The Skeptical Convert 3/11/13

Four-Letter Words

An EMR can work well but it can work not so well. I want to try to show you what I mean and not tell you, so I will do this with no words that are long, no more than 4 type hits per word. Why do this? In my head I know why but it is hard to say here just yet. And you can see now how hard it can be to work this way, but I will try to keep to my task.

When you use an EMR to pick out words you want to pick them off of a list. This can be easy if you do not know how to type, but it is not easy to say what you mean all of the time. A list may take you down a road you do not want to go onto, and the way they set an EMR up, a word down the line may not fit with the word up at the top. I see this all of the time when I do my work on the gut and find  a word that is what I want to say, but up over top of it is a word I do not want to say and I can not get out of it.

But what is good when you use a list like that is that all who use it have some way to do it in the same way. They may not all do that but they can do it if they want to. Thus there is some way to make the word sets look and feel the same, so that when you look at it you know where to look to see what you want to see when you want to see it. I also like it, when I work, when I can see what I do, and go back and fix it when I want to say more of what I get in my head as I work.

The idea here is a very big idea and many have had much to say on it for many a year, back more than the year one AD in fact. But I go on too far away from my goal.

On one side I want all the word sets to look and feel the same, but on side two I want to say what I want to say that only I can say. What to do, EMR man? I see that you set it up so that I can do them both if I want to. Is that good? Do we do more good if we all look the same, or do we do more good if some do it a way that they want to and some do it a way that they want to. Is it good to read talk in a way you do talk, or to read some talk in a way you do not talk? I do not know.  

But it can be a good thing to work with a limit.

Oh hell wait…

Robert D. Lafsky, MD is a gastroenterologist and internist in Lansdowne, VA.

Collective Action 3/11/13

The views and opinions expressed are those of the author personally and are not necessarily representative of current or former employers.

What Do You Stand For?

I just couldn’t believe it. There was no way you could convince me when I was 18 that I would live to 21. My lifestyle was so self destructive that I knew I wasn’t going to make it. I was riddled with addictive behaviors. Self-pity absorbed my every thought, and future plans included my funeral and not much more. I literally was standing on what I thought was the truth that I would not see 21.  

It wasn’t until I started to share this with a few people that an orchestration of events happened. I was led into a recovery program that launched me into a new life. I stand on something much different now, a different set of truths that I base my life upon.

Things change and we as people change. Thought processes come and go. Belief systems come and go. You might stand for something one day, receive some different or additional information and your mind changes, now you stand for something else.

There is a saying that bears some thought: if you don’t stand for something, you will fall for anything. There has to be something, however, that we can stand on, something that will not change with new information. I would like to offer a change to that saying because I believe that if you do not stand ON something, you will fall for anything.

The core values for my life are much different today than when I was 18. I was falling over everything, grasping for anything that could give me hope. I didn’t realize I was looking in all the wrong places until I became beat up enough to ask for help. As I found the help I needed, there began to arise in me a foundation for life resulting in a set of core values for my life.  

As I matured,  the core values emerged definable. Today they are Honesty, Integrity, Unity, and Transparency.  

As a leadership team at work, we have incorporated these core values at a departmental level and try to emulate them for our staff. We hold staff accountable to these and ask them to hold us accountable to them as well. They are more than ground rules for behavior, they are a platform that we all can stand on. While there is hierarchy in the department from an org chart perspective, these core values transcend the org chart. In other words, no one should operate and behave outside of the core values.  

Core values are considered before everything we do: decision making, budgeting, staff meetings, difficult conversations, and status reports. Most often they are not considered verbally, it is more instinctual than anything else, regardless, those values are present. Core values alone do not lead to a Utopian environment where everyone is whistling, but they do allow us to move about our day with confidence that we are doing our best and making the best decisions that we can.

Recent events caused me to look at these values as people questioned my decisions. I am confident in my decisions, but I have to admit that I do not always have all of the information. It is impossible to be a decision maker and always have all of the information – that would be way too easy.  

When someone questions a decision, I look at it and see if there is additional information. Perhaps there is a correction either to an assumption I made or to information that was provided. One thing I do not have to do is cover my tracks or try to hide my motives. Core values give me an unshakable foundation to stand on. That’s right, an unshakable foundation. These values do not change based upon any individual circumstance.

Do I adhere to them all the time? No. That is why I have people I trust in my life who have permission to point this out to me and help me humbly apologize and get back on track. They are not designed for a perfect life — they are designed to keep me on a specific path.

Do you have a set of core values that you can verbalize off the top of your head? The truth is that if we don’t know what our core values are, that doesn’t mean we do not have them. We are not even the best person to verbalize our core values. Others around us are better at it because they are more aware of our actions than we are.  

Ask my wife what my core values are. Ask the members of my leadership team, those who work with me day in and day out, what my core values are. Core values are more than just words. They are the way you live, act, play, work, shop, or do anything in life. Core values are behind everything you say and do.

What does this have to do with healthcare? Why do I continue to harp on principles when we have so many other things to be talking about?

I say it again — if we do not stand for something, we will fall for anything. During sweeping change, stability is important. Great focus is needed to guide us through this period of healthcare reform. Define your core values.  If you are not currently living by them, ask some trusting people around you to help. You will be surprised at the response you get.  

If you have them defined, use people around you to help keep you accountable to them and encourage others to do the same  These times are critical and the next generation is depending on us to get this right.

Bill Rieger is chief information officer at Flagler Hospital of St. Augustine, FL.

Curbside Consult with Dr. Jayne 3/11/13

Lt. Dan’s inclusion of “Cisco Study Reveals 74 Percent of Consumers Open to Virtual Doctor Visit” in this morning’s headlines caught my eye. According to the summary, “given a choice between virtual access to care and human contact, three quarters of consumers find access to care more important than physical human contact with their care provider and are comfortable with the use of technology for the clinician interaction.”

I’m not opposed to virtual visits – in fact I’d love to do them for certain patients or for certain conditions. In my market, however, clinicians contracted with the majority of commercial payers are not able to bill for these visits, and patient willingness to pay out of pocket is extremely low. Several of my colleagues have attempted to bill patients for after-hours telephone visits and the practice has been the subject of scorn, not only in the physicians’ lounge, but also with the local medical society.

A true virtual visit is more than a phone call. It’s a scheduled time to talk about the patient’s issues, review medications, review home vital signs, blood sugar readings, diet logs, and other patient data points. Based on a careful history and these elements, changes to the regimen can be made and behavioral interventions can be supported. The history elements, data, care plan, and goals still need to be documented in the patient chart, however, and that takes time. Unless you’re operating under a capitated model where you’re being compensated for these services through a per-member/per-month payment, you can’t perform these services without some sort of compensation.

Virtual visits also generate real liability. They can allow for physicians to care for greater numbers of patients which can increase risk if there is not close adherence to protocols and guidelines or if patients are not well known to the clinician. This makes the need for appropriate scheduling and documentation even more important. Virtual visits aren’t something physicians should be expected to cram onto their schedules in lieu of overbooks to the office schedule.

I do find Cisco’s findings somewhat contrary to my experience in solo practice. When I employed a nurse practitioner to care for my patients as my informatics duties grew, there was a lot of resistance to the team-based approach by some of my elderly patients, who grew up in an era where seeing the doctor was something special and had a unique value outside of the actual medical care. Some patients chose to wait weeks to see me rather than accept same-day appointments with someone other than “my doctor.”

This attitude is somewhat borne out in a later statement in the piece where it was noted that “consumers will overlook cost, convenience, and travel, to be treated at a perceived leading healthcare provider to gain access to trusted care and expertise.” I’m not saying I was a leading healthcare provider (in fact, when I was first in solo practice, I was a fresh grad with a bit too much idealism) but I was a good listener and genuinely cared for my patients. I’m not sure that level of empathy can be easily translated to the virtual experience. I had the privilege of truly getting to know my patients, who also felt they were able to know me.

We exchanged more than symptoms and diagnoses. We also swapped recipes and baked goods, stories of our small community, handicrafts, and more than our share of heartache. I had the distinct privilege of being able to function as an “old school country doctor” in the middle of the suburbs. This was mainly because the opening of my practice solved an access problem, but also gave patients a place they could think of as their medical home, whether it was a designated Patient Centered Medical Home or Center of Excellence or any other buzzword of the day.

I miss having continuity patients and I think about some of my favorite patients often. Every once in a while I will run into one while working in the emergency department and that is a rare treat. Although virtual visits may be cheaper (if they are ever reimbursed where I live) and more expedient, I don’t think they’re going to be as good for building that level of “trusted care” that patients expect when they’re faced with a life-threatening condition. What do you think about virtual visits? E-mail me.

E-mail Dr. Jayne.

Morning Headlines 3/11/13

Department of Veterans Affairs Review of Alleged Transmission of Sensitive VA Data Over Internet Connections

An audit report released by the Office of the Inspector General validates earlier rumors that the VA has been routinely transmitting sensitive patient information across unencrypted telecommunication networks, including patient names, Social Security numbers, birth dates, and EHR data.

Business news briefs: Human error the cause of UPMC electronic issue

A system-wide problem with UPMC’s EHR (Cerner) resulted in all facilities shifting back to paper charting for three hours. Human error was identified as the root cause.

Cisco Study Reveals 74 Percent of Consumers Open to Virtual Doctor Visit

Cisco releases a press release, blog post, and infographic advertising the findings of its Customer Experience Report on health care. The study concludes that 74 percent of consumers are OK with virtual doctor visits.

Health Care Providers Give Cloud Vendors High Marks on Security

KLAS releases a report on cloud-based software solutions. Security and reliability were the two primary factors identified as preventing widespread adoption, despite high marks in both areas from actual users.

HISsies 2013 Winners

HIMSS Wrap-up 3/8/13–Dr. Gregg’s Update

Walking Tale #HIMSS2013

You look upon a road, a long road down which you must travel. You can see the end, but it’s distant. You realize that you’d better get started because, even though it isn’t “a journey of a thousand miles,” it still will only be accomplished by taking the first step.

You begin, taking that first step, and then another, and then another. But before you’ve traveled even one thousandth of your beckoning road, you’re sidetracked by a road sign that calls to you. A way station along your path has already halted your progress and you spend the next twenty minutes partaking of the fare they offer.

Back out on the road and five more steps down the path before yet another beacon beckons your eye and begs you to stay and see. Another quarter hour passes before you rejoin your sojourn.

Each time you attempt to complete your travels, you find yourself halted after a mere few paces. Your goal of reaching the end of the road seems nearly unattainable. Still, each wayside stay brings interesting information that would be hard to otherwise glean. Each halting advance along the path adds something new to your mental arsenal.

Still, you have your goal. The end of the road seems as distant as when you started, yet on you travel.

Every few steps you notice a passerby who’s noticing your gleaming white tennis shoes. Some simply look, others grin, and more than a few pass with commentary which runs typically along the lines of, “You’re smart.”

“I’m not as slow as I look,” you reply (referring to your sagaciousness in choosing footwear suited to the trek you take, not to the speed with which you progress.)

You stride on, rarely feeling as if the snail’s pace of your excursion will ever bring the end within sight. Way station after way station, chit after chat…you always seem to be gaining something, but never seem to gaining ground.

Some of the way stations bring insights that you can use; others bring insights into things you know you’ll never use. Some show coolness and prescience; others show staleness and “catch-up-manship.” Some of the way station attendants are kind and courteous; others are neglectful and rude. (Most seem to wish they could have your footwear.)

Traveling on, you see mountains of the mundane. Many way station aides appear more interested in each other or in their digital social networks than in entertaining passersby. It worsens as the day drags on; their lassitude and languor grows driving your desire to try to disengage their disinterest down. Yet on you slog.

Occasionally, you see flashes of brilliance interspersed amongst the merely repetitive. This helps to keep you going, helps to keep you moving along toward your destination. It’s hard to know which way station will spark your imagination, but there are enough moments and methods of intrigue to keep you seeking the next. You look past the boastful, the bored, and the blatantly bland; you keep searching for the next truly bright idea or engaging way station assistant.

Finally, just when you think your feet can’t stand one more step, you realize you’ve reached the end! You’ve traveled the entire trail, meeting the brilliant and the meek-minded, seeing products superb and those barely-breathing, finding wise counsel and fulsome folly. You’ve seen it all and now you can rest…

…until, that is, you turn to walk down the next aisle.

From the trenches…

“The only exercise I take is walking behind the coffins of friends who took exercise.” – Peter O’Toole

Dr. Gregg Alexander, a grunt in the trenches pediatrician at Madison Pediatrics, is Chief Medical Officer for Health Nuts Media, an HIT and marketing consultant, and sits on the board of directors of the Ohio Health Information Partnership (OHIP).

Monday Morning Update 3/11/13

From Beth: “Re: athenahealth. My little brother just got a job at athenahealth in Boston. Should I congratulate him, or give him stolid advice on keeping a work-life balance? What are the differences between Epic and athenahealth for an implementer?” Good question, which I will defer to readers since I have no first-hand employee knowledge of either company having spent my working life in non-profit hospitals.

From Cat’s Eye: “Re: Neal Patterson. Let’s start a game of Where’s Waldo? with him. Here he is in the UpToDate booth.” I have to admit that I like Neal’s look.

From Boy George: “Re: HIStalk. HIStalk has not been a HIMSS booster and I know as a fact that HIMSS is acutely aware (and envious) of your sponsorship exposure and HIStalkapalooza.” I would hope HIMSS has other HIT worlds to conquer without worrying about my microscopic corner of it. I’ve been writing HIStalk for 10 years while working in a non-profit hospital, so I work pretty hard for whatever success I get, and that success wasn’t (and isn’t) my motivation anyway. As for HIStalkapalooza, I’ll give credit to the companies that sponsor it and the folks who spend the evening with us each year. I do greatly admire the companies that sponsor HIStalk since for most of them, it’s not just a traditional ad buy but rather their interest in truly supporting what I do. I had none for the first few years of HIStalk and I don’t take any of them for granted. I seem to vaguely remember AMIA or CHIME or some group wanting to work with me years ago, but they realized that I’m a loose cannon.

From HIMSSed Out: “Re: booth experiences. Jeff at eClinicalWorks gave a very concise perfectly targeted presentation of their software doing a sore throat visit. No excess, no droning on, just answered my questions in a timely manner. Well done. Lyndsey at athenahealth did a very nice sore throat demo showing me what I needed and answering questions expertly. AND she blew me away when escorting me to be scanned and then handed me a KINDLE to read their material on. Put me down as impressed by the demo, low key attitude, and rocking gift!” I criticize the folks who use the booth as their employee lounge without naming names, but I like calling out those people who do a good job. There is no reason reps need to use their phones during booth duty – assign someone to monitor and return their calls and e-mail if need be, but if you give anyone under 40 a smartphone they’re going to be screwing around with it nearly constantly because that’s what they do off the job and they can’t resist its lure.

From Frank Poggio: “Re: MU. Farzad Mostashari recently said the MU Incentive bonus was safe. So much for political promises. The sequester cuts include an across-the-board reduction in Medicare payments of 2 percent effective April 1 and include cuts to MU bonus money. In my opinion, this will be just the beginning. Big deficits usually mean big cuts for providers. The Obama administration sold the HITECH act to Congress based on a projected savings of $800 billion per the original Rand study, which just a few months ago Rand said was full of errors.” Government doesn’t have “get smaller” in its vocabulary, so I’m pretty sure agencies will apply their sequester reductions in the most publicly visible way possible, i.e. shutting down national parks and closing offices early in the hopes of creating public outrage. There is no way that the government is so efficient that a 2 percent cut should even be noticeable, but they will make it so in protest.

From Guy with the Funny Accent: “Re: HIStalkapalooza. No longer talking to Bonny Roberts as she wouldn’t let me wear the Mr. HISTalk ‘Secret Crush’ sash on the final day of the exhibition.” I like that my secret crush is protective of her regalia. I think I may have blushed a bit as she read her poem on stage and I’m not so sure Bonny didn’t as well since she wasn’t planning to recite her work in front of a bunch of people. She figured out who I am when I lauded her demo style in the Aventura booth a couple of years ago, and with minimal provocation, recited my comments verbatim as we were entering Rock ‘n’ Bowl. She is, as they say, a trip.

From A. Vendor: “Re: HIMSS. It was a wonderful experience for a first-time vendor. HIMSS staff were absolutely wonderful in making preparations and taking care of our needs during the show. It couldn’t have been more effortless. Other than a modest case of booth envy, things went very well and exceeded my expectations. People who were looking found us. We met many interesting colleagues and a number of old friends. In addition to a few good leads, we stumbled into some unexpected opportunities we hadn’t expected. I’m definitely up for 2014, and maybe a little wiser.” I think part of being happy with the exhibitor experience is setting reasonable expectations, like having a central location to meet with clients and prospects, maybe picking up some foot traffic even in the hinterlands, and having access to other vendors in the hall during off hours. Non-vendor HIMSS attendees miss the point that many deals are struck between vendors during the show – marketing agreements, signing up to help with consulting and staffing needs, and perhaps finding an investor if that’s on the agenda. One vendor told me that the VC folks were rapid-firing from one booth to another without regard to what company occupied it, barking out a series of questions about their business in hopes of finding companies to invest in.

From Data Sharing Optimist: “Re: CommonWell. Started six months ago when Arien Malec (now Relayhealth/McKesson, but remember he did a stint with ONC and developed Direct) connected with Dr. David McCallie (VP, medical informatics at Cerner) – they are both very good guys and they decided to create some standards for this type of data sharing. They just finished the standards a few weeks ago. Neal and John H. loved the concept, because even though it might have some competitive issues, they both truly want to see the healthcare system improved, as do all the major CEOs. They went to a small group of folks they believed would hop right on board so they could get a press release out by HIMSS. They did not ask everyone, including Epic, but are talking to them now. From what I heard, they didn’t mean it to sound like Epic refused. That was not their intent, but with two weeks to pull things together, they had to limit things. I talked to Carl about it and got the sense that Epic needs to learn more and see if it is real, but would likely join eventually. Use cases will involve a specialist being able to view and even accept data from an outside hospital on a shared patient, as well as pharmacists being able to bi-directionally communicate with doctors.” Someone who knows all the players told me the same thing – it had to be Malec and McCallie since those are the guys smart enough to make it happen and sell the idea to the suits. I think it was a mistake to rush the announcement and play up the participants without having even invited major vendors like Epic and eClinicalWorks, but apparently the PR urge was strong. So far its accomplishments involve press releases and a Web site. One might logically ask questions like: (a) who pays for the service since infrastructure is required? (b) does the EMR user have to buy or install anything? (c) what are the queries running against? and (d) how is this better than companies like Epic and others that already allow sharing information outside their systems? I like the idea of a standard way of doing things without having a particular vendor owning the platform, so we’ll see if it happens or gets smothered in the bureaucracy of these not-always-nimble big companies.

From Ole: “Re: We are in discussions with EmergeMD regarding telemedicine and would like your unbiased opinion.” I don’t know anything about the company, but perhaps readers who do will weigh in. I would have kicked tires on your behalf at HIMSS but I ran out of time. Actually I didn’t run out of time, but I was so tired of traipsing the exhibit hall by early Wednesday afternoon that I went back to the hotel well before the exhibits closed, had a very early dinner, and finally took my shoes off to write HIStalk. I was really tired, although I now know that I was coming down with a bug at the time.

Here’s to you, IT foot soldiers who will be wide awake at 2:00 a.m. Sunday to make sure systems don’t choke when their clocks spring forward. I’ve been there.

Two-thirds of poll respondents say we’re experiencing and EHR backlash. New poll to your right: why do you think several vendors formed CommonWell Health Alliance?

Speaking of CommonWell, I noticed that they’ve populated the FAQ section of their site. They say the organization won’t actually be established until a 12-18 month proof of concept is completed, making you wonder why it was necessary to announce so early other than to put a stake in the ground.

I hope everybody got out of New Orleans OK. I left Thursday afternoon and the airport was an absolute zoo, so I can only imagine what it must have been like Wednesday evening. Security and check-in lines wound throughout the terminal, the concession vendors ran out of pretty much everything (including cream for the coffee), and the little airport didn’t have enough seats so people were sitting on the floor. It is clear that New Orleans, for all of its virtues, just can’t handle a conference the size of HIMSS without a lot of snafus.

I got home only to be hit with a respiratory infection that sent my temperature soaring and kept me up hacking all night, so I’ll just clean up some loose ends and get back to my Tylenol and Halls cough drops.

UPMC goes to paper for three hours when its patient care systems go down due to human error.

Ernest Health will work with NTT Data to create new post-acute care capabilities in its Optimum product suite.

Heritage Groups makes an unspecified investment in coding services and software vendor Aviacode.

I mentioned several days ago that I received advance word that several EHR vendors would be announced as working with Michelle Obama’s Partnership for a Healthier America in adding obesity-related features to their products. “Several” turned out to be “three”: Cerner, GE, and Physician’s Computer Company. I like the idea and I’m not sure why other vendors didn’t sign on, except maybe because they’re already diverting much of their development budget into complying with federal requirements instead of delivering user-requested enhancements.

Just to clarify a reader’s comment last week: GE Healthcare sold its outsourced physician billing service, not software products like its EMR.

Another MyWay-related lawsuit is filed against Allscripts. Cardinal Health pre-paid $5 million for 1,250 MyWay licenses for resale in April 2009 and is stuck with the 994 of those licenses that it hasn’t sold and are now valueless since MyWay won’t be made ICD-10 and MU compliant. Cardinal looked at Allscripts Professional and passed because of cost, complexity, and the fact that Allscripts sells it directly and they don’t want any part of that as a substitute. Cardinal is suing for beach of contract and wants the $4 million back for its unsold MyWay licenses.

KLAS releases a very small study (100 providers) of cloud computing perception. It says vendors are sloppy with their terminology, calling products cloud-based that are really just hosted and using Citrix or other emulation services instead of true Web services. I like the graphic above.

TeraRecon introduces iNtuition Review, which I’ll describe in the company’s words since it’s a little over my head: “iNtuition has always complemented PACS with advanced functionality to resolve specialized use cases and workflow challenges not adequately addressed by existing PACS solutions. This role is now expanded and enhanced with the new, powerful iNtuitionREVIEW client, designed to complement PACS with multi-monitor display of multi-modality data, in specialized use-cases such as cardiac (CT, MR, Cath, Echo, EKG) or breast (MR, Mammo, Ultrasound). iNtuitionREVIEW is also designed with co-operation and collaboration in mind, with specialized features for the preparation and execution of physician conferences, demos, and multi-disciplinary team meetings.”

Weird News Andy titles this story “An Arresting Development.” A Florida OB-GYN e-mails a patient, threatening to have her arrested if she doesn’t come in for an emergency C-section for her week-overdue delivery. WNA also says he’s not surprised by this 30/70 rule: a third of VA primary practitioners say they’ve missed critical lab results in the EHR due to being overwhelmed with alerts. PCPs said they received an average of 63 alerts per day, with 87 percent saying that’s too many and 70 percent say they can’t manage them all.

Arcadia Software will expand the use of ICU patient monitoring software it developed for Boston Children’s Hospital by collecting data from a network of hospitals to develop insights into treatment decisions and outcomes.

Vince covers the origins of HIMSS in this week’s HIStory.

Final HIMSS Conference Thoughts

Inga liked this: the Vonlay folks prepared a welcome package for newly anointed HIStalk Queen Sarah, who works there (note the labeled cupcakes). Some companies were planning to frame the sashes their employees wore and some folks were supposedly going to wear their sashes to the conference on Tuesday although I didn’t see any first hand.

A low-key announcement during the HIMSS conference involves the formation of the HIMSS-backed accelerator Avia, which is supposed to help provider organizations implement innovative technologies. I don’t really understand what they’re trying to do even after reading the information on their site. Nor do I understand why HIMSS is involved. HIMSS might as well bite the bullet and just buy some vendors and peddle their products directly since they’ve encroached into almost every other aspect of the market.

Brian Ahier got Karl Rove to talk about healthcare IT on camera at the conference.

Vendors have told me that it’s so expensive to dismantle, ship, and store components of their HIMSS booth that a lot of the glitz you see in the exhibit hall goes right to the trash afterward. Good idea by Orchestrate Healthcare, which bought furniture for its new two-story booth and donated it after the show to the New Orleans chapters of Habitat for Humanity and Ronald McDonald House. There’s even a patient aspect: Ronald McDonald House was planning to convert part of its dining room into a conference room where and families can meet with caregivers and Orchestrate’s donation of tables and chairs made that room immediately available for its intended purpose since they had no furniture otherwise.

This reader-supplied HIStalkapalooza photo appears – by virtue of an optical illusion — to have captured Jonathan Bush ticking the chin of an unamused Farzad Mostashari.

The majority of people who left the conference Wednesday missed the most electrifying and informative presentation I’ve seen at a HIMSS conference. I was walking over Thursday morning and a fellow attendee warned me that Farzad Mostashari is a dry presenter because he’s a data guy. I could not disagree more – he is a really good speaker who uses data to support his statements. ONC posted his 2012 keynote on YouTube and I hope they do it again for the 2013 version since everybody needs to hear what he had to say.

Inga and Dr. Jayne are still swooning that the PatientPay folks sent them each a chocolate high heel, thus combining two of their most cherished vices into a single package.

HIStalk traffic was heavy during the conference as it usually is, with visits and page views peaking on Tuesday at 11,000 and 19,000 respectively. Inga, Dr. Jayne, and I were posting and occasionally tweeting from New Orleans, of course, while Lt. Dan kept the home fires burning with daily HIStalk headlines and HIStalk Connect posts. It’s a bit of a potpourri during HIMSS week since we cover whatever is interesting to us, which is almost everything.

More HIStalkapalooza pictures by Istrico Productions. Lots of smiles. I always feel strange seeing my logo (the new one in this case) put on buses, shirts, signage, and electric lights.
 

HIMSS Takeaways

Attending the HIMSS conference is like trying to simultaneously watch every channel on satellite TV. You choose what looks good in the guide, but invariably there’s a lot of crap among the good finds in both the education rooms and the exhibit hall. Even then you’ll see maybe 5 percent of what was offered. At any tableful of people, the only shared experiences may well be the keynotes and perhaps a large social event (looking at you, HIStalkapalooza).

That makes it really risky to summarize the experience and draw relevant inferences from it. Here are my thoughts, which may differ wildly from yours.

• The CommonWell Health Alliance announcement delivered the burst of fireworks that everyone expected, but whether it’s a new commitment to patients or simply an expedient anti-Epic marketing strategy developed by marginally committed members remains to be seen. We don’t really know what will be delivered, whether it will work as described, and how hard it will be for providers to connect to whatever communications infrastructure is developed. If it succeeds, will it put yet another nail in the HIE coffin? Can it be successful without the participation of vendors like Epic, eClinicalWorks, and others? Can vendors really deliver the needed technology along with their ICD-10 and Meaningful Use enhancements, and if so, how will they prioritize the work? It’s easy to get wrapped up in the feel-good, patient-friendly marketing prose and characterize non-participants as patient haters, but let’s see what they can deliver and which companies dominate the process before waving the CommonWell flag.
• Analytics doesn’t make good booth demos, so it’s hard to have a solid takeaway. Everyone knows they need better data, but approaches range from technical toolkits to turnkey systems complete with algorithms and reports for common requirements. We’re past the multi-year, big-expense data warehouses of just a few years ago, but it would still be easy to make a misstep in the zeal of preparing for ACOs and other delivery changes for which the data requirements are still fuzzy. This may be yet another area where providers will wish they had measured twice and sawed once.
• New Allscripts CEO Paul Black has wasted no time in trying to erase the painful memory of a series of Keystone Cops-like corporate gaffes that left the company as a punch line. Remarkably, some recent Sunrise sales and the acquisition of Jardogs and dbMotion provides validity to their claims as a serious player, although it’s early in the recovery.
• The industry is quickly transitioning from the traditional hospital and practice system model, which emphasizes transaction entry and charging, toward a public health focused emphasis that requires heavy consideration of non-episodic patient activity and cost management. This will require yet another round of vendor technology investment on top of ICD-10 and Meaningful Use requirements, polarizing the market even more into those vendors positioned for the future vs. those just trying to milk what market is left selling old-school systems.
• HIMSS finally recognized the role of patients in the healthcare system, at least superficially. You’ll know the movement is real when real patients and their advocates lead significant sessions, hold non-token HIMSS roles, and are actively represented on vendor advisory groups and even company boards.
• More and more of the healthcare IT market direction is driven by the government in general and ONC in particular. Vendors and customers aren’t talking a lot about incremental enhancements or product tweaks. It’s all about analytics, transparency, interoperability, and outcomes. It will be a challenge to turn these somewhat vague concepts into concrete development plans.
• The audience for usability seems to be selective. Lots of people are talking about it, but nobody’s doing much despite government report emphasizing the need to make systems safer and easier to use.
• The market for consulting services is going to be very strong, but it will shift from system selection and implementation to system optimization. That will drive consulting firms to further specialize into specific practices, most notably for Epic and Cerner. IT systems are necessary but not sufficient to drive the needed changes, and that will favor CIOs who have a good working relationships and reputation outside of IT.
• mHealth has a decent chance of improving health in nations where the problem is lack of basic health needs and medical services. It doesn’t seem to have the required impact in countries challenged by prosperity-fueled problems like obesity, lack of exercise, and time-challenged citizens who don’t put their health first.
• The HIMSS conference keeps getting bigger, but nobody knows if the proportion of actual practicing caregivers (rather than former caregivers turned IT cheerleaders) is increasing or decreasing. It’s easier to be irrationally exuberant when the front-line naysayers aren’t in the building.
• My assessment of the educational program and the CE submission process is that it continues to go downhill, making it almost an afterthought to the cash cow, the exhibit hall.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

HIMSS Wrap-up 3/8/13 – Inga’s Update

From Brian Ahier: “Re: HIMSS.  Aside from HIStalkpalooza (which was awesome and thank you very much for inviting me!) where I got to spend over a half hour having a fascinating and detailed conversation with Judy Faulkner. A couple of other highlights were the interviews I got with Jeb Bush and Karl Rove. They are not your usual HIMSS attendees. I even got Rove to make a statement on health IT for YouTube.” Love the picture of Judy holding her HISsie award for Best Leader of a Healthcare IT Vendor or Consulting Firm. Mr. H doesn’t want to run the photo because he knows Judy doesn’t enjoy having her picture published, but she looks happy holding her HISsies award. Thanks for sharing the YouTube of Rove, who claims he is a big fan of HIT.

From Fashion Conscious: “Re: porno nurse. I’d like to contact the vendor who had the nurse in the porno get-up. Do you know or can you find out who that was? The picture has gone viral and nurses are not amused and want to let them know. I’m less prudish than anyone you know and a good sport but if they had an MD in a G-string or CEO in his undies people would be aghast. It amazes me that this Neanderthal thinking continues. It plays out in disrespect to nurses by IT.” I am totally with Fashion Conscious on this one. It’s not only offensive to nurses, but to women in general. And while some marketing type (male, I am sure) thought it would be a great way to attract all those male CIOs, I am certain plenty of men agree that the look works far better at Hooters than HIMSS. I am not certain of the vendor because someone sent me the picture. If you can identify the vendor, please share.

From H2O Lover: “Re: New Orleans. We should never have HIMSS in NOLA again. The city can’t support this many people!” Sadly I have to agree. I was one of the lucky ones with a hotel room two blocks away and didn’t have to mess with overfull buses or long taxi lines. I know Jazzfest and Mardi Gras bring bigger crowds than HIMSS, though more I assume more folks are local and don’t need hotel rooms. Still, I love New Orleans (even though I didn’t see much of it this visit) and found the convention center much easier to navigate than the Sands in Las Vegas.

Through Thursday morning, total HIMSS attendance was 34,696, which included 13,985 professional attendees. At the same point in 2012, registration was 36,586 with 15,262 professional attendees.

HIMSS annual leadership survey finds that nearly two-thirds of HIT professionals in provider organizations surveyed have already qualified for MU Stage 1 and three-fourths expect to qualify for Stage 2 in 2014. Eighty-seven percent of respondents expect to complete their conversion to ICD-10 by the October 2014 deadline.

I loved the final keynote featuring James Carville and Karl Rove. I don’t think they figured out the answers for the economy, healthcare, or any other issues, but the two were entertaining. Rove was witty and supported his arguments with a lot of data. Carville supported his views with a different set of data, of course, and also sometimes rambled, but had a number of laugh-out-loud one-liners, including:

This ain’t Fox News. You can’t just make stuff up.

Prices on a hospital bill mean as much as a price tag on a rug in Istanbul.

I may not be from Wisconsin, but I am going to milk this thing pretty good.

Wednesday I waited about 30 minutes in the Starbucks line (it was more about catching up with a friend than the coffee.) As we neared the front, a representative from Iatric (Judy, I believe) handed out $2 off coupons for the next 12 people in line if we agreed to wear an Iatric slap band. It was a brilliant and effective marketing idea and I bet I wasn’t the only one who stopped by the Iatric booth to say thanks.

I primarily work out of my house, ,and during the work day, I rarely talk to anyone in person or on the phone. However, I can be a Chatty Cathy and enjoyed bantering in the Starbucks line with Julie from RF Ideas, who happens to wear the same perfume as me and likes the same brand of flats that I was wearing.

Sometimes I forget that not everyone goes to HIMSS to check out the bleeding edge stuff. I talked with the purchasing manager for a large health system who said her primary mission was to find a good source for batteries and power supplies for her COWs. I guess that is why fax vendors still shell out money to exhibit.

I was disappointed that so many of the exhibitors were packing up their booths two hours before the floor closed. I was with a physician friend who was interested in an EHR solution for a niche specialty and had identified the exact vendor he wanted to see. When we got to the booth, everything was boxed up, though the rep did open his laptop and show us a few things. The same guy told us that you can’t “clone” previous chart notes and insert them into new notes because it was a violation of HIPAA. My friend quickly advised him that whether or not cloning was an acceptable practice had nothing to do with HIPAA.

I love to ask other people their impression of the convention and what people were talking about. I was surprised that no one I asked mentioned ICD-10 as a big issue. I am not sure if that’s because organizations already have identified their ICD-10 solution or because ICD-10 is simply not their area of concern. I didn’t find anyone overly impressed with the CommonWell announcement, though I somewhat disagree. The only other big announcement was the Allscripts acquisitions of dbMotion and Jardogs, which wasn’t exactly earth-shattering news.

After five days of HIMSS, I am left with the impression that the industry is moving past the emphasis on core EMR and HIS systems and looking for solutions that make existing systems work better. The exhibit hall was full of vendors offering integration and interoperability solutions. Even more vendors were promoting data analytics and population management tools. Other smaller vendors were demonstrating niche solutions that bolted on or worked behind the scenes with core applications to improve the user experience (such as a more user-friendly user interface) or to add functionality (e.g., clinical decision support tools.) Patient engagement tools were also hot.

I think Farzad had it right in his keynote speech when he noted that the transformation process is far from complete. Organizations have implemented many of the basic EMR functions, but now providers are just beginning to take the collected data and consider ways to use it to improve the care process. Usability is still hindering adoption, so providers mush push vendors to improve usability. At the same time, providers need to develop and embrace more efficient and effective workflows.

E-mail Inga.

From HIMSS 3/7/13–Dr. Jayne’s Update

Wrap-Up

Although I had to leave early and missed today’s keynotes, I unfortunately didn’t miss some major hassles trying to depart. Let this serve as a warning for those of you who haven’t checked out yet. And I mean checked out of your hotels – there are certainly plenty of people who have checked out already and we saw lots of them working the booths.

My hotel bill this morning didn’t show the deposit I paid last September and they wouldn’t believe the printout I had with me. The staff tried to use a calculator to figure out what I would pay but couldn’t get it to add up, so they adjusted the bill manually and charged it through (after they also adjusted off the bag of Fritos that I certainly didn’t pay $5 for on the day I checked in). While I was at the desk trying to resolve the issue, at least five other people tried to check out and the hotel didn’t have them on record as leaving until tomorrow, which was causing problems.

At least I got good story material – while waiting I witnessed what had to be the winning performance in the “Worst Behavior by an Exhibitor” category. A woman (again trying to check out early according to the hotel computers) was trying to settle her bill to two different credit cards, one of which did not belong to her. The very patient clerk split it exactly as she asked, then she turned around and asked to have it split a different way and went into a very long diatribe about her company’s expense policies and how they fired a VP last year for expensing something that wasn’t real, even dropping the company’s name in front of the 20-odd people who were now in line trying to check out while the two available clerks were dealing with increasingly aggravated customers.

Folks in line were grumbling about the hotel staff generally not knowing there was a convention in town and not staffing accordingly. I had been having a pretty pleasant stay until now, but I returned to the room and checked my credit card online, finding they had charged all kinds of different amounts that made no sense, including the $5 Fritos as a separate line item. I was tired of dealing with the desk and will call their accounting department and On Peak tomorrow to get it resolved. I’m sure I’ll also be dealing with our internal expense auditors who will no doubt see the excessive charges coming through the corporate credit card and flag me for interrogation.

I headed for the airport with a smile because a very sweet vendor friend offered me a ride, for which I am grateful. Thanks for taking pity on a non-profit hospital staffer and sharing your car service. Flights were being delayed due to the snow in the north east, so be sure to check your status before you leave. At least with the computers thinking everyone is staying a day longer than they actually are, you shouldn’t have a problem getting a room if your flight is canceled.

The airport was packed with people trying to depart and the limited restaurants in our terminal couldn’t keep up. Seating was at a premium and the empty gate area with no seats whatsoever was a nice touch. I returned home safely (and with my magnificent chocolate shoe unscathed) despite the weather. I know that the rest of HIMSS is in good hands with Inga and Mr. H covering the remaining events.

In honor of all the Shoe Divas out there, I offer a picture from my home town airport. She’s definitely working it with the sneakers complimenting her full-length mink.

Morning Headlines 3/8/13

Topol helps patient in second airline drama

Three hours after giving a keynote speech at HIMSS, during which he discussed the value of mobile health devices and in particular smartphone-enabled ECG solutions, Eric Topol, MD, was flying back to San Diego when flight attendants began asking if there was a doctor on board. Dr. Topol responded and found a patient experiencing an irregular heart beat. He then used the very same device he had demonstrated during his keynote speech at HIMSS to diagnose atrial fibrillation. Dr. Topol was able to calm the woman and the flight landed shortly there-after. 

Mostashari talks ‘human toll’ of broken health system

In the week’s last keynote speech, Farzad Mostashari, MD, discussed ONC’s goals for the year ahead, which include: increasing the footprint and effectiveness of the nation’s HIEs, promoting interoperability, and increasing transparency and access to data for patients.

A Hospital System’s Wellness Program Linked To Health Plan Enrollment Cut Hospitalizations But Not Overall Costs

A recent study published in Health Affairs suggests a correlation between an employer sponsored wellness program which required smokers to enter a cessation program, and all employees to promise that they would eat well and exercise and a resulting 41 percent drop in hospital admissions for COPD, stroke, and heart disease. This study, however, comes with a surprise ending. Researchers conclude that wellness programs are unlikely to significantly reduce healthcare costs in the short term because outpatient visit costs rose almost as rapidly as inpatient visits dropped.

CMS, ONC issue request for information for HIE

CMS and ONC have issued a joint RFI asking for suggestions on what more, or less, the federal government should be doing to advance clinical information exchange.

From HIMSS 3/7/13 — Inga’s Update

It’s Thursday morning and I am still in New Orleans and excited to see James Carville and Karl Rove. Dr. Mostashari was the keynote this morning and discussed the “why” of Meaningful Use (basically we need to capture the data, share the data, change processes…which in time will result in better outcomes) and strongly emphasized that MU is making impact and there is data to prove it. He knocked the media and “bloggers” a bit, as well as other naysayers who promote the “man bites dog” stories instead of the celebrating the evidence that adoption continues to climb. A couple other notes:

• He expressed shock that so many vendors and providers don’t understand the final 2014 EHR standards
• This year’s interoperability showcase was the “best ever” and involved “real exchange” and not just PowerPoints
• Patients must be more involved in their care and providers must provide patients with their data
• No one should make a profit holding patient data hostage

Mostashari is not only a terrific cheerleader for MU and its success to date, but he also clearly believes in the potential of HIT. I noticed Mr. H tweeted that hearing Farzad brings home the point that like it or not, we’re all in the public health business. He had a great message and it’s unfortunate his keynote was scheduled the day after most people had already left for home.

The crowd for Bill Clinton on Wednesday was insane. I walked in 30 minutes early, just as they were closing the doors and pushing everyone to the overflow section. I was able to stand fairly close to the front, but my body still aches from standing in one spot for two hours. Clinton was as smart and charming as I expected and his overall message was that we’ve got to fix healthcare in order to reign in costs; healthcare needs to be accessible to everyone;  pricing must be transparent; and, everyone needs to become engaged in his own health.

I spent most of the rest of the day Wednesday on the exhibit floor. I probably won’t have time to share all my impressions until tomorrow but I will mention a few things.

I asked someone very familiar with GE why GE was not part of the the CommonWell Alliance. Her impression: GE is traditionally very slow to move on anything, including getting their own products and software to talk.

Several vendors noted the heavy presence of venture capital folks looking at companies.

Loved the green tennis shoes at the Emdeon booth.

Iatric had quite a crowd of people watching their pool shark make a fancy shot while sharing a few details about the company’s data integration products and services. They had a monitor on the opposite side of the booth that was attracting almost as many people as the live view.

I noticed a big crowd of people watching demos of athenacollector.

Practice Fusion’s booth was quite sparse and they had a monitor displaying the number of patients seen using Practice Fusion’s EHR during HIMSS (436,000 and counting) and in 2013 (6.6+ million.)

The woman manning the CHADIS booth stopped me long enough to give me a concise description of their offering: a Web-based screening, diagnostic, and management system for pediatrics that offers online questionnaires for parents. Clinicians use the collected data to manage the care process more efficiently.

Lifepoint Informatics had two engaging guys standing on the edge of the booth (without phones) and greeting people as they walked by. I chatted with them a bit and they handed me two Starbucks cards. Just because. The Lifepoint guys mentioned they had more vendors stopping by and pitching their offerings than prospects asking about the company’s integration services.

I was intrigued by the artist in the Covisint booth and her mural. I wanted to hear what it was all about, but I couldn’t get anyone’s attention.

I took a stroll through the Mobile Health Knowledge Center, which was hopping. There seemed to be a mix of big name vendors as well as some I have never heard of.

There was a long line to tour the Intelligent Hospital, which included an OR, ER, and data center. If you didn’t need to get up close, you could view the set-up through the glass walls.

I chatted with the eClinicalWorks folks for a little bit and asked them why they were not part of the CommonWell announcement. The executive I spoke to didn’t know if they had been asked to participate, but he felt sure they would be willing to look at it if asked, even though they already connect to a variety of other systems. eClinicalWorks always has a modest booth compared to many of their competitors, but they seem to hold their own in terms of traffic.

As Mr. H has noted, way too many exhibitors were busy on their iPhones and iPads. However, I didn’t notice any phone use in a number of booths, including Hospira, Merge, Epic (except for a guy in a Hill-Rom shirt who apparently had walked across the aisle take his call in Epic’s booth rather than Hill-Rom’s), Caradigm, Microsoft, and dbtech.

About the only booth really busy the last couple hours Wednesday was OnBase, which was serving beer. Do these folks look tired or what?

I’ll have one last summary report tomorrow, as well as my impressions on the Carville/Rove session.

E-mail Inga.

Morning Headlines 3/7/13

Q&A: Mostashari on sequester, RECs, CommonWell

ONC Farzad Mostashari, MD, held a Q&A session at HIMSS today, discussing REC’s, the CommonWell Health Alliance announcement, and the federal budget sequester, of which he says "This is going to hurt. We are not furloughing people, which is the bulk of the budget, so our contracts are going to take a big hit."

HIMSS13: athenahealth Issues HIT Industry ‘Code of Conduct’

Responding to recent calls from Farzad Mostashari, MD, for vendors to "step up" and agree to a code of conduct that protects patients, athenahealth publishes just such a code which includes five principles: Empower Data Portability and Provider Choice, Built a True Nationwide Information Backbone, Protect Patients, Prevent Fraud, and Drive Meaningful Use.

Epic’s Faulkner Says Rivals May Use Data Pact as Weapon

In response to the CommonWell news, Judy Faulkner was quoted as saying "“It appears on the surface to be used as a competitive weapon and that’s just wrong." Epic representatives have maintained that they were not invited or informed of the new collaboration between EHR vendors until the public announcement. Together, the five EHR vendors included in the CommonWell Health Alliance represent 41 percent of the market for hospital EHR systems.

Information Overload and Missed Test Results in Electronic Health Record–Based Settings

A study published in JAMA Internal Medicine concludes that clinical notifications, and the alert fatigue that they sometimes cause, is having the unintended consequence of causing physicians to miss abnormal lab results. The study was conducted across the hospital and clinic settings within the Department of Veterans Affairs health system.

From HIMSS 3/6/13

From BD: “Re: finds from the show. Warm and fuzzies all around us.” Funny, I noticed those exact items too. I was picturing a criminal lifer in the back seat of a cab fingering his .45 nervously, but then being scared off upon learning the news that blasting the cab driver might lead to punishment. Apparently New Orleans has a target audience of literate and easily influenced would-be cabbie killers.

From IVANS to Tell You…: “Re: IVANS. ABILITY Network to acquire IVANS. Press release out tomorrow.” Unverified. Both companies are involved with Medicare/Medicaid connectivity.

From Tweeter and the Monkey Man: “Re: Jardogs acquisition by Allscripts. That effectively eliminates Jardogs from 80 percent of all deals as their portal is no longer agnostic. Will a Cerner community buy an Allscripts product? Doubtful. Watch for a rebrand.”  

Wednesday of HIMSS week is always kind of a letdown. Everybody’s tired, sluggish from too much food and drink, and many (or most) of them head out for home later in the day. You could feel the energy sucked out of the exhibit hall, which I left early because my feet were tired (I think I’m coming down with a cold) and I had pretty much seen everything (four trips back and forth the length of the hall today alone.) Above is a typical booth view, with everybody heads-down on their phones.

[ANNOUNCEMENT] We are declaring tomorrow the official bow tie day of #HIMSS13! Let’s give @farzadsbowtie some company!

— HIMSS (@HIMSS) March 7, 2013

I attended an early ONC session that wasn’t interesting enough to hold my admittedly short attention span. At the end, some douchebag PHR vendor CEO charged the microphone in pretending to ask a question by orating endlessly at the ONC panel, then went off in a long, pedantic description of how wonderful his thumb drive PHR product is (including histrionics like waving it around in the air) and claiming it could replace HIEs. If there was one of those bank teller panic buttons, I’m sure one of the ONC people would have pressed it to have him forcibly removed, but without it they could only smile through gritted teeth hoping he would accidentally come up for air so they could interrupt his infomercial. I was afraid I’d get trampled as most of the theater joined me in fleeing for the exits. I wish I had noted the company’s name to award them the appropriate level of public ridicule.

I hate it when people ask their long-winded questions after a presentation. I’d much rather let them use index cards or tweets so I don’t have to listen to their life story instead of the speaker I came to hear. Why are they encouraged to introduce themselves since nobody cares? Why doesn’t someone hold the microphone and yank it away when they refuse to shut up? When I see the self-important folks sprint over top of each other to line up salivating for their turn at the microphone, I make an equally speedy beeline for the door knowing that the interesting part of the session is officially over.

I say it every year, but the best asset of any vendor is the Hyland magician outside their sports bar exhibit. Not only is his magician’s patter amazing (“Wanna see something cool?” which is probably equally good as a pickup line) but he then works the crowd and talks knowledgably about how the OnBase product connects to Epic or Cerner or whatever. There’s no way he could memorize all that, so he must be an employee who just happens to be a magician. Whatever they pay him isn’t enough.

People keep asking me whether Epic should join its competitors in CommonWell. My answer: I wouldn’t, at least not yet. My understanding is that the participants signed a non-binding letter of intent and kicked in up to $2 million each to perform vaguely described interoperability work on an undefined timeline. Set an Outlook reminder for a year from now and let’s see if these large publicly traded companies can actually accomplish anything that benefits patients in ways that existing interoperability and HIEs haven’t. By apparently not inviting Epic initially, at least part of their agenda is pretty clear. The HIMSS timing raises the possibility that it’s more of a marketing program than it seems, to the point that I heard that Allscripts didn’t even sign up until Sunday night (Paul Black wasn’t present at the announcement, maybe for that reason). If they can actually make progress quickly, then Epic can always join at that time since they claim membership will be open to everyone. Being in favor of patient-benefiting interoperability doesn’t necessarily mean signing up for CommonWell, and if the market demands such participation, more companies will get on board.

I heard many people today complaining about having eaten too much very rich food this week. Nobody even wanted the beignets vendors were handing out from their booths today. I was glad that I had a delightful river view tapas dinner with a new friend Tuesday night since I was overloaded with gumbo, etouffee, jambalaya, andouille sausage, fried oysters, and bread pudding. My serum Tabasco levels are off the chart.

A pet peeve: sales guys wearing white lab coats. I don’t think they realize how offensive it is to clinicians (me included) who worked hard to earn the right to wear them in appropriate situations. Maybe next HIMSS I’ll don priest vestments to listen to their pitch.

Bill Clinton drew the largest keynote crowd I’ve seen at a HIMSS conference, totally filling the main hall and darned near overwhelming the huge lobby that served as an overflow area (above). It was like Billstock. I heard that people were so packed inside the hall that they had to clear some of them out because all the blocked aisles were a fire code violation. I guess he was OK in a big picture kind of way, and it’s always fun to get a little bit of inside baseball knowledge from a former president. There were snickers when one of his stories involved “walking down the street with my young intern,” but he clarified that it’s a guy.

Live from the HIStalk Executive Lounge(that’s how Medicomp labeled it) at HIStalkapalooza – attendees issue their predictions for 2013.

Impact Advisors sent over some pictures from their Monday night event at the Grand Isle Restaurant.

Exhibit Hall

Someone from Microsoft apologized here for their employees texting and ignoring booth attendees, so I figured I’d give them another chance. I walked up to the very same station, stood still and made eye contact, and a MSFT guy who was texting walked very slowly away from me, like he wasn’t in a hurry to get anywhere except away from me. I was then intercepted and engaged professionally and cordially by Sarah, but then again she’s the healthcare marketing executive and you would expect her to be excellent (and she was.) Still, it was a much better experience.

I assume the Microsofties and others who have minimal booth personality are technical people and you can forgive them for that. At the opposite end of the spectrum was the utterly delightful young lady at the Tellennium booth. I told her there’s no way she’s a real employee since she was just too upbeat and magnetic and she proudly said that she’s a “brand ambassador.” I liked her instantly.

Here’s a shout out to Chelsey from Radianse, who had the best engagement style I’ve seen so far this week. She wasn’t arrogant, forceful, or overly rehearsed, but she also wasn’t scared to go shoulder to shoulder into the details of their product. Nice job. She pulled me in off the aisle I was walking down and actually taught me a few things that were good to know.

Spectralink had a pretty cool “man down” phone that automatically opens a call to hospital security if the wearer either drops it or starts running. The call is initiated in speakerphone mode, so if there’s something going on or the wearer is unable to reach the phone, the person on the other end will hear it.

Salar’s booth was in a terrible location behind the menacing adjacent booth that loomed up into the rafters, but Greg Wilson did a nice job engaging me, probably just happy to see an actual person in the HIMSS no-man’s land the company assigned the company since it started over on HIMSS points after being acquired a couple of times. Our sign was out there, which is what caught my eye in the first place.

I saw our signs out at the booths of PDR Network, VitalWare, Divurgent, and SuccessEHS. Thanks to those sponsors.

Here’s a rare HIMSS sighting of Cerner’s Neal Patterson, who I noticed as he entered the Motion Computing booth this afternoon right after the Bill Clinton break.

Here’s a video of Dr. Jayne playing Quipstar in Medicomp Stadium.

Some of my favorite people are the ESD crew, who not only sported a fun and beautifully green booth that coordinated with our sign, but who were a blast at HIStalkapalooza this week, sponsored last year’s event in Las Vegas, and might reprise that role in the future. They dutifully posed for a picture. The company really is a great supporter of our work, going way beyond just mailing in a check.

This company always makes interesting shirts.

A reader sent this photo of the cool (but kind of creepy) Greenway smart-alecky avatar. The reader says its name is Christo.

I admire this ingenuity and dedication. Strata Decision Technology is a brand new sponsor and came on board too late for us to make them a booth sign. They e-mailed to say they took a picture of someone else’s, added in their own name, made their own sign, and proudly displayed it in their booth. That is just cool and it honestly moved me, like a lot of things our sponsors do to support our work. I dropped by and chatted anonymously with the folks there, who pleasantly explained what they do when I asked (a single financial platform for capital and operational budgeting, financial decision support, performance reporting, etc.) They didn’t mention it, but I see they announced a new StrataJazz customer today, St. Luke’s University Health Network (PA).

Charlie from Orchestrate Healthcare sent over this picture of our front-and-center sign. Nice.

Announcements

• Bronx-Lebanon Hospital Center (NY) chooses Allscripts Financial Manager.
• We already stated that the VA’s big $543 million RTLS project involves CenTrak and Intelligent InSites, but CenTrak makes it official.

Mr. H’s Ten Commandments for Booth People

1. I will either turn my phone off and leave it off or, better still, put it away out of easy reach before commencing booth duty. If I can’t stay focused on doing the job I’m well paid to do for a handful of hours without screwing around with my phone, I should quit and let someone more motivated take my place.
2. I will stand at all times, sitting only if accompanying a booth visitor.
3. I will maintain a distance of at least 10 feet from the nearest fellow booth person to avoid the temptation of making co-worker small talk that will discourage visitors from initiating contact.
4. I will not interrupt my fellow booth person who is speaking to a visitor, even though I might be tempted to help them complete a thought or help out with a demo. Trying to follow two people talking over each other is fatiguing.
5. I will suggest that the most engaging of our people work the perimeter, with the assignment of quickly engaging passersby and then quickly handing them off to less-gregarious experts who can take it from there. Only the most personable people should serve in this prospect picket role.
6. I will start conversations with pleasant chit-chat and not an overly rehearsed set of facts or questions no matter how many times I’ve delivered the spiel. Nobody likes to be bombarded immediately.
7. I will approach every person who pauses, looks at anything in the booth, or appears lost. People of various personality types may signal their potential interest in a variety of ways.
8. I will have a 10-second answer ready for the inevitable “what does your company do” question.
9. I will not discriminate how I engage with visitors on the basis of job title or organization except perhaps in the case of a direct competitor. You never know who will be an influencer, either in their current role or down the road, and my time isn’t so valuable that I shouldn’t speak at least briefly to anyone who is interested.
10. I will remember that visitors have walked miles and are probably carrying several pounds worth of vendor giveaways, so if I convince them to watch a demo, I will personally make sure they have a seat and a place to lay down their bag.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

From HIMSS 3/6/13–Dr. Jayne’s Update

HIMSS Update

Day 3 at HIMSS and this morning’s run revealed the Harrah’s Employee Health Center. I wonder what platform they use? The weather started to warm up today and it was downright muggy by noon. I spent most of the morning catching up with old friends. It still feels a little strange to have friends that you are very close to and talk with daily but only see once a year at HIMSS or some other meeting. I’m grateful for the opportunity for actual face-to-face interaction especially when beignets are involved.

I spent a good chunk of time on the show floor today, looking for the next big thing. I was happy to see several vendors with their HIStalk sponsor signs prominently placed. It’s always fun to see my avatar smiling back at me and I hope everyone appreciates the hand cramps from all the signing. Thanks to Surgical Information Systems, Orchestrate Healthcare, and Billian’s HealthDATA for sponsoring us and for displaying your signs with pride. I saw a lot of ladies in flip flops today and can only assume they were dancing the night away at HIStalkapalooza and are therefore recovering.

I attended a great lunch and learn session dealing with interoperability and data exchange. I was glad to see a speaker who was even more gloom and doom than I sometimes am about interface and exchange projects. His summary: however difficult you think this is going to be, without the right kind of planning it’s going to be way more difficult and complicated. I’ll be sharing his presentation with several of our internal customers as I try to explain why moving patient data isn’t the same as driving a wheelbarrow of mulch from the hospital’s front landscaping to the back entrance.

One of the cooler things I saw today was PatientTouch. Their “Mobile Care Orchestration” solution looks as good as it sounds. Their iPhone-based solution allows real-time access to care plans, patient lists, medication administration, alerts, and a whole host of other data. They’re partnering with some big folks (including my emergency department vendor) and our nurses would love to get their hands on something like that soon.

I also enjoyed visiting with the folks at Apixio, who knew how to handle a prospect and have a slick-looking solution to extract data from clinical narratives. I’m looking forward to getting it in front of my care managers to see what they think.

Not surprisingly, Judy Faulkner responded to yesterday’s CommonWell Health Alliance announcement by stating it’s a thinly-veiled attempt to attack Epic. I didn’t hear much speculation about it today, but then again I was pretty busy trying to visit 8,000 booths in just a few hours.

I was supposed to meet up with a group of brilliant physician informaticists tonight, but was sidetracked by a crisis at the hospital. Instead of exchanging ideas with great minds, I was sitting on a conference call providing leadership support while the team brought a critical system back up. Not that I added much to the team’s efforts, but I wanted to be there for any escalation requests that needed to be carried up the chain. I hope Inga was able to make it to some gatherings without me.

I’m flying home today to make a board meeting early tomorrow morning, so this will be my last post from HIMSS13. It’s been real, it’s been fun, and most of all, it’s been the Big Easy.

From HIMSS 3/6/13–Inga’s Update

I started my Tuesday morning at the keynote session with Eric Topol, who I found to be a great speaker. He discussed the potential of new technologies, many of which are available directly to consumers, and which have the potential to transform healthcare and save money.  I’ve been a little skeptical in the past that consumers will actually embrace technology to monitor their own health, but Topol showed some options that are extremely simple to use and allow patients to track and monitor their health in the comfort of their homes instead of the doctor’s office, the hospital, or a sleep lab.

I think that by the third day of HIMSS, flip flops are totally acceptable.

I hit the exhibit floor next and began looking for caffeine. Thank you Perceptive for the coffee and the beignet.

HIMSS has a number of theaters and kiosks set up in different areas of the exhibit floor. The Meaningful Use Experience section was at the far end of the hall and didn’t seem to be getting too much traffic.

Many, many sponsors, including Access, were displaying their HIStalk signs, which we appreciate.

I noticed that Caradigm, which was displaying a sponsor sign, was strategically located across from GE and next to Microsoft.

GE was attracting a crowd by giving attendees a chance to simulate a flight over New York City. It’s fun to watch.

I know I mentioned this last year but I like the Caretech booth, which uses black and white photos on its outer walls. Definitely stands out amongst the flash and colors of almost every other booth.

I have tried to limit the number of trinkets I’ve picked up this year but I figured I had enough room for this key ring with dangling clogs from Forcare, a Dutch company that offers interoperability solutions.

Kudos to Matt with Yseop, who stepped in the aisle to draw me into his small booth and delivered a nice pitch. Pronounced, “easy-op,” the company has rules engines that take data from a variety of formats and converts it into a narrative. They are just entering healthcare so they couldn’t show me much clinical content, but I liked what I saw.

Thank you to Level 3, who handed me the cookie I am now eating for breakfast and gave me a chance to register for an iPad Mini.

The Meditech booth is somewhat off to the side, but was reasonably busy as I passed by.

One of the ladies from Siemens stopped me long enough to take a swipe of my badge as part of their effort to raise money for Hope for the Warriors. Siemens will be donating up to $10,000 to the charity, whose mission is to enhance the quality of life for post 9/11 service members and their families.

The caramelized pecans from Novell are worth stopping for.

I found the outside wall of the InterSystems booth pretty eye-catching.

I was unable to get a good picture, but Suzanne in the Orion booth was sporting some pretty hot patent leather pumps.

I enjoyed chatting with Ken Harvey of TerraWi, which helps organization secure their mobile devices. Ken is a former professional football player who spent time with the Redskins and Cardinals and delivered a great elevator pitch on the company and its services.

I loved these fun ribbons that Liason Technologies was offering.

I think the ladies at Onyx are vying for the Hottest Booth Babe award.

I checked out PatientSafe Solutions, which has an all-in-one mobile platform that supports communication, med administration, care interventions, alerts and more. It uses either an iPhone 5 or iPod Touch and works with a hospital’s existing EHR.  I thought it was so slick that I made Dr. Jayne check it out as well. She, too, gave it a thumbs up.

This display at the Panasonic booth tells a great story in a simple way.

Both Allscripts and dbMotion were displaying signs saying they were pleased to have joined the Allscripts family.

I may need to make time for the Bantec booth today, which is offering chair massages.

In general there seem to be fewer gimmicks this year to draw in crowds. While there are a few magicians, I haven’t noticed any famous chefs whipping up fabulous appetizers or people dressed in ridiculous costumes. I definitely don’t miss that creepy knight from years past. That being said, there were a few roulette wheels and I won half a pound of chocolate playing Wheel of Fortune at the Pepid booth. Seth at Pepid did a good job asking my friend and me our backgrounds prior to delivering his succinct elevator pitch.

I saw several Regina Holliday jackets, including this one that Amy Gleason was wearing. I love the individualized messages.

I strolled through the very busy Epic booth, primarily to check out the art. It was heavy on animal themes this year.

The crowd at the CommonWell Health Alliance booth was deep with people trying to get a handle on what the new organization is all about.

Philips was hosting a crowd of folks, presumably all from the same country, who required an interpreter during the demonstration. It’s fascinating to walk through the exhibit hall and hear so many different languages.

Today’s agenda includes Bill Clinton (!), more exhibits (I don’t think I got past the 6000’s yesterday), the Interoperability Showcase, and possibly one other session. Off to seize the day!

E-mail Inga.

Morning Headlines 3/6/13

Allscripts (MDRX) Announces Acquisition of dbMotion, Jardogs

Allscripts announces that it has acquired patient engagement solutions vendor Jardogs, which offers a highly rated PHR and a population health manager among other products.  Allscripts also announces the acquisition of HIE vendor dbMotion. The acquisitions support Allscripts strategy of creating a connected community of health solutions. Details were not announced, although a financial publication from dbMotion’s home base of Israel placed that transaction’s value at $235 million.

Verizon Introduces Messaging Service for Health Data Transfer

Verizon unveils a secure universal messaging service that aims to allow clinicians to exchange messages and medical records through a secure browser interface regardless of whether they belong to the same health network or HIE. The platform provides an entirely independent option for physician to physician communication and file sharing.

HL7 Announces Plans for Freely Available IP and Future Membership Model

Health Language Seven (HL7) announces that it will make most of its intellectual property, including of its standards, freely available effective April 1st. The company had promised as much in September, but had not disclosed details or set an effective date.

Accretive to restate financials

After delaying the release of Q4 and Year End financials, Accretive Health has announced that it will not submit its year end report on time and will need to restate both current and past financial results. Shares are down more than 20 percent since the initial delay last week.

From HIMSS 3/5/13

From Strange Bedfellows: “Re: Allscripts acquisition of Jardogs. Healthland is now effectively partnered with Allscripts to provide its Stage 2 MU patient portal. Must be the era of friendlier inpatient HIS vendors.”

From GE Going Gone: “Re: GE. I am sure you have your hands full at HIMSS but I didn’t see this news reported in your roundup. GE sold its EMR business (GE Strategic Sourcing) to Gores Group. Gores Group is a private equity firm known for buying assets in need of turnaround at low prices; they specialize in corporate carveouts.” GE has sold its strategic sourcing operation, which sounds from the announcement like outsourced EMR and revenue cycle management services.

Here’s the Medicomp video of HIStalkapalooza. Everybody looks good. Not to be repetitive, but thanks to everyone involved, especially Dave Lareau and Medicomp for making it happen. I met Medicomp founder and MEDCIN engine inventor Peter Goltra the other day and I was like a teenager meeting Justin Bieber.

Thanks to Judy and Carl for dropping by HIStalkaplooza. Judy even graciously posed with her trophy (I’ll list all the awards when I get time). Also among the folks I saw there were Farzad Mostashari, former National Coordinator Rob Kolodner MD, someone I haven’t met but need to Regina Holliday, and many other industry luminaries and really nice people, especially those who either already knew me by sight or who I shyly introduced myself to during the event who made me feel less nervous.

A nice moment captured by @Sphere3CEO.

Our reigning HIStalk Queen Sarah Van Dyke outside her palace.

Here’s a video of the CommonWell announcement. Inga and I spent some time with Jonathan Bush on the show floor Monday afternoon and he said he was surprised that John Hammergren and Neal Patterson were pretty funny on the stage, at least for billionaires.

Congrats to Tim and Inga: Social analytics reveal @histalk as a favorite among hospital CIOs bit.ly/XUyjoO

— Rob Cronin (@robcroninNY) March 5, 2013

Thanks to Rob Cronin at WCG, which performed a study of social media activity. HIStalk was the most popular healthcare IT source among health system CIOs, trailing only The New York Times and NPR. Very cool – thanks for doing this and for letting me know the result.

I was talking to a guy in the hall today who was in a Hampton Inn about 20 minutes out of town because it’s all he could get. He said the cab line was two hours long at 8:30 a.m. He jogged over to the adjoining highway and flagged down a cab, only to be chased by several line-waiters angry that he got a cab before them even though the cab wasn’t going to stop at the hotel anyway. It’s getting real Lord of the Flies out there.

In another example of New Orleans workforce motivation, nobody had bothered to remove the “do not drink” signs from the water fountains in the restroom even though the boil water alert had been lifted 24 hours previously.

No thanks to Allscripts, an HIStalk sponsor who took out two others today with their acquisition of dbMotion and Jardogs. Just kidding – acquisitions are a natural step as companies progress, as I’ve seen first hand by watching the remarkable number of sponsors who have been acquired, very often by other sponsors. We don’t lost many sponsors and acquisitions are by far the #1 reason. We enjoy the result of their accomplishments and like to think we had a tiny, tiny part in them.

Speaking of Allscripts, a Florida judge denies the company’s request to force a class action lawsuit brought against it by unhappy MyWay customers to arbitration, a ruling that allows the lawsuit to continue. The law firm representing the Florida medical practice that claims a forced switch from MyWay to the Allscripts Pro EHR will cost it a lot of money and that the company’s promise of Meaningful Use and ICD-10 capabilities were broken.

Epic says that despite the claims made by the co-opetition members of the CommonWell Health Alliance, nobody asked Epic to join the group that’s made up of the publicly traded companies losing business to the privately held Epic. Epic President Carl Dvorak says the group is attempting to make its members look like leaders instead of the followers they are and for that reason, he doubts Epic will join.

Exhibit Hall

I’ll make a small confession: when we cruise the exhibit hall finding interesting things to write about, we like to check in with our sponsors, especially those who displaying the autographed HIStalk sign that we offer them for free (we really, truly appreciate that level of support – thank you). Sunquest is among those who put theirs front and center in Booth #911 (congratulations to whoever wisely snagged that easily remembered number). They’ve had some fine speakers in their booth, and if you’re interested in Meaningful Use for the lab, they’ll be presenting in Booth 149, Meaningful Use Kiosk 85, at 9:45 a.m. Wednesday.

I’m like those Notre Dame football players that have to touch the overhead wall as they head out the tunnel onto the field – I can’t leave a HIMSS conference without caressing the cool carts from Enovate. This one sports a peds theme, but it still has the smooth, supple curves that I can’t keep my hands off of.

QlikView has a cool booth with a giant eye floating above it. Thanks for putting out the HIStalk sign. I’ve received a few raves from users of that product. They’re a new sponsor that I’ll talk more about later.

Good looking booth, Infor, and thanks for putting out your HIStalk sign.

I got only an over-the-shoulder look at GetWellNetwork’s platform, but I liked what I saw.

Partners Consulting, a Caradigm partner, gave me a good demo of a product they’ve built on top of what’s now called Caradigm Intelligence Platform (formerly Amalga).

Our own CIO Unplugged Ed Marx played Medicomp’s Quipstar on the show floor to benefit his charity of choice. I wasn’t able to stay to see if he won, but he was looking good up there. I met Ed in person for the first time last night at HIStalkapalooza and he’s the real deal.

Thanks, HealthMEDX, for putting our sign front and center. We appreciate it.

Do you suppose it was coincidence that this vendor person just happened to stroll down the main aisle wearing next to nothing? Do you care?

One of my favorite people to visit during the HIMSS conference is Mark Johnston of forms management software vendor Access. Once we’re finished talking healthcare IT, we move to a more serious topic: barbeque. Mark’s a on a prize-winning barbeque team, and every year we try to devise ways to work around policies prohibiting him from cranking out brisket and ribs from the smoker at or near the convention center. We branched out in a different direction today, discussing the variants of jambalaya, which his team also makes on the circuit. Green is my favorite color and his team’s shirts are a nice shade of it.

My third-favorite product of the day was the MioCARE Android-powered, semi-ruggedized tablet with a built-in 2D barcode reader. Not only was it very cool (bright green, highly ergonomic) it can run a wide range of apps using SAP’s EMR Unwired middleware (which I admit I know nothing about). They told me it costs $879, but given that you can wipe it down and drop it, it’s probably worth the difference for patient care use.

My second-favorite product of the day was ReadyDock’s tablet sterilizing system (it also charges and syncs). You’ll notice a hand on the device because everybody within arm’s reach was caressing it like an adorable child, including at one point when I was trying to slyly take a photo, THREE sets of hands, one of them belonging to a prospect and the other two attached to the loving company people. This bad boy will disinfect an iPad in 60 seconds. ReadyDock just released the CleanMe app (right) that reminds users to clean their iPad, includes a training video on cleaning, and keeps stats on the process.  I think this is brilliant.

My favorite product of the day, although I admit I saw only a 15-minute overview and demo, was BluePrint HealthCare IT’s Microsoft CRM-based Care Navigator tool that provides full visibility by both caregivers and family. It keeps all caregivers up to date with alerts, like “just registered in ED.” Users can do a lot of the patient management right from Outlook. I’ll take a second opinion if someone with more expertise than me wants to evaluate it.

Winner of the Most Fun Booth People is SynaptiCore, which does EHR implementation and support work. I heard their people hooting an hollering down the aisle and they are a ton of fun. They have a slot machine, beads, and a great sense of humor.

• Microsoft people are usually jerks in the exhibit hall and today was no exception. I strode up in front of a couple of Windows 8 devices and patiently waited while one employee directly in front of me was texting madly. His adjacent co-worker looked up long enough to glare, then walked a few feet away and started texting himself. Vendors, I’m telling you to confiscate mobile devices because I swear at least 20 percent of reps in the hall were totally absorbed in their smartphones and ignoring passers-by. If your people are under 50, they can’t go more than 30 seconds without doing something pointless on your dime.
• Hitach had a coffee bar and charging station.
• One vendor gave me very cool booth swag, an Apple TV, but made me promise not to tell where I got it since it was supposed to be for elite customers. Very cool.
• Philips Enterprise Imaging had a big crowd.
• Streamline Health had our sign out – thanks.
• I stopped by one booth that had five employees on duty, one of them an SVP. I stood looking at monitors for three minutes hinting that I was interested and none of them came up for air from their intra-company conversation to pay me the slightest attention. A sign said “Ask for a demo,” so I guess they took that as literal. HIMSS has the most expensive employee lounges anywhere out there on the show floor.
• An imaging vendor had six employees in the booth and zero customers. Two were screwing around with their phones and the other four had set up shop at a table and were in deep conversation, oblivious to anyone who might intrude, like a prospect.
• 3M’s booth has the deepest carpet I’ve ever seen. It was like walking on a very soft beach.
• ICA – had our sign out. Thanks. I recommended them as being worth checking out to someone asking for potential HIE vendors, along with some other HIE sponsors.
• Liberty Solutions is giving away USB-powered bladeless fans. Cool (no pun intended).
• I asked someone at patient content vendor Healthwise to explain what they do, which he did quite nicely. They’re one of few non-profits on the floor and that’s reason enough to drop by and say hello (and an HIStalk sponsor at that).
• CareCloud looked good on the monitor, but nobody took the cue that I’d like a look so I moved on.
• Greenway had a big crowd looking at PrimeSUITE. They had a live avatar working the crowd that was kind of cool.
• I saw Bob Lorsch from MMRGlobal in RelayHealth’s booth talking to one of their employees. Not sure what that was about.
• Hannah from Halfpenny drew me in and gave a perfect answer to the “what do you do” question. They had our sign out, too.
• Healthspot had an interesting looking consumer virtual visit portal, but I couldn’t get their attention.
• Joshua from Ping Identity gave a nice overview of cloud-based security when I asked.
• Infor had an interesting coffee machine and popcorn.
• Meditech’s booth was well off the beaten track and nothing much was going on there.
• Siemens had a blinding white booth and a big coffee bar.
• Innovative Healthcare Solutions had our sign out and I chatted with Pat Stewart a bit.
• API Healthcare gave an overview of Healthcare Workforce Information Exchange, which allows facilities to collect information about each employee on a single screen. It looked cool and customers are apparently saving money with it.
• VersaSuite had our sign out and gave a good elevator pitch on their full, Microsoft-based hospital information system for smaller facilities. The guy said they’re doing well and picking up business from hospitals that regret their first EMR decision.
• Virtelligence had a long list of available Epic expertise they offer.
• Liaison Healthcare Informatics gave me an overview of their cloud-based data transformation and exchange tools.
• Versus did a demo of their RFID-powered handwashing station that monitors compliance and allows following up with low-performing units or individuals.
• Epic’s sign on the opposite side of the booth I saw yesterday says they have 80 million patients “covered on the Care Everywhere network” and that a third of the 3.4 million monthly exchange transactions it manages are with non-Epic systems. (in other words, they are already exchanging data outside Epic even though competitors claim otherwise).
• Imprivata’s HIPAA compliant messaging tool  Cortext looked cool, but I couldn’t get anyone’s attention to show it to me.
• Lifepoint Informatics had our sign out, gave a great elevator pitch, and handed me a $5 Starbucks gift card, which I may confer on someone else since I don’t drink coffee.
• CHADIS, a questionnaire app that I’m too tired to look up at the moment but its something to do with special needs peds, was well presented by its MD founder in the booth.
• MModal’s booth was super busy. They had our sign out.
• SIS had our sign out as well, although I couldn’t steer the rep into showing me anything. He seemed puzzled why a non-surgery hospital employee should care, a point that is valid but that also kept them from letting me tell you about their product.
• Vocera had a lot of people visiting.
• I get the Aprima red vests now – there’s a poker table on the side of the booth I didn’t see.
• e-MDs had our sign out – thanks.

Announcements

• Iowa Health System chooses Security Audit Manager from Iatric Systems.
• Epic and other EHR vendors will use Nuance’s Clinical Language Understanding.
• TeraRecon is demoing its iNtuition enterprise image management solution to support enterprise-wide vendor-neutral viewing of medical images at HIMSS this week. The company also announced that it will provide its expertise to Fujifilm.
• Adventist Health will turn over its revenue management services to Cerner.
• PatientPoint and Miami Children’s Hospital are named winners of the Microsoft Health Users Group 2013 Innovation Awards.
• Orion Health announces Version 2.0 of its Direct Messaging product suite, also announcing mobile apps for remotely managing its Rhapsody integration engine.
• DrFirst announces that e-prescribing of controlled substances rose over 400 percent in 2012.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.