearly argue that Janet and eHI are one of the primary reasons that HITECH was included in the ARRA legislation in the first place.

Congratulations Janet. This day must be very sweet.

I hear that Eric Rose, medical director of McKesson Physician Practice Solutions, has signed on with Microsoft’s Health Solutions Group to work on global health technology offerings. 

A reader tells me that a Vermont hospital’s practice EMR has been down for two days so far after its vendor tried to apply an upgrade, apparently mistakenly loading the 64-bit version instead of the 32-bit. They had to go to backup, and everybody could have predicted what happened next: the backup was no good. I guess downtime doesn’t get you Meaningful Use credit.

St. Joseph Health System (CA) chooses periop and anesthesia systems from Picis for its 13 facilities. A couple of readers have sent over positive rumor reports about Picis lately, so without my speculating about the details, I expect to hear news shortly.

Listening: The Doors, because I was watching the mediocre, Johnny Depp-narrated When You’re Strange on Netflix and got stoked about them all over again (actually, it was pretty good other than Johnny). May favorite Doors tunes: Crystal Ship; Yes, the River Knows; Not to Touch the Earth; The Unknown Soldier; and When the Music’s Over. Mr. Mojo Risin’ has been dead for nearly 40 years, but his digital detritus remains vibrant and essential. We should all be so lucky.

Consumer Reports says it can’t recommend the iPhone 4 because of its notorious antenna problems, saying Apple should fix its own phone instead of telling owners to buy themselves a case (or use duct tape like CR recommends) to prevent touching the antenna and thereby drop signal strength. The iPhone scored at the top of its ratings otherwise.

If you clicked the e-mail link to read this post, you’ll notice a single sponsor ad at the very bottom, right before the comments. That was the brainchild of a couple of readers who felt guilty that they don’t always look over the ads in the left column, but who said they’d pay significant to attention to a single strategically placed one. All sponsor ads get an equal chance – it’s a random display for each page view. Thanks for the idea and for supporting HIStalk’s sponsors.

Speaking of sponsors, thanks to new HIStalk Gold Sponsor My Health Direct. You’ll recall that I interviewed CEO and Chairman Jay Mason a few weeks back. The best way to describe the company’s offering is as “OpenTable for Healthcare”, a SaaS application that connects patients (usually ED ones) with provider appointments in the community. The system searches open provider appointments and manages the mix of low-paying reimbursement those providers are willing to accept. It also increases compliance with follow-up visits since patients leave the ED with a firm appointment. Thanks to My Health Direct for supporting HIStalk and its readers. And in case it looks suspicious, I promise there was no discussion about sponsorship when we did the interview. I often interview somebody who is then overwhelmed by the “hey, I saw your picture on HIStalk” feedback they get afterward from the very cool HIStalk readership, so they send the marketing people my way.

Weird News Andy loves his UK stories, of which this one is big: NHS will restructure and take hospitals out of the system, eliminating all 10 strategic health authorities and the 152 primary care trusts in favor of local control answering to an independent NHS board. Their private income was previously capped. From the video: “Our guiding principle will be no decision about me, without me.” Sounds like the opposite of what we’re doing here. I wonder if Don Berwick admires them more or less now?

Interoperability vendor Holon announces GA of its Medication Management Solution, which accepts electronic or scanned orders and routes them via a workflow scheduler.

Healthcare claims processor and cost management vendor MultiPlan will be acquired by private equity investors in a deal valued at $3.1 billion. You just know you’ll see more of this as investors lick their chops at the profitable administrative overhead sure to be introduced by healthcare reform (irony intentional). Surely nobody thinks insurance companies and their lobbyists will voluntarily find another line of work.

Iowa HITREC chooses Greenway’s PrimeSuite EHR.

Dentrix Enterprise Dental Practice Management earns certification as an electronic dental record solution for the Indian Health Service.

Kronos introduces its new Rich Internet Applications. I had to look that up – it means Web apps that work like desktop apps by using browser plug-ins or virtual machines. Gmail is an example.

It’s not exactly poverty-vowing nuns running hospitals: Wayne Smith, CEO of publicly traded hospital operator Community Health Systems, took home $17.8 million in compensation last year.

E-mail me.

Inga Compares the Preliminary Meaningful Use Rule to the Final

This is a first pass at trying to catalog the changes in the final rule. Your comments and observations are welcome!

CPOE

Preliminary rule

• Practices: use CPOE for orders involving medications, laboratory, radiology, and referrals.
  Hospitals: medications, laboratory, radiology, blood bank, PT, OT, RT, rehab, dialysis, consults, and discharge and transfer.
  Orders do not have to be sent electronically to the fulfilling department (lab, pharmacy, etc.)
  Practices must enter 80% of their total orders directly by the clinician into the CPOE system. Hospitals must have 10% of all orders entered by CPOE.

Final rule

• For practices and hospitals: more than 30% of unique patients with at least one medication in the medication list have at least one medication ordered through CPOE. The denominator is no longer total orders generated. Lab and diagnostic orders eliminated from the CPOE requirement. Any licensed professional can enter the order. ED orders count toward the inpatient total for CPOE.

Clinical Checking of Orders

Preliminary rule

• Real-time screening (drug-drug interactions and drug-allergy contraindications), formulary check, user ability to maintain screening rules, track user responses to alerts.

Final rule

• The EP/eligible hospital/CAH has enabled the drug-drug, drug-allergy, and drug-formulary check functionality for the entire reporting period. Any EP who writes fewer than 100 prescriptions during the EHR reporting period is exempt.

Problem List

Preliminary rule

• Longitudinal current and active diagnoses coded in ICD-9-CM or SNOMED CT.
  80% of unique patients must have at least one coded problem/diagnosis, with “none” being an allowed entry (hospitals and practices).

Final rule

• At least 80% of patients have at least one entry or an indication that no problems are known. Data must be recorded as structured data . Coding doesn’t have to be done concurrently – the codes can be added later by anyone.

E-Prescribing

Preliminary rule

• Practices only.
  Must send 75% of non-controlled substance prescriptions electronically.

Final rule

• Threshold dropped from 75% to 40%

Active Medication List

Preliminary rule

• 80% of unique patients must have at least one coded entry, with “none” being an allowed entry (hospitals and practices).

Final rule

• Unchanged.

Medication Allergy List

Preliminary rule

• Longitudinal with allergy history.
  80% of unique patients must have at least one coded entry, with “none” being an allowed entry (hospitals and practices).

Final rule

• Unchanged.

Demographics

Preliminary rule

• Practices: preferred language, insurance type, gender, race, ethnicity, and data of birth.
  Hospitals: all of the above plus date and cause of death if applicable.
  80% of patients must have demographics recorded as structured data.

Final rule

• Threshold dropped from 80% to 50% .

Vital Signs

Preliminary rule

• Height, weight, BP, BMI, growth charts for patients 2-20 years old, temperature, pulse.
  80% of patients aged 2 and over must have blood pressure and BMI entered.
  Children 2-20 must have a growth chart.

Final rule

• More than 50% of patients 2 years and older must have height, weight, and blood pressure recorded as structure data. EPs who believe that measuring and recording height, weight and blood pressure of their patients has no relevance to their scope of practice can be excluded. For MU purposes, providers do not have to maintain BMI and growth charts, although certified EMRs are required to do the BMI calculation and display growth charts with structured data.

Smoking Status

Preliminary rule

• Record if current smoker, former smoker, or never smoked.
  Must be recorded for 80% of patients.

Final rule

• Must record at least 50% of patients 13 and older for smoking status.

Clinical Decision Support Rule

Preliminary rule

• Included five measures beyond drug screening, based on demographics: diagnoses, lab results, or medication list. Real-time alerts and suggestions based on evidence. Track response to alerts.

Final Rule

• Implement one clinical decision support rule relevant to specialty or high clinical priority for EPs, or one clinical decision support rule related to a high priority hospital condition for hospitals. Also must track compliance with that rule.

Record Advanced Directives

• This is a new one not included in the preliminary rules to prove meaningful use. Hospitals must record at least 50% of inpatients 65 years old or older an indication of an advance directive status.

Structured lab results

Preliminary rule

• Display results, translate LOINC codes, allow maintenance based on new results.
  Must record as structured EHR data 50% of all results that are delivered in positive/negative or numeric format.

Final rule

• Threshold reduced to 40% of clinical lab test results.

Patient Lists

Preliminary rule

• Allow user to select, sort, retrieve, and output patient lists based on demographics, medications, and conditions.

Final rule

• Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities, research, or outreach.

Report Quality Measures to CMS and States

Preliminary rule

• Calculate, display, and submit quality measure results.

Final rule

• Clarification: this is for hospital quality measurements. For 2011, provide aggregate numerator, denominator, and exclusions through attestation. For 2012, measures must be electronically submitted.

Patient Reminders

Preliminary rule

• Practices only: issue based on patient preferences, demographics, conditions, and medication list.

Final rule

• Reminders must be sent to at least 50% of patients age 50 or over that are seen by the EP.

Insurance Eligibility

Preliminary rule

• Allow user to record and display based on eligibility response from insurer.
  Must cover 80% of unique patients.

Final rule

• Requirement withdrawn for Stage 1 but look for it in Stage 2.

Submit Claims

Preliminary rule

• Must submit 80% of all claims filed electronically.

Final rule

• Requirement withdrawn for Stage 1 but look for it in Stage 2.

Electronic Copy of Health Information to Patients

Preliminary rule

• Allow user to create an electronic copy of test results, problem list, medication list, medication allergy list, immunizations, and procedures. Hospitals must also provide a discharge summary, but not procedures. Must provide an electronic copy of health information to requesting patients within 48 hours.

Final rule

• Provide patients with an electronic copy of their health information (including diagnostic test results, problem list, medication lists, medication allergies,
  discharge summary, procedures), upon request. Discharge summary and procedures are for hospitals only.  Must provide to at least 50% of requesting patients within three business days.

Electronic Copy of Discharge Instructions 

Preliminary rule

• Hospitals only.  Must provide electronically to 80% of discharged patients who request them.

Final rule

• Threshold reduced to 50%.

Timely Patient Access to Health Information

Preliminary rule

• Practices only: diagnostic results, problem list, medication list, medication allergy list, immunizations, and procedures. Within 96 hours of availability.
  Must provide to 10% of unique patients.

Final rule

• Practices must to 10% of its patients within four business days of being updated in the EHR, subject to the EP’s discretion to withhold certain information.

Clinical Summary of Each Office Visit

Preliminary rule

• Practices only: diagnostic results, medication list, procedures, problem list, immunizations. Must provide for 80% of office visits.

Final rule

• Provide clinical summaries provided to patients for more than 50% of all office visits within three business days.

Access to patient-specific education resources

• Another new item that was not in the preliminary rules. Use EHRs to identify patient-specific education resources and provide those resources to the patient if appropriate. Both EPs and hospitals must provide patient-specific education resources to at least 10% of patients.

Information Exchange

Preliminary rule

• Enable electronic sending and receiving of diagnostic test results, problem list, medication list, medication allergy list, immunizations, and procedures. Hospital requirements also include a discharge summary. Must conduct at least one test of information exchange.

Final rule

• Exchange key clinical information among providers of care and patient authorized entities electronically. Both practices and hospitals should exchange problem list, medication list, medication allergies, and diagnostic test results; hospitals should also exchange discharge summary and procedures.

Preliminary Rule

• Compare and merge two or more medication lists into a single list that can be displayed in real time. Must be performed in 80% of encounters and care transitions.

Final Rule:

• Threshold is reduced to 50%.

Submit Data to Immunization Registries

Preliminary rule

• Must conduct at least one test of submitting information.

Final rule

• Perform at least one test of certified EHR technology’s capacity to submit electronic data to immunization registries and follow up submission if the test is successful (unless none of the immunization registries to which the EP, hospital, or CAH submits such information have the capacity to receive the information electronically).

Submit Lab Results to Public Health Agencies

Preliminary rule

• Hospitals only. Must conduct at least one test of submitting information.

Final rule

• Perform at least one test and follow up submission.

Submit Syndrome Surveillance Data to Public Health Agencies

Preliminary rule

• Must conduct at least one test of submitting information.

Final rule

• Perform at least one test and follow up submission.

Protect Electronic Patient Information

Preliminary rule

• Unique identifier, emergency access for authorized users, session timeout, encryption where preferred, encryption when exchanging information, maintain audit logs, provide integrity check for recipient of electronically transmitted information, verify user identities and access privileges, record PHI disclosures.
  Must conduct a security risk analysis and implement security updates.

Final rule

• Conduct or review a security risk analysis, implement security updates as necessary, and correct identified security deficiencies.

Meaningful Use – Final Version Full Text

Meaningful Use – final

Click the Fullscreen link at the top to read more easily.

We will be adding comments to this post as we find important facts in the long document. Feel free to add your own findings or thoughts.

Monday Morning Update 7/12/10

From Holy Smoke: “Re: Cerner. Misidentification incidents have been reported with Cerner PowerChart and Millenium in hospitals in Indiana, Michigan, and others after a Cerner upgrade. Entries are placed in the wrong electronic chart and reviewed data is for the wrong patient.” Unverified. I saw nothing in the FDA’s Maude database, so if it’s happening, customers should file an experience report.

Former Cerner COO Paul Black, now working with a private equity firm, is named board chair of Truman Medical Centers (MO).

Lots of us may benefit from the redistribution of taxpayer money into our healthcare IT pockets, but our taxpayer side apparently wins, as almost 2/3 of readers say they wouldn’t have voted for HITECH had they been given that chance. New (similar) poll to your right: if you’d had the chance to vote on Don Berwick’s nomination to CMS administrator, would you have voted for him?

Health officials in Canada’s Northwest Territories say they’ll start enforcing medical faxing policies requiring cover sheets and pre-programmed telephone numbers after patient information was faxed to the CBC in at least four separate incidents. A recent embarrassing incident had led to a temporary ban on medical faxing except in emergencies. This caused big problems for pharmacies, who were given no advance notice that the 30-40% of their business that involves faxing would be shut down.

Doctors in Taiwan are taking iPads to the bedside, using them to show patients their diagnostic images right in their beds.

Bruce Greenstein, a Seattle-based Microsoft managing director of worldwide health, will become secretary of Louisiana’s financially struggling Department of Health and Hospitals after incumbent Alan Levine quits to go back to the private sector. Levine was previously CEO of Broward Health (FL).

Senator Richard G. Lugar of Indiana pitches HIT during a stop at Union Hospital East and at the remarkably coincidentally named Richard G. Lugar Center for Rural Health, which does some small telemedicine projects. The article mentions some of the hospital’s technologies: smart beds, patient tracking systems, bar code scanning, electronic inventory, and and Vocera communicators.

Inga and I are thinking that we need to get our ears a little closer to the ground with all the healthcare IT news that’s breaking this summer (mergers, Meaningful Use, etc.) We’re thinking of anonymously crashing the Allscripts user group meeting in Las Vegas the first week of August since that’s a pretty big one that should give us lots of insight beyond just Allscripts news. Inga always does MGMA. I usually only go to HIMSS, but I’ve got a lot of time off at work and figure I might as well do something useful with it. We will report the rumors and trends from wherever we end up.

Struggling Grady Memorial Hospital (GA) is criticized for giving its CEO a $291K bonus on top of his $615K salary. The board says he put the hospital into the black and met his performance targets, but it’s still getting $80 million per year from taxpayers. And in Calgary, the CEO of Alberta Health Services earns $744K in 2009 while the organization failed to meet many of its goals and ran a $885 million deficit.

More on Don Berwick’s Institute for Healthcare Improvement. Tax records indicate that it took in $43 million last fiscal year, of which Berwick was paid almost $2.5 million, although $1.4 million of that looks like vested benefits from the previous seven years and his base salary plus bonuses was $621K. Nothing unusual or extravagant that I can see.

As a comparison, HIMSS reported $41.4 million in revenue, about the same as IHI, according to its most recent tax documents filed in May. Only $5.3 million of that came from member dues, while the annual conference raked in $18.9 million. Steve Lieber received compensation of $731K (CEO). Other salaries are above: Dave Garets (former CEO of HIMSS Analytics), Carla Smith (EVP), Norris Orms (EVP/COO), Jeff Kenjar (EVP Sales, HIMSS Analytics), Mike Davis (former EVP, HIMSS Analytics), Kelly Laidler (senior director, sales), and Jessica Daley (sales director, HIMSS Analytics). The Advisory Board must be paying Garets and Davis really well since they walked away from some pretty big salaries. HIMSS isn’t big on technology, apparently, having spent $675K on IT, a paltry 1.6% of expenses.

Former Columbia HCA president and Florida gubernatorial candidate Rick Scott challenges the state’s “millionaire” campaign finance law, saying it restricts his free speech by giving his opponent matching state funds once Scott spends $24.9 million. Scott has spent $20 million so far. His opponent’s campaign manager said, “It should come as no surprise to anyone that Rick Scott, a man who oversaw the most massive Medicare fraud scheme in history, just can’t seem to play by the rules.”

E-mail me.

News 7/9/10

From Sturges: “Re: The Berwick saga is a great view into just how political healthcare is right now (and will be through 2012). It obviously will be a big topic in November, a key part of the Berwick opposition in the first place. It also will command big attention next year as Congress takes on the deficit. The upshot is cuts for hospitals on the spending side in ’11 and a much more political environment for the rule-making process on the regulatory side in ’11-13. Mr HIStalk for Congress? Your slogan can be, ‘I think it’s crap, too’ or, if we need something more positive, ‘Yes we can — anonymously!’” Don Berwick was the right person for the job, I’m convinced (though why he’d want it is beyond me) and even though people don’t want to hear it, some kind of financial allocation (“rationing”) is unavoidable given the way the current and previous administrations have put the country deeply into debt to preserve the illusion of prosperity. It’s political poison to cut healthcare and entitlements, but Berwick is right — we don’t have a choice, especially now that the government controls so much of healthcare delivery and payment.

Speaking of Don Berwick, this article says he makes almost $900K running IHI and listed more than a dozen current jobs on his ethics filings, but most of them are voluntary or honorary, including compensation-free positions at Children’s Boston, Harvard, and Brigham and Women’s that the White House describes as “essentially honorary professorships.” The article suggests that the White House inflated his credentials with those positions, but I don’t see it that way — it looks like they just wanted to include everything whether they were required to or not. It does mention, however, that in taking the CMS job, Berwick’s annual salary will drop to $165K for running a $800 billion organization. That sounds like public service to me.

From TooLate: “Re: iSoft. To make cuts to UK staff — sales and marketing, product strategy, and implementations.” The company looks to be an acquisition target, which means slashing expenses to make short-term numbers attractive. It announces a $30 million credit facility from an obscure US investment fund, which the company will use to replenish the cash it spent on 2010 acquisitions (which didn’t help much given that shares are still at or under 20 cents).

From Lemmy: “Re: E&Y. From this job posting, it does appear that your rumor that they are trying to rebuild their healthcare consulting business is correct.”

From HITInsider: “Re: Eclipsys. It joins Epic as the only vendors with CCHIT Certified 2011 Enterprise certification.”  

From Wildcat Well: “Re: Tim, ol’ boy. ARRA, HITECH, and now $1B for broadband initiatives including health centers. Comcast. Microsoft. All talking. Time for the adults to take over. Most EMR vendors could be an afterthought. Buy stock.” I keep getting rumor reports about EMR executives talking shop with the cable operators, but I don’t have details. Not that I wouldn’t enjoy having some, mind you.

From Frank Poggio: “Re: A Meaningful Ruse. As a follow up to by February Readers Write piece, note today’s announcement: The Centers for Medicare & Medicaid Services has issued a proposed rule imposing a 0.25 percentage point reduction to the fee schedule increase factor for outpatient hospital services. If you do not met meaningful use criteria, which most providers won’t per the recent Glaser interview, you get a reduction in this adjustment. Let’s see, that’ll be 0.33 times -0.0025 = +0.000825 increase! Or is it 0.66 times -0.0025 = -0.000166 decrease? Seems to me either way you come out better.”

From HCDude: “Re: KLAS report on professional services firms. New players are entering the market. It doesn’t look like all the acquisitions done by IBM, CSC, and ACS worked. One of these days, the big boys will realize this is a cottage business where big companies just don’t ever seem to get it.” KLAS says all those acquisitions drove the principals to leave and start new companies, bringing people with them. They specifically mentioned Encore and Santa Rosa, started by former executives from Healthlink and Superior, respectively, saying that while Encore didn’t make its list because it wasn’t consider by prospects often enough, it still earned as much attention as CTG. This life cyle is obvious to old timers who have seen it time and again:

1. Sales-savvy former consulting company executives start their own consulting company.
2. They cherry-pick the good consultants who want a change, offering clients the same people and services at half the price the big boys charge since they have low overhead and no shareholders.
3. They build up the business, finding some niche for which providers are willing to pay.
4. They dress up the offerings by claiming to be in “life sciences” (i.e., make it sound like rich drug companies and foreign genomics rock stars are beating their doors down).
5. They wait for some industry development that makes consulting look like a hot industry that will never fade (data warehousing, CPOE, Meaningful Use, ERP, etc.)
6. They sell out to a cash-rich, often plodding big company that’s tired of low-margin hardware sales which thinks consulting looks easy and profitable and which is too lazy and impatient to start their own consulting organization, preferring instead to pay a ridiculous premium for a company that basically does little beyond reselling the bodies it employs at multiples of what it pays them.
7. The former consulting company executives, flush with cash and quickly fatigued by corporate BS, leave the stifling bureaucracy claiming they will retire or pursue non-competitive interests.
8. Go to #1.

From The PACS Designer: “Re: Scribus. TPD has been testing open source desktop publishing software called Scribus. It’s kind of like Visio, which has been around for a long time, but has more robust features.”

Listening: The Smiths, influential early 80s Brit indie pop featuring Morrissey on vocals. Still sounds good.

McKenzie Medical Imaging (OR) wins NueSoft’s Make Software Sexy video and photo contest, featuring user submissions with employees wearing free company tee shirts. I may steal that idea.

Proposed HITECH-related HHS modifications to HIPAA (warning: PDF) would expand the right of patients to access their own information, restrict some types of disclosure, and expand rules to cover business associates. AHIMA releases a statement supporting the change (one paragraph) and pitching itself and its members as being essential to further discussions (three paragraphs). We asked privacy advocate Deborah Peel, MD of Patient Privacy Rights for her reaction:

What we heard in the remarks of Secretary Sebelius, OCR Director Verdugo, and the National Coordinator for HIT Dr. Blumenthal is a very significant and welcome major change of direction at HHS and ONC. Several VERY strong, positive comments were made today in the press conference announcing the NPRM today by Sec. Sebelius, OCR Director Verdugo, and Dr. Blumenthal which support the patient’s right to privacy and consent. Sec. Sebelius said. “It’s important to understand this announcement [of NPRM, a new Web site, and other new initiatives] are part of an Administration-wide commitment to make sure no one has access to your personal information unless you want them to.” Then during her remarks, OCR Director Verdugo said, “The benefits of health IT will only be fully realized if health information is kept private and secure at all times.” And finally during his comments, Dr. Blumenthal stated, “We want to make sure it is possible for patients to have maximal control over PHI.” And he referred to the Consumer Choices Technology Hearing last week, which demonstrated consent tools enabling patients to make choices about how their information is used and disclosed from EHRs and for HIE.

The great news from the press conference announcing the NPRM was the very CLEAR language, from the Secretary of HHS, to the Director of OCR, to the National Coordinator for HIT, that supports building Americans’ rights to consent and control over PHI into electronic health systems and data exchange. We hope the details in the NPRM actually do give Americans the kind of control over sensitive personal health information that will enable them to trust health IT systems and data exchanges. We will share our analysis of/comments on the NPRM as soon as we have it.

Royal Philips Electronics announces that President and CEO Gerard Kleisterlee will step down in April, announcing that it will nominate former Philips board member Frans van Houten to replace him.

HealthcareMegaMall is running a text ad here announcing a September 1 go-live, but I know nothing about the company. A Google search finds this press release, which describes it as an online marketplace for sharing information, comparing products, and viewing demos (including HIT products, apparently). They’ll also communicate with providers and advertise both in print and electronically (so I guess that explains the ad).

On HIStalk Mobile, we review ReachMD, which offers medical CME via the iPhone.

Jobs: Cerner SurgiNet and PowerOrders PMs, Manager, Clinical Informatics, Senior Software Engineer, Cerner Clinical Analyst.

Weird News Andy finds this story of an enterprising London hospital that “generated substantial income” by renting out an empty patient unit to a film company that used it as a location in a big-budget porn movie.

Gwinnett Hospital System (GA) expects to save $300K per year and speed up its revenue cycle as a result of its medical records digitization project involving EDCO Group’s Solarity technology.

Baltimore’s mayor will announce as the city’s new health commissioner Dr. Oxiris Barbot, a pediatrician whose credentials include creating an EMR for New York City’s school health system and developing disease management and public health programs. The search committee was led by Michael Klag, MD, MPH, dean of the Baltimore-based Johns Hopkins Bloomberg School of Public Health and a member of HHS’s HIT Policy Committee.

Two Australian hospitals will implement an ICU EMR system from Vision Software Solutions of Queensland. I can’t say for sure, but I’m guessing it’s actually the iMDsoft MetaVision system since Vision is (or was at one time, anyway) a distributor for it in Australia.

I don’t recall if I already knew this, but apparently Resurrection Health System (IL) is going Epic, based on this job listing.

Cal eConnect, the group created to oversee California’s HIE projects and to spend $39 million in federal money, hires Carladenise Edwards as CEO. She was formerly HIT coordinator for the state of Georgia, an HIT advisor to former Florida Governor Jeb Bush, executive director of South Florida Health Information Initiative, and owner of a consulting company that sold services to Florida’s state government.

Strange: hospitals in China, reacting to a rash of patient deaths due to suspected medical negligence, hire local police officers to “improve relations” between doctors and patients. Critics say hospitals are cozying up to police to get them to arrest people who complain about their medical services. State-run media coined the phrase “hospital troublemaker” to describe unhappy family members who display banners, set up altars, or abandon the corpses of their deceased family members, any of which could get them locked up.

E-mail me.

HERtalk by Inga

The 120-provider Physicians Alliance (PA) plans to implement Allscripts EHR, which will connect directly to its existing Allscripts Vision PM system. Allscripts execs, by the way, are meeting with bankers to secure up to $720 million to finance the buyout of Misys Plc’s ownership stake and the purchase of Eclipsys.

Physicians running Advanced Data Systems PM/EHR will soon be able to connect to the Jersey Health Connect HIE using RelayHealth’s HIE tools.

Ochsner Health System (LA) says it is now connecting thousands of community physicians to Ochsner’s patient medical records using Orion Health’s HIE technology.

Speaking of HIEs, KLAS says only five vendors are considered in more than 10% of purchasing decisions: Medicity, Axolotl, RelayHealth, ICA, and Epic (the latter in Epic-to-Epic exchanges). Cerner, dbMotion, GE, InterSystems, and Orion rounded out the top 10.

The Santa Cruz HIE implements Anakam Identity Suite into its Axolotl Elysium Exchange to provide secure access to health information.

Dr. Bill Tierney is named CEO of the Regenstrief Institute, taking over for Dr. Tom Inui on October 1.

Christ Hospital (NJ) selects Allscripts reseller ITelagen to provide EHR and PM for the hospital’s affiliated medical practice.

Health Net agrees to pay $250,000 to the state of Connecticut to settle a HIPAA violation case. The suit stems from the theft of a disk drive that contained financial and medical data on 1.5 million consumers, 500,000 of them from Connecticut. The deal also includes two years of credit monitoring, $1 million of identity theft insurance, and reimbursement for the costs of security freezes.

Industry veteran Mark Trigsted is named EVP of healthcare for Diversinet. Trigsted must have friends all over HIT, having worked previously at 1-800-Doctors, Sysware, HEALTHvision, Sunquest, Oacis, McKesson, and GE Medical.

EDI testing service QualEDIx names Larry Watkins EVP of healthcare strategy and business development.

Six orthopedic surgeons from Rush University Medical Center (IL) are under fire for violating Medicare rules. The US District Court says the physicians routinely overbooked their schedules and relied on residents to perform surgeries. A fellow surgeon and a former hospital executive filed the suit.

E-mail messaging between patients and providers improves the quality of care provided, according to a Kaiser Permanente study. Patients with diabetes and/or hypertension were found to have statistically significant improvements in HEDIS scores when patients and physicians communicated via e-mail and were 7-10% less likely to schedule an office visit.

Elsevier launches Top Doc, an iPhone app designed to help medical students and residents improve with visual diagnosis skills. The $15 app includes quizzes with more than 600 questions and allows user to determine the correct diagnosis by viewing actual photographs. You can even have your grade posted to Facebook. Kind of cool, but I’ll stick with Scrabble.

E-mail Inga.

Obama Names Berwick as CMS Head, Using “Recess Appointment” Authority

President Obama today named Donald Berwick to head the Centers for Medicare and Medicaid Services while Congress is recessed, allowing Berwick to bypass nomination hearings and Congressional voting. The move also avoids public debate of the administration’s healthcare reform law before the midterm congressional elections.

Berwick, a Harvard Medical School professor and president of the Institute for Health Care Improvement, would have faced questions about previous comments in which he praised Britain’s government-run National Health Service and stated that healthcare rationing is inevitable.

Sen. John Kerry (D-MA) said, “Republican lockstep stalling of Don’s nomination was a case study in cynicism and one awful example of how not to govern. When these federal programs were in trouble, they denied the administration the capable guy the president had chosen to oversee them. The president did the right thing making this a recess appointment”

A statement from Sen. Mitch McConnell (R-KY) said, “As if shoving a trillion dollar government takeover of health care down the throat of a disapproving American public wasn’t enough, apparently the Obama Administration intends to arrogantly circumvent the American people yet again by recess appointing one of the most prominent advocates of rationed health care to implement their national plan. Democrats haven’t scheduled so much as a committee hearing for Donald Berwick but the mere possibility of allowing the American people the opportunity to hear what he intends to do with their health care is evidently reason enough for this Administration to sneak him through without public scrutiny."

Sen. Max Baucus (D-MT) who chairs the Finance Committee that would have overseen Berwick’s nomination hearings, was was quoted as saying, “Senate confirmation of presidential appointees is an essential process prescribed by the Constitution that serves as a check on executive power and protects Montanans and all Americans by ensuring that crucial questions are asked of the nominee – and answered. Despite the recess appointment, I look forward to working with CMS as they implement health reform to deliver the better health care outcomes and lower costs for patients we fought to pass in the landmark health reform law.”

News 7/7/10

From GladToBeLongGone: “Re: Sentillion. You should check with your sources at Sentillion or now the marketing leadership of HSG of Microsoft in Andover about some recent changes in personnel with one of the key players leaving, which they are keeping hush hush.” I did check. Microsoft confirms that it will announce today that former Sentillion president Paul Roscoe has resigned as GM of worldwide sales. Steve Shihadeh will take over as GM of North American sales, reporting to Peter Neupert.

From Boboloo: “Re: Stryker Imaging Division. It’s being sold to Merge Healthcare.” Unverified. Stryker focuses on orthopedic PACS, including CR, HDDR, OrthoPad EMR, and NetPractice PM.

From Sabrina: “Re: Ernst & Young. They are trying to restart their healthcare consulting business. VP/MD Bill Fera of UPMC is moving there. Guess the Capgemini non-compete ran out.” Unverified. E&Y sold their consulting business to Cap in 2000, which then sold everything but life sciences consulting to Accenture in 2005.

Reminders of stuff you can do: (a) the search box to your right covers HIStalk, HIStalk Practice, and HIStalk Mobile, so it will dig through millions of words at your command; (b) sign up on each site to get updates when we run something new; (c) Friend or Like us on Facebook; (d) send us your guest article, interview idea, or rumor; and (e) support our sponsors so they will keep supporting us. Oh, and (f) give yourself a little wink in the mirror like Inga would do if she were with you, just because we’re crazy about our readers.

CCHIT responded to a reader’s question about its commissioners, trustees, employees, and consultants. Its Web site is current with regard to commissioners and trustees, it says. It does not publish the names of employees. Specifically, Linda Kloss of AHIMA is a trustee, while Steve Lieber of HIMSS is not. Update: I should have noted that while the site lists Linda Kloss as AHIMA CEO, she stepped down from that role last November.

E-mail me.

HERtalk by Inga

Access acquires the intellectual property and contracts of Formetta. Access is the developer of the Access Enterprise Forms Management suite and Formatta is a provider of on-line forms and workflow solutions.

The University of Texas MD Anderson Cancer Center says that 28,000 patients have accessed their medical records on its year-old portal, with 40% of referring community physicians tracking the progress of their patients online.

Kansas City’s Swope Health Services selects eClinicalWorks EMR/PM for its 200-provider FQHC.

University HealthSystem Consortium partners with AcuStream to offer a co-branded version of AcuStream’s RevBuilder service to UHC members.

Last week I was on a field trip of sorts, hanging out in a hospital. The level of automation at this community hospital was pretty typical: clinicians still rely heavily on paper charts despite having a clinical system (CPSI) in place. Providers enter orders into the system (though not at the point of care), which are then available to the pharmacy, lab, etc. The hospital uses a Pyxis CUBIE system for medication administration with individual stations at each nursing pod. (I actually asked the nurses to give me a demo of the Pyxis system, but they looked at me like I was some sort of drug seeker.) I was reassured to learn that the hospital and community physicians were able to see one another’s record. All and all, their IT usage at this stage won’t qualify them for Meaningful Use money, but it seems to be serving their needs.

Here’s something I’m all for: software that simplifies medical terminology so that clinical information is better understood by the masses, suggesting plain-English replacements for jargon. That topic reminds me of the time a male doctor once suggested I had cellulitis. I almost slapped him.

Capital Health Systems (NJ) contracts with Aprima for EHR, PM, and RCM solutions. The health system manages 13 practices with 49 physicians.

A HealthPartners Research Foundation team wins a five-year, $3.7 million NIH research grant to develop and implement an EHR-based clinical decision support system to help reduce patients’ risk of heart attack or stroke.

HIMSS names CynergisTek CEO Mac McMillan as chair of its Privacy and Security Steering Committee.

A former VP from Beverly Hospital (MA) faces charges of commercial bribery and felony larceny. Paul Galzerano is accused of accepting kickbacks in the form of cash and services in exchange for awarding contractors lucrative hospital contracts. In addition, Galzerano allegedly placed valuable hospital-owned antiques in his own home. Prosecutors believe the schemes netted him almost $500,000.

The CDC awards the Association of Public Health Laboratories $2 million to provide technical assistance in advancing the electronic exchange of laboratory data. That’s chicken feed compared to the $800 million in loans and grants the government will spend to bring broadband to underserved Americans, including $17.7 million to the Iowa Health System.

Patient Safety Technologies (PST) closes on $6 million in private placement financing to be used to fund working capital and continued growth. The company also names a new president and CEO plus four new directors. PST has quite a complicated history, so if you care to read the tale of a suffering company, here’s a recap.

A class action lawsuit is filed in connection with a patient privacy scandal at University Medical Center (UMC) in Las Vegas. A former UMC employee was paid $8,000 to fax information on over 55 patients involved in traffic accidents. The lawsuit claims UMC “recklessly” distributed news releases that indicated when credit monitoring would end for affected patients, thus alerting would-be privacy thieves.

The 24-bed Lower Umpqua Hospital (OR) agrees to spend $560,00 for an EMR, which includes $332,000 for software from Healthland.

Nebraska Orthopaedic Hospital makes plans to implement Wellsoft’s EDIS.

Dell’s strategy to increase its healthcare presence seems to be making an impact. Its service division, which includes the former Perot Systems, accounted for 13% of Dell’s first quarter revenue and helped sustain the company’s 17.6% margin. In addition, the services unit is fueling sales for hardware, including a recent $3.5 million order from Methodist Hospital (TX), which has a services agreement with Dell.

E-mail Inga.

Monday Morning Update 7/5/10

From Cherry Capri: “Re: MMRGlobal. Docs are required to inform patients when they refer them to a facility in which the doctor has a financial interest. Do physicians also have to disclose to patients that they get a kickback if the patient upgrades to MyMedicalRecordsPro?” I’d guess they aren’t doing that since they also don’t disclose financially beneficial drug company ties, but maybe they’re supposed to.

From Jerry: “Re: how to add an HIStalk icon to the iPhone desktop. Click the icon at the bottom left of any Web site and click the Add to Home Screen button.”

From Barry Zuckerkorn: “Re: EMR patents. There are several. How can HIT vendors sell EMR systems without infringing? Or are they paying royalties to all these guys?” Good question. I’m surprised that patent trolls like Acacia Research Corporation, which routinely shakes down HIT vendors, haven’t jumped on this. I notice that Acacia just lost a case against Red Hat and Novell, which it ridiculously sued for infringing its patent for network-based desktop icons. The only surprise there is that Acacia actually took it to court since they specialize in “license fees” that costs less than a legal defense, making it teeth-grittingly easier to just write them a check to make them go away.

We talk a lot about CPOE applications, but the survey shows what we all really know: when it comes to CPOE success or lack therefore, the customer should get the credit or blame, not the company that wrote the software they use. Hospital culture and leadership are the most important, 79% of you say, with just 7% of readers saying it’s all about the application. New poll to your right: if you as a citizen were allowed to cast a ballot for or against $20 billion in federal spending for HITECH EMR incentives, how would you vote?

TPD has updated his iPhone healthcare apps list, which now numbers more than 200.

Jobs: Senior Software Engineer, Manager Clinical Informatics, Epic Ambulatory Trainers, Cerner Orders Consultant.

CPSI fires suspended CFO Darrell West, saying it has confirmed that he charged $55,000 to a company credit card to pay a personal tax bill. You’d think a CFO should have (a) known that he would get caught, and (b) calculated the net present value of years of lost income vs. $55K now and realized what a bad deal that is. Former CEO David Dye is brought back as interim CFO.

Weird News Andy deviates from his core competency in finding this article, which he says isn’t weird, just cool. A laid-off software engineer whose three-year-old son has cerebral palsy is shocked by the “stone age” devices that therapists were using to train him. Being a MS in software engineering from the best school in the country for that field (in my mind, anyway — Carnegie Mellon) he buys a Mac Mini, signs up for Apple’s iPhone developer program, and creates TapSpeak Button. It allows pictures to be uploaded and then pressed to play recorded messages. He’s selling quite a few at $10 per copy.

HHS CTO Todd Park on the now-open HealthCare.gov that helps people find medical insurance:

You know, I think everyone, I would presume, is in favor of better informed consumers. Everyone’s in favor of healthy Americans, everyone’s in favor of more functional marketplaces. I mean it’s not a political thing, it’s an American thing.

Britain’s NHS spent $2.4 billion on IT in the most recent fiscal year, most of it on NPfIT. The NHS spending that’s making headlines, however, is $10,500 in grants to teach unemployed women how to be stand-up comics.

Here’s another case, this one in Ireland, where critical patient lab results were recorded in the computer but were not seen by the physician in time to prevent a serious mistake.

Private equity firms are checking out iSoft, rumor has it, now that its share price has been beaten down. Among those supposedly interested is General Atlantic, whose other healthcare holdings include Emdeon and CompuGROUP.

The new president at University of Illinois announces his intention to run the organization, including its hospital, as a single university. He describes the Chicago hospital as “dilapidated”.

The ACLU sues Rhode Island’s state health department, claiming its not-yet-live Currentcare HIE will not adequately protect patient privacy. And in Alaska, ACLU sues the state’s Department of Law for failing to ensure the privacy of medical records that were seized in a raid on a midwife’s office, brought to light when an officer with the Ketchikan Police Department taunted a patient’s daughter by saying her mother had been treated for a sexually transmitted infection.

E-mail me.

News 7/2/10

From Jack Ripert: “Re: Cisco Pad. Apparently it will run Android. This may have killer healthcare application if done right.” Cisco will launch its Google Android-powered Cius tablet PC next year: smaller and lighter than the iPad and with two cameras, USB connections for external devices, and an easy tie-in to Cisco’s Telepresence videoconferencing system. They’re shooting for an under-$1,000 price. IT shops aren’t crazy about supporting Android, but they probably like it better than Apple and Cisco carries a lot of CIO clout, so this could be a big deal in hospitals, at least those prepared to wait for it. Those with long memories will recall that Cisco sued Apple over the use of the iPhone name (Cisco was selling a $12 iPhone), then settled with Apple and gave them the name (reported here in January 2007).

From I Have Friends in Military: “Re: AHLTA. To be declared a failure and replaced.” Unverified. That would be huge (and expensive) news if true, but I’m a doubter. Confirmation, anyone?

From Big Dave Brewster: “Re: [HIT publication name omitted]. Looks like it’s going toes-up.” Another HIT rag that I won’t name apparently goes on death watch. They’ve laid off the editor and no ads are displaying on the site (no loss from what I can tell from online stats – it looks like it’s only drawing a handful of visitors each day). Someone said management had already decided to run only advertiser-friendly stories to try to keep the money coming in. Something’s wrong with the cost structure if you can’t make a living charging high five figures for a yearly full-page ad and nearly that for an online ad that nobody will see.

From Denise: “Re: most overused press release buzzwords. You’re gonna love this one.” Right you are, Denise! It’s a press release word frequency list, with the most common being (1) leader; (2) leading; (3) best; (4) top; (5) unique; (6) great; (7) solution; (8) largest; (9) innovative; (10) innovator. Now if some would just write a Word add-in that would count these in a document, I could run a Buzzword Bingo game using real-life press releases and make it part of the HISsies awards.

From Texass Longhorn: “Re: Dell. I didn’t know that we at UTex could come up with a math problem so difficult as to bring down a Dell computer.” It was probably trying to calculate Texas football coach Mack Brown’s $5 million salary. Dell, stung by complaints and lawsuits about widespread failure of its OptiPlex PCs three years ago because it used cheap (and leaky) Asian capacitors in 11.8 million of them, is surely embarrassed by this New York Times story. When UT’s math department complained about failing Dell PCs, the company blamed the university for overworking them with tough math problems. An interest fact: the legal firm defending Dell from huge lawsuits over the problem had 1,000 of the bad PCs itself; Dell stiffed them too. Who would have guessed that 90s darlings like Dell and Microsoft would be struggling?

From Del Taco: “Re: CCHIT. Can you please shed some light on who the actual commissioners, trustees, and staff are at CCHIT since Mark Leavitt’s departure? Its Web site is out of date. How many HIMSS employees are still considered as staff of CCHIT? There should be more transparency if CCHIT intends to apply for more government grants.” I e-mailed your questions to both Sue Reber and the press contact at CCHIT Thursday morning. No response yet, but I’ll let you know one way or the other.

Welcome to new HIStalk Platinum Sponsor Capsule Tech, a leading provider of medical device connectivity. The company, operating in 27 countries and 600 hospitals, offers the vendor-neutral, 510(k)-cleared Capsule Enterprise Device Connectivity Solution, which allows connecting any medical device to hospital information systems. Part of that system is Capsule Neuron, a touch-enabled bedside platform for managing device connectivity that adapts to the environment it’s operating in. Our long-time HIStalk friend Ann Farrell of Farrell Associates will be co-presenting Capsule’s July 21 Webinar on medical device integration and its impact on patient safety, care outcomes, and meaningful use, so I know it will be good. Thanks to Capsule Tech for choosing to support HIStalk.

CynergisTek announces three new products for small healthcare organizations: IT support services, e-mail, and HIPAA/HITECH security compliance review.

A reader e-mailed me about the cool Mass General ED finder for smart phones. I agreed it’s cool, but opined that they’ll be sued in no time since any obsolete information is going to make someone needing an ED unhappy about being led to a closed one. Another reader noticed that problem when he tried the app: it highlighted EDs in his area that have closed. Its database is from 2007, he believes. They’d better have a lawyer review the disclaimer extra carefully.

MedAptus is awarded a patent for its automated process for capturing professional and facility charges in outpatient settings.

Showing the new HIStalk mobile display is as pointless as showing a fancy TV’s picture in a TV commercial, but just in case you don’t have a smart phone and wonder what it looks like, here you go (thanks to Inga for the early morning screen shots). Several readers e-mailed to say they love it, so thanks for that. One reader suggested creating a downloadable launcher for BlackBerry, iPhone, and Droid to avoid having to go to browser bookmarks, so if anyone knows how to do that, let me know because I don’t.

Speaking of smart phones, strong rumors say Verizon will start selling iPhones right after Christmas.

BJC HealthCare (MO) signs a $49 million, 12-year agreement to migrate 11 of its hospitals to Soarian Financials. Also, Platte Valley (CO) and Kingman Regional Medical Center (AZ) each signed multi-year deals for Soarian Clinicals.

The healthcare industry spent $8.2 billion globally on handheld devices last year. Kalorama Information predicts sales will grow 7% per year for the next five years and physicians and hospitals purchase new IT systems.

Results of the investigation into $11 million worth of delayed charges at University of Iowa Hospitals and Clinics: budget cuts left them with only one person to perform the required manual record review to document the appropriateness of cardiac cath charges, so it didn’t get done. Doh!

API Healthcare issues a set of best practices to help hospitals deal with nurse shortages.

AMIA names Jonathan Grau as VP of corporate relations.

Family doctors in the UK say they will not allow the medical records of themselves or their families to be stored on the troubled Summary Care Record, citing privacy concerns.

An interesting All Things Considered story on athenahealth, which processes 30,000 pounds of paper per month. A fun Jonathan Bush quote: “Because what healthcare really is is this awkward word slapped on top of a million little tiny markets.” An interesting factoid: New York Medicaid, among the worst claims payers, requires claims to be filed on special forms that must be ordered from Albany, then hand signed by the doctor.

Encore Health Resources announces two new hires: Julie Morrison (CSC, FCG) as client services executive and Paul Murphy (KSA) as services area leader for IT strategy.

HIStalk readership easily set a new record in the normally slow month of June. The tally, for those scoring at home: 101,652 visits and 139,766 page views (up 50% over a year ago). Most of that wasn’t because of the Allscripts or John Glaser news since those days were up only a few thousand visits. The e-mail list has 5,746 verified subscribers. Thanks to everybody who made that possible: readers, sponsors, authors, interviewees, commenters, and of course my trusty companion and kindred spirit Inga. It was fun writing HIStalk back in 2003 when nobody was reading, but I admit it’s more fun now.

Weird News Andy notes this story: in preparing for the rollout of its Healthcare.gov portal, HHS gets all cool and takes over a dormant @healthcaregov Twitter account, but forgets to clear the favorites list. As a result, HHS’s list of favorite tweets include several about P. Diddy and the vodka he was pitching a year ago.

Cash-bleeding West Penn Allegheny Health System will lay off 1,500 employees and cut back operations at West Penn Bloomfield. Considering the big money UPMC makes, that looks like an area ripe for consolidation if you don’t mind the idea of UPMC having no competition (like it really does anyway).

FormFast will offer a July 13 Webinar on avoiding HIT contracting pitfalls.

Rockford Health System (IL) chooses Epic, the same system used by its potential acquisition partner, OSF HealthCare.

If anyone still cares about The Leapfrog Group, it expresses concerns about those CPOE systems it’s been bugging everyone to buy for years. Leapfrog’s tests find that CPOE (actually its decision support component, which isn’t distinguished separately) misses a lot of really dangerous orders. CEO Leah Binder says, “The belief that simply buying and installing health information technology will automatically lead to safer and better care is a myth.” I agree, but wasn’t Leapfrog perpetuating that myth by making CPOE adoption one of its Leaps without really getting into the nuts and bolts? Above is a snip from a 2000 press release, which shows unconditional CPOE love.

A Florida county’s EMS department pays $500K for 911 software that claims to predict where the next emergency call will come from based on historical data. Paramedics say it wastes their time sending them to areas waiting for calls that never come.

ProHealth Care (WI) plans to replace multiple modality-based software applications with McKesson’s Horizon Imaging PACS, Cardiology CVIS, and Study Share case collaboration tool.

Adventist Health System signs up with Lexi-Comp for drug data. I guess they didn’t like Cerner’s Multum product even though they’re running Millennium.

Software Testing Solutions will demo two new products at the upcoming SUG 2010 meeting for Sunquest users: Application Monitor and Calculation Extractor. Product data sheets are here.

The ever-optimistic MMRGlobal predicts massive MyMedicalRecords and MyMedicalRecordsPro sales increases, with the business model being the 35% skim that doctors get for convincing their patients to upgrade. The company says that “can result in substantially more income to doctors than the $44,000 in government stimulus programs.”

Norton Brownsboro Hospital (KY) connects its GetWellNetwork system to Cisco Unified Communications, allowing patients to send messages to their nurses.

WellPoint notifies 470,000 of its insurance customers that their medical records and credit card numbers may have been exposed in a March breach cause by a problem with its online insurance application system. A customer noticed that she could see other people’s information by tweaking the browser address of her own. She let WellPoint know — by filing a lawsuit against them.

Another breach: Siemens Medical Solutions USA FedExes several CDs full of unencrypted patient information to its billing client, a New York hospital. The CDs fall out of the envelope during transit, apparently, and FedEx assumes they were trashed. The breach affects 130,000 patients.

I’m skipping town for the holiday and haven’t decided if/when to do the Monday Morning Update, so for those who start e-mailing me when the withdrawal symptoms hit late Saturday afternoon (yes, I’m pleased to say those people exist – maybe they’re the same ones who keep track of the readership stats), be prepared for these eventualities: (a) I don’t publish the update until late Monday afternoon; or (b) I bag it entirely. The only HIStalk that will get my undivided attention this weekend is Mrs. HIStalk, but I’ll probably sneak back sometime Monday for some PC intimacy. I hope everyone has a happy Independence Day.

E-mail me.

News 6/30/10

From The PACS Designer: “Re: Yoono. Yoono allows you to connect to all your social networks and instant messaging services in one place.” Guess all the good domain names were taken if Yoono was all that was left. I gave up on Twitter about five minutes after I tried it. Recruiters have run everyone off from LinkedIn. Facebook is pretty cool, but trending up on self-conscious constant users trying to impress their phony online friends with minimally clever observations. Still, Inga and I like it when someone Likes or Friends us on FB because we’re just as vain as everyone else when it comes to public displays of fake affection, the electronic version of the Hollywood air kiss.

From ExER: “Re: Betsy Hersher. It seems she’s back in the recruiting business. Her picture and references are gone from CES Partners and she’s working with former employee Bonnie Siegel on a search.”

From GladToBeLongGone: “Re: you won’t run this, but word is that Mr. Big Yahoo whose name sounds like his initials at a company being acquired is already looking for a new gig. This should be good news for all the sales people at Newco since the guy who should get the top job doesn’t have that incredible ego.” I expected that — the coattails he rode in on are long gone.

From Medsync: “Re: baby pool. Join the pool on the arrival of the Blumenthal twins, Meaningful use and Certification.” Someone set up an online “when will the baby be born” contest. Funny. The MU draft went out right before New Year’s, as I well know since I worked frantic hours summarizing it here, so maybe the final version will come out this holiday weekend and mess up another holiday for me.

I’m in solo mode again as Inga takes a bit of me-time. Here are a few quotes from her e-mails to me today to tide you over (feel free to guess the context): (a) “Seems to be a lot of interest in porn stars these days”; (b) citing readership increases since she came on board, “just saying … I’m sure your work contributed to that growth as well”; (c) with a forwarded press release of dubious value, “Hmmm …”; (d) when testing a change I had made in the HIStalk display on smart phones, “We have been re-mobilized.” She’s a bit terse from her iPhone, but always entertaining.

Listening: new from The New Pornographers, indie pop from Canada.

Back in March, I dug out a juicy nugget from an internal VA report: it was scrapping a $150 million patient scheduling system without ever bringing it live. The GAO weighs in with its official report (warning: PDF), pegging the cost at $127 million and saying “VA has not implemented any of the planned system’s capabilities and is essentially starting over.” The contractor that developed the system with “a large number of defects” walks away with $65 million. GAO finds much to criticize about the VA’s involvement: lack of competitive bidding, sloppy specs, unreliable status reports, and lack of action by project oversight groups when the project started tanking. They made the same massive mistake they made with BearingPoint in the also-failed, $472 million CoreFLS — they just gave the incumbent contractor more work orders against an existing maintenance contract instead of bidding it out. All of this started coming out a couple of years ago in various reports, which got a few VA bigwigs fired and some politicians fired up to hold VA accountable. The contractor is not conspicuously named in any of these documents, but it appears to have been Southwest Research Institute of San Antonio, a non-profit bringing in $564 million per year. It was founded, oddly enough, by an Texas oilman named whose last name was Slick.

A Compuware survey attempts to make a point about clinical system response time, but I’m not going to bother with the results because their methodology was terrible. They scrounged up 99 respondents to take their survey, all from social networking sites and with no apparent attempt to qualify the respondents by the system they use, their roles, etc. Given that the company is in the infrastructure business, you will not be shocked to learn that they conclude that clinicians taking Twitter surveys aren’t happy with response time. (note to self: develop a Twitter-based CPOE system and go public fast).

A Dr. HITECH contribution for Independence Day (please, can we avoid calling it the Fourth of July?) Ross Martin, MD, MHA re-imagines a National Anthem that’s easier to sing and allows variations (hopefully better than those godawful hack jobs done to the Star Spangled Banner by “Nashville recording artists” and diva-lites before NASCAR races). You can vote for Ross’s version.

A new KLAS report covers cardiovascular information systems. Its conclusion: they suck. Every vendor except Philips and Digisonics gets a lower client satisfaction score than last year, making the CVIS segment one of the worst. Those vendors: Agfa, Fujifilm, GE, HeartIT, Lumedx, McKesson, Merge, ScImage, Siemens, and Thinking Systems. KLAS says 30% of respondents are hoping to dump their vendors, concluding that they “fail to deliver on integration, functionality, and service expectations.”

I installed a new smartphone display format for HIStalk, HIStalk Mobile, and HIStalk Practice. If you’re a mobile user, it should be fast, sleek, and easy to read.

I liked HIT better before the politicians got involved and vice versa. Dr. Ron Kirkland, a self-styled conservative Republican running for Congress and former chair of the American Medical Group Association, bragged on AMGA’s political involvement in getting HITECH passed. Now that he’s running for office, he hates HITECH, saying the country is going bankrupt because of “the bailouts, the ridiculous stimulus plans, the outrageous farm subsidies to big corporations, and yes, even the small incentives for electronic medical records. We must end them now!” In the mean time, his 120-doctor clinic will lap up $4 million from the HITECH feed trough. A bang-up reporting job by Andis Robeznieks from Modern Healthcare. You can tell the real journalists like Andis from the posers: Google their subject and see how often (95% of the time, in my experience) they obviously just saw a press release, e-mailed a couple of people for vanilla quotes, and wrote it up cleverly like they sleuthed out real news.

Ed Marx always updates his CIO Unplugged posts with responses to reader comments, which he’s just done for his CPOE adoption one.

I’ve mentioned business analytics vendor Qlik Technologies a couple of times going back to February 2006. It’s doing an IPO valued at around $700 million.

Mass General’s Emergency Medical Network develops an ER locator app that covers the entire US.

Misys PLC CEO Mike Lawrie says that even though the company will cash in most of its Allscripts shares, it remains committed to Misys Open Source Solutions. It’s an odd press release: he made the quoted announcement at a company sales conference, not generally perceived as the best venue to deliver objective news.

IASIS Healthcare extends its plans for McKesson Horizon Clinicals, committing to physician documentation and CPOE in its 16 hospitals.

University of Tennessee Medical Center chooses GE Centricity Perioperative.

Industry longtimer Bettina Dold joins transcription vendor Acusis as director of product development. 

Australians won’t be able to review their medical records online for at least two years, the health minister says.

Sponsor news:

• IntraNexus has a shiny new Web site, which I notice includes a handy features and benefits list for each application in their SAPPHIRE lineup.
• Bayonne Medical Center (NJ) goes live with Picis ED PulseCheck two months ahead of schedule, integrated with Meditech.
• Hoag Memorial Presbyterian Hospital (CA) chooses Medicity as its HIE partner, signing up for ProAccess Community, MediTrust Cloud Services, and the Novo Grid.
• St. Cloud Medical group (MN) signs up for Greenway PrimeSuite for its 55 providers, including its patient portal and mobile version for hospital rounding.

Samsung launches its Android-powered, 4G-capable Epic smart phone on Sprint, which I’m mentioning only because I’m sick of hearing about iPhones.

Conmed (seriously) gets a $9 million, five-year contract to provide services to the City of Roanoke, VA, including implementing an EMR for its jail.

The FBI is brought in to investigate a hacker’s demands for data ransom after claiming to have penetrated the Texas Cancer Registry. Seems suspicious: the firewalls are intact, only one message was sent, and no proof was provided. It sounds like it could be an employee trying to coax more budget money from the state with a false alarm, but I’m sure the Fibbies will figure it out.

Former McKesson VP Mikael Ohman is named COO of T-System.

Odd lawsuit: two former porn stars are suing a clinic that provides medical clearance for the adult film industry, saying its release forms allow disclosure of their health information to almost anyone. I never thought of porn stars as being particularly protective of their anatomy and physiology, but I guess they’re like the rest of us.

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Monday Morning Update 6/28/10

From MaxPayneUK: “Re: iSoft. Shares hit 17c AUS – penny stock range. Directors and CEO reportedly selling off shares and rumors of massive layoffs in the UK and India have come up. ANZ MD sacked – will the UK MD be next? Too right!” Shares dropped to as low as 13.5 cents Friday when CEO Gary Cohen sold some of his, saying he had no choice due to margin calls. Denis Tebbutt, managing director in Australia and New Zealand, has been replaced. Wanna buy a train wreck cheap? Someone could pick iSoft up for a song, disengage from its money-losing UK business, and still become the non-US world’s biggest healthcare IT player.

I appreciate the support of CapSite, new to HIStalk as a Platinum Sponsor. CapSite is a healthcare technology research and advisory firm that offers an easy-to-use online database of evidence-based information to support healthcare technology capital expenditures. It provides the always-elusive pricing transparency (i.e., “Am I getting a good deal compared to hospitals like mine?”) by offering line-item details from contracts and proposals, broken out into software, hardware, and services. Its scope includes healthcare IT, imaging equipment, and medical devices. CapSite offers services to vendors as well, helping them understand pricing, competitive positioning, and industry trends. They’ll give you a live demo if you ask nicely. Thanks to the folks at CapSite for supporting HIStalk and its readers.

Orlando Health (FL) signs a deal with Health Care DataWorks for an enterprise data warehouse.

Finally, a meme (and a background buzz) even more annoying than Meaningful Use: vuvuzela.

The MyMedicalRecords people seem to be desperate to make something happen with the PHRs that nobody wants (including free ones, and theirs runs $100 per year), so their latest attempt is to run a commercial during the Daytime Emmy Awards (honoring the best of Unemployment TV). Last time I checked, the money-losing company had a dozen or so employees with microscopic revenue going down instead of up and with an odd D-list celebrity board of advisors that includes former astronaut Buzz Aldrin, former politician Dick Gephardt, and former boxer Sugar Ray Leonard. I was going to include their commercial video here, but it doesn’t work unless you manually switch to HD mode, so I’ll just link.

John Glaser e-mailed to confirm that he’s moving from Partners HealthCare to Siemens, where he’ll be CEO of its healthcare IT business, reported here first thanks to a non-John tipster (if you haven’t signed up for updates, do it now to avoid future in-your-face gloating by those who have). John will have held three big jobs in one calendar year: Partners CIO, ONC advisor, and now vendor CEO. Some are speculating that his move was due to announced Partners cost cutbacks, but he tells me he was just getting restless after 22 years at Partners and his ONC stint stimulated his desire to try something new. Congratulations to him. I always say the best times to take risks are in your 20s (no money, no kids, no clue) and your 50s (money, kids grown, ready for deferred excitement). If he wanted a tough job, I think he found it.

Singapore’s national EHR project chooses its vendors: Accenture, Oracle, and Orion Health get the $144 million USD deal to tie together Singapore’s EMRs to meet its “one patient, one record” vision.

We’re firing on all cylinders on HIStalk Mobile, double-teaming mobile health news with Travis (MD, MBA, software developer reporting news and opinion) and the enigmatic M (who’s contributing app spotlights and iPhone news). Sign up for the e-mail list over there and jump in with comments or guest articles if you are so inclined.

This is encouraging: nearly 2/3 of readers say their doctor used an EMR in the exam room during their most recent visit (mine did too, by the way). New poll to your right: which factor most directly affects a hospital’s adoption of CPOE?

MIT researchers develop a $2 cell phone add-on called PerfectSight that will let patients, particularly those in developing countries, check their own eyesight. Also using consumer technology to create diagnostic tools: Rice University, whose biomedical engineers worked with MD Anderson to rig a $400 Olympus digital camera and special dyes that can detect cancerous cells in the cheek, which could make it possible for non-pathologists to perform portable cancer screening.

The FDA and FCC will meet in July to “identify regulatory challenges” with mobile health devices and ensuring their safety and effectiveness. A UK article says the FCC is interested in reports that wireless broadband could interfere with medical equipment, saying that GE Healthcare has asked for increased regulation to avoid interference to its hospital equipment.

Raj Toleti, who founded kiosk maker Galvanon and content management company Cytura in the Orlando area, joins another Orlando kiosk company, PatientPoint, as CEO.

The West Virginia Health Information Network outsources its entire six-person payroll, including its CIO, in a no-bid contract with a research institute. They say it’s cheaper because the employees don’t receive state benefits and that its structure could change anyway.

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Report: Glaser to Leave Partners, Head Siemens Health Services Division

An internal Partners HealthCare communication indicates that CIO John Glaser will be leaving that organization in mid-August to become CEO of Siemens Health Services Division. He will presumably replace former Siemens CEO Janet Dillione, who resigned on April 1 to join Nuance as EVP and manager of its healthcare business.

According to the communication, Deputy CIO Mary Finlay will also leave Partners to become a professor at Simmons College.

I’m attempting to confirm with John Glaser directly and will update this post if I’m successful.

Update 6/25/10

John confirms the above.

News 6/25/10

From Robert Simplicio: “Re: Stack Overflow. The hugely popular programming Q&A site now has a community-driven system to decide whether to create a new site or not. It’s staging a healthcare IT version. To continue to the next step, it needs followers and questions. I can’t think of anything more relevant to your readers, myself included. This could save us all a great deal of time.” It’s a great idea. Click here to check it out and give it some support. This would be a free site that’s platform/system agnostic, so healthcare techies should be all over it.

From Blue Mist: “Re: Duke University Hospital. CIO Asif Ahmad has resigned.” Verified. He’s going to US Oncology.

From JoJoBoston: “Re: GE. Kent Rowe, GM for Centricity Business (the old IDX Flowcast), has resigned. He was one of the last main IDX players left. GE looks to be smothering the product, which once had 85% of the academic medical plans.” I asked a GE spokesperson, but they don’t respond to personnel-related inquiries. I thought our earlier Allscripts acquisition rumor made sense. Maybe there’s a connection.

From Capezio: “Re: Cerner. Your comment from the KLAS CPOE report was a bit off the mark.” Probably so: I said Cerner has low CPOE adoption, but with a third of its clients doing CPOE, that’s actually pretty good. It still has more hospitals live on CPOE than anyone else and KLAS says its adoption rate is growing at 30% per year.

Healthland provided this response to LouisvilleLouie’s Tuesday report that CEO James Burgess has stepped down:

James F. Burgess, chief executive officer of Healthland since 2007, resigned from the company for personal reasons on June 17, 2010. John Trzeciak, Healthland board member and operating advisor for Francisco Partners, is serving as interim CEO. Trzeciak has an extensive background in executive leadership with a variety of healthcare IT organizations. A search is underway for a permanent replacement for Mr. Burgess. For Healthland employees and customers, it’s business as usual.

Listening: Crowded House, a long-gone and perpetually underrated Aussie band now trying to make a comeback with their thoughtful and intelligently crafted pop that reminds me more than a little of the Beatles. Excellent. And also unrelated, Amazon has dropped the price of the Kindle to $189 after BN brought out a WiFi-only version of the Nook for $149, so I bought one as a gift for a special lady. It’s pretty cool.

On the Sponsor Jobs Page: Vice President, Business Development, Vice President, Solutions Marketing, Meditech Consultant – Long Term, Epic Certified Clinical Documentation Consultant. On Healthcare IT Jobs: Clinical Pharmacy Specialist, McKesson HED Consultant, Cerner FirstNet Consultant.

Universities and hospitals in Memphis are connecting to Oak Ridge and other research centers via 10-gigabit-per-second connectivity and Internet2.

McKesson’s John Hammergren banks $35 million in proceeds from selling shares.

Microsoft announces that HealthVault is now available in the UK, three years after its US debut.

Indian companies are seeing gold in the US healthcare reform bill, specifically in business process outsourcing, reading diagnostic images, medical tourism, and drug manufacturing. Also mentioned is that because the bill limits offshoring, Indian companies are opening offices here and also buying domestic companies.

Motion Computing announces its J3500 tablet PC for healthcare and other vertical markets that require a rugged device. It’s way uglier than an iPad and quadruple the price (it starts at $2,299) but it’s tougher.

iSoft shares drop to $0.19, down nearly 75% in the past six months. The company had planned to make some US acquisitions (I’ve heard a couple of names), but that’s probably not going to happen with that loss of equity.

Interesting lawsuit: the CEO of Tallahassee Memorial Healthcare (FL) subtly tinkers with the formula approved by the hospital’s board to calculate his retirement benefits and submits it in his employment contract. The hospital’s board chair now admits that he “signed it, as was his custom, without reading it.” The CEO retires and the hospital is shocked to find that it’s stuck with paying him $614,000 per year for the rest of his life, triple the expected amount (even that amount sounds wildly generous – who gets a guaranteed lifetime pension of $160K per year on a $380K salary?) The hospital doesn’t want to pay, so he’s suing them. And in Ohio, a hospital CEO forced into retirement from his $530K job after highly paid family members were found on the hospital’s payroll faces another charge – shipping hospital baby formula to his daughter.

HHS CTO Todd Park says his team is working startup-like hours to launch the HealthCare.gov consumer insurance site by the legally mandated July 1 live date.

Strange, especially in this economy: 90 union construction workers at Central Washington Hospital (WA) walk off the job because two Port-a-Pottys of the 24 on the job site were dirty and one was out of toilet paper. Maybe they had to get in the iPhone line.

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HERtalk by Inga

Franklin Wood Community Hospital (TN) selects GetWellNetwork to provide patients with its bedside interactive learning tool. Among other functions, the GetWellNetwork system noteswhen patients finish their prescribed educational content and documents that information into the hospital’s Soarian EMR.

Money can’t buy you love or the the world’s best healthcare. A new Commonwealth Fund report ranks the US last for healthcare outcomes compared to six other industrialized countries despite its per capita cost of $7,290. The next biggest spender is top-rated Netherlands at $3,870. The US ranked particularly low in efficiency due to high expenditures and administrative costs. Other contributing factors included low scores on IT usage, re-hospitalization, and duplicative medical testing.

Nuance Communications buys the IBM spin-off Shapewriter, a continuous touch application that allows users of mobile devices to type by swiping their hands across a keyboard instead of hitting individual keys. I’ve never seen a similar app and I thought the online demo looked cool. I’m not sure if Nuance plans to add it to any HIT applications or if it even really does make input faster, but it looks sexy.

Speaking of Nuance, the company announces the winners of its 2010 eScription Million Dollar Awards. Twenty-two organizations were recognized for saving one million dollars or more on medical transcription using the eScription platform.

Over on HIStalk Practice, Dr. Joel Diamond weighs in on e-prescribing. Joel is a regular 2010 Renaissance man who not only writes blogs, but also serves as CMO for dbMotion and still manages to practice medicine a few days a week. Plus he’s got a great way of getting his point across while also making me laugh (I doubt I am the only one.) Here’s a sampling:

A colleague of mine told me of the time he once prescribed drops for a baby with an earache. The instructions were: “Put two drops in right ear every four hours” with right abbreviated as an R with a circle around it. The mother returned when the child did not get better. She showed the doctor the baby’s wet rectum as evidence of complying with the prescribed treatment. It turns out the pharmacy printed the instructions as “Put two drops in R ear every 4 hours”.

Even  though I just got back from vacation, I’m already thinking about what I’ll do for my next trip. Denver at the end of July sounds pretty inviting, especially if you’re interested in hearing  some experts chat about HIE adoption and implementation. The Institute for Health Technology Transformation is hosting a Health IT Summit July 27-28 and has lined up an impressive list of speakers and moderators, including John Moore of Chilmark Research, Lisa Khorey of UPMC, and Mary Anne Leach of The Children’s Hospital.

Design Clinicals contracts with ExitCare to enhance patient education features in the MedsTracker software. ExitCare will interface its ExitCareEDTM and ExitCareIPTM products with the Design Clinicals’ MedsTracker application. MedsTracker, by the way, was recently certified to connect with the Surescripts e-prescribing network.

Forerun, Inc. plans to incorporate Anoto Digital Pen technology into its Forerun Chart program for EDs.

Automated telephone reminders can increase colon cancer screening rates by 30%, according to a KP study.

Sad: the administrator and associate administrator at Central Louisiana State Hospital resign following the deaths of three patients from food poisoning. The cause of the outbreak was tied to improperly stored chicken salad. Another 54 patients and staff members were sickened.

Also sad: that the world needs this type technology. Baptist Memorial Health Care completes installation of RF Technologies’ Safe Place Infant and Pediatric Security Solution at eight hospitals. The system prevents abduction of infants by sounding an alarm and locking all doors if a baby is moved without authorization.

A medical technologist who worked worked at a couple different hospitals in Newark, DE, is arrested for stealing men’s shoes. Police discovered 3,900 shoes that were presumably stolen over the last 20 years. I thought I might have found a sole-mate (sorry) until I read more details about him. I mean, I could never go for a guy who just boxes up all his shoes and leaves them in his basement.

E-mail Inga.

News 6/23/10

From LouisvilleLouie: “Re: Healthland. Rumor has it that Francisco Partners, owner of Healthland, has parted ways with Healthland CEO James Burgess.” I’ve tried to verify this rumor with no luck so far. He’s supposedly moving to the board of T-System, another FP investment. I’ve heard that FP is gearing Healthland up for an IPO.

From WisconsinBiker: “Re: Aurora Health Care Milwaukee. The longtime Cerner Millennium user will be switching to Epic.” Unverified, but WB’s Rumor Report included an authentic-looking message from Aurora President and CEO Nick Turkal, MD explaining that they’ll transition over three years after determining that “Epic offers the best solution” based on performance, user friendliness, reliability, and support, not to mention all the other swell organizations that have already chosen it (and also not to mention that Epic’s in Wisconsin, it pretty much owns that market, Aurora’s competitors are using it for interoperability, and Aurora was already using Epic on the ambulatory side). If the message is legit (and I strongly suspect it is), Cerner might want to pull down its self-congratulatory Aurora case study.

Here’s a telling newspaper story and quote from Aurora CIO Phil Loftus from a year ago when Froedtert and other area hospitals started linking up via Epic’s Care Everywhere:

The problem, however, is that the hospital systems are not using the same electronic medical system manufacturers. While Froedtert has chosen Epic, other hospital systems have opted for other providers such as Cerner Corp., Kansas City. While competing companies using different computer software wouldn’t normally be an issue, it is an issue in the health care industry where patients can move between hospital systems. “It’s very important to find the tools that can connect the organizations,” said Philip Loftus, chief information officer and vice president of information systems for Aurora. “There is a big Epic population and we are going to have to figure out a way to integrate that with the Cerner population.” Loftus sees the importance of interoperability daily because while Aurora uses Cerner, Aurora Advanced Healthcare, a group of about 300 physicians that Aurora acquired last year, is on the Epic program. Loftus said Cerner has yet to develop a product like Care Everywhere. He is hoping Epic’s Care Elsewhere, which is not yet available, will eventually allow various software programs to connect, regardless of the manufacturer. “We are very committed to opening up our records to other hospital systems,” Loftus said.

Healthcare security vendor CynergisTek partners (warning: PDF) with NitroSecurity, Inc. to offer a fast-response security event monitoring solution that incorporates log management, database activity monitoring, application data monitoring, and intrusion prevention.

In Australia, a newspaper speculates that the Premier of Victoria’s hospital press conference was moved because he was embarrassed about medical staff complaints involving the hospital’s Cerner EMR. Senior medical staff sent a letter Friday to executives at 330-bed The Alfred, claiming that “it will only be a matter of time before we see catastrophic and perhaps fatal outcomes.” Among their complaints: doctors can’t find available PCs, the system is slow, and record scanning isn’t being performed correctly (those are mostly not Cerner’s problems from what I can tell). The hospital says the complaints understate the benefits the Cerner system offers over paper records, but admits that outpatient appointments are being pushed further into the future as a result of the implementation. Clarification: this is not Victoria’s $314 million (USD) HealthSMART system that’s running years behind schedule and millions over budget, although it, too, runs Cerner.

Here’s a fun interview with Partners CIO John Glaser. An interesting point: he says Congress never expected a majority of hospitals and physicians to qualify under Meaningful Use and that it was intended to stimulate EMR uptake, but not cover the whole cost. He also predicts that “some states will screw it up” when it comes to HIEs and says that the biggest weakness of the government’s plan is not putting enough money into the Regional Extension Centers. The story of why he got expelled from his Jesuit high school is a big bonus. Definitely worth a read.

Free EMR vendor Practice Fusion claims its user count grew by 72% in the first half of this year, capturing 7% of the total ambulatory EMR market. I think I’d want to see more information on what constitutes a user versus a tire kicker, so maybe that will be forthcoming.

An IDC Health review of HIE vendors (warning: PDF) finds that Medicity earned the highest possible rating in nearly all of the criteria that involved market fit and likelihood of a positive customer experience. It also notes Medicity’s 700+ hospitals. It has been 18 months since Medicity acquired Novo Innovations, with 25% of Medicity’s customer base now running the full integrated HIE platform. It has also accounted for every sale so far in 2010. I just searched the KLAS database (the free part I can see) and for some reason they still have the Novo Grid as its own product, but it’s pretty much one company and one product as far as I know.

It looks like new HIMSS EVP John Hoyt will have a VP reporting to him, as HIMSS posts a VP of Healthcare Organizational Services job. It’s called a “concierge service so that it’s an easy decision for them [CIOs] to renew their organizational membership and to grow our influence with that community.” It also involves pitching HIMSS Analytics to CIOs to get them to do the survey and to “help sell CIOs on extended benchmarking engagements.” Basically, the job involves selling HIMSS stuff to CIOs, with sales experience mandatory. It’s a nice business model: hospitals pay for their executives to be HIMSS members, which also then makes them prospects for sales pitches from both HIMSS vendor members and HIMSS itself. That’s like a rube Florida tourist offering a free weekend stay and a Chili’s gift certificate to a timeshare salesperson. 

Speaking of HIMSS Analytics, it announces HIMSS Analytics Europe. I didn’t know this that I recall: HIMSS apparently very quietly and very recently bought The Hospital IT Network, with which it had worked previously, and is now turning it into the new organization. The Hospital IT Network, like HIMSS Analytics, sells hospital information to vendors.

Don Berwick takes heat in his confirmation for CMS administrator because of comments on record in which he extolled the virtues of healthcare rationing and Britain’s NHS, about which he said, “… any healthcare funding plan that is just must redistribute wealth … please don’t put your faith in market forces.”

According to e-Health Insider, InterSystems will win the laboratory information system business in Wales, with its TrackCare product beating out Cerner and iSoft.

This is one of those times where I beg forgiveness in being way far behind and thus tardy in e-mail responses. I’ve been super busy, but I’ll catch up soon – promise.

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HERtalk by Inga

Gardner Family Health Network (CA) selects NextGen’s EHR and PM, as well as the QSI Dental System. Gardner is a five-location, 50-provider FQHC.

Thomson Reuters chooses MedAssets’ Contract Manager program as the preferred contract management solution for its hospital client, replacing Thomson Reuters’ Ascent software, which will be discontinued at the end of 2012.

Beaufort Memorial Hospital (SC) claims to have increased gross revenue by $1.3 million within a month of implementing MEDHOST’s EDIS, mostly through better E&M coding and IV infusion charge capture.

Another cool iPhone app in the works: Emerging Healthcare Solutions hopes to sell 1 million downloads of the e-911 app within its first year of release. The app automatically delivers medical information to first providers or physicians when 911 is dial from the patient’s iPhone. If you are an Emerging shareholder, you’ll be able to download the app for free (currently trading at a mere $1.02/share).

The US hospital market for claims management/EDI represents almost a billion dollars in new and replacement business, with $150 million in spending projected over the next 18-24 months. That according to a new CapSite Consulting study.

RelayHealth introduces a new claims and remittance management solution for hospitals and health systems. If you’re at HFMA in Vegas, you can stop by RelayHealth’s booth #437 and check out RelayFinancial Assurance Pro.

Emdeon pays $18.9 million for Chapin Revenue Cycle Management, which offers a proprietary contract management system that calculates reimbursement.

Riverside Health System (VA) implements Zynx Health’s ZynxOrder evidence-based order sets. The order sets are integrated with Riverside’s inpatient EHR (Soarian Clinicals, I believe).

Speaking of Soarian Clinicals, Siemens says its latest version is now in GA. The new release incorporates electronic medication reconciliation, provides new CPOE capabilities, and offers the ability to create a continuity of care document.

MediConnect Global announces that its MediConnect PHR (formerly known as PassportMD) supports iPad/Phone/Touch devices, as well as Android and WebOS mobile operating systems.

Picis names six hospitals as winners of its 2010 Customer Recognition Awards.

In case you missed it, we just posted our latest HIT Vendor Executive question. Check out what industry leaders how to say about the Allscripts/Eclipsys transaction and some of its broader implications for the HIT industry. You won’t see most of the news from HIStalk Practice repeated on HIStalk, so sign up for e-mail updates while you’re there.

CCHIT chair Karen M. Bell, MD says her organization will, not surprisingly, apply to be an ONC Authorized Testing and Certification Body (ONC-ATCB) now that ONCHIT refused its request to be grandfathered in. The Drummond Group doesn’t officially announce (again) that they are in, though their recent EHR Blog posts suggest they’re still committed.

University Health System (TX) CIO Bill Phillips tells the local paper they’ve spent about $25 million rolling out an EHR over the last five years. The health system, which uses Eclipsys Sunrise on the inpatient side, has also automated its clinics and runs 99 real-time interfaces.

Heathcare systems and vendors were well represented in Computerworld’s 100 best places to work for IT professionals. A few that stood out in my mind:

• #36 – Lehigh Valley Health Network (PA) employees are encouraged to participate in community service activities throughout the year, usually on company time. For $3, employees can pay to wear jeans on Fridays and have the funds go to disadvantaged children in the community.
• #27 – Kaiser Permanente (CA) encourages employees to submit ideas for technology projects to improve quality and service. If the suggestion is accepted, Kaiser’s Innovation Technology Fund will move the idea into production. Twenty-seven projects were seeded through this program last year.
• #30 – OhioHealth is all about hosting social events like picnics, holiday meals, and golf outings, plus an annual all-staff meeting with entertainers and games. Of course, I like parties.

Plastic surgery, anyone? An enterprising physician develops a new iPad application that includes hundreds of before-and-after photos by type of operation and details on the various procedures. Now that would be a cool thing to analyze over my next chick lunch.

E-mail Inga.