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News 7/10/13

July 9, 2013 News 7 Comments

Top News

7-9-2013 7-27-41 PM

Mobile clinical workstation manufacturer Stinger Medical merges with competitor Enovate, forming the country’s largest mobile workstation provider that will operate under the name Enovate Medical. Stinger’s CEO and CFO will continue those roles with the new company, as will Enovate’s COO.


Reader Comments

7-9-2013 6-06-38 PM

From HIT Veteran: “Re: death of Milton Antonakos. The industry has lost a sales superstar. Milton was always a top performer because you couldn’t outwork him. He was a bundle of energy, had great life balance, and was always encouraging others. Tragic and a reminder to live every day fully.” Milton Antonakos of CareAnywhere, previously with Allscripts/Misys for 23 years, was killed in the crash of an air taxi in Soldotna, AK on Monday along with his wife and three children. Also killed were Chris McManus, MD, a radiologist with Greenville Health System, his wife and two children, and the plane’s pilot. Condolences to family and friends.

7-9-2013 6-48-02 PM

7-9-2013 7-02-49 PM

From QSII Watcher: “Re: Quality Systems, parent of NextGen. Looks like another proxy battle ahead. The Clinton Group, an activist investor, has filed an alternative board slate that includes former President Scott Decker. He’s the second former exec to try to join the board – Pat Cline was added in the last (failed) proxy battle by the second-largest shareholder Ahmed Hussein. Doesn’t look like Hussein is officially part of this proxy battle, but the SEC filing alludes to conversations with him. You can bet he’ll vote his shares in their favor. Also on the board slate is Peter Neupert, formerly of Microsoft and now at David Brailer’s Health Evolution Partners.” The  proxy statement says the performance of Quality Systems lags its peers in earnings and total return, with share price flat since 2008 while the S&P 500 rose nearly 60 percent. It cites equity analysts in saying that management has no clear strategic plan, keeps chasing distractions, is losing sales, and has questionable potential in the small hospital segment. Above is the five-year share price of QSII (blue), the Nasdaq composite (red), Cerner (green), and Allscripts (brown).  

7-9-2013 7-38-34 PM

From Ricardo: “Re: pet health portal. Yesterday I received an e-mail from dog’s vet introducing me to their new Pet Health Portal, where I can log in to see my pet’s health record, request appointments, search their pet health library, view vaccination history, etc. I actually laughed out loud considering I’ve received no indication whatsoever of a patient portal offering from my primary care physician. Thought you might appreciate that.” I do indeed appreciate that information, having been equally impressed by similar systems, often rolled out by veterinary chains like Banfield. Vets also offer Pet Mail to answer questions. Next time someone says they’ve been treated like a dog, congratulate them.

7-9-2013 7-20-28 PM

From Keith: “Re: JAMA opinion piece from Dartmouth, of all places. The educational and cognitive purpose of the evolved medical chart has been devalued by EHR.” The editorial by Robert S. Foote, MD of Dartmouth-Hitchcock’s nuclear stress laboratory says, “Discussions of EMRs have tended to be dominated by descriptions of their potential benefits, while less attention has been paid to their potential hazards, among which are breaches of privacy, incompatibility of different systems, introduction of computer-based errors, and loss of productivity owing to cumbersome procedures that EMRs sometimes require. I think it behooves us as well to consider the impact of these systems on a very basic element of clinical practice, namely, how clinicians think.” Among his comments:

  • Epic has “68 tabs, many of which lead to numerous subtabs and links” and lists every field generically (like “code report”) even when they don’t apply to the particular patient
  • Notes written by all providers, including non-physicians, are jumbled together and often copied and pasted, interrupting the thought process.
  • The system tries to force standardization through the use of checkboxes, but often omits important information as a result, saying that he has never seen a checkbox saying, “my daughter died of the chemotherapy you are proposing for me.”
  • The medical record is not data or a repository to hold data, but rather information that has been transformed by caregiver knowledge.
  • The medical record is a battleground over the future of healthcare, because “as it becomes more difficult to write like a clinician, sooner or later it will become more difficult to think like one.”

7-9-2013 7-44-20 PM

From ColonelPeter: “Re: QlikView. Our organization just chose to purchase a BI technology called QlikView after seeing a demonstration of its integration with Epic at HIMSS. The pre-sales guy was a former Epic veteran who said that they were still working through logistics of a partnership with Epic.  Seems if Epic wants to dispel the belief that they’re difficult to work with, they should be trying to fast track a partnership with these guys. We’ve only had the software two weeks and already have gotten a ton of value from just playing with it.” I’ve mentioned QlikView several times and have played around with their free download. You can try their surgery scorecard live demo.


HIStalk Announcements and Requests

The upcoming HIStalk Webinar, “Five Steps to an Enterprising Imaging Strategy,” sponsored by Merge Healthcare, has been rescheduled for Wednesday, July 24 at 3:00 – 3:45 p.m. Eastern.


Acquisitions, Funding, Business, and Stock

7-9-2013 10-27-15 PM

Predixion Software raises $20 million in a Series C financing round led by Accenture and GE Ventures.

7-9-2013 10-41-18 PM

Coppersmith Capital Management, LLC, which owns 7 percent of the shares of Alere, launches a proxy fight in nominating its own slate of three directors for consideration at the August 7 Alere shareholder meeting. Its letter to shareholders urges the company to sell its Health Management division, which connects diagnostic devices to health management services.

The Italian subsidiary of Germany’s CompuGroup Medical will acquire a majority stake in Studiofarma Srl, which sells pharmacy software in Italy and has 7,000 customers.


Sales

7-9-2013 10-30-36 PM

WellStar Health System (GA) selects Besler Consulting to assist with the identification and recovery of Medicare Transfer DRG underpayments.

CareBridge Palliative Care Services(OH) will implement Authentidata Holding Corp.’s Electronic House Call and Interactive Voice Response telehealth solutions for remote patient care.

7-9-2013 10-29-13 PM

Alameda Health System (CA) engages MedAssets for A/R services.

The Children’s Care Alliance (PA) will create a health information exchange for underserved children based on HIE technology from Alere Accountable Care Solutions.

North Shore-LIJ Health System extends its managed services agreement with Allscripts through 2020.


People

7-9-2013 6-14-32 PM

Truven Health Analytics names Roy Martin (WELM Ventures) COO of its hospital, clinician, employer/health plan, and life sciences customer channels.

7-9-2013 6-15-32 PM

Arcadia Solutions appoints Chuck Garrity (Beacon Partners) RVP.

7-9-2013 7-51-21 PM

Dartmouth-Hitchcock (NH) names Terry Carroll chief innovation officer. He was previously SVP of transformation and chief information officer at Fairview Health services (MN) and has held CIO roles at Detroit Medical Center (MI) and Baystate Health Systems (MA). 

7-9-2013 10-09-53 PM

Christopher Olivia, who was paid $6 million in his last year as president and CEO of money-losing West Penn Allegheny Health System (PA) before Highmark bought it in 2011, is named president of Continuum Health Alliance, a physician management company whose offerings include IT services.


Announcements and Implementations

7-9-2013 10-34-16 PM

Doctors May-Grant Associates (PA) and Lancaster General Health’s Women’s & Babies Hospital (PA) successfully exchange CCDs between the practice’s Greenway Medical platform and the hospital’s Epic system.

Greenway Medical will add PatientPay’s online patient payment solution to its PrimeSUITE EHR/PM platform.

Resolute Anesthesia and Pain Solutions begins a nationwide expansion of Shareable Ink’s Anesthesia Cloud for iPad following an initial deployment at the Boca Raton Outpatient Surgery and Laser Center (FL).

Miami Children’s Hospital implements the AnyPresence solution to enhance development of mobile patient engagement apps.

Northern Ireland launches its national patient record system based on Orion Health’s portal and integration technology.

7-9-2013 10-33-12 PM

The Brooklyn Hospital Center implements the MedAptus Professional Charge Capture solution for the coding of inpatient and outpatient encounters.

HIMSS will announce its HIMSS Health IT Value Suite in a July 16 event streamed live from Washington, DC. It sounds like a pitch for the ROI of products and services offered by its vendor members.


Government and Politics

7-9-2013 8-13-15 PM

CNSI, whose $200 million Medicaid claims system contract with the State of Louisiana was cancelled over alleged bidding irregularities, claims the state will lose $100 million by keeping its old system instead. A state DHH spokersperson responded, “CNSI really is not in any position to be commenting on costs that may be incurred by the state, especially in light of its own actions.” DHH Secretary Bruce Greenstein, a former CNSI executive, resigned after the probe was announced.

In England, the Office of Fair Trading launches an investigation to determine if hospitals become overly dependent on healthcare IV vendors when outsourcing and whether certain vendors try to stifle competition by limiting their interoperability with competitors. Experts suggest that Cerner, McKesson, and Epic will earn lower margins if they don’t open up their systems to third-party products given NHS England’s interest in best-of-breed systems.


Other

Gartner ranks Dell as the leading provider of healthcare IT services globally based on 2012 revenues.

7-9-2013 8-04-54 PM

The annual healthcare IT report from Robert Wood Johnson Foundation finds that 44 percent of hospitals had a basic EHR in 2012, up 17 percentage points from 2011, with the number tripling going back to 2010 when HITECH started paying. Only 42 percent of hospitals met Meaningful Use Stage 1, however, with that number expected to drop for Stage 2, and only 27 percent participated in an HIE. The report also concluded that practices weren’t far behind hospitals in adoption percentages, but small practices continue to lag.

Fitch Ratings upgrades the bonds of Beebe Medical Center (DE) to “stable” despite weaker 2012 operating results partly caused by its write-down of the “not sufficiently robust” McKesson system that was replaced by Cerner at a cost of $37 million.

7-9-2013 10-36-41 PM

Vermont’s largest employer is now Fletcher Allen Health Care, with 7,100 employees.

Weird News Andy says the nurses were right again. The Syracuse newspaper uncovers an HHS report describing a series of errors that almost resulted in St. Joseph’s Hospital Health Center harvesting organs from a patient who was not brain dead. The doctor ignored nurses who argued that the overdose patient was responding to touch and breathing on her own. The patient survived her hospitalization, but committed suicide two years later.


Sponsor Updates

  • Covisint offers a Direct Toolkit that explains how Direct messaging relates to HIEs and why providers should adopt it.
  • Aspen Advisors announces the addition of 19 healthcare clients and 18 employees during the first six months of 2013.
  • Perceptive Software releases Document Filters 11, which allows software companies and services providers to embed their solutions with technology to unlock unstructured files and extract data.
  • Vitera hosts a July 24 Webinar highlighting steps to prepare for ICD-10 success.
  • The Healthcare Network Accreditation Program awards Capario full EHNAC accreditation.
  • Staffing Industry Analysts names Intellect Resources the fastest growing staffing firm in the US for 2013 based on its 125.5 percent growth rate.
  • Twelve CareTech Solutions customers win honors for their hospital websites.
  • Imprivata introduces a suite of proximity and fingerprint readers integrated with Imprivata OneSign to provide an end-to-end identity and access management solution.
  • The SSI Group aligns with ABT Medical to provide release of information services to SSI’s RAC solution.
  • Orion Health moves forward with expansion plans for its Christchurch, NZ development center.
  • Bottomline Technologies will honor Joshua Krantz, an employee who died from injuries received in an assault, at a July 15 memorial service when an award in his name will be announced. 
  • The FDA lists iMDsoft’s myAnesthesia app as a Class 1 medical device.
  • TrustHCS launches the TrustHCS Academy to train and place coding professionals in advance of ICD-10.
  • Impact Advisors leads an online CHIME focus group July 16 discussing optimization services.
  • Ingenious Med employees provide financial and onsite support to the Zambia Medical Mission, which provides medical assistance to underprivileged Zambians.

Contacts

Mr. H, Inga, Dr. Jayne, Dr. Gregg, Lt. Dan, Dr. Travis.

More news: HIStalk Practice, HIStalk Connect.

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Morning Headlines 7/9/13

July 8, 2013 Headlines Comments Off on Morning Headlines 7/9/13

Study: Remote Patient Monitoring Adoption Poised For Robust Growth, Says Spyglass Consulting Group

A new study compiling the opinions of more than 100 healthcare leaders working in organizations that provide telehealth services finds that remote patient monitoring solutions are positioned for strong short-term growth, driven by ACOs beginning to formulate population health strategies and hospitals looking to proactively control 30-day readmission rates.

A shorter wait in the ER is just a click away at hospitals with startup’s virtual waiting service

Health IT startup InQuicker is making inroads working to reduce ED wait times. The company has developed an online waiting service similar in functionality to OpenTable. The software, which is accessed from the hospital’s website, allows patients with non-life-threatening conditions to check in from home and wait there during the time they would normally spend in the waiting room.

Brookings finds healthcare jobs soaring over other industries

The Brookings Institution releases a report on job growth that places healthcare ahead of all other sectors, realizing a 22.7 percent employment growth rate over 10 years compared to an average 2.1 percent from all other industries. Across the 100 largest metropolitan areas in the US, healthcare accounted for more than one in every 10 jobs.

JRMC Formally Announces Agreement with Sanford Health

Jamestown Regional Medical Center (ND) has partnered with 35-hospital network Sanford Health in order to have Sanford’s Epic EHR installed at JRMC. In addition to the EHR agreement, Stanford will help expand oncology services offered at Jamestown. The 25-bed hospital will otherwise continue to operate as an independent critical access hospital.

Comments Off on Morning Headlines 7/9/13

Advisory Panel: Industry Publications Read Regularly

July 8, 2013 Advisory Panel 1 Comment

The HIStalk Advisory Panel is a group of hospital CIOs, hospital CMIOs, practicing physicians, and a few vendor executives who have volunteered to provide their thoughts on topical industry issues. I’ll seek their input every month or so on an important news developments and also ask the non-vendor members about their recent experience with vendors. E-mail me to suggest an issue for their consideration.

If you work for a hospital or practice, you are welcome to join the panel. I am grateful to the HIStalk Advisory Panel members for their help in making HIStalk better.

This question this time, suggested by an HIStalk reader: What healthcare IT industry publications do you read regularly? (please indicate whether you read online or by printed copy)


Prefer online. HIStalk, Radiology Today, Advance, Healthcare Informatics.


Healthcare Informatics, JAMIA, Gartner.


Healthcare IT News, ONC blog and website, HealthLeaders  Media, User conferences and Government Health IT, FierceHealthIT as well as HIMSS online groups. Your blog remains my favorite.


Aside from HIStalk, I don’t read too much directly online.  I get e-mail updates from ACHE, HIMSS, Modern Healthcare, CHIME, and Healthcare IT News that I skim through and might follow a story if it is a hot topic for me. I skim through magazines and journals from Modern Healthcare, ACHE, Clinical Innovation+Technology, and Health Data Management. 


HIStalk, of course! Online. Healthcare IT News,  online and get printed copy too. HIMSS  Newsletters online.


I read most major publications for our industry, including Hospitals & Health Networks, Healthcare Informatics, Health Data Management, Applied Clinical Informatics, CIO Magazine, Executive Insights, Healthcare Executive, Health Management Technology, InformationWeek, Journal of Healthcare Management (ACHE), AND Journal of AHIMA.


HIStalk, Modern Healthcare, HIMSS, Healthcare IT News, iHealthBeat. And about a million blogs. Everything is read online.


Your esteemed blog. Then HealthsystemCIO online, Healthcare informatics online, healthcareIT online, mobihealth news online.


HIStalk and a variety of other electronic publications.


Healthcare Informatics, CIO and Information Week (some HC coverage), Modern Healthcare, Advance for something or other in healthcare, and HIStalk, of course!


HIStalk is my primary (daily) read. I used to read several others but I can’t seem to find time to stay up with the amount of information available.  I generally peruse Health Affairs as well as Healthcare Executive.


HIStalk of course! Also Healthcare Informatics, Healthcare IT News, Beckers Hospital Review, Healthcare Advisory Board, and HealthsystemCIO.  I read online versions. In addition I get a pdf from Michael Lake on latest technology which I find very helpful.


All online: HIStalk suite of course, Computerworld, Informationweek,Wall Street Journal,CSO. Printed: Healthcare Informatics, Health Data Mgt, CIO, CMIO,Clinical Innovation + Technology. It seems like the analogy of drinking from a fire hose would apply here with all the publications that are available on-line and in print. I would really like to hear others’ perspective as to what pubs they monitor and target in order to stay current.


Other than HIStalk :)  FierceHealthIT (online), Healthcare Info Security ENews (online, with daily emails), 3M Health Information Systems (online), iHealthBeat (online), PHIPrivacy.net (online), and the HIPPABlog (online).


Health Affairs (online and print), Modern Healthcare (online and print), Government Health IT (online), Health Data Management (online and print), Healthcare Informatics (online and print), Healthcare IT News (online and print), Health Leaders Media (online and print), American Medical News   (online), For the Record (online), Information Week (online and print).


HIStalk of course, healthcare it news, Becker’s newsletters, HDM newsletters, Health Informatics technology.


HIStalk, Modern Healthcare’s Health IT Strategist, & Smartbrief all online. I receive a dozen or more paper publications that are placed in the department bathroom that I may flip through if the cover looks interesting.


Online – healthcareit news and blogs.


Modern Healthcare, Advance, Health Leaders, HFMA Journal, Health Data Management (all in print) Healthcare IT News (digital) and, of course, HIStalk.


JAMIA (online and printed), but that’s about all I have time for these days unfortunately.


I always read HIStalk online, healthsystemcio.com, and HDM printed edition. Sometimes other HIT publications from CHIME and others. The CHIME online newsletter has an app that makes it hard to read on my iPhone.


Fewer and fewer it seems.  I would say I routinely scan healthcare informatics, hospitals and health networks, and health data management.


HIStalk, of course.  I skim through the paper copy of Clinical Innovation + Technology (formerly CMIO Magazine).  I receive the email updates from iHealthBeat.


Health Affairs, Modern Healthcare, JAMIA, For the Record.  All print.


HIStalk (love it because we know you keep everyone honest); Healthcare IT News.


Healthcare Purchasing News and many security related pubs, both online and print. At work I prefer online pubs, but when reading at home, I prefer print.


JAMIA (print), JIMIA, (print) ,  the rest on line:  your stuff, i-health, fierce, AHRQ announcements, ONC advt for HIT.


HIStalk (online), Health Data Management, Healthcare Informatics, Scott Mace in HealthLeaders (Scott Mace has been writing in the IT industry forever. He wrote for InfoWorld circa 1980; I think the world of his reporting.) I also read Journal of AMIA, Applied Clinical Informatics (online only) and everything John Moore of Chilmark writes (online). Unless noted as "online" I get these on paper and mostly read them that way.


Curbside Consult with Dr. Jayne 7/8/13

July 8, 2013 Dr. Jayne 4 Comments

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I’ve been working on a major project for the last couple of months and tomorrow is the go live. Tuesday is the traditional day for new releases at my organization. Although the IT staff likes to do things over the weekend, we know that Monday mornings are the busiest day in most outpatient practices and asking users to accept (let alone successfully adopt) changes on a Monday is just a bad idea.

The project involves a unified laboratory ordering scheme across multiple reference laboratories and hospitals, some of which are competitors. As a regional player, our health system took charge of this project with the goal of allowing physicians to more easily order tests from different facilities based on insurance and patient preference. I’m sure the side benefit of being able to see the ordering behaviors of non-employed physicians so that the hospital-owned labs can lobby for greater market share might have played a role in our leadership as well.

It would have been challenging enough to obtain the historical order data from the hospital-owned labs and create the crosswalk to send the proper codes to the designated facilities. We knew from standardizing the lab orders within our own health system that you can’t always map apples to apples. They could be Golden Delicious, or Granny Smith, or Fuji. Sometimes they are eaten via biting, sometimes sliced with a paring knife, and sometimes with one of those fancy gizmos that never quite fits in your kitchen drawer. They may each be an apple, but in the lab world they are entirely different orders.

Throw in the fact that we had to obtain order data from competing facilities and things started to get interesting. One national reference lab was very cooperative . They have 85 percent market share for some of the physicians and are eager to keep it that way. They provided the data exactly as requested and included all kinds of additional data we didn’t ask for initially, such as reference ranges, order entry questions and their expected responses, and even the type of tube needed for blood draws. They also provided it within one week of the request, which was outstanding.

Another national reference lab was less cooperative. They have a decent market share, but tend to act like they are the only show in town, and their response to our data request was handled accordingly. They initially provided data that lacked vital fields and wasn’t even for the time period we requested. They would send different parameters for different physicians on different spreadsheets. We had to explain to them multiple times that we needed consistent data to keep our analysis functional across all the practices and facilities. It took nearly eight weeks to finally receive the data.

The rest of the facilities fell somewhere between those two on the spectrum. Thank goodness I had a health information management intern to help out. As the data started to come in, we began the analysis. What we found was interesting, namely that physician ordering patterns were all over the place. We knew that we would see a wide variety of ordering behaviors given different specialties and geographies. We didn’t expect to see as wide a distribution within a single specialty, however.

Once we started to see some of the outlier tests that were being ordered, we also asked for data looking at how often the labs were contacting ordering providers for clarifications or substitutions. The preliminary analysis led us to increase scope and add the complicating factor that’s making me the most worried about tomorrow’s go-live: we made it easier to order the right test and a bit more difficult to order the wrong one rather than just mapping everything that had been used in the past. Given the fact that many of the participating providers have at-risk contracts or are part of an Accountable Care Organization, most people were on board with efforts to drive ordering behavior. How users respond to it in a live environment may vary.

Even without that particular challenge, managing the data was going to be difficult. We compared the lab-provided data to order data extracted from some of the provider EHRs and found that quite a few providers had test libraries with incorrect or outdated order numbers. We had to compare the tests they were intending to order with the current order numbers and ensure that we didn’t have duplicates or mismatches.

We had to work closely with a diverse group of resources – physicians, office managers, nurses, laboratory technicians, pathologists, interface specialists, software developers, and more. It was interesting to see each group’s perspective. However, I was surprised at how little some groups knew about the end user experience and what providers need to order labs accurately and efficiently.

Right before testing began, I thought I was losing my mind with collating all the different facility and provider approvals. I’m extremely grateful to a colleague who presented me with a delightful addition to Excel that helped me do the final bit of data cleansing. I don’t know how I lived without it. I am thankful not only for a new tool in my belt, but for someone who cared enough to see a problem and offer to solve it.

I’m sure there will be some unhappy providers who can’t find the tests they’re used to ordering. We’ll have a fully staffed go-live war room with not only directions to find the correct test, but an explanation of why the “old” tests were retired. I’ll be manning the phones as well, not only for escalations, but to see how the process is working overall. Wish me luck!

Print

E-mail Dr. Jayne.

Morning Headlines 7/8/13

July 7, 2013 Headlines 2 Comments

Outsourced UPMC workers protest cuts

Transcriptionists at Pittsburgh’s UPMC protest the decision to outsource their jobs to Nuance. The workers were offered remote positions with Nuance, but at a significant pay cut.

ONC Patient Safety Webinar

ONC will hold a meeting on its recently announced patient safety plan this Wednesday, July 10, at 3:45pm EDT.

Low sign-up for Australian eHealth records

In Australia, the highly publicized national patient portal is criticized after the one-year anniversary of its launch passes with only two percent of the Australian population having created accounts.

Open Letter to Chuck Hagel: DoD still doesn’t know what the hell they are doing

VistA expert Tom Munnecke publishes an open letter to Chuck Hagel in which he explains why implementing VistA would be a logical choice for the DoD and why a commercial solution would be an expensive mistake. He uses England’s NPfIT failure as an example of what can go wrong when a national strategy is centered around integrating multiple systems and points to the NHS’s recent decision to evaluate the use of VistA as a single, integrated solution as validation of that approach.

Monday Morning Update 7/8/13

July 6, 2013 News Comments Off on Monday Morning Update 7/8/13

From Utopic: “Re: Notice of Privacy Practices. HIPAA 2013 regulations require that the NPP and breach notices be written in plain language. That didn’t happen in the original HIPAA notices and probably won’t happen in this version either. Communicating in plain language doesn’t seem to be an issue for any of your survey respondents. I have a three-page summary if anyone is interested.”


HIStalk Webinar July 17

7-6-2013 3-32-09 PM

The next HIStalk Webinar will be “Five Steps to an Enterprising Imaging Strategy” on Wednesday, July 17 from 1:00 to 1:45 p.m. Eastern, sponsored by Merge Healthcare and presented by Steve Tolle, senior VP of solutions management. The US performs 800 million studies annually and industry experts predict steady growth over the next three years. How do you plan to share this information across your organization and your referral network and to securely store it? Implementing an enterprise imaging strategy and archiving data in either the world’s largest VNA or the cloud is your ticket to true interoperability.

C-level HIStalk readers have provided presenter feedback and the session will be moderated by HIStalk. According to one of the CIO reviewers who reviewed the rehearsal session, “I have to be honest, I wasn’t sure if a presentation on enterprise imaging would grab me. The presenter did a great job in covering why an enterprise imaging solution is needed in today’s world and what it could do to alleviate issues in hospitals.” Register here.


7-6-2013 4-31-02 PM

The vast majority of respondents think McKesson’s customers should care that John Hammergren will get a pension of at least $159 million, although the comments are equally passionate for both sides. New poll to your right: now that implementation of the ACA employer mandate has been pushed back, should healthcare organizations proceed plans to buy software to meet ACA-driven needs?

7-6-2013 3-56-49 PM

Welcome to new HIStalk Platinum Sponsor CoverMyMeds. The Columbus, OH-based company has put the Prior Authorization process for prescriptions into modern decision support workflow. Over 100,000 providers use its service for free with health plans, PBMs, and drug companies footing the bill because CoverMyMeds makes them more efficient. Providers access the service through their EHR or from the company’s all-payer portal and get real-time determination. It’s not just about efficiency – when Prior Authorization takes too long, 30 percent of patients to just give up and abandon their prescriptions, causing all kinds of clinical and cost issues. The average doctor spends six hours per week filling out PA forms. If your company sells a pharmacy or EHR system, you can add the “Best Feature Ever” with APIs that can manage PAs either before they are submitted or after they are rejected. Thanks to CoverMyMeds for supporting HIStalk.

I found this YouTube video on how CoverMyMeds works.

7-6-2013 4-12-39 PM

Constantine Davides has updated his popular HCIT Consolidation Chart for HIStalk readers. It lists all of the healthcare IT acquisitions by company. Take a look if you (a) wonder why your vendor’s allegedly integrated products aren’t because they were simply bought and relabeled; or (b) you are creating a healthcare IT trivia contest and need hard questions like, “What was the name of the event notification software vendor that Philips acquired?” (answer: Emergin.)

7-6-2013 4-41-41 PM

NHS England publishes “Safer Hospitals, Safer Wards: Achieving an Integrated Digital Care Record” that describes its all-digital goal for 2018 and the $387 million in available grants for NHS Trusts. NHS says it will consider the use of the VA’s VistA, summarizing, “One of the significant products we have investigated is VistA and for reasons described in more detail below we are looking to adopt some of the ethos behind its creation and potentially part, or all, of the technical product, in combination with others to generate NHS VistA. NHS VistA as a concept will focus on bringing together the best of breed capability of Open Source solutions and will be driven by NHS organisations with the support of NHS England and others. The US Veterans Health Administration VistA system was created in the 1980s by clinicians and software engineers from the ground up. It has become renowned across the world as the first truly integrated, clinically owned system. It has been in operation long enough to be able to demonstrate real clinical outcome benefits.”

VistA expert Tom Munnecke’s “Open Letter to Chuck Hagel: DoD Still Doesn’t Know What the Hell They Are Doing” says “DoD is trying to get out of a hole by digging it deeper.” A snip:

Rather than lifting up the VA eligibility problem to a shiny new common information system, you are on the verge of dragging health IT into the same bureaucratic vortex that has already done so much damage in the past. AHLTA was declared “intolerable” in a Congressional hearing four years ago. Yet, not only is it still around (and absorbing $600m/yr operations and maintenance costs), but it is also serving as a template for the next generation of the IEHR – a top down, mega-centralized administrative system far removed from the clinical needs of health care professionals and patients. DoD continues to focus on the organization chart, not the patient, closely coupling their software designs to their bureaucratic stovepipes.  Indeed, it is rare for me to even find the word “patient” in any DoD health IT documents.

7-6-2013 7-13-51 PM

Christopher Assad, MD develops a prototype CPR app for Google Glass that walks laypeople through the process of performing CPR effectively following the beat of “Staying Alive,” which coincidentally sets a pace of 100 compressions per minute.  

Thanks to the following sponsors, new and renewing, that recently supported HIStalk, HIStalk Practice, and HIStalk Connect. Click a logo for more information.

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Outsourced UPMC transcriptionists hold a rally outside the health system’s headquarters in the US Steel building in Pittsburgh to protest the transfer of their jobs to Nuance. Their union wants them to receive severance pay, health insurance through Nuance, uncontested unemployment claims, and an apology from UPMC CEO Jeffrey Romoff. All were offered jobs by Nuance, but at $8 per hour instead of their previous $12-15.

ONC will hold a Webinar on its just-released patient safety plan on Wednesday, July 10 from 3:45 to 5:30 p.m. Eastern.

Vince covers the death the death last week of computer mouse designed Douglas Engelbart.


Contacts

Mr. H, Inga, Dr. Jayne, Dr. Gregg, Lt. Dan, Dr. Travis.

More news: HIStalk Practice, HIStalk Connect.

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Comments Off on Monday Morning Update 7/8/13

Morning Headlines 7/5/13

July 4, 2013 Headlines 1 Comment

May 2013: EHR Incentive Program

May marks the slowest growth in eligible professional attestation since June 2011, netting just 892 new EPs and moving total attestation rates from 55.3 percent to 55.4 percent.

Safer Hospitals, Safer Wards: Achieving an Integrated Digital Care Record

In England, the NHS issues a report which confirms that it is evaluating the implementation of VistA to meet its health IT goals in an open source environment.

Lawmakers release comments on call for ‘reboot’ of Meaningful Use program

Six Republican senators have released the public comments they solicited in April regarding a request to HHS to publish a written plan for how it is implementing the HITECH Act.

Indiana FSSA notifying clients of potential information breach

A computer glitch that caused medical records to be erroneously printed and mailed to the wrong patients is being blamed for a massive personal data breach in Indiana that has impacted as many as 187,000 patients.

News 7/5/13

July 4, 2013 News 8 Comments

Top News

A Dow Jones article says Intuit not only found its healthcare portal business to be a poor fit in its financial product lineup, the company had to write down $46 million in May after Allscripts bought Jardogs, which offered a patient engagement platform that will likely eliminate the dependence by Allscripts on the Intuit Health patient portal. The customer comments I heard at ACE 2010 (the Allscripts user group meeting) weren’t complimentary about Intuit’s portal, which it had just bought with its acquisition of Medfusion. It will be interesting to see if Allscripts will make a play for Intuit Health since it has already acquired Jardogs as an alternative.

Those with memory deficits might want to study yet another example of how outsider companies throw down big money to buy their way into the healthcare market because it looks easy, then slink off licking their wounds shortly afterward as they dump customers off to any bidder willing to take over the smoking wreckage of what used to be a decent company and product. That might be a fun exercise: leave a comment about which big company screwed up the most in its unsuccessful foray into healthcare. I always vote for Misys, which I’ve always suspected was created solely to amuse the industry with an exaggerated parody of incompetence.


Reader Comments

7-4-2013 9-40-51 PM

From RustBeltFan: “Re: HIPAA Omnibus Rule Advisory Panel responses. Scary answers! Maybe you’d be doing all of us a favor by developing a HIPAA Omnibus Rule 101 series for HIStalk!” Most of the CIO/CMIO respondents said their organizations were generally oblivious to the new rule, which kicks in September 23, 2013. If you are an expert on the topic, consider presenting an HIStalk Webinar to enlighten readers. This would be purely educational, with no commercial bias or sponsorship, and I’ll provide the platform and promotion to let you reach an appreciative audience (and it’s not bad for resume expansion and industry exposure besides.) Contact me if you’d like to present on this or any other educational topic.


HIStalk Announcements and Requests

Happy Independence Day. I’m not a fan of calling it the “Fourth of July” since that’s devoid of creativity and as dull as calling Christmas the “Twenty-Fifth of December” or New Year’s Day the “First of January.” About the only good thing about calling it the Fourth of July is that politicians weren’t tempted to make it a Monday holiday and thus destroy its historical significance simply to give Federal workers (and eventually the rest of us) a long weekend. At any rate, my flag is flying outside and I hope yours is, too. I worked a regular day today at the hospital and now I’m writing HIStalk, so I’ll celebrate by watching a few minutes of “A Capital Fourth,” which I’ve actually seen in person on the National Mall once. It was fun but dangerously hot, and while I’m glad I did it once, I have no plans to do it again other than on TV.

Other than HIStalkapalooza, what HIStalk activities, if any, would you like to see at the HIMSS conference in February? Let me know. I’m planning it now before I get swamped again starting in October.

On the Jobs Board: Senior Healthcare Policy Analyst, Epic Project Director, Android Developer – Healthcare + Google Glass, Staff Software Engineer .NET.


People

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Scott MacLean, deputy CIO and director of operations at Partners HealthCare, starts his one-year term as chair of the HIMSS board. Carol Steltenkamp, MD (CMIO, University of Kentucky Healthcare), is named vice chair; Paul Kleeberg, MD (CMIO, Stratis Health) becomes chair elect; and Pete Shelkin (Shelkin Consulting) is named vice-chair elect.

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New HIMSS board members starting their three-year terms this month are Beverly Bell, RN (VP, Health Care Dataworks); Beth Halley, RN (principal advisor, MITRE Corporation); Rick Schooler (VP/CIO, Orlando Health); and Michael Zaroukian, MD, PhD (VP/CMIO, Sparrow Health System).


Government and Politics

7-4-2013 9-02-50 PM

The Wall Street Journal apologizes for not having been critical enough of the Affordable Care Act, which it calls “a fiasco for the ages” and a “rolling train wreck.” It speculates that the Treasury Department pushed for delayed implementation (possibly illegally since Congress didn’t approve a delay) of the employer mandate because its own software isn’t ready to handle the changes. Apparently only the WSJ missed the obvious point that employers could bypass new healthcare expenses by either (a) cutting their headcount to drop below the 50-employee minimum; or (b) turning full-time positions into part-time positions. Their conclusion: the whole ACA could go right down the toilet because it was sloppily written, is impossible to execute, and will hurt employment. 

Speaking of the ACA, here are some interesting thoughts from a well-connected reader who knows what he’s talking about: with the announced delay in the ACA employer mandate and the uncertainty about the individual mandate, will hospitals ever really see the influx of newly insured patients they have expected? And if they have any doubt about that (which they should), will they curtail big software investments now?


Other

7-4-2013 9-08-46 PM

US Army Sgt. Kyle Patterson and his wife Ashley thank The Aroostook Medical Center (ME) for using an iPad and Skype to create a video connection that allowed him to participate in the March 29 birth of his daughter from his post in Afghanistan. According to Ashley, “Kyle was just over the moon. He told me before the birth that he was not going to cry, but he did. He sure did.” The family presented TAMC with a flag that Sgt. Patterson flew in their honor at Bagram Airfield. The hospital flew that flag on July 4 to honor all members and veterans of the military.

A New York Times article entitled “American Way of Birth, Costliest in the World” says we spend $50 billion per year on four million births, a lot more than other developed countries that provide comparable access to services and technology. It describes a pregnant woman whose insurance doesn’t cover maternity costs trying to figure out how much money she would need, only to be told by the local hospital that it would be between $4,000 and $45,000. Her response: “How could you not know this? You’re a hospital … I feel like I’m in a used-car lot.” 

7-4-2013 9-46-58 PM

Maine Medical Center says it has fixed its problems with Epic, with Epic itself issuing a rare statement in saying MMC’s problems weren’t related to software defects. The hospital admits that the computer issues caused budget problems, but says those aren’t related to the buyout offers it will send out to 400 employees this week.   

7-4-2013 9-48-12 PM

The bonds of North Mississippi Health Services (MS) are downgraded because of financial losses largely due to $11 million in one-time expenses in implementing Allscripts at its Tupelo campus. Fitch Ratings says the implementation required more staffing and budget than expected and also increased length of stay.

In England, the head of the defunct NPfIT is called out, along with two other executives, for spending more than $100,000 for a consultant to help them look good in a single meeting with the Public Accounts Committee. A Member of Parliament describes their performance at the hearing as “woeful,” and suggests, “Perhaps they should ask for their money back.”

7-4-2013 9-58-56 PM

Weird News Andy succinctly titles this photo, “The ‘M’ stands for … “


EPtalk by Dr. Jayne

A Minnesota study demonstrates improved blood pressure readings using telemonitoring technology. Patients also kept their blood pressures controlled six months after the intervention ended. Pharmacists provided consultation and education over the phone once readings were received.

We know that exercise helps many of us deal with stress. Princeton researchers show that exercise creates new brain cells while also creating calm in other parts of the brain. The study involved mice running on wheels, which is a lot like being employed in the health information technology realm, especially during the summer. So many people assume summer is a “slow” time but I’ve found it to be stressful with many co-workers on vacation and the same amount of work to be done. Don’t forget to get your exercise and be glad you don’t have to be immersed in ice-cold water to be stressed (like the mice were.)

Thank you to everyone who sent comments (both posted and e-mailed) regarding my “tale of the ED” Curbside Consult. I’m happy to report that my sweet grandmother was discharged home to continue living independently. Her medications were adjusted, she’ll have some home therapy, and we’re off tomorrow to see if she’s a candidate for an injection of the pinched nerve that seems to be the root of the problem. I’m pleased to report that the care she received on the med/surg unit was both high touch and high tech, which renews my hope that we don’t have to sacrifice one for the other.

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Thank you also to HIStalk contributor Ed Marx, who was the first to wish me a Happy Birthday this morning even though he is in the midst of climbing Mount Elbrus. His team is scheduled to summit on the 10th, so please join me in wishing them a safe journey. For our US readers, enjoy the Independence Day holiday. If you’re working in the trenches, double thanks to you.


Contacts

Mr. H, Inga, Dr. Jayne, Dr. Gregg, Lt. Dan, Dr. Travis.

More news: HIStalk Practice, HIStalk Connect

 

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Advisory Panel: HIPAA Omnibus Rule

July 3, 2013 Advisory Panel 4 Comments

The HIStalk Advisory Panel is a group of hospital CIOs, hospital CMIOs, practicing physicians, and a few vendor executives who have volunteered to provide their thoughts on topical industry issues. I’ll seek their input every month or so on an important news developments and also ask the non-vendor members about their recent experience with vendors. E-mail me to suggest an issue for their consideration.

If you work for a hospital or practice, you are welcome to join the panel. I am grateful to the HIStalk Advisory Panel members for their help in making HIStalk better.

This question this time: Are your organization’s executives paying a lot of attention to the HIPAA Omnibus Rule or is it just business as usual?


It has been difficult to get executive attention on HIPAA security topics in general. We are going to use the HIPAA Omnibus rule to kick start a new education and training program across the entire organization. We will start with executives first.


Pretty much business as usual.


No, or if they do, we are not aware of it, which is just the same. Business as usual — the yearly training from a hired overpaid consultant so we can check the box for compliance.


[vendor member response] We are paying a lot of attention. As part of a recent acquisition, we are now part of a larger organization that is working to extend coverage of HIPAA, HITECH, and the BAA more broadly.


Business as usual.


It’s primarily business as usual, however, there are some provisions of the rule that may require us to revisit many of our third-party contracts. That has the potential to be a major endeavor, so it is something we are evaluating now.


Business as usual.


IT executives are because we are also on the hook for data security. The ability to not share data on specific encounters defined by payer type (insurance vs. self pay) concerns me a lot. I am not sure the HIS/ EMR/ EHR vendors are ready. I can’t say any of our other executives have even read a brief on the Omnibus rule.


[vendor member response] We are very concerned about the increased risk/liability for breaches. This is a big concern when using contractors. Our clients are not knowledgeable about the changes and truly not focused on it at all. On the ambulatory side of things, practices, even larger ones, are so swamped with EMR/EHR, and revenue loss from managed care that they consider HIPAA a done deal.


No. They are not at all, even after several attempts to raise awareness.


The organization is ignoring the rule, but the expectation is that IT and HIM stay on top of it. I don’t have a problem with that and so IT/HIM are finishing up our changes in order to comply.


We hired a CISO out of the military with a background in technology security. She makes sure the execs are paying attention. We have a team that consists of privacy officer, corporate compliance, audit, and CISO. They meet regularly to address all aspects of HIPAA and HITECH requirements including education.


It is business as usual with no real interest from the senior team or the board.


Our Privacy & Security Officer are, and they’re slowly getting the attention of leadership. We addressed a lot of the changes in the proposed rule, so we don’t have as much to address as we would otherwise.


Business as usual.


[vendor member response] Within our customer base I am seeing customers starting to pay attention to making sure all BAAs are updated and signed. However, I have had a couple of folks tell me there is no ‘hurry, since we have until early fall to totally comply.” I personally am not hearing of any urgency to meet the rule within any conversations I am having at the executive level. I am hoping that urgency is there just not being expressed to me!


Business as usual.


Some attention — trying understand implications…


Except for Compliance, Legal, and IT, it hasn’t had a lot of attention. Many vendors, especially small to mid-sized cloud hosting vendors, have not fully realized the implications.


Appropriate attention has been paid by those over that area.


Our executives have reviewed the rule to see where we need to comply and what actions to take.


Yes.  his has been an agenda item for our executive-level compliance, privacy steering committee. As a result we’ve modified our business associate agreement, are in process of rewriting notice of patient’s right to privacy, same with data breach evaluation criteria.


Just business as usual.  Haven’t heard it come up even once.


Business as usual.


Business as usual. We are overwhelmed right now with MU and NCQA. So many regulations, such limited staff to execute.


If anyone is paying attention to this, it is hard to tell.


More of business as usual. The interpretations and evasions are so vast and pandemic that it more of a series of workarounds than a policy.


All with active BAAs are being touched. Mail-merged form letter, follow-up phone call, lawyer letter if still no response.


Morning Headlines 7/3/13

July 2, 2013 Headlines 6 Comments

Health IT Patient Safety Action and Surveillance Plan

ONC releases its much-anticipated patient safety and surveillance plan that tackles a number of issues, such as how patient safety problems will be reported and tracked. EHR certification bodies will be required to confirm functionality and usability not only through testing, but through field observation. The Joint Commission has also been contracted to help identify and address safety issues.

Intuit Announces Next Phase of Structural Moves; Organizational Foundation Now in Place

Intuit will sell its Intuit Health Group, reporting that it had initially evaluated healthcare as a growth opportunity, but that it had come to realize that its health group would be better off with an organization that has a stronger focus on the healthcare industry.

Judge orders Affinity to bargain with union

A judge in Ohio has sided with a nurses’ union at Affinity Medical Center after they filed a unfair labor charge over a rushed Cerner implementation. Nurses claimed that the go-live date was too aggressive and a lack of training compromised patient safety. The judge ruled that Affinity leadership violated labor laws a number of times, first by refusing to negotiate with the nurses’ union, but other less-than-honorable examples cited by the judge included managers reducing the number of nurses in the ICU as retaliation and managers scrutinizing the charts of nurses who were outspoken union supporters in an effort to initiate disciplinary actions.

Washington Hospital "goes live" with $86 million electronic medical records system

In Freemont, CA, 339-bed Washington Hospital goes live on Epic across all inpatient and outpatient departments.

News 7/3/13

July 2, 2013 News 4 Comments
Top News

7-2-2013 6-10-06 PM
 
ONC releases its patient safety and surveillance plan based on public comments the draft received this past December. In summary:
  • ONC wants EHRs to be equipped with a “report a problem” type button that would collect information about the issue and send it to Patient Safety Organizations using AHRQ’s Common Formats.
  • Certification bodies will be required to “conduct surveillance” to ascertain that the capabilities of a given certified EHR are the same in the field as they were observed in certification testing.
  • Certification body surveillance will also monitor EHR vendor responsiveness to user complaints.
  • ONC will monitor FDA’s MAUDE medical device problem reporting database to find reported events that are related to health IT.
  • Meaningful Use and certification standards will be expanded to cover more patient safety-related objectives.
  • ONC will create tools that will allow provider EHR users to assess patient safety in their organizations.
  • ONC awards the Joint Commission a sole source contract to assist the ONC in detecting and proactively addressing health IT-related safety issues across a variety of care settings. The Joint Commission will develop an IT incident classification system, provide de-identified reports on related sentinel events, conduct at least five event investigations each in hospitals and practices, develop provider tools to help providers understand IT-related sentinel events, and publish a research paper that analyzes IT-related sentinel events.

Reader Comments

7-1-2013 12-52-11 PM

From Evangelist: “Re: Epic. Killing it in large practices.”More than half of all EMR-using practices that have 40 or more doctors use Epic, according to SK&A. Allscripts and eClinicalWorks each serve a substantial percentage of the smaller offices and the top 20 vendors support almost three-quarters of all practices using an EMR. Where people get in trouble is trying to infer from this limited information who’s buying what, which is more a question of practice ownership rather than practice size as hospitals keep buying out doctors and sticking Epic and Cerner in there.From Pointy Head: “Re: McKesson. Killing the MED3OOO Unity project and sunsetting InteGreat in favor of Practice Partner. There have been layoffs.” Unverified. McKesson acquired MED3OOO in October 2012 and claimed major go-forward love for InteGreat, so that’s quite a change in stated direction if so.

7-2-2013 11-02-42 PM

From Iknowa: “Re: Inova. Will collaborate with ValleyHealth, which has hospitals in Virginia and West Virginia, in several strategic areas, including IT. Inova brought its final two hospitals live on Epic over this past weekend, with all five now live on both financials and clinicals.”

From Patient Portal Believer: “Re: portals. Mr. H, you are spot on about the need for a strong patient portal strategy. EMR vendors that don’t currently have a tested and feature-rich patient portal should go out and acquire a portal vendor while there are still a few companies available. The portal is too important to MU2 and beyond to ‘partner’ with a portal vendor and it’s too late in the game to still be developing your homegrown solution. Yet, there’s still a handful of sophisticated inpatient EMR vendors without a portal answer. Hard to believe.“

7-2-2013 8-59-21 PM

From HITEsq: “Re: IRS conservative targeting scandal. RHIOs seeking non-profit tax exemptions were sent to the IRS group that reviewed Tea Party applications.” A New York Times article from last week says the IRS targeted not only conservative groups, but any groups whose use of non-profit application keywords suggested political activities. Among the keywords the IRS used to trigger further scrutiny was “regional health information organizations.”

From West Coast Angel: “Re: RECs. Over half of the 63 ONC grant-funded Regional Extension Centers are developing new service lines in privacy and security, patient engagement, practice optimization, and new service delivery models like ACOs. First round will go live in September.”


Acquisitions, Funding, Business, and Stock

7-1-2013 3-05-33 PM
 
EyeNetra, which offers inexpensive eye-testing technology using smartphones, raises$2 million in equity funding.Allscripts closes $650 million in new financing, which with previously announced credit lines gives it a net of $400 million in liquidity.

7-2-2013 11-06-31 PM

inga_small As reported here this past weekend on HIStalk from an Indoor Privy rumor, Intuit announces plans to divest its health group, including the patient portal business it acquired from Medfusion in 2010 for $91 million. Intuit says it thought the health group could make money, but it needs to be owned by someone who understands healthcare better. It would not be surprising to see one of Intuit’s resellers — such as Allscripts, GE, or Greenway — make a play for the business.A union investment group urges McKesson’s shareholders to vote out Chairman and CEO John Hammergren and two other directors because of Hammergren’s compensation, also demanding that the company split the chairman and CEO roles he holds.

7-2-2013 10-54-17 PM

The Boston newspaper says a real estate deal involving athenahealth as a corporation and Jonathan Bush as a personal investor, along with a developer, will turn several real estate parcels in the Arsenal on the Charles area near athenahealth’s headquarters into apartments, restaurants, and boutiques that will cater to young technology professionals.  According to Bush, “We have work but we couldn’t get live and play into the Arsenal on the Charles. Nobody in this generation wants to schlep for an hour and a half on the Mass. Pike to a little patch of land. This is a generation of people who are just coming out of their dorm rooms. That’s who we’re hiring. These are people who want to work and live near a restaurant that grows its own food, a bar that makes its own beer.”

Sales
 
Women’s Healthcare Associates (LA) selects Vitera PM/EHR.
 
7-2-2013 2-32-56 PM
 
Memorial Hospital (MS) will implement ProVation Order Sets from Wolters Kluwer Health.
 
7-2-2013 6-41-18 PM
 
Liberty Hospital (MO) contracts with Allscripts for IT management services and will transfer its 30 IT employees to Allscripts.
 
Medical Services of America selects Patientco as its RCM solution.

People
 
7-2-2013 11-08-27 PM
 
GetWellNetwork names David D. Bennett (Krames StayWell) EVP/COO.
 
7-2-2013 9-45-36 AM
 
Kathleen A. Frawley, AHIMA board chair and president, died last week at the age of 63, according to an AHIMA notice. She was also a professor and chair of the HIT program at DeVry University’s North Brunswick, NJ campus. Angela Kennedy will take over as AHIMA board president/chair.


Announcements and Implementations
 
Washington Hospital (CA) launchesits $86 million Epic system.Core Health releases results of its healthcare integration compensation survey.
 

7-2-2013 7-22-54 PM 7-2-2013 7-23-35 PM

Flagler Hospital (FL) went live this past weekend on Allscripts SCM, ED, lab, radiology, HIM, registration, scheduling, billing, pharmacy, medication administration, and CPOE. According to HIStalk friend CIO Bill Rieger, “So far so good. Mandatory compliance for physician training has led to some great conversations. The Breakaway Group training simulator program has worked and benefited us Day 1 more than we thought it would. MAKE Solutions workflow testing team work really saved us a lot of Day 1 pain as well. Kudos to the Allscripts team for excellent support and response.” CMIO Michael Sanders, MD dressed for the occasion in a brand new Kevlar vest and garish go-live socks, while the command center crew kept on top of the trouble tickets.


Government and Politics

7-2-2013 11-11-01 PM

The Treasury Department announces that the Affordable Care Act mandate that businesses with more than 50 employees must provide health insurance will be delayed for a year to 2015.

Innovation and Research

7-2-2013 6-59-50 PM

The Hoosier Healthcare Innovation Challenge will present three developer challenges in Indianapolis on July 12: reduce infant mortality by delivering educational information, eliminate duplicate messages caused by multiple Continuity of Care Documents, and perform medication reconciliation across inpatient and outpatient encounters. Teams can receive cash and an in-kind services worth up to $25,000.

The US Patent and Trademark Office awards LDM Group a patent for a method of providing targeted information to a patient through a physician’s server as a prescription is written.


Other
 
CORHIO reportsthat approximately 44 percent of Colorado’s 5.2 million residents are represented on the statewide HIE.Tea party activists in Ohio will use a little-known IRS provision that allows citizens to challenge the non-profit status and executive salaries of hospitals, saying that citizens should question why hospitals with large cash reserves need more federal money to deliver indigent care. One of the group’s leaders calls out Cleveland Clinic’s $9 billion in assets and CEO Toby Cosgrove’s $2.5 million annual salary, saying, “This guy’s making $2 million a year, pleading poverty to help poor people. It just seems a little disingenuous to us in the tea party who volunteer for nothing. We’re curious to see their definition of poverty.”

An unnamed South Carolina hospital’s humorous employee training video demonstrates the frustration patients feel when asked mandatory Meaningful Use questions. “I live in the US of A. My primary language is American.”

Walgreens will pay $1.38 million to a woman who sued the drug chain for filling a prescription incorrectly written by her doctor. The doctor realized that she had specified 100 mg of promethazine, quadruple the intended amount, and called the pharmacy to cancel it. The pharmacist did so, but a computer problem allowed the prescription to be filled anyway. The patient claimed side effects caused her to be fired.

One of the 850 employees laid off last month by St. Vincent Health (IN) was CMIO Alan Snell, MD. The health system also gave a pink slip to its chief medical officer.

7-2-2013 11-12-39 PM

Ohio State University’s Wexner Medical Center paid almost $1 million in legal fees and fines in a frantic effort to avoid having its clinical lab shut down by the federal government. That effort, aided by appeals by the state’s lawmakers to HHS, was successful. The hospital’s laboratory information system incorrectly flagged a proficiency test to be sent out to an external lab and a medical technology student didn’t catch the mistake.

Weird News Andy is fascinated that dogs are being trained to detect hyperglycemia in children by their smell, allowing them to paw the child as a signal to take corrective action. He also concludes that “you can’t legislate intelligence” after reading the story of a woman who mixed up Super Glue and cold sore cream with predictably gripping results and another in which six armed police officers take down the suspected “Surgical Mask Bandit” in a Wells Fargo bank, only to find that he’s a chemo patient making a withdrawal.


Sponsor Updates 
 
  • Vocera demonstrates how its badges work with the Stanley Hugs infant  protection solution.
  • Infor integrates NextGate EMPI and identity management solutions with its Cloverleaf integration and information exchange suite.
  • ZirMed announces that its first claims acceptance rate is averaging 98 percent or higher.
  • Sunquest launches a new website.
  • SIS posts a blog entry called “Careers in Nursing Informatics: Applying Your Knowledge.”
  • The ONC Beacon-EHR Vendor Affinity Group names SuccessEHR National Director of Government Affairs Adele Allison the group’s co-chair, along with Chuck Tryon of MyHealth Access Network.
  • Truven Health Analytics releases the Truven Health Unify ACO solution to help Medicare shared savings program participants manage their ACOs.
  • Forrester Research names CommVault a leader in The Forrester Wave: Enterprise Backup Software, Q2 2013.
  • Jonathan Handler, MD, MModal’s CMIO, shares his thoughts on population health data and why doctors struggle with it.
  • T-System creates a video on its RevCycle+ RCM solution.
  • St. Cloud Orthopedics (MN) discuss how the practice earned $342,000 in Medicare incentives payments following its implementation of SRS EHR.
  • A Windows 8.1 version of AirStrip ONE Cardiology will be released as part of the company’s strategic partnership in Microsoft’s AppsForSurface program.

Contacts

Mr. H, Inga, Dr. Jayne, Dr. Gregg, Lt. Dan, Dr. Travis.

More news: HIStalk Practice, HIStalk Connect

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Morning Headlines 7/2/13

July 1, 2013 Headlines 2 Comments

Halamka: IT Must Plan For Disparate EHRs

InformationWeek picks up a blog post by John Halamka, MD, CIO at Beth Israel Deaconess Medical Center, in which he suggests that the "rip and replace" approach to integrating large health systems will not be possible much longer as ICD-10 and Meaningful Use Stage 2 continue to consume capital and IT resources. He advocates a form of affiliation planning in which critical workflows are targeted and automated rather than integrating all care areas.

El Camino Hospital Cuts Readmissions 25% With Health IT

The 433-bed El Camino Hospital in Mountain View, CA reduces readmissions by 25 percent by identifying patients who are likely to be readmitted and taking aggressive action to correct the problems. One solution that shows promise is a tele-transfer planning program that requires clinicians working at long-term facilities to begin participating remotely in discharge planning meetings early in their patient’s stay at the hospital.

Digital health funding is up, but growth slows, says Rock Health

San Francisco-based health IT incubator Rock Health releases a report detailing venture capital investment activity in the health IT startup sector. The report concludes that investments are up 12 percent from last year, with nearly $900 million invested in startups thus far in 2013, but that the pace of growth has slowed as compared to last year.

Facebook grapples with rules for patients seeking organ donors

Facebook is working on implementing a communication platform that will help match patients seeking organ donors with those that may be in a position to respond. This is the second major announcement from Facebook on the subject. The company recently implemented a program that allows users to declare themselves organ donors on their Facebook profiles, an action that automatically launches an official donor registration website where users can register, then posts a message about being an organ donor on the users profile. That initiative has been credited with significantly increasing organ donor registration rates since its deployment.

Readers Write: Uncovering the Unexplored Role and Benefits of Clinical Data Abstraction

July 1, 2013 Readers Write 1 Comment

Uncovering the Unexplored Role and Benefits of Clinical Data Abstraction
By George Abatjoglou

7-1-2013 8-35-33 PM

With the industry’s move to electronic health records (EHRs), healthcare information management (HIM) professionals as well as RNs must play a guiding role through implementation and beyond, seeking processes and solutions to manage the conversion of enormous amounts of historical health information into meaningful, structured data. One helpful and often underexplored strategy for getting organizations up and running smoothly on an EHR involves pre-go live clinical data abstraction.

Historically, clinical data abstraction has been used to retrieve meaningful information that exists in unstructured formats – paper or otherwise – to fill in the “holes” in the electronic chart. Typically, this occurs so an organization can perform better financial or quality reporting. However, with the current push to implement EHRs within the ambulatory setting under Meaningful Use, healthcare organizations often underutilize or completely overlook using clinical data abstraction as a strategy for jump starting the EHR rollout process. In short, by populating EHRs with these details from paper charts and unstructured legacy EHRs before organization-wide rollout, physician practices to health systems and ACOs can reap EHR benefits more quickly, while ensuring more optimal data quality and integrity.

Whether patient records are electronic or paper-based, most contain “legacy” health information that requires someone to pluck relevant data from unstructured content and incorporate it in a structured, representative history in the EHR. While you may think it sounds like copying and pasting, the medical and scientific nature of the information makes this more complicated than it seems. In other words, clinical abstraction, when done well, is best left to the experts, including trained and credentialed HIM professionals and RNs who are consistently focused on clinical data integrity in their day-to-day roles.

With practice makes perfect, and experts in this arena are skilled magicians at identifying and pulling nuggets of information that will provide practitioners with the most valuable details moving forward, especially from a continuity of care perspective. Moreover, these individuals understand data in a broader way than a coder might, and as a result, take into consideration different clinical components that shape the picture of a person’s whole health as they mine critical details for the new EHR.

Leveraging clinical data abstraction as a strategic step in EHR population can take two forms.

  • Existing resources. Healthcare organizations can facilitate the effort themselves by using staff clinicians and/or hiring additional nurses, medical assistants or students to abstract clinical data.
  • Outsourcing. Other healthcare organizations work with partners who embed clinical experts within the organization to facilitate the process.

Although it’s feasible for smaller healthcare organizations—community hospitals, critical access hospitals, and small practices, for example—to abstract and manage data internally, clinical data abstraction becomes increasingly complicated for larger physician groups and health systems that provide care to hundreds if not thousands of patients in a given day. When these large systems try to enlist internal staff to conduct data abstraction and enter historical data into EHRs, they are likely to run into roadblocks.

For example, relying on internal resources for data abstraction will further decrease the productivity of clinicians and HIM professionals already diminished by an EHR implementation and preparing for the ICD-10 deadline. Clinicians typically decrease the number of patients seen during the EHR implementation period in order to adjust to the new workflows demanded by the technology. A physician who normally sees 20 patients per day may need to decrease patient appointments to 12 per day and gradually work back to a normal activity level after several months. If paired with abstraction responsibilities as well, the productivity decline is often viewed as too steep.

Although it may seem counterintuitive, using internal resources also can lead to the generation of even more non-standard, unstructured data. With patient care being the top priority for clinicians, abstracting clinical data and entering historical information may not always be executed in the same way as a full-time abstractor whose sole focus is on that one task, guided by standardization across every record. While some data is better than none, the benefits of unstructured data within an EHR are not much different than working with paper-based records, which defeats the value of EHR implementation.

An EHR implementation can only be as successful as the quality of its data. As the saying goes, “garbage in, garbage out.” Regardless of an organization’s decision to use internal or external resources, clinical data abstraction overseen by seasoned HIM professionals and supplemented by knowledgeable RNs offers several benefits—some of which are more heavily weighted in the interest of utilizing outside consultants:

  • Improved data integrity. As healthcare organizations go live with EHRs, data need to be organized in a structured and sustainable format to provide consistent core medical content for clinicians across all patient records.
  • Increased patient safety. When data consistently and accurately reflect patient conditions in a streamlined, structured format, EHRs become easier to navigate from a decision-making and care management perspective, contributing to increased patient safety and care quality.
  • Enhanced productivity and satisfaction. By relying on outside experts rather than tapping internal resources to abstract and enter historical data, clinicians’ time is maximized and remains focused on providing patient care, while internal HIM professionals are able to focus on other mission-critical tasks like ICD-10 training.
  • Better patient experience. Tasking clinicians to enter data does not add value to the delivery of care, nor does it contribute to the clinician–patient interaction. Unfortunately, with the learning-curve that often accompanies EHR implementation, a patient appointment can become rather data-driven and impersonal if clinicians spend more time looking at the computer screen than their patients. Using data abstraction experts allows physicians to maintain a positive “human” interaction with the patient, a critical component to meeting patient expectations.
  • Higher return on investment. No matter who facilitates it, there is an absolute cost associated with abstracting clinical data. Outsourcing the process does carry an initial expense, which may then be recouped by physicians’ sustaining their activity loads. On the other hand, revenue lost through decreased provider productivity when clinicians are tasked with performing data abstraction may not be regained. Cultivated by the improved patient experience, outsourcing the clinical data abstraction effort may also lead to additional gains such as practice expansion and patient retention.

The number of provider choices for patients is multiplying and steering healthcare into a more consumer-driven model. The healthcare organizations that thrive into the future will be the ones that safeguard data integrity and use it to streamline the physician/patient interaction. Tapping into the data management expertise of HIM professionals in particular and using clinical data abstraction to improve data quality, patient safety, and clinician productivity is one key to providing a positive experience for patients and clinicians alike – both throughout and beyond an EHR implementation.


George Abatjoglou is CEO of IOD.

Readers Write: My Tradeshow High Horse

July 1, 2013 Readers Write 2 Comments

My Tradeshow High Horse
By Annie Oakley

Perhaps you’ve read HIStalk posts in the past – particularly after HIMSS – lambasting the poor showmanship of exhibitors at tradeshows. Eyes down, phones on, beckoning smiles nonexistent.

You may also have read subsequent reader comments from said exhibitors attempting to explain away their need to ignore attendees for the sake of an incoming service call. I get it. Everyone has multiple jobs to do while at a conference. I’d be surprised to find a healthcare professional – provider or vendor – who doesn’t wear multiple hats these days and gets taken advantage of by 24/7 connectivity.

But, like many others out there in HIStalk land, I say turn your phones off when you’re in the booth. If you need to take or make a call, exit the exhibit hall.

I’ve been on both sides of the booth at tradeshows over the years, and so I feel qualified to get up on my high horse for just a few more paragraphs about my recent trip to the HFMA ANI show. It was an experience that left me optimistic about the tradeshow experience overall, but left me with a bitter taste in my mouth on more than one occasion.

The HFMA staff and volunteers were incredibly helpful, always had smiles on their faces and good attitudes to back them up. The majority of exhibitors that I had a chance to approach were pleasant to speak with. Some were downright engaging, leaving me with lasting positive impressions of their employees and brands. Most were extremely patient in explaining revenue cycle concepts and challenges – not easy completely absorb on first go round.

The “booth babe” phenomenon continues to die a slow death, unfortunately. I found out during an educational session that HFMA membership is 60 percent women. Do exhibitors really think they’ll attract female attendees with models dressed up in racing gear? I saw one male attendee look happy enough as he posed for pictures with them, and I shook my head in shame. Is that really how you want to get your leads? Is that really the impression you want to leave people – mostly female people – with?

Drew Brees was on the show floor for a time signing autographs, an attraction which drew a few dozen folks into a line that crisscrossed the exhibit floor. Now that’s a way to create buzz without alienating anyone.

One more comment, then I’ll get off my high horse. Exhibitors, please don’t be stingy with your giveaways. You and I both know that come the last day of the show, you’ll be moaning and groaning about having to ship them back. I approached one booth BECAUSE of their unique giveaway, but was immediately turned off when the rep, thinking I’d already been by, gave me the cold shoulder. I pleasantly explained to him that we had indeed conversed the day before, but I had not acquired any of his trinkets. He apologized – sort of – and actually said he hates having to talk to people twice! Buddy, if you don’t like talking to people twice, maybe you shouldn’t be in sales.

This particular conference was a great experience for me overall. The positives far outweighed the negatives. But, it’s true what they say: one bad apple can spoil the tradeshow bunch.

Curbside Consult with Dr. Jayne 7/1/13

July 1, 2013 Dr. Jayne 6 Comments

It’s been a busy couple of days for me with a lot going on outside of work. Unfortunately, it was all healthcare related and not in a good way. As I was leaving the office Friday, I received a call from an elderly relative. I wasn’t surprised to hear from her since her daughter had e-mailed me earlier in the week for advice.

It started out last Monday as as a classic tale of the things that can go wrong in a medical office – phone messages not making it to the physician in a timely manner, test results being misplaced, and more. Surprisingly, this was happening in the flagship office of a hospital’s employed medical group that had been on EHR for years. There was no excuse for lost messages, missing results, or delayed callbacks, especially with a frail patient. It was bad enough that she was considering a change of physicians after nearly 20 years at the same practice.

Unfortunately the best advice I could offer based on the information available (and it being Friday after 5 p.m.) was a recommendation to go to the emergency department since the likelihood that she would get a call from the physician was low. I offered to pick her up rather than wait for her daughter to drive over. After all, when you can take a spare physician to the ED with you to make sure you stay safe, you might as well.

The facility wasn’t very busy, but the registration experience left something to be desired. She was in a wheelchair and couldn’t see the “Guest Relations Specialist” over the tall counter. I put that title in quotes because I’m not sure what she was really there to do. She wasn’t performing registration (and in fact refused the insurance cards that were offered) or doing triage. Basically she just found the name in the computer and went back to chatting with her co-worker, which she did for most of the time we were in front of her.

After some time, we met with a triage nurse, who clearly had already reviewed the patient’s records in the EHR was able to ask targeted questions in addition to the required screenings and assessments. We moved quickly to an exam room, where the actual registrar came in and took care of the insurance paperwork. She also corrected a phone number that was at least six or seven years out of date despite several recent visits to the health system.

As sometimes happens in the ED, we saw the physician before the nurse came in. I was pleased to see that the nurse had already reviewed the chart when he arrived. He specifically mentioned that he had looked at her information and would try not to ask the same things as the doctor, which was much appreciated. Although a long-time employee of the health system, he was new to the facility. We sympathized about the EHR and getting used to it. He apologized for being slow on the system and we appreciated his honesty.

I can’t say we appreciated the nurse that was mentoring him, though. She would come into the exam room from time to time and tell him he needed to do things differently in the computer. She never introduced herself or acknowledged the fact that there was a patient or a family member in the room. She barked instructions at him and then left. I could tell he was embarrassed by her behavior. I appreciated his attempts to make up for it.

We finally received the radiology results more than three hours after the tests were performed. After five hours in the ED, she was admitted, which took another 90 minutes. There was little communication about what was going on and why it was taking so long. I know it was frustrating for her as a patient and it was even more frustrating for me as a support person and especially as an ED physician who knows we can do better.

The fantastic nurse wrapped our sweet nonagenarian in heated blankets for the trip to the med/surg unit. He was rolling her out the door when his mentor stopped us to complain about his data entry skills and to make him fix the entries before he left the ED. She had absolutely no compassion for the patient and didn’t even apologize for leaving the gurney half hanging out in the hallway while she complained about the documentation.

We finally made it to the floor, only to experience another bit of silliness. Although the patient was asked at triage whether she was suicidal, whether she felt safe in her home, and the level of her pain, she was never asked her preferred name even though I know there’s a field for that in the system. She goes by her middle name rather than her first, so asking might have been courteous. The nurses immediately called her by her first name and that’s what they had on the white board in her room as her preferred name. Regardless of whether she uses her first or middle, as a healthcare professional, I would never dream of calling a non-pediatric patient (especially one in her 90s!) by anything other than Mrs. or Ms. and her last name.

By now it was nearly 2 a.m. and I helped the nurse get her settled. I’m not sure why we had to go through the instructions for the touchscreen meal ordering system or how to operate the television at that hour, but we did, along with a stack of paperwork that I’m fairly sure she would not have understood without my help. She was finally allowed to rest. Since then her hospitalization has been uneventful, but she has savvy family members that are keeping up with her treatments and medications and making sure to minimize the risk of medical misadventures.

In thinking back about all of it though, it makes me sad. I think we’ve lost the care in healthcare. We’re so busy meeting the letter of the law and checking the boxes that we can’t deliver what we hoped to when we were called to the healing professions. Those making the rules forget that patients are seeing and hearing everything we do and are recognizing that our focus is not on them.

As colleagues in healthcare IT, let’s promise to do our best to turn it around. How do you think we can make a difference? E-mail me.

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E-mail Dr. Jayne.

Morning Headlines 7/1/13

June 30, 2013 Headlines 1 Comment

Jackson plans $830 million overhaul

Jackson Health System, a six-hospital network based in Miami, FL, is asking local taxpayers to foot the bill for an $830 million overhaul. The money would come from a proposed increase in property tax on Miami-Dade residents and would pay for building repairs, new elevators, room renovations, and $130 million in new software for the health system.

Hopkins, Walgreens partner on East Baltimore pharmacy

Walgreens is opening a new location in East Baltimore in partnership with Johns Hopkins Medicine that will be used to pilot new health products and services, including in-store clinics capable of providing urgent, non-emergency care.

Lost piece of thumb drive contained thousands of patient records

A practice in Nebraska is notifying more than 2,000 patients that their medical records may have been exposed after a physician loses an unencrypted thumb drive.

Pa. hospital sued over uninsured man’s 2011 death

In Pittsburgh, UPMC-Mercy is sued along with four doctors for failing to operate on a patient with diverticulitis over 15 months of treatment, allegedly because he did not have insurance, a fact that was noted in his medical record.

Monday Morning Update 7/1/13

June 30, 2013 News 18 Comments

6-30-2013 3-59-13 PM

From Zaphod Beeblebrox: “Re: Allscripts. The second successful activation occurred this month for Allscripts in a UK NHS hospital. This one was on time and on budget. The previous one (Salford) was three months early and on budget. Almost unheard of in the UK NHS marketplace.” The announcement from Liverpool Heart and Chest Hospital says it went live on Sunrise 15 months after their project started. UK hospitals are indeed tough customers as vendors always underestimate the localization challenges, so those Allscripts accomplishments are significant. Sunrise has always been a good product but under iffy executive leadership. The challenges for Sunrise going forward are integration, since Cerner and Epic usually tromp Sunrise easily in that regard, and wariness of the company by prospects after the previous management ran the Allscripts ship aground. A lot hinges on North Shore – LIJ, which is probably locked in no matter what because of the money and energy they’ve spent. I’d want them as one of site visits if I were a prospect, making sure to veer off the planned hospital itinerary and seek out frontline clinicians since Sunrise should excel in that regard. I’d really pay attention to the medication management aspects. And watch those KLAS scores, which if the company can turn itself around, should start to move up a couple of quarters from now.

6-30-2013 3-56-18 PM

From Indoor Privy: “Re: Intuit Health’s patient portal business. Allscripts and others are in discussions to acquire. More details may be coming Monday.” Unverified. I’ve always been amazed that Allscripts put its entire practice EMR strategy at risk by choosing a third-party patient portal in the former Medfusion, acquired by Intuit in May 2010. Intuit was apparently looking for some kind of consumer finance play that would be complementary to Quicken, but like most big companies toe-dipping in healthcare, their impact was minimal and the healthcare business is rumored to have never made a profit.

6-30-2013 3-23-08 PM

Two-thirds of poll respondents don’t routinely take all of their PTO. New poll to your right: should McKesson’s customers care that John Hammergren’s pension will be at least $159 million? Your“yes or no” answer isn’t descriptive, so click the comments link after voting and explain your thought process.

Johns Hopkins Medicine will work with Walgreens to open a new East Baltimore, MD drugstore that will develop health and wellness programs for all Walgreens locations, including offering non-emergency urgent care services delivered by nurse practitioners backed up by Hopkins primary care doctors. It’s a brilliant move since chain drugstores have a massive geographic footprint and often serve as the de facto shopping center for urban areas, allowing Walgreens to scale offerings without additional fixed costs or overhead. The company can make money even if the urgent care service doesn’t because, unlike other medical facilities, a Walgreens store has a lot of higher-margin products to sell to cash-paying customers. It’s also nice for locals because of easy access, shorter waits, and lower cost. High-margin, ambitious, and scandalously inefficient hospitals keep erecting higher and more-expensive figurative walls around themselves and are buying up all the physician practices, so the best hope for affordable, accessible care and health advice may well be chain drug stores.

6-30-2013 4-38-07 PM

Paul Henry (ADP/AdvancedMD) joins CareCloud as VP of small group sales.

It turns out that BlackBerry’s Phoenix-like rise from the ashes has been mostly hype so far, as the company admits that sales of its new products failed to stave off a Q1 loss and will likely result in continued losses in Q2, sending the stock into the toilet Friday down 28 percent for the day. The exuberant analysts are now back to business as usual, i.e. wondering what the flesh-picking buzzards might be willing to pay for the pieces and parts in a fire sale.

A ED medical scribe company touts its success at two Arizona clinics that use its services to avoid having its doctors waste time documenting in the EHR. According to an orthopedic surgeon at on of the clinics, the scribes “may will have saved the clinic by helping with the implementation of the new EMR.”

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I’m intrigued that in the promotional video above there’s a cheap, in-window air conditioner behind Kevin Parks, MD, medical director of San Antonio Community Hospital (CA), that appears to be held in place by badly cut plywood and what looks like Scotch tape (00:20).  They’re expanding the ED to 52 beds, with the opening scheduled for this year, so it’s probably a temporary solution (and looks like it.)  

6-30-2013 7-25-12 PM

Jackson Health System (FL) want taxpayers to provide $830 million for facility and equipment upgrades over the next 10 years, including $130 million for computer software and hardware. The health system hopes voters will approve a property tax increase to pay for the improvements, which it says will make it competitive.

The widow of a UPMC-Mercy Hospital (PA) diverticulitis patient sues the hospital for not performing surgery on her husband over 15 months’ of treatment before his lower intestine burst, claiming that the man’s medical record was flagged with a note that he had no insurance.

A Nebraska medical practice notifies more than 2,000 patients that their demographic information has been exposed when the doctor loses the thumb drive that he wore on a lanyard a round his neck.

Long-time HIStalk friend Dave Miller, vice chancellor and CIO of University of Arkansas for Medical Sciences, explores his artistic side by playing a variety of ensemble roles in a North Little Rock, AR community theater production of “Jesus Christ Superstar.”

Vince wraps up his Epic HIS-tory this week, ready to move on to Siemens in next week’s edition.


Sponsor Updates

6-30-2013 4-03-36 PM

  • Aventura employees cooked and served dinner to children and families at Ronald McDonald House of Denver this weekend.

Mr. H, Inga, Dr. Jayne, Dr. Gregg, Lt. Dan, Dr. Travis.

More news: HIStalk Practice, HIStalk Connect.

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