Allscripts announced this morning that it has acquired HIE technology vendor dbMotion and patient engagement solutions vendor Jardogs to extend its reach across the healthcare continuum. Details were not announced, although a financial publication from dbMotion’s home base of Israel placed that transaction’s value at $235 million.
We ran a reader’s rumor report of the Jardogs transaction on HIStalk last week.
HIMSS Update
Day 2 at HIMSS and there has been a lot going on. I was able to enjoy the still-sleeping city on my early morning jog although there were still some folks out from the night before, which is a little sad. There’s something about New Orleans that creates an “IT Staffers Gone Wild” atmosphere even above and beyond that created by Las Vegas. Maybe it’s the free-flowing liquor or maybe it’s the Bourbon Street establishments offering a variety of services that you probably can’t buy in other cities. I did find a potential breakfast venue for Inga, however.
While Mr. H and Inga covered the ONC Town Hall, I decided to brave the exhibit hall when it opened. I was able to enjoy this jazz combo while I waited, although they took a break right when I decided to take a photo. Note that the trumpet player is using the bottom of a plunger as a mute. The security team was quite vigilant about making sure no one other than exhibitors was admitted until right at 1 p.m. As I watched the last-minute race of vendors trying to make it to their booths on time, I was glad they at least had to weave through the throngs of attendees as punishment. Punctuality is apparently dead as there were scores of reps coming in at the last minute.
Logistics are still an issue. I was surprised by the full trash cans even with the hall just opening. Some areas had stacks of packing boxes out in the main aisle. The water was still suspect this morning, but I had grabbed some extra bottles from my hotel rather than wait in long lines for expensive water at the convention center. I’m always sensitive to the amount of trash that a meeting like this produces and am disappointed that there are no recycling bins in the exhibit hall, at least not that I could find. I did see clearly marked bins upstairs, however.
The hall was packed and I spent a couple of hours getting the lay of the land and plotting my strategy for the rest of the week. I liked the pediatric-designed computer carts at Enovate and the booth staff was not only engaging but well informed. There were big crowds at the Cerner booth and also at Healthagen (although I learned that most of the people at the latter were employees who were joking about having to do introductions to each other to fill their time). There were a couple of magicians, but no contortionists or splash painters like we’ve seen in the past. The overall tone is pretty calm and I only saw a handful of booths handing out Mardi Gras beads, which I would have thought would be everywhere given the venue.
I was excited by what Tellenium has to offer (management of telecom services for large organizations) but disappointed that they launched right into their pitch without finding out who I was or why I was stopping by. They did have a claw grabber machine where you could try to win prizes, but I was unable to score the pink t-shirt that called to me.
One highlight of the afternoon was competing in Medicomp’s Quipstar game show, although I finished last due to a tricky “double or nothing” question where I buzzed in too early. As a result, I now have the ICD-10 code for trauma sustained while parachuting burned into my brain. Too bad I don’t see much of that in the emergency department.
The other significant highlight of the afternoon was a lovely gift from sponsor PatientPay. They’re clearly reading (and not just skimming) because they delivered the beautiful chocolate shoe I was wishing for on Valentine’s Day. The picture does not do it justice and I’m pretty sure I clapped my hands with glee and squealed like a little girl when I opened it. It is magnificent and I do really appreciate the gift. Thank you!
Monday night of course was HIStalkapalooza, and thanks again to Medicomp for sponsoring. I was pleased with the number of attendees who jumped on the bowling shirt bandwagon. Full credit goes to the team from ESD who not only had matching Converse All Star shoes and bowling shirts but also the shoes had the ESD logo created in crystals on the toes. I didn’t get a pic but I think Inga did so, hopefully she’ll post. My favorite attendee outfit was the pink poodle skirt with saddle shoes. I especially enjoyed the details, including the poodle on your sock.
My heart went pitter patter when my bowtie-wearing crush appeared in person to collect his HISsies award. He’s sporting the “Blue Button: Sequester Edition” lapel pin.
Speaking of HISsies, Jonathan Bush did his usual hilarious job of presenting the awards and stripped off his athenahealth bowling shirt to reveal something truly psychedelic. I felt sorry for the youngsters who stood right in front of our anonymous selves during the shoe contest and announced that they were leaving to attend the Impact Advisors party. They missed the whole thing. They also missed the appearance of Judy Faulkner and Carl Dvorak – Judy looked amazing and was very gracious to an admirer trying to take her picture.
After the awards, the bowling tournament switched into high gear as did the Zydeco band. I knew, however, when the hula hoops appeared on the dance floor that it was time for me to go so I could rest up for the long day tomorrow. A note at the hotel revealed the boil order is no more, for which I’m grateful.
Tuesday morning came particularly early today after a long night of HIStalkapalooza fun. The Medicomp crew did an outstanding job, as did our emcees Lindsay Miller from RelayHealth, James Aita and Dave Lareau from Medicomp, and Jennifer Lyle from Software Testing Solutions. Thanks also to our shoe and fashion judges Timur Tugberk (DrFirst), Matt Holt (Health 2.0), and Jennifer Dennard (Billians). The attire was a fun mix of bowling chic, serious chic, and a few vendor-logoed t-shirts. And plenty of fun shoes!
I tried the Typhoon Jayne and Hurricane Inga, but quickly decided both would be a bad choice for a long evening. The food was yummy, especially the jambalaya. I haven’t heard who won the bowling tournament but everyone seemed to having fun. The Medicomp team will need to advise us on the final number of attendees but I am sure it was north of 700. And, the music was definitely hopping. I didn’t take too many pictures but I have seen a few on Twitter (#histalkaplooza if you want to check them out). I will find a few good ones to share.
Jonathan Bush and Farzard Mostashari had what appeared to be a serious discussion.
I have noticed several Regina Holliday jackets, both at HIStalkapalooza and at the convention center. She was in attendance and had many admirers saying hello.
The ESD folks collectively won best bowling shoes, which included a sparkly version of their logo on the toes.
More than a few fabulous shoes were removed from tired feet late into the evening.
I went to the ONC Town Hall Monday afternoon, which was just OK. I was hoping for breaking news, but it was more of an introduction to some of the ONC leadership team. I spent the afternoon walking the exhibit hall before watching my BFF do a fabulous job playing Quipstar at the Medicomp booth.
Thanks QlikView for having your HIStalk sign out. Many other sponsors found a spot for a sign as well, which we appreciate. Be sure to tell these folks thanks for supporting HIStalk.
I noticed several overflowing trashcans, leading me to believe the convention center may have a shortage of workers.
Hot shoes outside the athenahealth booth.
Another hot look, though I can’t imagine how her whole body felt by the end of the day.
Really? Hmm.
I did more cruising than I actually taking time for demos, though I did see a quick run-through of CareCloud’s newest EHR version.
I got a pedometer from the Optum booth. I only had about 2,500 steps by the time I left the exhibit floor, but I only wore it a couple of hours. Optum is donating money to charity for every step logged.
Generally most booths seemed quite busy throughout the afternoon. I didn’t pick up too much swag, but the OnBase chocolate was super yummy. HealthPort was giving out beignets but told me they could not give me one since I am not a provider. Did I mention it was a beignet and not an iPad???
Attendees had multiple transportation options after a long day.
I’m out the door to hit the opening session, then will spend some time digger deeper at the exhibit hall. Dr. Jayne has us all lined up for parties tonight, but I may need extra caffeine to survive.
There’s no way I can catch up on the whole day since I’m starting at nearly 11 p.m. post-HIStalkapalooza time and the hotel Internet isn’t exactly screaming, so I will follow up later. Thanks to Medicomp Systems and their crew for putting together a great event; to our hosts, judges, contestants, and other participants; to Ross and Kym Martin for a great musical opening; for Jonathan Bush for another memorable HISsies presentation; and to everyone who came out to Rock ‘n’ Bowl. Lots of people were involved in arranging transportation, running the registration and coat check areas, setting up for the band, and working together to make sure everyone had the best time possible. We had some interesting attire, amazing shoes, and some truly lovely ladies and gentlemen both on the stage and off.
Welcome to new HIStalk Gold sponsor Strata Decision Technology. The company offers cloud-based financial analytics, business intelligence, and decision support, having integrated with EHRs (Cerner, Epic) and ERP (Lawson) systems. They do the integration and hosting, meaning the only IT time required is a couple of hours to coordinate. Customers get a single database and an integrated platform for operational budgeting, capital planning, financial forecasting, strategic planning, service line planning, cost accounting, contract analytics, and performance management. Provider organizations need to understand and manage true cost of care and margins that span episodes of care, service likes, and patient populations and Strata’s tools provide that capability. They’re not a recent addition to the analytics/BI landscape – they’ve been around 15 years. Customers include Cleveland Clinic, Hopkins, Yale, Allina, Duke, Legacy, Spectrum, and Intermountain. and they announced Mission Health (NC) as a new customer today from HIMSS. Thanks to Strata Decision Technology for supporting HIStalk.
I didn’t turn up any Strata videos on YouTube, but here’s one of CEO Dan Michelson (formerly of Allscripts) talking about a non-profit he started that hosts an annual benefit concert to send children who have been abused and neglected to overnight camp. The organization just received the “Innovation in Philanthropy Award” from the Make it Better Foundation.
Opening Session
There didn’t seem to be as much of the self-congratulatory HIMSS hoopla this time and I kind of missed that, to be honest. No looping slides listing committee members, fellows, etc. The brought in a high school marching band that seemed pretty good, but the airplane hangar acoustics make it hard to say for sure since all I heard were drums.
In an ironic moment, the teleprompter died while Willa Fields was speaking, forcing her to go back to paper.
The mayor gave a good speech. I don’t know what he’s like as mayor and he didn’t mention the fact that we were still under a boil water advisory (lifted soon after), but he was an engaging speaker and city cheerleader. He represented well. He mentioned that the city is investing $3 billion in a health complex for the VA, university hospitals, and some other players that I didn’t write down. It seemed confusing to be talking about spending all that money in the attempt to create healthcare jobs, but at the same time to be urging that we bend the cost curve (unless he meant up instead of down). Healthcare may create jobs, but it’s a drain on the economy, not a sustainable economic engine, and I found his message confusing. Healthcare can be maddening in that way as an odd mix of community pride, employment, comfort, and yet a crippling cost that someone has to pay.
The CEO of Ochsner was up next. He was pretty good, saying that only insurance companies have all the patient data from all locations, meaning we don’t really know our patients as well as they do. He pitched the idea that vendors need to not only cut their costs, but be on the hook to get paid only when their systems improve productivity. I think I would have put Bill Clinton in the opening keynote slot, but there’s a big HIMSS announcement coming Tuesday about their partnership with his foundation so they have him on Wednesday’s agenda.
Educational Sessions
Maybe it’s just me, but the educational component of the conference seems to be getting less and less interesting. I automatically don’t go to sessions that involve a vendor presenter, only because that always seems too much like a living white paper. Some sessions didn’t appeal to me, and one I attended didn’t appear to have any rigor at all behind it. I’ve served on the Annual Conference Education Committee in years past and I have to assume that they just don’t get that many submissions, leaving them no choice but to accept some iffy ones. It doesn’t help that they’ll be soliciting presentations in just a few days for next year’s conference, with the ridiculous year-long lead time. No wonder there’s nothing innovative being discussed – everything is at least a year old by definition.
I went to a VA-DoD session on iEHR, but it was more of an overview than anything newsworthy. Theresa Cullen, MD, MS of the VA was an engaging and personable speaker and I found her really likeable. She talked about the VA’s informatics programs, their role as the government’s living lab, and mentioned some of their research work, including in human factors. She described the Janus legacy viewer that will straddle the VA and DoD systems, which sounds almost like an HIE. They are still working through identity management problems.
The ONC Town Hall was fun because the ONC folks introduced themselves and their backgrounds and showed a more human side than you might typically picture.
There were a lot of bow ties being worked everywhere. It’s Farzad’s brand and it’s catching on.
Exhibits
Liaison Technologies was distributing fun add-on badge ribbons, as demonstrated by a reader’s photo.
An de-identified Dr. Jayne playing Quipstar in the Medicomp booth with her security detail. She didn’t win, but she was sassy and fun and she answered some tough questions. Everybody loves Dr. Jayne. Medicomp donated money to the charities designated by the players.
Here’s the Kaiser Permanente press release announcing the HISsies win of George Halvorson for the HIStalk Healthcare IT Lifetime Achievement award and Kaiser’s repeat win as best provider user. George’s son Seth and daughter-in-law accepted the award at HIStalkapalooza on his behalf. It’s nice recognition of both George and KP.
The big news of the day and maybe the whole conference was the formation of the Commonwell Health Alliance trade association by EHR rivals Allscripts, athenahealth, Cerner, Greenway, and McKesson (and its RelayHealth unit). They say they’ll promote data exchange among their systems and invite other vendors to join them. Notably missing from the list is Epic, whose commercial success surely had a role in bringing together its competitors.
Valence Health had a cool exhibit featuring a full-size school bus along with miniatures to give away. They had our booth sign out – thanks!
A very cool stuffed dragon giveaway by Workbeast. I got one, although I’m not exactly sure what I’m going to do with it.
The Aprima folks were sporting red vests. That’s our booth sign on the tabletop in green, signed by Inga, Dr. Jayne, and me.
Ladies from HITEKS giving out Mardi Gras beads. They were nice to pose for a picture.
Plantronics was giving out (and wearing) fun hats.
Booth observations:
Announcements
Photos from HIStalkapalooza
Dr. Gregg’s bowling shirt.
Farzad accepting his “When ___ Talks, People Listen” HISsies award.
Medicomp CEO Dave Lareau and Software Testing Solutions CEO Jennifer Lyle interview Bonny Roberts of Aventura on the red carpet.
Bonny with her “Mr. H’s Secret Crush” sash.
James Harris sent this pic of the Orion bowling team: David Leach, Tanya Niemeyer, and Paul deBazio.
A James Harris shot of Tom Visotsky, winner of Inga’s Secret Crush.
Food. I liked the jambalaya and etoufee.
That’s it for now since I’m tired and it’s late.
Contacts
Mr. H, Inga, Dr. Jayne, Dr. Gregg, Lt. Dan, Dr. Travis.
More news: HIStalk Practice, HIStalk Connect.
The major news from HIMSS today is that the Cerner-McKesson announcement turned out to be much larger than suspected, including a total of six major players coming together to form the CommonWell Health Alliance. The organization will be an independent non-profit for EHR vendors together that want to achieve a higher level of interoperability between systems.
Nuance and Cerner Partner to Offer Point of Care Solution for Clinical Documentation Improvement
Cerner announces that it will integrate Nuance’s suite of clinical language understanding products to support physician documentation in a new workflow that will allow physicians to dictate notes while the tool simultaneously performs quality review, prompting clinicians for clarifying information where needed.
A recent survey of 260 healthcare professionals involved in ICD-10 planning reveals that only 55 percent of respondents are confident that they will meet the October 1, 2014 deadline. Primary concerns center around additional training needs and a lack of time. 43 percent of respondents reported frustration with vendors "not providing an adequate schedule to ensure we will be ready by the deadline."
HIMSS 2013 iHIT Study – Final Report
HIMSS releases its 20132 Impact of Health IT report. The results paint a suspiciously rosy picture of end user satisfaction, including 83 percent of respondents agreeing that HIT applications support clinical processes and workflows. The survey-takers were comprised of 63 percent nurses, 22 percent pharmacists, and 11 percent physicians working at larger than average (and most likely more technologically refined) hospitals with an average 681 beds.
It was a rough start this Monday morning after a busy night of HIMSS social events with my BFF Dr. Jayne. Because of the water issue, the hotel had to brew coffee the old fashion way, which was not nearly fast enough for the caffeine-dependent masses. As I waited 15 minutes for the staff to bring more coffee, I watched person after person attempt to get a drop of caffeine out of the empty urns.
Dr. Jayne and I started our Sunday evening at the opening reception. The band was fun and the guitar player earned bonus points for his red shoes.
His nametag said “Old Buffalo,” hence the horns. I couldn’t hear the full explanation for his nickname, but I am sure he is fun to party with. Old Buffalo works for McKesson.
Mr. H liked the under-couch lighting and glowing side tables. Who knew he was such a party guy?
Of course I was on the look out for hot shoes, including these sporty loafers.
Dr. Jayne and I moved from the reception to athenahealth’s soiree and spent a few moments chatting with the dapper Jonathan Bush.
Not surprisingly, Jonathan got happier as the night progressed.
Definitely one of my favorite looks for the evening.
Our next stop was the CommVault party, where Dr. Jayne and I hung out on the balcony. Our biggest disappointment was the lack of beads to throw to the folks on Bourbon Street.
On the way to the Divurgent event Dr. Jayne and I did a little window shopping. These were a few of tamer PG-13 items.
I am out the door early for a big day at the convention center and a bigger night at HIStalkapalooza. Can’t wait.
HIMSS Update from Dr. Jayne
I’m not as fast as Mr. H and Inga in getting my HIMSS write ups done, so this is my catch-up from Sunday’s events. It’s Day Two of the water supply problem and subsequent boil order and one of my staff back home decided to send me an article about how bathing is not recommended in New Orleans. Having just been out for a run, this was not welcome news, but some quick Googling revealed that it’s not recommended for infants to bathe in water that hasn’t been sterilized first.
My trip in was uneventful except for the plane being at least two-thirds full with HIMSS attendees. Those of us in the coveted exit row seats decided we should just exchange cards and hear the various pitches on the plane and make our work more efficient – kind of like speed dating for vendors. Alas it was not to be, but I did make a new friend who hopefully can help me with some analytics initiatives.
Last night’s opening reception was nicely done, with minimal lines at the bars and reasonably good food. My only complaint was the dimness of the room, which although great for cozying up to your colleagues, it made it hard to read name tags. At least that’s the excuse I’m using for randomly accosting a poor unsuspecting physician who I thought was a friend of mine. After he recovered from the unexpected hug and I figured out he was not the CMIO I was looking for, we had a nice chat and exchanged cards. I appreciated his good humor about the whole thing.
Our next social event was an athenahealth reception at the House of Blues, where we were treated to a jazz funeral procession (complete with mourners and a mock coffin) and bid farewell to Software. The food was good, although I was a little puzzled by the sliders that had pickles and cucumbers rather than pickles and catsup. Fried okra balls were definitely the highlight.
After that we joined our friends from CommVault at Bourbon Vieux and enjoyed the balcony over Bourbon Street. It was still early in the evening so the debauchery wasn’t quite to the level I’ve seen it on previous trips. The party was low key and the band was good, with their breaks allowing a bit of quiet to talk to other attendees. I added a couple of stops to my “must see” booth list based on the networking, so hopefully I can knock out some equipment purchase decisions tomorrow.
Our last stop was the SummHIT mingle sponsored by DIVURGENT, which was held at The Swamp, which happened to be directly across the street from Bourbon Vieux. The lower level of The Swamp has a mechanical bull-type “Thing” that could be ridden although I didn’t see any takers. Inga and I did get some beads, however, and didn’t even have to work for them. Although we were feeling the Mardi Gras vibe by this point, we knew we needed to get our beauty rest for the long day ahead so headed back to our hotels.
I’m off to the exhibit hall (and to compete in Quipstar at the Medicomp Systems booth) then of course to HIStalkapalooza. See you there!
The day started out very cold and windy, but it turned reasonably nice Sunday afternoon and will be much warmer on Monday. Thank goodness – many attendees (me being one) didn’t bring the heavy coats that were needed, both outside and in the exhibit hall today (I slipped by a security guard to roam around).
I’m beginning to be annoyed by the hotel that HIMSS foisted on me after they cancelled my reservation for the hotel I actually wanted. I nearly froze last night, and today I made sure the thermostat was set to heat and 70 degrees when I left for the convention center. Right now, it’s 56 degrees in the room and the air that’s blowing is cold. The hotel has no restaurant and needs maintenance – I’ve never until now seen a toilet whose bowl is actually peeling apart below the water line, and there’s rust on almost everything in the bathroom. For about the same money, I could have had a very nice hotel within a couple of blocks of the convention center with an actual restaurant, bar, and lobby. I didn’t even get the swag bag that Inga mentioned in her post. I feel like a stepchild.
We’re on a boil water advisory in New Orleans supposedly until at least Monday morning, so the nice hotels dropped off bottles of water in each room, while mine left a note on the bed to traipse down to the front desk if I needed bottled water. Given that the note says you’re not supposed to even brush your teeth with water from the tap, exactly who isn’t going to need a bottle? Since that’s the case, why make every guest visit the front desk?
The water problem forced Starbucks to stop selling coffee early Sunday morning. It’s going to be an ugly scene if they don’t figure out a caffeine junkie workaround for Monday morning.
I guess you can’t blame HIMSS for the boil water advisory, but the same problem occurred here a few months ago due to the city’s crumbling infrastructure, which includes 100-year-old water processing plants and old pipes. As much as I like the restaurants and the local character, there’s no doubt in my mind that New Orleans is not capable of handling a major convention in a professional manner. The airport is small and outdated, there aren’t enough cabs to get people the long way to downtown, and I’m hearing that hotels are oversold and people are being assigned rooms out in the sticks. It feels like a backward country where nobody really cares about the small details. The only positive I can muster is that the convention center is OK and the restaurants are good.
I’ll assume this was the work of a prankster and not an inattentive convention center worker. Maybe the one sitting behind me near the food court, who was reminding everyone within earshot about the awful conditions and deaths that occurred inside the very same convention center during Katrina.
The HIMSS printed materials seem less well organized this year. I’ve overheard people who, like me, can’t find sessions they know are taking place. There is no mobile app – it’s all printed.
I haven’t heard much in the way of news and rumors so far. Most of what I’ve seen posted elsewhere appeared here last week. Monday should be the big day of announcements, including the much-awaited Cerner-McKesson interoperability one at 11 a.m. Central time. I’m not including the webcast link or physical location since the invitation was only for the press.
Inga, Dr. Jayne, Dr. Gregg, and I had what Inga called our HIStalk board meeting this afternoon (meaning we had a drink at a bar). We headed over to the opening reception, which was OK as opening receptions go (a huge bare room, decent food, and some local options like Abita amber beer and jambalaya). The band was OK. We saw some folks we know either individually or collectively before I headed off to dinner with a friend at Red Fish Grill, which was as good as when I ate there at the previous New Orleans conference.
I feel like Jim Cantore on the Weather Channel, describing how conditions are changing as a storm moves close, the storm in this case being the rumored 35,000 people who are attending the conference. Monday morning will be the usual madhouse, with the added complication of being unable to use tap water. We’ll have more detailed reports and a quick HIStalkapalooza recap if I have the energy to stay up late to write it. We can’t see or know it all, so your contributions are welcome.
Contacts
Mr. H, Inga, Dr. Jayne, Dr. Gregg, Lt. Dan, Dr. Travis.
More news: HIStalk Practice, HIStalk Connect.
Deloitte, Intermountain to share big data tool schedule at HIMSS13
Following last Thursday’s announcement that Deloitte and Intermountain had forged a five-year-deal to extract and publish big-data best practices, the pair today announce that they will be demonstrating the newly developed technology which will power the initiative at HIMSS this week.
In line with the latest in EHR vendor trends, NextGen unveils a new population health application, which will be demonstrated at HIMSS, booth 5313.
Hoag and St. Joseph Health Complete Historic Health Care Affiliation
5-hospital health system St. Joseph’s Health and 2-hospital system Hoag announce plans to affiliate, creating a new Orange, Calif.-based health system called Covenant Health Network. While Hoag hospitals will be joining the St. Joseph’s system, they will retain their Presbyterian affiliation and operational standards, rather than adopting St. Joseph’s Catholic affiliation.
Power loss leads to water problems, and grumbles, in New Orleans
HIMSS-goers awoke to an unpleasant surprise Sunday morning as all of New Orleans was placed under a city-wide boil water order after a fire broke out in the city’s primary water treatment facility. The city’s emergency response website is calling for everyone to boil water for one minute prior to drinking, cooking, brushing teeth, washing hands, bathing (sponge baths with pots of sterilized water is the only recommended option for bathing) or preparing food, until further notice.
HIMSS13 starts Monday, already the twitter hashtag #HIMSS13 is exploding with traffic. Several pre-conference sessions were held today and the day ended with the official HIMSS13 reception. For those sitting out this years events, HIMSS is live broadcasting most speakers, including keynote speaker Bill Clinton, and sessions for remote viewing . In true HIMSS style, they’re charging $40 a session.
Greetings from chilly New Orleans! Okay, “chilly” is relative, but I was expecting a little bit warmer weather, as were many others who shelled out $30 or more for a Bourbon Street-logoed sweatshirt. Fortunately there is lots of sunshine, so walking outside during the day was not too bad.
I arrived Saturday afternoon and spent 30 minutes waiting for a cab. The line moved rather fast, but it was still quite a wait. After quickly settling in at my hotel (which is fine) I headed to Bourbon Street for a yummy dinner with friends. I wisely opted to be in bed by 10:30 rather than hit all the fun bars.
Sunday was mostly pre-sessions that cost additional fees, but I was able to poke my head into a couple. Nothing too exciting to report and I learned more talking to other attendees. A number of people mentioned they were looking at tools for mobile devices (such as how to keep them secure and applications that can improve communication.) Others mentioned the need for storage and for analytics tools now that they have more data than ever before.
I also went into the exhibit hall, which was chaos. Amazing to think of the transformation that will happen in just 24 hours. The loading dock doors were all open, making the hall breezy and quite chilly, so I was feeling sorry for the under-dressed vendors.
When I returned to my hotel room, I found a swag bag of goodies. I already ate all the gummy bears from Covisint and played a few notes on the harmonica from MediQuant. The bag mostly contained information on various vendors and giveaways, including:
Off to meet Mr. H, Dr. Jayne, and Dr. Gregg for our annual HIStalk board meeting. Have fun everyone!
From AlohaSally: “Re: acquisition. Word on the Street is that Epic consulting company [company name omitted] just sold for $40M. Not shocking as I’ve heard stories owners were focused on building to cash in. Will they maintain culture under new identity?” We asked the company, which said they would provide a response but haven’t so far. The wording of their reply and the timing of the rumor give me the feeling that something is indeed afoot. A transaction in that price range would probably warrant a Monday morning announcement, especially assuming that companies with $40 million to spend know how to publicize themselves. As to your question, I don’t know if I’ve seen an example yet where an acquired company’s culture isn’t replaced almost immediately with that of the acquirer, sending some of the consultants and sometimes the clients themselves fleeing depending on the degree of change. It’s like a software vendor forcing clients to migrate from a retired product to another company offering – it may be perfectly fine, but it’s not what you signed up for.
Perhaps I should title this “From New Orleans” since the conference hasn’t started yet as I write this Saturday. In any case, I arrived with no problems. The airports were teeming with spring breakers headed to Mexico and other warm climes. The New Orleans airport, which seemed to me to be small and old, was already overwhelmed even though most of the ingress will be Sunday. Taxi lines were running 30-45 minutes, so who knows how bad it will get Sunday since the number of cabs is finite.
The cab fare to downtown is a fixed $33 for 1-2 passengers, and don’t even be tempted to save a few dollars by taking the shared shuttle, which earns nearly universally negative reviews. Single travelers, which I would guess make up the majority, would be better off to self-organize the line into groups of two or three folks going to the same or close-by hotels, thus not only saving time and money, but freeing up a cab for someone else. Thank goodness a new law (which the taxi companies threatened to strike over) requires cabs to accept credit cards, which any city hoping to lure visitors should do.
My impressions of the ride from the airport to my hotel, courtesy of the billboards lining the rather unattractive route: people come to New Orleans to eat, buy hot sauce, and visit strip clubs.
I mentioned that HIMSS dumped me off to a hotel I didn’t reserve when mine became oversold even though I made my reservation in September (how did that happen?) Note the fine craftsmanship on the bathroom door that $200 a night gets you (yes, that’s a half-inch of nothingness between the knob and the closest available wood). The “we care about the environment, so don’t make us wash your towels” sign is adjacent to a faucet that leaks in a constant stream and the full-length mirror threatens to fall off the door since two of its six holders have broken off. At least the Internet speed is good (until everybody else checks in Sunday), the bed and TV are huge, and the location is excellent.
Weather wise, it’s around 50 and mostly cloudy (downright gloomy at the moment) with a freeze warning in effect for tonight, with similar weather predicted for Sunday before a big warm-up Monday. It’s slightly springy with green grass and early leaves.
I’m patting myself on the back for my wise decision after suffering through too many HIMSS conferences trying to write voluminous HIStalk posts using the Chiclet-style keyboard of my intentionally small laptop. This time I prepared by buying a USB-powered trackball and full-size keyboard, having realized that the screen size isn’t the main challenge, it’s the input devices, and they take up almost no luggage room.
Sunday is open for me since I didn’t sign up for any of the paid workshops, so I’ll just stroll around a bit, drop by the convention center to pick up by badge, and stop by the opening reception. It’s not only cheaper to fly in on Saturday, it makes Sunday a relaxing day.
I see on Twitter that bunches of HIMSS attendees are limbering up their fingers preparing to unleash a non-stop barrage of tweets about everything they see and hear all week. The online noise will be deafening, so I would guess that nobody’s going to read most of what’s being indiscriminately spewed.
Inga, Dr. Jayne, and I will be posting all week. Send us anything we should include – photos, rumors heard, and insightful observations. We never seem to get enough HIStalkapalooza pictures to satisfy everyone, so snap some shots there Monday evening. Help us figure out the prevalent themes of the conference since attendees often miss the forest for the trees (and the social distractions.) News and rumors will abound and we like hearing reader reactions.
Contacts
Mr. H, Inga, Dr. Jayne, Dr. Gregg, Lt. Dan, Dr. Travis.
More news: HIStalk Practice, HIStalk Connect.
The Art and Science of HIMSS Networking
By Jodi Amendola
By now you have scheduled your meetings, RSVP’d to all your party invitations, and if you’re a Type A personality, you’ve probably already packed your briefcase and most of your suitcase. But you still have some prep work to do if you want to maximize the benefits you receive from attending HIMSS, which remains the best annual forum for networking with prospects, customers, the media, industry analysts, and potential partners.
To achieve success with your networking efforts you must:
1) Know what you want to accomplish (e.g. networking, media interviews, intelligence gathering, lead generation, scouting new partners and/or business opportunities, etc.;
2) Be prepared; and
3) Follow up on your leads after the show.
Sounds pretty simple, right? But the key isn’t accruing a stack of business cards, reciting well-rehearsed talking points, or sending follow-up e-mails before your plane touches down at your local airport. Those activities will probably yield some results, but to achieve the greatest possible success you should think quality vs. quantity.
Just between us… the real secret for getting the most out of HIMSS is getting people to listen—not just hear—you, and to remember you and some of what you discussed. Ideally, you will provide at least one “light bulb” moment that resonates and sticks with your audience. And that’s not simple–or is it?
Below are my secrets for building relationships with the movers and shakers at HIMSS. Remember, you will be competing with lots of noise, hype, giveaways, competitors claiming they’re as good or better than your company, short attention spans, and overstimulated brains. Here’s some tips:
Truly connecting with people is both an art and a science, as any great leader will tell you, but it’s less daunting if you remember that you’ll mostly be relating to one or two people at a time. The important thing is to be yourself. Smile and they will smile with you. Networking doesn’t have to be a chore or intimidating. Showing up prepared with the right attitude can even make it fun as well as profitable. Have a great HIMSS!
Jodi Amendola is CEO of Amendola Communications of Scottsdale, AZ.
I wrote weekly editorials for a boutique industry newsletter for several years, anxious for both audience and income. I learned a lot about coming up with ideas for the weekly grind, trying to be simultaneously opinionated and entertaining in a few hundred words, and not sleeping much because I was working all the time. They’re fun to read as a look back at what was important then (and often still important now).
I wrote this piece in June 2008.
Want Doctors to Use EMRs? Find a More Effective Strategy than Shame
By Mr. HIStalk
Doctors are generally pretty smart. We agree on that, right? So why does the healthcare IT industry keep treating them like idiots?
A new, ultra-expensive study found that doctors aren’t exactly flocking to EMRs (it took an expensive study to determine that?) The hidden message: somebody has to do something to get those dummies to buy EMRs.
EMRs are, in other words, so darned compelling that prospects should be shamed or maybe even forced into buying them for the public good, kind of like seat belts (imagine some models of seat belts that cost $50,000 and require 30 minutes extra every time you start your car.)
In America, doctors are business owners, even though some people think that’s a distasteful concept. They have customers, employees, overhead, and equipment. They make good business decisions or they go broke. You can’t help patients if your practice tanks.
Many of those smart business owners don’t see the value of EMRs. They understand that EMRs might improve patient care in some cases, but the practical and immediate considerations of their cost, support, and time requirements win every time.
Doctors won’t use EMRs just because non-doctors preach at them. They will not be shamed for sticking with paper when it makes personal economic sense. Societal benefit aside, they have to protect their income and their time (which are synonymous).
EMRs, in other words, are no different than any other piece of medical equipment that the doc/business owner might buy. It’s a logical decision made by a smart person. If I’m a doctor, my decision tree might look like this.
First, can it make me money? Doctors buy fancy imaging equipment because they can bill the heck out of it under current reimbursement rules. EMR assembly lines would have to run night shifts to crank enough of them if docs could bill for their use. They can’t, which means payors (including patients) aren’t convinced about EMR benefits, either.
Second, would having an EMR give me competitive advantage? Here’s a question that gives you the answer: would you go find a new doctor just because your old one, who just happens to be the greatest doctor you’ve ever known, doesn’t use an EMR? Neither would all those Joe Sixpacks who are prodded by industry polls into saying that EMRs are essential, but who in reality don’t care whether their own doctor uses one or not.
Third, will using an EMR get me sued less? You’ll know that’s true when medical malpractice insurers give significant discounts to EMR-using doctors.
Fourth, when it breaks, who do I call? Doctors are not hospitals, with their separate department of nerds anxious to tackle the latest problem due to operating system quirks, software upgrades, driver incompatibility, and user errors. The Geek Squad guy is not only expensive and not found in most American towns, he also doesn’t know much about EMRs.
Sticking with the “how we do things here in America” theme, here’s how you get doctors to use EMRs. Make them faster, easier to use, and better supported to the point they provide inarguable business and clinical value, no different than a fax machine or an office PC. In other words, don’t just complain about paper — beat it in a fair fight.
And once you figure out how valuable EMRs are, make the person who gets that value pay for them.
Remote Control: Why Remote Consulting Works for HIT
By Casey Liakos
With the recent proclamation by Yahoo’s CEO Marissa Mayer that all company employees must work in a Yahoo office, the business world and Internet have been abuzz with arguments for or against this decision. Remote work is something that is on our minds often since it is a service our consulting firm offers in the EHR/Epic space. We haven’t seen anybody join the debate with a specific focus on EHR or Epic consulting, so we thought we’d chime in.
What Yahoo is requiring is really an apples-to-oranges comparison to the onsite/remote debate in EHR consulting. These are two different industries with two different sets of circumstances, and Yahoo’s decision clearly has no direct bearing on the HIT world. But there are corollaries between the two, and we think this is a good time to spur some discussion.
It should be pointed out that we are big fans of Mayer. She’s an inspirational figure in many ways, and above all, she’s from Wisconsin. So we have her back.
Time will tell whether this decision will benefit Yahoo, and there’s no shortage of people who feel strongly about it one way or another. But when we look at remote vs. onsite strictly through the lens of EHR/Epic consulting, we think that the logic Yahoo used in this decision is all wrong.
Why EHR projects are a natural fit for remote consulting
We are not advocating for all HIT consulting to be handled remotely. But we strongly believe that there are certain project phases and key areas where it just makes sense.
By now there have been countless philosophical points made on both sides of the Yahoo debate. But to our company, there are two factors that need to be considered, and these are the only two that truly matter when it comes to assessing value of a consulting purchase: productivity and cost.
Productivity
The remote services model that we offer to our clients has several key advantages when it comes to productivity. First, it puts resources on your team for the entire week. Traditional consulting practices have resources working Monday through Thursday – but of course your business doesn’t stop on Friday. Remote consultants can work a schedule to match your team’s hours, which brings an instant productivity boost.
Another factor that people may forget is that the technology available to us today makes remote work nearly seamless. I don’t need to go into detail — we all know many technologies that can put someone “in the room” when needed. With widespread remote system-access tools and file collaboration products already implemented in your organization, the remote consultants don’t miss a beat.
In fact, there are strong arguments to be made that communication can actually improve with a remote services model. A recent Harvard Business Review blog entry about working remotely makes some nice points:
Note: we’re not necessarily advocating working from home, which can potentially present its own set of distractions. Our remote teams work together in client teams, primarily from our company offices. This minimizes distractions, encourages collaboration, and helps solve customer issues quickly.
Cost
The most obvious cost savings with remote consulting is the rate. When priced correctly, this model can save your organization a boatload of money over the course of the engagement.
The other key savings with remote work come with eliminating travel expenses. Flights, hotels, rental cars, meals… these are very real and often prohibitive factors when your project requires outside help. With tasks like build, testing, and system bug/incident resolution, the work can almost always be done remotely if managed well. Why pay a huge premium to stick the resource in a cube down the hall all day?
The cost savings of using remote consultants go much deeper than just hard dollars saved on rate and expenses. Easy administration indirectly saves you money. Managing office space, computers, telephones, security badges, etc., all carry a cost that you can eliminate. With remote consultants working from their firm’s offices, these costs are incurred by the firm, not the client.
There’s inherent stability associated with remote consultants as well. Turnover is much less of an issue when you have happy team members sleeping in their own beds every night. The cultural and organizational learning curves associated with consultant turnover carry a large cost that can be eased greatly with a remote model.
Most importantly, we feel remote consulting is the most cost-effective way to find and hire the best consultants for the job. Think about it in the context of Epic. Many of the very best Epic minds and most experienced resources are former Epic employees. A great number of these folks no longer work there because of the travel burden associated with being at customer sites every week.
Epic is a great place to work for a million reasons, but it should be no surprise that the #1 reason cited for leaving Epic is the heavy travel. Hiring remote consultants is the best way to gain access to these resources. They still want to work on Epic projects, they just don’t want to travel or can’t due to family obligations.
Tips for making remote engagements successful
Even if the consultants work remotely, you are still the manager. Speak with consultants or get a status report at least weekly. Any resource that is ignored, whether onsite or remote, has the potential to be working on the wrong things at the wrong time.
You and your team should be responsible for funneling work to consultants. This is the #1 hurdle we’ve seen: getting hyper-productive consultants enough work to stay busy. When all else fails, give them a brand new project to plan and execute from the ground up and watch what they can accomplish with a little support from your team and SMEs.
Make remote workers part of your team. Make sure they’re involved in all team meetings, e-mail lists, and communications.
You are not Yahoo
Many have attributed Marissa Mayer’s decision to the need to foster more innovation within Yahoo. Time will tell whether this move helps achieve that goal. HIT projects require organizations not only to be innovative, but to move quickly and get things done in a cost effective way. For this, a remote consulting solution can be an excellent option.
Casey Liakos is client relations director of Vonlay LLC.
From HyWay: “Re: Costco. They sent an e-mail to customers who purchased Allscripts MyWay through Costco’s program saying they are working with Allscripts to ‘offer solutions for members who do not feel the move to Pro is right for them.’ In the mean time, Costco has initiated arbitration proceedings against Allscripts to make sure its users get the service they expected when they bought MyWay.” Unverified, but the forwarded e-mail appears to be authentic. Its tone was amicable.
From The PACS Designer: “re: iWatch. While we wait for the anticipated Apple iTV later this year, there’s something else to look forward to and that’s an Apple iWatch. TPD posted about the Pebble watch, and speculation is that the so called iWatch will be much more innovative and unique in its style and features. Apple has a patent requesting pending on a Amoled flexible wristband device to consider as the possible final product launch, or it could still be a traditional watch similar to the Pebble.”
I’m actually writing this Friday night since I’ll be traveling to New Orleans on Saturday, so don’t be confused when I also post on Saturday and/or Sunday and the days look goofy. Inga, Dr. Jayne, and I will be writing profusely from the HIMSS conference, and to avoid giving you inbox fatigue, I’ll collect the individual links into a single e-mail blast each day.
Lt. Dan had e-mailed me off the record about problems he’s having personally because of the lack of VA-DoD system integration. I suggested he write it up since he’s both a veteran and an HIT person, not to mention the author of HIStalk’s daily headlines and most of the posts on HIStalk Connect. I think his piece, Making the Transition: What the iEHR Failure Means for Veterans, paints a clearer picture of the problem than you’ll get from the agencies themselves.
Welcome to new HIStalk Platinum Sponsor Caristix, which offers HL7 software for interface lifecycle management. The company offers Cloak (HL7 de-identification), Pinpoint (interface troubleshooter), Conformance (interface specs development), and Test (complex interface validation and simulation). They will also help get you connected to the Mirth open source integration engine. You can download trials of everything from their site, and also the entirely free HL7 profile reader and an HL7 listener and router for recording and playing HL7 messages to validate connectivity. They have tools for providers and vendors alike. Interface folks will enjoy their HL7 Survival Guide, a no-nonsense guide to interface projects and technology. I featured the company in my Innovator Showcase just over a year ago, which included an interview with one of its customers and another with President Stéphane Vigot. Thanks to Caristix for supporting HIStalk.
Welcome to new HIStalk Gold Sponsor eHealth Technologies. The company’s eHealth Imaging Solutions provide single-click access to diagnostic quality X-rays, CT scans, ultrasounds, ECG, etc. from an existing EHR or HIE solution. Clinicians gain the ability to view and collaborate using eHealthViewer ZF, a zero-footprint unified imaging platform that allows secure viewing of any image over the web. eHealth Imaging Solutions supports trauma and emergency access to images, allows transferring DICOM images between PACS locations so that radiologists can view outside exams, and provides cloud-based archival and disaster recovery solutions. Hospitals, IDNs, and HIEs can strength their referral networks, reduce the cost of physical media, meet MU Stage 2 image sharing requirements, reduce patient risk from unavailable images and radiation exposure from duplicate exams, and lower IT costs with the zero-footprint viewing platform that runs on all browsers and platforms (including iOS and Android). Thanks to eHealth Technologies for supporting my work.
Here’s a video I found featuring customers describing the benefits of eHealth Technologies for accessing images.
The Department of Defense chooses Health Language from Wolters Kluwer Health to provide terminology solutions to support enhanced documentation, population analytics, and business intelligence reporting across the Armed Forces Clinical Database.
TeleTracking will announce its Real-Time Capacity Management platform at HIMSS, with clients on hand in Booth #6619 to describe their experience with the company’s systems.
NextGen Healthcare will unveil NextGen Population Health at the HIMSS conference, which will help providers meet patient-centered medical home and ACO goals.
Vitera Healthcare Solutions releases Intergy v8.10, which includes enhancements for ICD-10, Meaningful Use, patient engagement, disease management, and performance-based reimbursement.
Covenant Health (TN) and Capital Region Health Care (NH) choose McKesson Paragon.
Hackensack Alliance ACO chooses Health Catalyst for care coordination, to be announced Monday.
Patients whose hospitals or physician practices are customers of lifeIMAGE will be able to review their medical imaging results online using a free new service offered by the company, which also announces its support for Blue Button.
HIMSS Analytics will showcase the products and services of the recently acquired CapSite at the conference in Booth #4929, including the CapSite Database (pricing and contracts) and an expanded Consulting and Research & Advisory Services offering.
Medical documentation vendor Command Health will use Clinithink’s CLiX natural language processing technology to turn physician narrative into indexed and tagged free text. Clinithink also announces that Health Evolutions Partners operating partner and former Microsoft Health Solutions Group VP Peter Neupert has joined its board.
Baystate Health (MA) chooses Awarepoint’s RTLS solution for asset management and capacity management in its three hospitals.
Vonlay has posted a page that displays photo-containing tweets that use the #HIMSS13 hashtag, which they also did during Epic’s UGM. It has several photos already but will surely blow up with tons of them come Monday (you’ll see a gazillion pictures of a microscopic Bill Clinton later in the week).
Quest Diagnostics, which includes Care360 and MedPlus, will host several speakers in its HIMSS theater, including HIStalk Connect’s Travis Good, MD.
We reported that Practice Fusion has discontinued its billing system partnership with Kareo based on the wording of an e-mail sent to Practice Fusion users that referred to the relationship in the past tense while announcing enhancements to Practice Fusion’s own billing system. According to Kareo, the business relationship continues and users of the products will continue to benefit from the integration.
I said from the beginning that Groupon’s business model was unsound for several reasons (low barrier to entry, discounting rarely earns businesses loyal customers) but I’ll give its now-fired 32-year-old CEO Andrew Mason kudos for writing the best executive resignation letter in history. Snips from it:
People of Groupon, after four and a half intense and wonderful years as CEO of Groupon, I’ve decided that I’d like to spend more time with my family. Just kidding – I was fired today. If you’re wondering why… you haven’t been paying attention … As CEO, I am accountable. You are doing amazing things at Groupon, and you deserve the outside world to give you a second chance. I’m getting in the way of that. A fresh CEO earns you that chance … For those who are concerned about me, please don’t be – I love Groupon, and I’m terribly proud of what we’ve created. I’m OK with having failed at this part of the journey … If there’s one piece of wisdom that this simple pilgrim would like to impart upon you: have the courage to start with the customer. My biggest regrets are the moments that I let a lack of data override my intuition on what’s best for our customers. This leadership change gives you some breathing room to break bad habits and deliver sustainable customer happiness – don’t waste the opportunity! I will miss you terribly. Love, Andrew.
Secure Threads introduces bring-your-own hospital gowns intended to prevent medical errors by having the patient’s name, blood type, allergies, age, medical conditions, and emergency contacts embroidered into the fabric.
Safe travels and an enjoyable and productive week for all those traveling to New Orleans. For those who aren’t attending, feel free to goof off all week while your boss is away.
Contacts
Mr. H, Inga, Dr. Jayne, Dr. Gregg, Lt. Dan, Dr. Travis.
More news: HIStalk Practice, HIStalk Connect.
House panel blasts DoD for overlooking VistA
After cancelling iEHR plans, DoD is facing pressure to consider VistA as an alternative that would allow DoD and the VA to continue with plans of adopting a single system. DoD has instead issued a RFI for a commercial solution, leaving many speculating that they will follow the Coast Guard’s path toward Epic.
Why Vocera Communications Shares Tumbled
Vocera announces Q4 results: revenue increased 24 percent to $27 million, EPS was $0.10 vs $0.07. Stock dropped almost 10 percent after guidance was adjusted for first-quarter forecasts. Vocera reported guidance of $23 million to $25 million, far less than analyst expectations of $28 million.
Health Catalyst adds $8 million toward its $41 million Series B round, with contributions from Kaiser Permanente and CHV Capital.
Resolute Health selects Allscripts Electronic Health Record
Currently in construction, Resolute Health Hospital, of New Braunfels TX selects Allscripts as its EHR in preparation for its spring 2014 opening.
St. Vincent’s Health Partners, Inc. Selects McKesson To Help Reduce Risk and Drive Better Health
St. Vincent’s Health Partners will implement McKesson’s new population health application, recently secured through the McKesson’s acquisition of MedVentive.
This article was written by Lt. Dan,who writes for HIStalk Connect and provides daily headlines on HIStalk.
After eight years of service — during which I traversed seven countries across three continents, lived in three states, and had the privilege of working alongside the very best, brightest, most dedicated, honest, and sincere men and women I have ever known — the time finally came in November 2009 for me to walk away. I signed my discharge papers on November 11 (Veterans Day), got in my car, and drove off base for the last time. I was sad, scared, and very excited.
Fast forward three months. I am sitting in a doctor’s office, about to have a physical from my new PCP. The office was clean; the staff was polite. This was nothing like sick call, where all ailments were treated universally with a prescription for Motrin 800 and a return-to-work slip. During the appointment. my doctor told me to send him my medical records from the Army.
I tracked down the clinic on the base I’d been assigned to and asked for my medical record. They told me it had been forwarded to the US Army Human Resources Command. I called them. They said that they didn’t have my records, didn’t know where my records were, were not responsible for processing requests to access said records, and suggested that I call the VA.
Undaunted, I did call the VA. They told me that US Army HRC was probably misinformed because they should have my records, but to be certain, I would need to fill out some forms, mail them in, and wait for an estimated 90+ days.
At this point, it was beginning to sound like my medical records were having a far worse go of it in civilian life than I was. I told them never mind, the whole thing seemed pointless since I knew everything that was in them and could just tell my PCP the history myself the next time I saw him.
When I went for my first civilian dental exam and was asked if I had a dental record, I was smart enough to just say no. To date, I still don’t have my military medical records and probably never will.
Transitioning out of the military is not easy. It’s moving long distance back to your home town and finding a new job. It’s changing the way you talk so you don’t accidently swear in a business meeting, or call a 22-year-old co-worker “ma’am.” It’s learning to make friends with people you don’t have something intimately in common with. It’s a good bit of doubting yourself and whether you are going to be good at this very different new life.
This stress is exacerbated by an estimated 35 percent prevalence of PTSD in returning veterans, and an estimated 20 percent prevalence of traumatic brain injury, which along with more traditional disabilities, has resulted in nearly 50 percent of departing veterans requiring disability services from the VA.
When that 50 percent of discharged veterans leave the military, their healthcare is transitioned from DoD facilities to VA facilities. The hope is that this will one day be seamless. For now, before the VA will provide services, soldiers submit a disability claim to receive approval to start receiving benefits.
Herein lies the problem. It takes an average of 277 days from the time a claim is submitted until the time a decision is made, much higher than the VA’s stated goal of 125 days. During this waiting period, veterans are left in limbo without access to services or entitlements. There is new policy in place that will allow a departing soldier to submit a disability claim with the VA prior to exiting the military, but currently they can only submit 180 days prior to their discharge date. Helpful, but another example of the needs of the veterans getting lost in translation with the policy makers.
The enormous disability claims backlog has made national news for more than a year now because it is larger than it has ever been in our nation’s history, approaching 1 million claims. Veterans who are leaving the service are usually dealing with a new job, a long distance move, and basic emotional transitions and simply do not have the energy to tackle another exhausting problem in their lives. But the VA’s disability claims process has become exactly that, an exhausting problem in the life of veterans who need services.
Over the last several years, the VA has put in place a plan to correct the disability claims backlog. It was a two-tiered technology implementation plan that involved developing iEHR, which would reduce the time it takes for veterans’ medical records to make their way to disability claims processors. A new disability claims automation system was expected to reduce the time and resources required to process a claim. These two projects were expected to solve the backlog, and so they were heavily funded and highly prioritized.
The disability claims system, called the Veterans Benefits Management System or VBMS, was a $500 million system that began its implementation this past summer. It hit the ground with a loud thud despite the fact that a significant portion of its allocated funding was spent. The implementation has been mired in delays and functional issues that have repeatedly sent engineers back to the drawing board.
In June 2012, VA CIO Roger Baker acknowledged the issues in an interview, saying, “In mid-December, the volume of VBMS usage grew rapidly as users from the 18 [regional offices] were added. VBMS began to experience dramatic slowdowns in response time for some users, especially during peak usage hours. A root cause analysis determined that the issues were due to the way data is being read from disk storage. Since the impact was considerably more read/write work for each transaction, it had a greater impact as more users attempted to perform work on VBMS.” The initial recommendation was to halt any non-critical tasks, but the permanent fix will require a significant redesign.
VBMS was initially scheduled to complete its implementation across all VA processing centers by the end of 2012. At the close of 2012, just 5 percent of claims processors were using the new system. The implementation timeline has now been pushed out until the end of 2013.
iEHR was also conceived as a way of tackling the benefits backlog. The overriding goal of iEHR was to bring all stakeholders in the transition of veterans’ healthcare under one system to allow for a fundamentally more streamlined process for both soldiers and benefits processing for the VA. Summarized best by California House Representative Jeff Dunham during a recent hearing, “Those who have volunteered at a time of war … if they come home tomorrow, they ought to be in the (electronic-record) system tomorrow, knowing what benefits they will receive … and that it doesn’t take a 5-day or a 50-day system.”
iEHR was halted on February 5 after officials within DoD and the VA realized that the total cost to develop the system had grown to more than $12 billion, more than double the original $4-$6 billion estimate CIO Baker quoted at the onset of the program. Following the announcement, the VA and DoD went back and forth over whether it would be feasible for DoD to implement the VA’s VistA EHR as a Plan B that would allow both organizations to operate within one EHR and maintain the overall goal of a unified system that could streamline the transition process for veterans.
In response to this idea, the Assistant Secretary of Defense for Health Affairs said “The current VistA system is a generation 1-plus-2, in terms of how we look at electronic health records. Industry is already at a generation 3 and moving to a generation 4. We would need to assess what’s required for us to bring VistA over, modernize it, and (calculate) what the total cost of ownership would be over time." On February 8, DoD announced that it was launching a vendor search, ending any hope that iEHR would be revived.
Within the past 30 days, CIO Baker along with VA CTO Peter Levin have been called before the Veterans House Services Committee multiple times to answer to outraged representatives over delays, cost overages, and systematic failures within both programs. For four years, the disability claims backlog grew with no improvement in the pace at which the VA processed new claims. Baker and Levin were the project owners for the two projects that were targeted to address the disability backlog issue. They drafted their plans, spent the money, the projects failed, and all that was left for them to do was resign, which is ultimately what they both did.
Now we have a growing disability claims backlog weighing down the VA. The proposed solutions have failed and the money is spent. Further complicating matters, the government is staring down the barrel of a federal budget sequester that is going to further limit the VA’s options to fix the disability claims backlog.
Meanwhile, a veteran population dealing with almost 10 percent unemployment and an unprecedented 22 suicides a day is going without disability benefits because the system that was designed to support them is fundamentally broken and programs intended to fix these problems are back to square one.
Top News
A House panel, obviously fed up by the DoD’s cavalier attitude toward the VA’s VistA system compared to its own AHLTA EHR, demands to know why DoD won’t adopt the highly successful VistA. DoD says it’s looking at VistA yet again, but says it will evaluate it against commercial systems in attempting to “skate where the puck will be” and is concerned about multiple VistA versions and lack of conversion documentation. Congressman Jeff Miller (R-FL), as puzzled as the rest of us about whether VA-DoD will adopt a single EHR or try to cobble their respective systems to merely look like one, summarized as, “It sounds to me like we’re doing a U-turn and going back to the exact same thing again.” Outgoing VA CIO Roger Baker says estimates to develop the integrated system had doubled to $12 billion. One might assume that given Epic’s previous rumored involvement, its Coast Guard EHR experience, and its track record in large and diverse organizations, it might enter the picture in some fashion as the words “commercial systems” are uttered in polite company.
Reader Comments
From Jardone: “Re: Jardogs. A sale to Allscripts is imminent. Layoffs began yesterday, which appear to be across the board. Since Jardogs is owned by Springfield Clinic, no severance will be paid. Today is the last day for many, including myself.” Unverified. I e-mailed our contact at Jardogs inviting a response, but haven’t heard back. Jardogs, which offers patient engagement and health management solutions, is an Allscripts partner.
From Looking Deeper: “Re: MU Stage 2 requirements. Do your readers have tips for getting clarification for questions that aren’t resolved in the documentation? We would like to contact CMS. It’s a shame they don’t have an e-mail address or form.” A reader reports having successfully used this form, selecting “EHR Incentive Program” as the topic. She got a response in three weeks.
From Festus: “Re: coding issues. Jail time?” A 63-year-old cardiothoracic and vascular surgeon is serving a 10-month sentence for Medicare fraud, convicted for upcoding his cases. The US Attorney says his case sends a message to doctors, while professional organizations say that message is that doctors shouldn’t accept Medicare payment because nobody can comply with its complex requirements and now they could be imprisoned for making mistakes. According to the Association of American Physicians and Surgeons, “This precedent criminalizes false statements in a private setting without any proof of billing fraud and a greater interference with the day to day practice of medicine is difficult to imagine.” The doctor’s dictated reports from 10 years ago were found to have specified the wrong kind of graft in two of 2,400 operative reports. He says he was too busy to keep up with the reports and had been told to use a code that was similar if he couldn’t find the right one. AAPS says the irony is that he could have justifiably billed a lot more than he actually did even with the mistake. The charges say the surgeon did more than just choose the wrong CPT code – they say he also falsified his progress notes. It would be interesting to see if those were generated with computer assistance since that’s the only reasonable excuse.
From CEO: “Re: HIStalk. I start every day by catching up and reading HIStalk. It really is a wonderful source of content that helps me keep a good pulse on the industry. Thank you for serving so many of us!!!” Inga was happy to read this CEO’s e-mail in response to receiving his HIStalkapalooza invitation as one of few positive comments we’ve received lately, as most of our recent e-mails are from people complaining about not being invited to HIStalkapalooza because they didn’t register. I suppose I should be flattered that people care that much about attending.
From CatsEyes: “Re: three tidbits. Did you mention that Dr. Tonya Hongsermeier (above) left Partners CIRD to become CMIO of Lahey? Lovely and very smart person. And with Partners, Boston Medical Center, Lahey, and Lifespan all going to Epic. From New Haven to Mid coast Maine – Epic rules.” I left out Tidbit #1 since it involved a sales VP whose new job I couldn’t immediately confirm. I’m dating myself by admitting that when I hear Tonya’s name I still think of her being at Cerner, which she hasn’t been forever.
HIStalk Announcements and Requests
I took an unplanned three-hour field trip to the ER on Wednesday. Of course I asked the staff all sorts of questions about what technology they had in place (and why they were using so much paper.) Turns out I am just fine and my stress over selecting the perfect pair of shoes for HIStalkapalooza does not seem to be a contributing factor. Mr. H, however, thinks all the e-mails begging for last-minute HIStalkapalooza invites may have put me over the edge.
Have you stayed current with HIStalk Practice? If not, some of this week’s highlights include: only 60 percent of physicians are interested in participating in ACOs. ISALUS Healthcare introduces a new version of its OfficeEMR. Memphis Obstetrics & Gynecology Association goes live on MED3OOO’s InteGreat EHR. Practices have an increased need for population patient health tools. I love new e-mail subscribers, so take a moment to register for updates when checking out these stories. Thanks for reading.
Welcome to new HIStalk Platinum Sponsor Forward Health Group, located on Capitol Square in Madison, WI. The orange above looks juicy and that’s no coincidence – the company’s PopulationManager tool serves up QI and outcomes data to health systems that’s fresh, never frozen, squeezing it from your current systems, claims data, or administrative data. It’s accurate, actionable, complete, and timely, not to mention physician accepted at the individual patient level. The founders started out working in public health reporting back in 2004, meaning they had to figure out early on how to extract and aggregate data from a veritable science fair of disparate IT systems to create apple-to-apples measurements (that’s my second fruit analogy if you’re scoring at home.) It’s a fruit punch (fruit reference #3) of advanced informatics, population health best practices, and elegant visual explanations. They’ll set up a meeting or come to you at HIMSS or at HIStalkapalooza to tell you more – just e-mail them. Thanks to Forward Health Group for their berry (#4) much appreciated support of HIStalk. I have a feeling they’re a lot of fun, so you might be on the lookout for CEO Michael Barbouche or docs John Studebaker, MD and Sean Thomas, MD Monday night at Rock ‘n’ Bowl.
I found this Forward Health Group video that talks more about Fresh Data.
Thanks to Levi, Ray & Shoup, which not only issued a press release calling out my recent interview with SVP John Howerter, but used most of it to say nice things about HIStalk. I enjoyed talking with John because I consider myself something of an expert on print spooling-related problems in hospitals (having gotten myself hopelessly stuck in the middle of those problems many times over the years, unfortunately) so I was asking questions from my own experience.
Verisk Health is supporting HIStalk as a Platinum Sponsor. The company builds solutions for every payer type, including medical cost management, government reporting, payment accuracy, and revenue compliance. They can help identify risk, save money, and improve care. Providers interested in accountable care programs need tools for cost control, quality improvement, and population health management, and that also means you would probably benefit from getting a free copy of Verisk’s provider toolkit. Edward Hospital (IL), for example, is using PopulationAdvisor (through Premier) to monitor its clinical and financial performance, combining Premier’s comparative provider database with Verisk Health’s risk-based payer analytics to gain a better understanding of outcomes and cost of care provided both inside and outside the hospital. Verisk Health President Joel Portice has been around the industry for a long time, holding executive roles with Intelimedix, HCI, Enclarity, and Fair Isaac (not to mention that he’s also a novelist). Thanks to Verisk Health for its support of HIStalk.
HIMSS Conference and Social Events
Wen Dombrowski, MD, who tweets under @healthcareWenF, forwarded me this list she compiled of socials, Tweetups, and physician exec events. She is doing a Segway tour Saturday afternoon that sounds particularly fun.
I’m posting this shoe porn for Inga and Dr. Jayne, sent in by the (male) president of a new sponsor who clearly understands their fixation. Very hot.
The weather forecast for New Orleans looks pretty darned good. The mild temperatures suggest open-toed shoes as a viable option. Heavy coats can remain at home, or at least in the hotel room.
HIStalk’s Guide to HIMSS13
HIStalk’s Guide to HIMSS13 Meet-Ups
HIStalk’s Guide to HIMSS13 Exhibitor Giveaways
Acquisitions, Funding, Business, and Stock
Practice Fusion buys 100Plus, a startup co-founded by Practice Fusion CEO Ryan Howard that provides analytics-drive personalized health predictions.
Health Catalyst increases its Series B round by $8 million with participation from Kaiser Permanente Ventures and CHV Capital.
Revenue cycle solutions vendor Cymetrix Corp. acquires analytics vendor CareClarity.
Sales
Resolute Health (TX) selects Allscripts Sunrise Clinical Manager EHR and Allscripts Community Record for HIE and analytics.
Physician-hospital organization St. Vincent’s Health Partners (CT) chooses McKesson Population Manager and McKesson Risk Manager to manage the health of high-risk populations.
PeaceHealth will integrate Streamline Health’s AccessAnyWare enterprise content management solution with Epic ambulatory.
Evolution Health will deploy Greenway Medical’s PrimeSUITE across its national network of house call providers.
Northeast Georgia Health System (GA) will implement McKesson Paragon.
Daughters of Charity Health System will implement CliniComp’s Essentris Fetal mobile EMR in all of its hospitals.
People
API Healthcare names Daryl Joslin (Defran Systems) chief marketing officer.
WorldOne, the parent company of Sermo, names Kerry Hicks (HealthGrades) chairman.
Press Ganey Associates adds Ralph Snyderman, MD (Duke University Health) to its board.
Beverly Bell (CSC) joins Health Care DataWorks as chief nursing officer and VP of implementation services and business performance management.
Announcements and Implementations
City of Hope (CA) implements Harris Corporation’s BI Practice Variation dashboards to identify opportunities for improving clinical outcomes, safety, and documentation.
Taylor Regional Hospital (GA) and Griffin Hospital (CT) complete activation of PerGen’s PeriCALM perinatal system in their labor and delivery departments.
Awarepoint makes its aware360 Suite for Workflow Automation services available on a cloud-based platform.
Wolters Kluwer Health introduces ProVation Care Plans powered by Lippincott’s Nursing Solutions, which provides tools for maintaining evidence-based interdisciplinary care plans.
First Databank announces new medication decision support tools that include interoperability mappings (linking RxNorm to FDB data, for example), enhanced AlertSpace functionality to reduce alert fatigue, and state and federal controlled substances information.
EHR vendor Practice Fusion announces that it has discontinued its relationship with billing system vendor Kareo due to “due to Kareo’s recent price hikes” while also acknowledging that “billing has not been our strongest feature.” The Practice Fusion announcement did not mention that Kareo announced its own free EHR last week. We invited both companies to respond and received this from Kareo:
Kareo is committed to delivering an open platform and supporting multiple EHR options driven by customer requirements, including partner-based solutions and Kareo EHR. Kareo will continue to work closely with our EHR partners to enhance and support our existing integrated solutions while adding new options over time. We believe this approach provides our current and future customers with the greatest flexibility to choose the best EHR for their specific needs. Kareo is proud of our reputation as a provider of intuitive and affordable solutions, and we are committed to delivering the highest value to our customers. The pricing plans for our customer base remain in place and have not changed in any way.
The iPad-powered Sparrow EDIS from Montrue Technologies becomes the first ED system to earn certification under the 2014 Meaningful Use criteria.
Allscripts will demonstrate award winners of its Allscripts Open App Challenge at the HIMSS conference, presenting $150,000 in prizes to 15 winners at Booth #3441 on Monday at 3:00 p.m. The company will also donate $5 to one of three charities (#AHA, #ACCS, or #JDRF) for tweets to @Allscripts answering the question, “What does Open mean to you” or “How have you benefitted by using Allscripts?”
Surescripts will announce Friday that electronic prescribing service NewCrop will connect to The Surescripts Network for Clinical Interoperability, which allows providers to securely share clinical information.
QuadraMed announces that Shands HealthCare (FL) will integrate the company’s AcuityPlus nurse resource management system with the Epic system that Shands is implementing.
VMware announces vCloud for Healthcare, which will allow healthcare IT customers to use a common cloud infrastructure inside and outside hospitals.
Sharp HealthCare (CA) and the Foundation for Health Coverage Education launch the for-profit PointCare Web-based eligibility software vendor, saying it will “change the tone of financial conversations with their uninsured patients.” Uninsured patients take a short quiz that identify the government programs that 80 percent of them are eligible for.
Other
Athenahealth will invest up to $10 million and lease up to 60,000 square feet of office space in Midtown Atlanta for more than 700 employees.
A CHIME survey finds that the average base salary for healthcare CIOs in 2012 was $208,417, with respondents holding the EVP/CIO title averaging 50 percent more. More than half held a master’s degree, earning 10 percent more than those with a bachelor’s degree. Three-quarters of the CIOs reported receiving a raise of less than five percent in 2012.
The Nashville business paper profiles Shareable Ink President and CEO Stephen Hau. The 50-employee, 82-hospital software company relocated there from Boston in 2010.
Security researchers using CyberCity, a military-developed model city used to study cyberattacks, find that the city’s electronic medical records system is full of security holes. “OpenEMR from a security perspective is a disaster,” overlooking the fact that few if any US hospitals use that particular open source system.
I’ve gotten wind of an upcoming announcement from Michelle Obama’s Partnership for a Healthier America in which several EHR vendors that I won’t name (mostly the usual suspects, with some surprises) will pledge to add five anti-obesity features to their products at the March 6-8 PHA summit in Washington, DC. The features are BMI and weight classification percentiles, activity and dietary assessments, weight goal monitoring, referral to providers and community resources, and the ability to create a Healthy Weight Plan.
In Australia, Canberra Hospital will upgrade its ED system security after several employees were found to be altering patient data to make wait time statistics look more favorable. Most of the employees could not be identified because the EDIS was set up with generic user IDs like “nurse” and “doctor,” with managers claiming that the department could not function if users had to sign on and off individually. The upgrade will include quick logon/logoff. A server crash of the same EDIS caused the hospital to go on diversion Wednesday as the ED went back to paper.
In Canada, doctors in Nova Scotia complain of system crashes and response time problems with their $4 million Nightingale Informatix EMR, for which they were paid $10,000 each in government incentives to use. The company acknowledges software problems.
Cerner is among four dozen medical device and supply vendors that will pass along the new PPACA-mandated 2.3 percent medical device excise tax directly to their hospital customers.
Weird News Andy wonders if Meaningful Use statistics could be similarly fudged. The acting CEO of an English hospital resigns after an investigation finds that Royal Bolton Hospital coded its patient deaths due to septicemia at quadruple the expected rate, with interim findings indicating “cause for concern.” Hospitals get paid more for treating septicemia.
Researchers find that drinking red wine may protect against noise-induced hearing loss. When not drinking Hurricane Ingas, I will make a point of sticking to red wine when club hopping in the Big Easy.
Sponsor Updates
EPtalk by Dr. Jayne
Several readers have asked Inga and me for HIStalkapalooza fashion advice. DO wear sassy bowling shoes or a cool retro bowling shirt. DON’T wear anything from MSN’s list of ugliest shoes of all time.
With HIMSS starting in a few days, my inbox is really filling up. If you’re exhibiting, that means you are a technology company of some kind or at least peripherally in the technology sphere. Up your game (and the chances that your message will actually be read) by proofreading your content and removing tags like that in the e-mail above prior to sending.
Even with a relatively full inbox, it’s a slow news week as everyone saves up their big news to announce at the show. You don’t have to make a big splash at HIMSS to be a success. Vendors are quietly certifying their products for Meaningful Use 2014 and I salute them.
I’ve had a lot of questions about what I’ll be looking at during the show. Rest assured I’m making my list and checking it twice. I plan to spend plenty of time in the far reaches of the exhibit hall looking for the next big thing, so stay sharp because you never know when we might come by your booth.
I’m off to the Crescent City tomorrow and will bring you the news and happenings of HIMSS. For those of you unable to attend, thank you for keeping the availability high, the loads balanced, and the issue resolution times low. We’ll raise a glass in your honor at HIStalkapalooza. Laissez les bons temps rouler!
Contacts
Mr. H, Inga, Dr. Jayne, Dr. Gregg, Lt. Dan, Dr. Travis.
More news: HIStalk Practice, HIStalk Connect.
HIStalk Sponsor Announcements
The poem: Well, it's not it's not the usual doggerel you see with this sort of thing. It's a quatrain…