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 October 2008.
Dirty Geeks and They’re Done Dirt Cheap: How Wall Street’s Huddled Masses Could Reshape Healthcare IT If We Just Asked Them By Mr. HIStalk
Healthcare IT has always been inbred. The same folks just keep moving between provider and vendor, hospital operations and IT, and Organization A and Organization B. The name tags change, but the faces stay the same. Most of the value of the HIMSS conference is in reconnecting with all those folks who scattered like billiard balls since you saw them last.
HIT is an esoteric discipline, at least according to those who are in it. We’ve kept it that way by demanding healthcare experience for most jobs, ensuring that few strangers and their highfalutin’ new ideas enter our comfortable midst (it also helps that healthcare pays less and uses bizarre technologies that the rest of the techie world has never heard of, like MUMPS and Magic).
Nobody knows whether healthcare will dodge the economic bullet this time around. If it does, lots of non-HIT techies will be pressing their noses to our glass, seeking a chance to start earning a paycheck again. It will look like that Twilight Zone episode where the guy is holding a gun on his neighbors to keep them out of his bomb shelter.
This Mariel boatlift of geeks could be great news for healthcare. Banks and investment companies were (note the past tense) full of experts in online transaction processing, security, project management, and forecasting. What will we tell those folks when they drop by?
Traditionally, it would be a slightly more polite variant of “hit the road.” No healthcare experience means we don’t want you, no matter how skilled and experienced you are at the same kinds of technology that we’re planning to use. We’re healthcare and we’re different.
That’s a mistake. The industry could use some new, baggage-free ideas from people who have spent their lives doing what healthcare is just now learning about: running large-scale, mission-critical systems and conducting business innovatively over the Web. And right now, especially if your hospital or company is anywhere near New York, Boston, Chicago, Hartford, Charlotte, or other cities that revolved (note past tense) around the financial services industry, I bet you could hire them for about the same money you pay those same old retreads.
This could be the most exciting HIT development in decades. Many of our bread-and-butter applications are old, poorly secured, and Web-indifferent. Developing portals and RHIO connectivity is a snap compared to keep tracking of some of those bizarre investment instruments their former finance bosses just choked on.
Interested in patient payment systems, real-time adjudication, Web-based customer service, or throughput modeling? Those are the folks who could knock that out right now, already used to skipping lunch and working long hours.
Healthcare has always been jealous of banking IT people, visibly grinding their jaw when innocent outsiders make the inevitable comparisons of their cutting edge work vs. healthcare’s 1980s-era challenges still being solved. Deep down, we knew they were right. Former hospital staff turned self-taught analysts couldn’t hold a candle to the best and brightest techies who headed to Wall Street in droves and moved that industry from staid old storefronts to cutting edge electronic commerce. Hey, their stuff works – it’s not their fault that their big-dollar bosses were a lot dumber than everybody thought.
Now we get even. Pay them a lot less, squeeze them into cubicles, and make them take orders from clinicians turned semi-programmers. The tortoise won this race. We don’t care about your international arbitrage software – just write an EMR system that doctors will actually use.
Think of this as your own Wall Street bailout, with benefits.
Allscripts releases Q1 results: a $11.6 million loss on the quarter resulting in a -$0.07 EPS compares to a $5.8 million profit and $0.03 EPS for the same period last year. The stock was down 10 percent in after hours trading but is up 47 percent on the year.
A recent study highlights electronic medical records utilization trends across eight countries. The United States is leading all nations in the adoption of EHRs and nears the top of HIE adoption.
Allscripts reports Q1 results: revenue down 4.8 percent, EPS –$0.07 vs. $0.03, missing estimates on both.
Reader Comments
From IT Exec: “Re: HIStalk. Thanks for everything you do. My day wouldn’t be complete without spending a few hours on there.” Thanks. Mine either.
From PCP Doc: “Re: athenahealth. Just got back from their user conference. Jonathan Bush did not mince words on stage, just like in their earnings call, when talking about ‘companies of Epic proportions.’ Athena going to Haiti to install an EMR in a rural clinic that treats spinal injury patients was a noble touch.”
From Green Lantern: “Re: CMIO searches. I am aware of a couple of hospital systems that restarted their search rather than make an offer to an existing applicant. Does that happen often with CMIO searches vs. other C-level corporate officers? Are there enough applicants, or are hospitals being unreasonable?” Your thoughts are welcome.
HIStalk Announcements and Requests
Highlights from HIStalk Practice this week: the AMA’s board of trustees chair criticizes the federal government for mandating the use of EHRs under threat of monetary penalty while simultaneously accusing providers of cloning documentation. Frederica Krueger responds to the AMA’s complaints in a “Nightmare on EHR Street” Readers Write post. DigiChart changes its name to Artemis. American Medical News reviews the status of various lawsuits against Allscripts since the company announced plans to stop regulatory development of its MyWay product. CMS creates a timeline for aligning quality measurement and reporting for multiple initiatives. Dr. Gregg considers patient engagement and patient empowerment from both the provider and consumer points of view. Get your fix of ambulatory HIT news and sign up for the email updates while you are there. Thanks for reading.
HealthTap raises $24 million in series B funding led by Khosla Ventures.
Alere reports Q1 results: revenue up 10 percent, EPS $0.09 vs. –$0.05, beating expectations on both. The company also acknowledged that an investment firm that is a major shareholder will launch a proxy fight.
The Advisory Board Company reports Q4 results: revenue up 19.1 percent, adjusted EPS $0.33 vs. $0.31, beating analyst expectations for both.
Canada-based vertical software vendor Constellation Software acquires Quantitative Medical Systems of Emeryville, CA, which offers dialysis-specific revenue cycle and EMR software.
Sales
The Mount Sinai Medical Center signs a multi-year agreement for Cureatr, a mobile app designed by one of its residents that offers HIPAA-secure group text messaging for care coordination.
Chicago Health System ACO (Vanguard Health Systems) selects Care Team Connect’s integrated care management platform.
SSM Health Care – St. Louis (MO) selects the EDCO Health Information Solutions day forward medical record scanning services for use at its seven area facilities.
Quality Health Solutions, formed to support the virtual network of seven healthcare systems and Medical College of Wisconsin, chooses population health management and clinical integration solutions from Valence Health.
People
Culbert Healthcare Solutions adds Jason Faaborg (Dell), Tom Gurdak (CSC), and David Howe (Public Consulting Group) as VPs of sales.
Forbes profiles Imprivata CEO Omar Hussain in an article on leadership.
Adventist Midwest Health names Thomas Schoenig (Wyoming Medical Center) as regional CIO.
Care collaboration platform vendor CareInSync names Steve Curd president and CEO. The company also announced a follow-on investment from California HealthCare Foundation’s Health Innovation Fund.
NCPDP names First Databank’s VP of Health Policy and Industry Relations Tom Bizzaro to its board of trustees.
Mike Vandiver (SecureWorks) joins Ingenious Med as CFO.
Charlie Ditkoff (Bank of America Merrill Lynch) joins Cumberland Consulting Group’s board.
Announcements and Implementations
Royal Philips and Al Faisaliah Medical Systems open Philips Healthcare Saudi Arabia, a 50-50 joint venture to market and sell Philips solutions and services in the Kingdom of Saudi Arabia.
Geisinger Health System (PA) will give patients access to their doctors’ notes in its RWJF-funded OpenNotes program, in which 82 percent of participating patients opened up at least one EMR note.
Martin’s Point Health Care will present at the AQA meeting in Washington, DC on May 13. They use Forward Health Group’s PopulationManager at all nine sites and 70 provider panels for micro and macro reporting.
API Healthcare and TeleTracking Technologies enter into a strategic partnership to offer API’s workforce optimization solutions and TeleTracking’s workflow automation offerings.
Project MIST takes first place in an athenahealth and MIT H@cking Medicine-sponsored hack-a-thon for its glaucoma eyedrop spray canister.
Lake Tahoe Regional Hospitalists (NV) and Shasta County Hospitalists (CA) deploy MedAptus for inpatient charge capture.
Rochester General Hospital (NY) implements EDCO Health Information Solutions’ point of care batch medical record scanning solution.
Government and Politics
HHS releases data on inpatient charges that shows significant variations in pricing, such as joint replacement that ranges from $5,300 to $223,000.
Innovation and Research
Healthfundr launches its equity-based crowdfunding platform for health startups, open to accredited investors only and working with more established companies.
Technology
Epic gives VMware Horizon View “Target Platform” status for EMR delivery through a virtual clinical desktop, quoting Metro Health CIO William Lewkowski as saying the move is saving his organization $1.6 million per year.
Other
Fletcher Allen Health Care (VT) will lay off 40 staff members and outsource its transcription services to Nuance Communications, which will offer jobs to 35 affected transcriptionists.
The Leapfrog Group finds in its spring update that hospitals have made only incremental progress in addressing errors, accidents, injuries, and infections that kill or hurt patients. Sixteen hospitals received an “F” grade.
Gila Regional Medical Center (NM), struggling with uninsured patient volumes, downgrades employees, halts an expansion project, and postpones implementation of a new hospital information system.
Keynote speakers at the MUSE conference May 28-31 in Washington, DC will be Farzad Mostashari and George Will.
A Surescripts report finds that 69 percent of office-based physicians actively e-prescribed last year and nearly half of patient visits generated an electronically-delivered medication history, 31 percent more than in 2011.
Allscripts will add 350 new jobs over the next five years in Raleigh, NC as it consolidates its US engineering centers. State officials will extend up to $5.35 million in incentives if Allscripts meets investment and hiring goals and maintains its 1,266 jobs in Raleigh.
An eight-country survey of physicians finds that 93 percent of US physicians report using an EMR. E-prescribing rates were highest (65 percent) among US providers, as were rates for entering patient notes into EMRs (78 percent.) While the majority of doctors in all countries report EMR and HIE have had a positive impact on their practice, US doctors were the least likely to report that their use reduced organizational costs.
Ken Roberts, MD and Jim Granfortuna, MD sing about EHRs in “Our Song of Epic Proportions.”
Weird News Andy wonders, “What is it with Brazilians and harpoons lately?” A couple of weeks ago a Brazilian guy accidentally shot a harpoon into his own head. Now a Brazilian man cleaning his spear gun in the living room accidentally shoots off a spear that goes through the mouth of his wife, who was in the kitchen at the time. She’ll recover fully. And in another incident, a Brazilian teen fishing in the Amazon River mistakes his brother for a fish, shooting a harpoon into his face and then paddling 195 miles in a canoe to take him to the hospital.
WNA also ponders this story, in which a South Florida plastic surgeon is arrested for using waterboarding-type torture on his girlfriend for 16 hours after being angered by her Facebook post.
Sponsor Updates
Consulting firm Virtelligence and its client Cone Health (NC) donated 400 tree seedlings via the Arbor Day Foundation to the Guilford County School System, whose students planted the trees around the Triad. The company tracked the number of pages printed during the Epic implementation and used an online program to estimate the number of trees required (361) to manufacture it.
NTT Data moves its North American corporate headquarters to Plano, TX.
EClinicalWorks releases agenda details for its 2013 National Users Conference October 11-14 in San Antonio.
Holon Solutions hosts a May 15 Webinar introducing the value of building an HIE.
Sandlot Solutions Director Rosalind Bell discusses how recent emergencies highlight the need for HIEs.
Billian’s HealthDATA releases its Provider Portal benchmarking database, which gives hospitals and health systems data for competitive analysis.
In a company blog post, Patientco addresses the growing patient payment problem.
Red Herring names Awarepoint, InstaMed, and Kony Solutions finalists for its 2013 Top 100 North American Award, which honors private technology ventures.
Aspen Advisors consultants will co-present at two sessions during next week’s Texas HIMSS Conference in San Antonio. Aspen’s Director of Clinical Informatics Mark Van Kooy, MD will participate in a panel discussion during an executive summit in San Francisco May 15-17.
Kathy LePar, VP of strategic services for Beacon Partners, offers recommendations for healthcare organizations for creating an integrated, holistic approach to strategic enterprise initiatives.
EPtalk by Dr. Jayne
Georgia Governor Nathan Deal signs the State Physician Shield Act, which is aimed at preventing use of Affordable Care Act provisions to establish standard of care in liability cases. Supporters want to ensure that payment guidelines aren’t used to define care standards to the exclusion of individual patient factors or other clinical standards.
CMS releases Medicare provider charge data for the top 100 most frequently billed discharges across 3,000 hospitals. The variation across some procedures is as much as tenfold.
CNBC recently ran a piece on bad habits demonstrated by younger job-seekers. There are certainly a lot of relatively young workers in IT departments, but I’ve found that regardless of age, behavior is becoming more boorish. I may not be Emily Post, but I’d like to offer some etiquette tips for the age of social media:
Learn how to put your phone on silent. Practice this skill often.
Texting or checking e-mail on your phone while in face-to-face meetings is just rude.
Choosing “Darth Vader’s Theme” as your supervisor’s ringtone is not a career-advancing move, especially if you haven’t learned to put your phone on silent.
If you’re hosting a Web-based meeting and sharing your desktop, turn your instant messenger and e-mail notifiers off. I’m tired of seeing embarrassing, unprofessional, and distracting messages come across while I’m trying to work with you.
If you’re attending a meeting by conference call, don’t multitask unless you have the skills to pull it off. Asking, “Can you repeat that? I was on mute.” makes no sense and brands you as inattentive and illogical.
If you join a meeting late, don’t waste the group’s time with excuses. Say “I’m sorry” then sit down and get to work.
Lock your Facebook page down like Fort Knox unless you can keep your mouth shut. Do you really think it’s smart to advertise to your co-workers that you accepted prime hockey tickets from a vendor and thereby violated corporate policy?
Learn how to use Scheduling Assistant, Busy Search, or whatever tools your company uses when inviting people to meetings. If an attendee is already booked and you make them “required,” have the courtesy to discuss it and obtain approval first.
Speaking of meeting etiquette, it’s been a rough week, so I was happy to see a tweet for The Ridiculous Business Jargon Dictionary. I think I’m going to try “acluistic” in a meeting I have scheduled for tomorrow and see if anyone figures it out.
MIT and athenahealth co-hosted a hack-a-thon this past weekend and have announced a winner of among the 20 teams that competed. Top honors and $5,000 went to Project MIST, which came up with a hardware prototype that helps glaucoma patients overcome aiming difficulties and more easily administer their eye drops.
Danville, PA-based Geisinger Health System will give patients complete access to their physician notes within the health systems patient portal in an effort to increase patient engagement. The decision follows a pilot program that showed promising results.
Conway, NH-based Memorial Hospital’s CEO Scott McKinnon reports that MaineHealth’s recent Epic problems are not enough to derail Memorial Hospital from joining MaineHealth. In earlier interviews, McKinnon had cited working under a system-wide Epic platform as a primary reason for joining MaineHealth.
McKesson reports a fourth quarter profit of $259 million, down from $521 million a year earlier. Revenue was down 3.4 percent, missing analysts’ expectations. The technology solutions sector saw revenue increase 6.2 percent over the year, with a gross annual revenue of $913 million. Stock ended flat on the day and was up 1.5 percent in after hours trading.
John Halamka, MD, CIO of BIDMC, reports his initial impression of plans for Meditech 6.1 which he says will be a cloud-hosted system based on standards, Web-centric and mobile-enabled, with both inpatient and outpatient capabilities, complete with analytics, a PHR, and care management tools.
A study published in JAMIA finds that transitioning to ICD-10 will be difficult and disproportionately costly to specialists. The study found that only 60 percent of ICD-9 codes have a direct ICD-10 equivalent, while the other 40 percent will require clarification.
UC San Francisco will create a Center for Digital Health Innovation to lead the institution away from "disease-based treatment approaches" and toward "individualized precision medicine." The new Center will be run by UCSF Medical Center CMIO Michael Blum, MD.
A Raleigh, NC clinic alerts patients that X-rays were stolen and patient information may have been compromised when a sham scanning and archiving company stole the x-rays for their silver content and then disappeared.
McKesson reports Q4 results: revenue down 3.4 percent, adjusted EPS $1.45 vs. $2.09, missing expectations on both. In the earnings call, John Hammergren mentions that the company will exit its international technology and hospital automation business. I don’t know which product lines hospital automation includes, for instance whether that means the medication packaging and distribution systems business (ROBOT-Rx, AcuDose-RX, etc.) Technology solutions revenues were up 3 percent, but profit was down 16 percent, “well below our expectations.”
Reader Comments
From The PACS Designer: “Re: Windows 8. The unfriendly start menu for Windows 8 has Microsoft scrambling to fix the problem.” The company admits that its flagship product has a steep learning curve as it forced users to use its touchscreen-friendly tile-based graphical system instead of giving them the familiar Start button.
From Kaye: “Re: HIStalk sponsorship. This remains the best value we get for the money in advertising!” Thanks – that’s a nice comment and we appreciate it, especially coming from a company that has sponsored multiple HIStalk sites since 2009.
From Anesthesiologist: “Re: Google Glass. How can I partner with companies to develop applications that might be useful in the perioperative setting?” If you’re interested in working with this doc, e-mail me and I’ll forward to him.
From Arcane: “Re: Epic implementation. Do you know of a source for rollout and post-live support staffing numbers?” I have many readers and consulting firms that have implemented Epic, so please add a comment with your thoughts.
Acquisitions, Funding, Business, and Stock
Greenway reports Q3 results: revenue up 3 percent, adjusted EPS $0.01 vs. $0.08, beating earnings estimates of –$0.02 but falling well short of revenue expectations. The company blames a faster-than-expected shift to subscription-based pricing. Shares are near their 52-week low. President and CEO Tee Green also said in the earnings call that with HITECH in the rear-view mirror, buyer fatigue has set in over the past several quarters. Training revenue was also impacted, he said, by customers choosing train-the-trainer and pushing training back to after the quarter’s close. He also said that Greenway’s participation in CommonWell hasn’t resulted in any sales (without expressing puzzlement at the analyst who apparently thought it might) but said more companies are signing on.
InstaMed raises $3.5 million in an internal round of funding.
Healthcare transaction processing firm MediSwipe signs a term sheet with a Chicago-based PE fund to receive up to $600,000 over the next nine months.
Vocera Communications reports Q1 numbers: revenue down 3.1 percent, EPS –$0.14 vs. -$0.08. CEO and Chairman Bob Zollars says the company saw an increase in new customer signings but did not complete several significant hospital deals.
Siemens Healthcare posts a 4.9 percent increase in Q1 profits, although revenues fell 2 percent.
Qualcomm Life acquires HealthyCircles, a startup that supports the secure sharing of patient data.
WebMD CEO Cavan Redmond, who has been on the job less than a year, will leave the company, along with CFO Anthony Vuolo.
Perceptive Software blames recent acquisitions for its decision to lay off about 40 employees, or three percent of its workforce.
Sales
Massachusetts General Hospital selects eHealth Connect Referral Portal from eHealth Technologies to support two-way communication between the hospital and its referring doctors.
East Kent Hospitals University NHS Foundation Trust chooses Harris Corporation’s Clinical Integration Platform to integrate data from six clinical systems across five sites. East Kent will also use Imprivata’s OneSign single sign- on technology.
Upper Peninsula Home Health, Hospice and Private Duty (MI) will implement the Procura for Hospice solution.
SCL Health System (CO) selects Leap-10 from Wolters Kluwer Health to streamline its conversion to ICD-10.
Amarillo Legacy Medical ACO (TX) selects eClinicalWorks Care Coordination Medical Record to advance its ACO objectives and coordinate care among its 100+ provider members.
Physical Rehabilitation Network will deploy NextGen Healthcare’s EHR, PM, PatientPortal, and NextPen products across its 100+ locations and use NextGenRCM Services for revenue cycle management.
Virtual Radiologic signs a five-year deal with Visage Imaging to implement Visage 7 Enterprise Imaging Platform for its 400 radiologists in a read-anywhere environment.
People
Ernst & Young names Intellect Resources President and CEO Tiffany Crenshaw a finalist for Entrepreneur of the Year 2013 in the Southeast region.
Former Cerner VP Ian Chuang, MD joins Netsmart Technology as CMO/VP of healthcare informatics.
Former National Coordinator Robert M. Kolodner, MD joins telehealth provider ViTel Net as VP/CMO.
Care Team Connect names Richard Popiel, MD (Regence BCBS) to its board.
Healthcare software solution provider MedicaSoft, LLC appoints Mike O’Neill (VA Center for Innovation) CEO.
Beebe Medical Center (DE) names Michael J. Maksymow, Jr. (Continuum Health Alliance) VP/CIO.
QPID hires Gary Zakon (ModelLogic) as VP of engineering and Caroline Smyth (Smyth Consulting) as VP of sales.
Eric J. Topol, MD is named editor-in-chief of Medscape. What’s most interesting to me is that his ongoing full-time employer Scripps Clinic apparently Photoshopped his black suit jacket to look like a white lab coat in the pictures above from their site.
Announcements and Implementations
Access is named as a Meditech Collaborative Solutions vendor, offering Meditech customers an integrated solution to capture and upload electronic signatures and data collected from clinical systems and medical devices.
Johns Hopkins Medicine integrates Epic with Hyland Software’s OnBase enterprise content management solution in its ambulatory and inpatient departments.
Philips launches Healthcare Transformation Services, a global business unit to provide consulting services to hospitals and health systems.
Trustwave introduces a mobile security practice to help enterprises with their BYOD strategies.
HCA MidAmerica Division equips seven hospitals and multiple physician offices in its Midwest region with Accelarad’s medical imaging solution.
Lifespan (RI) completes its rollout of the the TeamNotes electronic documentation system from Salar.
PerfectServe launches DocLink, a secure communications network for physician-to-physician communication.
Government and Politics
ONC publishes a governance framework for trusted health information exchange to help HIEs and other healthcare organizations understand ONC’s priorities and how to align with “national priorities.”
CHIME recommends in a letter to six Republican senators a one-year extension for Stage 2 MU before progressing to Stage 3. CHIME contends the extra year will give providers the opportunity to maximize their EHR technology to achieve the benefits of Stage 1 and 2 and give vendors time to “prepare, develop and deliver needed technology to correspond with Stage 3.”
Deputy National Coordinator Judy Murphy, RN kicks off National Nurses Week with a blog post on the role of nurses in healthcare IT and an invitation for nurses to share their stories.
Innovation and Research
UCSF creates the Center for Digital Health Information. It will be led by UCSF Medical Center CMIO Michael Blum, MD, who will assume the newly created position of associate vice chancellor for informatics and who will continue to lead its Epic implementation (physician leaders of the project are pictured above, with Blum on the left). Current projects include a team-based communications platform, an open source diabetes management system, a Web-based collaboration tool for virtual tumor boards, and a social media-based cardiovascular study.
Kaiser Permanente Center for Total Health will hold a Google Glass event in Washington, DC the evening of June 18.
South Carolina-based Iron Yard launches the Digital Health Program accelerator and incubator in the Spartanburg area.
Technology
Bloomberg TV covers the technology used by Palomar Medical Center (CA) and the "hospital of the future.” Palomar Health Chief Innovation Officer Orlando Portale is featured.
Other
An Imprivata-sponsored study finds that clinicians waste 45 minutes per day in using inefficient communication systems such as pagers.
Hospital IT leaders are focused on accommodating greater mobile and wireless connectivity to their networks and with ensuring the security of patient data in BYOD environments, according to a HIMSS Analytics study.
A Raleigh, NC clinic warns patients that it was scammed by a company that claimed it would digitize the practice’s old X-rays, but instead harvested their silver content and then destroyed the films.
University of Rochester Medical Center warns 537 patients that their PHI may have been compromised when a resident lost a USB drive containing quality improvement information. The hospital thinks it went to the laundry and was destroyed.
John Halamka reports on new Meditech 6.1 development after mixed response to Version 6: a cloud-hosted system based on standards, Web-centric and mobile-enabled, with both inpatient and outpatient capabilities, complete with analytics, a PHR, and care management tools. He says it will ship in 2014.
Drug chain CVS shuts down its drug company-sponsored refill reminder program because of limitations imposed by the new HIPAA Omnibus Rule on using patient information for marketing.
Weird News Andy refers to this story as “brain drain.” A man who thought his year-round runny nose was caused by allergies finds that it’s actually brain fluid leaking from a tiny hole. It’s been fixed and he’s fine. WNA also likes this story, in which researchers claim to have found the cause of graying hair (hydrogen peroxide buildup in the hair follicle) and a cure for both gray hair and vitiligo (a proprietary treatment involving a UV-activated enzyme).
Sponsor Updates
API Healthcare and The DAISY Foundation offer The Nurses Week Story Contest, with submissions from nurses due May 12.
McKesson releases version 13.0 of its Homecare solution.
Orion posts a video featuring Orion clients that have solved interoperability challenges.
More than 200 hospitals using CareWorks content management system from CareTech Solutions have received 32 Website awards in the past year.
Truven Health Analytics finds that healthcare spending is 20 percent higher for public sector employees than for the private employee population.
Passport Health Communications names Texas Health Resources, Trinity Medical Center (AL), and Kadlec Regional Medical Center (VA) winners of its Leaders at the Forefront of the Healthcare Experience contest for best healthcare access management practices.
Gwinnett Medical Center (GA) discusses how using RelayHealth services helped the hospital remove patient billing obstacles.
iHT2 hosts a May 29 Webinar on security, privacy, and compliance risks in a post-reform era.
Greenway Medical President and CEO Tee Green discusses the compatibility of innovation and other topics with PGA tour partner Jason Dufner.
Red Herring names Kony Solutions a finalist for its Top 100 North America award, which honors the year’s most promising private technology ventures.
EBSCO announces its intent to collaborate with the American College of Physicians to give ACP access to its DynaMed evidence-based clinical summary resources and literature surveillance.
Gartner names Health Catalyst to its list of Cool Vendors in Healthcare Providers 2013 and profiles Shareable Ink in its update on 2011 winners.
Greenway Medical releases agenda details for its PrimeLEADER 2013 user conference in Washington, DC August 22-25.
CommVault launches a customer education services program that includes customized user training and access to online training courses for its Simpana software.
ADP launches a Website to help clients and other employers plan for and comply with the Affordable Care Act.
Nuance names seven healthcare organizations winners of its Voice of the Customer award for improving quality of care, reducing costs, and accelerating EMR adoption using speech recognition and clinical language technology.
CCHIT extends EHR Module certification to the latest version of the Medseek Empower patient portal.
TELUS Health and McGill University enter a three-year joint venture to conduct research on how best to use technology to improve health and healthcare delivery for Canadians.
Following lowered year-end forecasts that caused a 22 percent one-day drop in stock price last week, Greenway sees an additional 2.8 percent drop after releasing its Q3 earnings report. The company suffered a $2.8 million net loss from operations over the quarter due to fewer one-time system sales and lower training and consulting revenue. Shares closed at $11.94, $0.11 higher than their 52-week low.
ONC releases its regulatory framework for health information exchanges. It establishes a common foundation and spells out regulatory exchange conditions for public and private HIEs to align with.
The College of Healthcare Information Management Executives sends a letter to six Republican senators recommending a one-year extension to Stage 2 Meaningful Use before progressing to Stage 3.
The American Telemedicine Association kicked off its annual meeting in Austin, TX with Mercy Health President and CEO Lynn Britton giving the keynote address, in which he spoke of about telemedicine and the return on investment Mercy Health realized from its initiatives.
Transitioning from Fee-for-Service to Fee-for-Value Requires Outcomes-Focused Patient Engagement By Richard Ferrans, MD, ScM
Critical to success under new care models is creating the right IT infrastructure to break down walls and foster better partnerships between hospitals, physicians, payers, and patients alike. We can no longer view inpatient and outpatient settings as different businesses. We must share complex clinical data between the “Care Layer” of physician and hospital EHRs and the “Value Layer” of HIT to integrate their disparate records and promote clinical analytics, value decision support (VDS), care coordination, and digital patient engagement.
Presence Health is the largest Catholic health system in Illinois with 12 integrated hospitals, 29 senior care locations, and more than 4,000 providers and 100 primary and specialty care medical practices. In January 2013, our Accountable Care Organization (ACO), Medicare Value Partners, joined the more than 250 other ACOs established through the Centers for Medicare and Medicaid Services’ Shared Savings Program.
A major part of our journey to becoming an ACO was the integration of employees, providers, and systems during the 2011 merger of Provena Health and Resurrection Health Care that created Presence Health. The combined experience and excellence of the two organizations is helping us succeed in the Shared Savings program. Specifically, both Resurrection and Provena, each with significant Medicare and Medicaid patient populations, had undertaken clinical integration and quality improvement pilot programs before the merger.
The proven patient outcome and financial improvement results of these efforts prepared us for the transition from a fee-for-service model to one based on value. Nevertheless, achieving the CMS’s required 33 quality of care measures while controlling costs will be a challenge.
An integral piece of our “Value Layer” is our patient engagement technology platform that allows us to provide patient-centric communication. We chose our partner, Emmi Solutions, because they have been focused on patient engagement for more than a decade. They have a complete solution proven to motivate patients to take preventive action, transition from one care setting to the next, and participate in shared decision making.
The technology supports web, mobile and interactive voice response (IVR) all in a single platform to deliver actionable information to patients. The platform uses language patients can understand and connects with them at their convenience and on devices they already own – both in and outside the hospital or healthcare setting.
Our patient engagement solution was first introduced to the Presence Health system at Presence Saint Joseph Hospital in Chicago. A survey of nearly 200 patients who had accessed the technology on the Web, conducted over a six-month time period, showed that 94 percent of patients said the engagement platform answered questions for which they normally would have called their doctor. In addition, 92 percent said it motivated them to change their lifestyle and all patients indicated it gave them a better understanding of their treatment options.
We do not passively “educate” patients, but rather use our interactive technology to engage patients in a two-way process where they become motivated participants in their care, exchanging information, validating understanding, and sharing concerns. This is more than a discreet intervention. It is a comprehensive set of reminders, calls to action, and tools needed throughout one’s entire healthcare journey.
We are in the process of expanding it across the Presence Health system and ACO to broaden our ability to cost effectively manage the health of populations and improve both clinical and financial outcomes.
Another reason we chose this technology is because its platform tracks the delivery and consumption of information, which enables us to measure the impact of patient engagement down to the individual patient level. With healthcare transitioning from a fee-for-service to a fee-for-value model, being able to quantify the return on IT investments is becoming a business imperative. Not only are we being held accountable, so is our vendor partner.
I think many of us in the healthcare IT trenches have simply become beaten down. There are dozens of different initiatives, regulations, and “incentives” causing daily pressure to change how our systems deliver care and how we interact with patients.
Some days I feel like I’m barely able to keep my head above water. There are so many competing priorities you can’t afford to get too worked up over any one issue or you might be sucked under.
In my informatics role, I’m exposed to a lot of different venues for care delivery. This week I served as a locum tenens in a primary care office and again had to confront something that has bothered me for years: pharmacies sending electronic requests for refills on controlled substances when they cannot be refilled electronically. Not only is this bothersome, but it wastes significant time in the practice.
Yes, I’m aware that the DEA issued rules that allow electronic prescribing of controlled substances. However, for this to be legal, the physician has to use certified e-prescribing software and two-factor authentication. Additionally, the pharmacy has to upgrade their systems to receive and process the prescriptions.
My state was one of the last to clarify its requirements for these transmissions, so adoption has lagged. Practices aren’t going to go through the credentialing process if the pharmacies aren’t ready, and our informatics team checks with the pharmacies monthly to see if they’re prepared to accept these scripts.
Our region has several major pharmacy chains that have spent the last decade sending refill requests for drugs that physicians cannot prescribe electronically. The physician (or his/her designee) has to deny the prescription electronically (otherwise be marked as “unresponsive” by the pharmacy intermediary system) then either call the script in if that’s permissible, or print and sign a prescription to mail to the patient or for the patient to pick up. These chains are still not enabled to receive DEA-compliant controlled substance prescriptions, yet they continue to send these refill requests that cannot be processed.
When I first saw this years ago, I called the pharmacy and asked why this was happening. I was told that the prescription management software couldn’t tell the difference between controlled and non-controlled substances, so they couldn’t block the inappropriate refill requests. They didn’t think their vendor would be willing to make a change. Flash forward and it’s still happening. I have to wonder why. Have systems not evolved in nearly a decade? Can vendors really not fix this?
It makes me wonder — where are the Meaningful Use requirements for all the other software systems with which my EHR has to interact? Why aren’t the pharmacies required to document the numerator and denominator for “percentage of refill requests sent that are actually legal to refill?” Why are only the providers and hospitals eligible for penalties?
If we’re going to have de facto regulation, let’s treat everyone the same – from the pharmacy to home health to post-acute care. When only some of the players are jumping through hoops and we’re just passing the meaningless work from one part of the industry to another, we’re not transforming medicine — we’re just being wasteful.
Steven Stack, MD, chair of the AMA board of trustees. spoke at a CMS listening session on billing and coding within an EHR system. He questioned the government’s mandating the use of EHRs while simultaneously orchestrating a witch hunt over cut-and-paste fraud accusations associated with physician documentation. Sack points to the generic, nearly uniform output of EHR documentation systems for causing a false perception fraud.
TriZetto announces an executive reorganization as CEO Trace Devanny departs immediately leaving an empty seat that will be temporarily filled by TriZetto board member Vicky Gregg. An executive search is underway for a permanent replacement for Devanny. Jude Dieterman, formerly EVP and COO, has been promoted to the newly created role of president.
The health department in India has issued an RFP for its recently announced e-health plan, which calls for each citizen to have a health card to hold demographic data and an integrated EHR that will automate hospital processes and bring all information into a centralized state health information system.
From MaineMan: “Re: MaineHealth / Maine Medical Center. Names interim CIO.” According to the March 25 employee newsletter, Andy Crowder (JC Solutions Group and Florida Hospital before that) is serving as interim CIO.
From The PACS Designer: “R: Intel’s Haswell. We are about to enter a much faster PC user experience with architecture from Intel called Haswell. One of the key features is Haswell provides is a nine-hour battery life through the use of more efficient chips. You can expect to see Haswell powered PC’s in the fourth quarter.” The article says the chip may revive the rapidly dying PC business by making them more competitive with tablets. Of course, that’s what Intel said about the Ultrabook, which hasn’t made Intel-powered laptops a bit more attractive vs. a Macbook Air or an iPad.
Three-quarters of respondents don’t think it makes sense for innovation conferences to exclude hospitals and physicians under the assumption that they helped cause the problems that seen to require more innovative approaches. New poll to your right: several hospitals have reported financial losses that occurred as they were implementing an EHR. Who is to blame?
Thanks to the following sponsors, new and renewing, that have recently supported HIStalk, HIStalk Practice, and HIStalk Connect. Click a logo for more information.
Two NHS trusts running NPfIT’s Cerner implementation issue tenders for replacement systems.
Centegra (IL) will go live on McKesson Paragon on May 6.
Some quotes from Jonathan Bush during the athenahealth earnings call Friday:
The company that started as an ill-fated birthing clinic and used to hold all-hands meetings from the tailgate of the Jeep Wagoneer is entering the big show. We have done well at the land war that is selling back office services doctor-to-doctor and hospital-to-hospital, but for the first time, we have a crack at the hearts and minds campaign.
Take athenaCoordinator. It is a really easy way for any health caregiver to connect to every other one without the complexity of an organ transplant. It is a two-week sales cycle and a two-hour implementation process.
We’ve already just announced today Epocrates EDU, which is a whole version of Epocrates to help educators, medical schools, the texting that we are going to be rolling out, secure HIPAA-compliant, patient-related texting between doctors. We’ll be able to attach links to athenaClinicals next year so that doctors who aren’t clients of athenaClinicals will be able to take a quick look at a patient face sheet in athenaClinicals.
I think we are seeing — particularly the folks who got pregnant with Epic, sort of they’re going to this sort of desperate burn-bright tactics. We heard where Yale-New Haven has told all the doctors that have privileges that they will either this piece of shit Epic that none of them want or do you have their privileges revoked. So there’s that kind of tactic going on. "Oh, we can’t interface." I’m like, "What you mean? Epic interfaces all the time. They actually do it really well." … The folks that have gone off and laid down more money than they have on Epic have, in the back of their mind, that they are going to make a real impact on referral patterns by getting doctors on to Epic that don’t want to be on it. And it’s — really, Epic is the only one. Cerner builds interfaces, no problem.
TriZetto announces that CEO Trace Devanny will leave the company immediately after two years on the job “to pursue other opportunities” as a search is undertaken for his replacement. EVP/COO Jude Dieterman is promoted to president, a newly created role. Board member Vicky Gregg will assume the role of non-executive chair.
Intermountain Healthcare is working with Blue Cirrus Consulting to develop a homegrown tele-ICU solution.
UCSF lauches MeForYou.org at the OME Precision Medicine Summit. The precision medicine project will link people with genetically similar others via their genomic information, environmental factors, and their EHR information to help guide clinicians. They differentiate it from personalized medicine in that in precision medicine, the information used goes beyond genomic data and scientists can tap into that information directly to guide research and treatment.
Team Break Fix won the $25,000 grand prize at the Cajun Codefest 2.0 in Lafayette, LA last week.
Weird News Andy says this gives heart attacks the finger. The EndoPat test predicts heart problems by checking blood flow in the fingers.
Vince has a Part 3 installment on GE Healthcare in this week’s HIS-tory.
Sponsor Updates
Cynthia Davis, RN, co-founder and principal of CIC Advisory, is named Entrepreneur Woman of the Year by the St. Petersburg (FL) Area Chamber of Commerce Women’s Leadership Council.
Allscripts posts the agenda for its ACE conference, to be held August 20-23 in Chicago.
This is in response to an April 29 reader comment suggesting that healthcare IT leaders are unable or unwilling to make decisive decisions that would improve the bottom line.
I don’t think it’s always not making a “responsible” decision on the part of the HIT leadership. There are different priorities in healthcare organizations versus us in the corporate world.
In the corporate world, we in IT are well aligned to the profit motive of our company. Period. In healthcare IT, leadership is often not worried about that profit motive. They say they are, but the other departments we serve — they say they are worried about finances, but they really aren’t. HIT leadership doesn’t want to have a crucial conversation with the department heads in the healthcare system about their wasteful applications.
The infrastructure is normally fully under the control of HIT leadership. There is a ton of cost cutting that happens there. Way too much in my opinion, causing unnecessary downtime that would never happen in a corporate IT shop. That’s due to the cost cutting to not have that switch stack be fully redundant or we don’t need to buy ALL that storage area network growth space now … and then you run out. I’m looking at you HIT shops in the North Carolina Tobacco Road region.
The real HIT waste is in the applications. Nearly every health system I’m familiar with have some pretty serious application redundancies. What I mean is an HR department that runs both Kronos and Lawson and the payroll department is not part of HR and not outsourced to ADP or the like. That’s two very expensive systems that can do the same job if someone can tell or convince HR to just pick one.
Or better yet, just let someone else run that whole part of your operation. Many of the corporate IT guys handled the payroll / processing / HR system cost issue a long time ago via outsourcing. Then HR can focus on, oh I don’t know, recruiting people and working on benefit plans. That doesn’t seem to be all that common in healthcare IT.
Also, your hospital maintenance departments run very expensive name-brand systems meant to run whole manufacturing operations. To do what? Inventory objects and print out repair orders. I’m not talking about your medical device department here, just good old facilities and services.
The list of applications that cost serious dollars and do only small jobs inside the healthcare operation as a whole goes on and on. Corporate-based IT shops would have had a programmer build a little Web application or SharePoint portal to eliminate a few hundred little apps inside a typical healthcare IT shop.
There’s not a lot of movement in HIT shops to simplify. Simplicity equals cost savings in both break/fix and maintenance/purchase dollars.
Why not focus on those applications particularly that need simplification and save costs?
I believe it’s political costs mainly in the healthcare IT field. Those department heads often hold much power in an organization. Healthcare IT is not the sole owner or, at minimum, the first owner of the application. That department or unit is. They can claim patient benefit or employee benefit, or most often, that the redundant systems allow them to have their own inflated head counts.
Will a healthcare IT leader have time to quantify those patient benefits into a dollar measurement to then justify the maintenance cost and support/time cost for that application? No. Who has that kind of time?
There are often redundant departments in a healthcare operation. Health systems have DBAs/report writers creating reports for clinicians, but there is a whole other Decision Support Services department with their own specialized application. Nine times out of 10, it’s the same data being reported in almost the same way, and let’s not talk about that DSS app and how it gets the data every day or night and the integration and support work there. In some shops, those DSS people with limited SQL writing skills will even tug some of that DBA’s time to help with their work.
In corporate IT, there is one measure — efficiency measured in real dollars. There are no patients, so the hard math is easier to quantify. How much does that application cost to have support, maintenance, and upgrades purchased? OK, that’s $100. What does it save us in time running the business vs. another application/process? We are in the positive side in $1,000s — it is justified. There isn’t a lot of worry about the business unit’s politics other than making sure their process is as lean and efficient as possible and that usability of the application is good so that the process time is as efficient as possible.
That’s not to say that a corporate business unit doesn’t have its own political pull, but often you can show the C-level the numbers and those numbers win the argument. Proof in the corporate world means something. I’ve been in many healthcare IT ROI discussions showing the cost savings that could happen. They are normally hundreds of thousands to millions when you take into account the database licenses at the infrastructure layer also. Healthcare IT leadership still passes. It’s not their priority to go against the department heads.
Internal politics are everywhere. In healthcare, political might can win an argument when the proof in dollars are staggeringly in support of the other point.
I’d say this is changing in healthcare IT as many organizations are having their bottom line get worse and now some of those golden goose political situations are getting weaker.
The dollars of cost argument is winning the day here and there. It’s just the wins are only on small projects and applications to show the cost saving committee that we saved $50K. That’s for show. The real cost saving opportunities that exist are hundreds of thousands in savings.
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 October 2008.
Every Time I Say It’s About Patient Care, You Tell Me It’s a Business: Healthcare IT Lessons Learned from “North Dallas Forty” By Mr. HIStalk
One of my favorite and most insightful lines from any movie comes from “North Dallas Forty,” a cynical and dark football film from 1979. In a key scene, fictional football player O.W. Shaddock, masterfully played by former Oakland Raider John Matuszak, explodes his rage and frustration onto the team’s coaches, who constantly resort to using fear and ridicule to get tired and injured players to keep performing even when they shouldn’t. "Every time I say it’s a game, you tell me it’s a business. Every time I say it’s a business, you tell me it’s a game."
The quote may have been about sports, but it’s relevant to healthcare as well.
I’ve worked for both vendors and hospitals. There were plenty of times on both sides where I wanted to scream at management, “Every time I say it’s about patient care, you tell me it’s a business. Every time I say it’s a business, you tell me it’s about patient care.”
Our unusually capitalist approach to healthcare delivery is schizophrenic. Everybody understands giving massages or tummy tucks for the biggest fee the market will bear, but there’s something inherently distasteful in performing life-saving surgery or seeing patients through their final days of cancer while a business guy taps his calculator every now and then to remind everybody — including the patient — to keep the cost down.
IT is usually smack in the middle of that rift between clinicians and executives, the bearer of bad news about something one group wants that the other is loathe to deliver. Clinicians resent being told how to deliver care by $1 million hospital CEOs and their business-savvy underlings. The people in the mahogany offices can’t talk slowly enough about cost control to get the message across the financially naïve white coats who would bankrupt the place if someone wasn’t watching the till. Somebody wants a CPOE system or a tool to run a balanced scorecard and the IT person knows exactly which part of the organization will be calling for his or her head.
Clinical people working for vendors have the same struggle. They’re supervised by executives who not only have never delivered care, but who most often drifted into healthcare by accident and will probably drift right back out again someday. Every undelivered system enhancement or overstated capability make the clinicians want to scream like O.W. Shaddock, physically threatening an overconfident MBA vendor suit whose last service to others was whispering the Black-Scholes equation to a B-school classmate during a tough finance test.
We’re in a confounding business whose mission is frustratingly mixed. Deliver the best care or the best clinical software possible – as long as it’s profitable. If it’s not, the MBAs are ready to rush in and whip the widgets into shape. That’s a threat and a promise.
Maybe it would help to see how the other half lives. Clinicians should sit through the meetings in which life-or-death decisions are made that concern the health of the entire organization, not that of individual patients. Executives should have to face real patients and caregivers regularly just to remind themselves of a mission more important than fancy new buildings and slick marketing.
And IT folks working for both providers and vendors … well, there’s really nothing you can do except wait for the dust to settle and support and enable whatever strategic plan results. Those other folks are playing tug-of-war and you’re the rope.
Maine Medical Center suffers a $13.4 million operating loss in the first half of the fiscal year, a situation CEO Richard Petersen calls a first in recent history. Petersen pointed to declining inpatient and outpatient volumes and an Epic install which is causing issues with billing. The remaining rollout of Epic is on hold until the situation is resolved. The system has also initiated a hiring freeze, cancelled unnecessary travel, and reduced overtime in an overall effort to save $15 million during the second half of the fiscal year.
A selectman and software developer from Edgecomb, ME blames MaineHealth’s decision to close a local ER on the health system’s $150 million Epic implementation. The selectman’s letter to the editor to the local newspaper notes that MaineHealth has charged “millions of dollars” to member hospitals, but has had “a real failure in its implementation,” resulting in unplanned operational costs with minimal benefit to the state. Meanwhile, in a memo to employees last week, Maine Medical Center’s CEO listed several causes for its $13.4 million loss in the first half of the fiscal year, including “unintended financial consequences” of its Epic rollout as well as incorrect charging. The organization has placed further Epic implementations on hold as teams from Epic and the hospital try to fix problems.
HIStalk Announcements and Requests
A few HIStalk Practice highlights from the last week: patients say the most bothersome aspect of doctor visits is unclear or incomplete explanations of problems. Health Texas Provider Network partners with MediMobile for its mobile charge capture solution. The number of physician office jobs for billers and medical record clerks has declined sharply over the last two years. Epocrates is the most popular mobile app among US physician app users. Athenahealth names St. Boniface Haiti Foundation the winner of its 2013 Vision Award. Physicians are generally making more money this year than last, but are also spending more time on paperwork. Most news items on HIStalk Practice are not mentioned HIStalk, so peruse HIStalk Practice regularly to stay current on the ambulatory HIT world. Thanks for reading.
Merge Healthcare reports Q1 results: revenue up 4.3 percent, EPS –$0.07 vs. –$0.02, missing earnings estimates.
API Healthcare announces the signing of over 25 contracts in Q1 and bookings that were 25 percent higher than the same period in 2012.
MedAssets announces Q1 numbers: revenue up 15.3 percent, adjusted EPS $0.41 vs. $0.24, beating expectations on both.
Athenahealth announces Q1 results: revenue up 30 percent, adjusted EPS $0.38 vs. $0.17, beating on both but adjusting fiscal year EPS guidance to below consensus.
Sales
University of Nevada School of Medicine chooses GE Healthcare’s Centricity Business, Centricity Practice Solution, and Centricity PACS-IW.
Filmore County Hospital (NE) selects NextGen Healthcare’s Inpatient Clinicals and Inpatient Financials.
Baylor Quality Alliance (TX) chooses Humedica MinedShare from Optum to analyze administrative and clinical data from payers, various EHRs, and the Baylor Health Care System HIE.
Louisiana Specialty Hospital will implement ONE-Electronic Health Record from RazorInsights.
MD Anderson Cancer Center (TX) chooses Epic as its vendor of choice, according to an internal memo forwarded by a reader. Other readers had reported that same rumor late last week, saying that Epic had beaten Cerner as VOC.
People
UNC Health Care (NC) interim CIO Tracy Parham, RN is named permanent CIO, where she will lead its Epic project.
Parallon Business Solutions names John Guevara (Allscripts ) as CIO.
Patient Privacy Rights names Adrian Gropper, MD (HealthURL Consulting) as CTO.
Stephen Collins (Allscripts) is named president of Austin-based behavioral charting system vendor ChartAssist.
The Advisory Board Company CEO Robert Musslewhite is named by Washingtonian as one of its 100 Tech Titans and is also profiled in a feature in The New York Times.
Galen Healthcare Solutions appoints Joel Splan (Northwestern Memorial Healthcare) as CEO.
Announcements and Implementations
Rockdale Medical Center (GA) implements Nuance’s PowerScribe 360 voice recognition software for the dictation of imaging reports.
PointClear will move its corporate headquarters from Huntsville, AL to Dunwoody, GA.
McKesson recognizes Peninsula Regional Medical Center (MD) as the 2013 winner of its Distinguished Achievement Award for Clinical Excellence for effectively using McKesson technology along with Modified Early Warning Scores to proactively identify patients at risk for a code blue.
Aprima Medical Software will interface its EHR/PM system with the Homecare Homebase platform.
LHP Hospital Group implements McKesson’s Paragon HIS at Portneuf Medical Center (ID), Seton Medical Center Harker Heights (TX), and Texas Health Presbyterian Hospital WNJ (TX).
Elsevier launches its third annual “Superheroes of Nursing” contest and is accepting nominations for applicants in the categories of Achiever, Protector, Educator, Validator, and Connector.
SCI Solutions adds text appointment reminders to its Schedule Maximizer scheduling solution.
Modern Healthcare has corrected its article about the State of West Virginia’s payments to Medsphere for implementing OpenVista. The originally reported figure was $8.4 million per year, but that was actually the total amount spent since the contract was signed in 2005. Current payments are just under $1 million per year.
Mount Sinai Medical Center (NY) announces that it has enrolled 25,000 patients in its BioMe program, which links DNA samples to its Epic EMR information to support targeted medical care and to provide de-identified data for research.
First Databank announces ICD-10 for Saudi Arabia at the HIMSS Middle East conference.
Government and Politics
HHS names Lyfechannel the winner of its healthfinder.gov Mobile App Challenge for its myfamily app, which helps individuals manage their family’s health through customized prevention information for each family member.
Healthcare modeling and analytics company Archimedes collaborates with CMS to give users easier access to public payer claims data.
CMS announces that hospitals and EPs have been paid $13.7 billion through the end of March, with $8.5 billion going to 8,558 hospitals and $5.2 billion to 255,722 EPs.
FDA launches the redesigned FDA Patient Network, which will educate patients and their advocates about FDA and will invite them to attend and present at FDA meetings.
Farzad Mostashari was a panelist in a discussion of technology in healthcare put on by Politico last week. The 77-minute video is of very high quality and it’s an interesting mix of people and topics.
CMS gets criticism for removing information on hospital-acquired conditions from its Hospital Compare site. CMS says the information is flawed and is redundant, but patient groups say CMS is buckling to the complaints of low-performing, high-profile hospitals.
Innovation and Research
Vanderbilt University launches the Health App Challenge to transform clinical summaries into a more patient-friendly form. Entries are due August 1, with the winner receiving $10,000 and up to five finalists being awarded $2,000 or more each.
Technology
Former Google Health product manager Missy Krasner, now involved in startups and an advisor to Box, says Google Health was a good idea in theory, but “It was a very bumpy user experience for even the most super-charged, IT savvy consumer.” She says Box will take over where Google Health left off for storing personal health records that it supports HIPAA requirements. She concludes, “So here is my hope for the future. If most EHRs can currently export a Continuity of Care Document (CCD) via the Clinical Document Architecture (CDA), why couldn’t Box grab that clinical care summary format and stylize it in a way that made sense to other doctors or patients via its documenting previewing technology? This would help the interoperability and file transfer juggernaut get a whole lot easier.”
FastCompany profiles companies started by founders who were frustrated with existing products, among them Amazing Charts.
Other
KLAS reports on the post-acute care market, which is critical for managing outcomes and costs. HealthMEDX was named the top performer among long-term care vendors with 100 percent of its customers saying the company keeps its promises and that they would buy HealthMEDX Vision again.
Weird News Andy summarizes this article as “coming clean.” Piedmont Healthcare (GA) admits that for two years it improperly cleaned colonoscopy requirement at one of its ambulatory surgery centers, requiring it to notify 456 patients that they should be tested for hepatitis and HIV. Employees cleaned the equipment with soap, but missed the disinfectant step.
Sponsor Updates
T-System posts a photo gallery from its linkED 2013 Emergency Care Conference held in Dallas April 22-25.
Emdat posts a case study from Illinois Bone and Joint Institute, which reduced documentation costs by 50 percent by implementing Emdat’s transcription software and the company’s mobile documentation tool.
The Nashville Business Journal names Passport CEO Scott MacKenzie one of the most influential business executives in Middle Tennessee.
First Databank hosts a May 14 Webinar on the use of RxNorm within information exchange and clinical quality measures.
Kareo offers a May 16 Webinar that considers five activities to prevent a government audit.
Executives from Yale-New Haven Health System, Hartford HealthCare, and North Shore-LIJ Health System will share strategies to reduce readmissions at the iHT2 Summit in New York City on September 17-18.
Porter Research posts a presentation that provides insight into the trends, challenges, and benefits of engaging consumers in every stage of healthcare.
Capsule Tech will exhibit at the annual MUSE conference May 28-31 in Washington, DC.
Truven Health Analytics receives a five-year accreditation from the National Institute for Health and Care Excellence for its Micromedex Medication Management solution.
The National Committee for Quality Assurance certifies Verisk Health’s Quality Intelligence solution to support quality reporting for commercial and Medicare Advantage populations in the California P4P program.
As part of this week’s Medical Library Association Annual Meeting and Exhibition in Boston, Elsevier pledges to donate $1 to One Laptop Per Child for every ClinicalKey search made at Elsevier’s booth.
Allscripts releases details on its annual ACE client conference in Chicago August 21-23.
Liaison Healthcare launches its EHR Partner Program, which give participants access to orders and results connectivity to over 100 major lab and radiology service providers.
EPtalk by Dr. Jayne
HIMSS opens the call for proposals for the 2014 conference in Orlando with 24 topic categories. If you’re like many of us in the non-profit trenches, being selected as a presenter may be the only way to go to a meeting, so good luck!
The hot topic in the physician lounge this week was HR 1701, the “Cutting Costly Codes Act of 2013.” Introduced by Representative Poe of Texas last week, it aims to block ICD-10 implementation. What surprises me most was the number of physicians who think the mere introduction of a bill will support their lack of preparation for ICD-10. News flash – if you haven’t started preparing, you’re already behind, and I certainly wouldn’t wait around to see if this becomes law before I get started.
It’s not health IT, but it’s my favorite story this week: “untethered microgrippers.” Engineers at Johns Hopkins are working on miniature devices to retrieve biopsy specimens. Although they’re not quite ready for human testing, they look cool and are promising as a mechanism to take multiple biopsies in hard-to-reach areas.
I almost missed this little tidbit in the Federal Register that would allow use of eight CMS record systems for emergency preparedness. The change would allow CMS to disclose individually identifiable records to “public health authorities and entities acting under a delegation of authority of a public health authority” for the purpose of providing health assistance in an emergency or disaster.
CMS issues a Call for Measures for potential Quality Reporting System items to be used in future rule-making years. CMS is focusing on measures that cover clinical outcomes, patient-reported outcomes, care coordination, safety, appropriateness, efficiency, patient experience, and patient engagement. Submissions must have strong scientific evidence, so I guess my “number of patients seen on time because they weren’t yakking on their phone when I entered the room” measure won’t make the cut.
Trinity Health Systems and Catholic Health East have completed a merger that will make the new 79-hospital organization the second largest not-for-profit system in the country. Interim CEO Judith Persichilli recently said that the new organization will choose which EHR can best support their needs. Trinity uses Cerner, while Catholic Health East runs Meditech.
New York University, NYU Langone Medical Center, and Blue Cross will collaborate on a project to develop machine-learning algorithms to identify cases of undiagnosed diabetes and to predict pre-diabetes.
The VA and DoD are holding a joint conference with EHR vendors to discuss the stalled iEHR project. The meeting will feature high-ranking speakers from both departments as well as representation from any vendor that expresses an interest in attending. The press has been explicitly prohibited from attending.
The New York eHealth Collaborative’s Patient Portal For New Yorkers project announces nine finalists in its search for a statewide integrated patient portal. The finalists were selected by public voting and will pitch their products to a live audience and a panel of judges.
Never had a breach? I find it remarkable that so many on the HIStalk Advisory Panel can answer so swiftly, so confidently, and so authoritatively, “No, we have never had a breach.”
I want to know how they know that. I want to know what they are doing — day in and day out — to monitor, audit, and confirm their operational performance that allows them to make that bold statement – the one that they report to HIStalk and its readers, their boards, and their patients.
I am sure you know the old saying, “The absence of evidence is not the evidence of absence.” For those that are reporting no breaches, just how hard are they looking? Would their staff even know what to report or how to report a potential breach?
I am not saying that a perfect record is not in the realm of possibility. It is just so incredibly improbable that it defies common sense. I would really love to know the secret formula that has gotten those CIOs that report no breaches to the place where they have that level of confidence and certainty. I am sure others would, too.
Along these lines, I finally got a chance to read ISMG’s Healthcare Information Security Today Annual Survey in which 35 percent of the 200 respondents reported that their organizations had not suffered a breach of any size in the past 12 months. I realize that this is a dangerously low sample size, but let’s just take it at face value for the sake of illustration. The trend is not too terribly off from the responses from the HIStalk Advisory Panel.
The question and response that really got me chuckling was this one, though. “What type of breach (of any size) has a BA with access to your organization’s patient information had in the past 12 months?” Can you believe that 59 percent of the respondents answered that their BAs had no breach of any size in the past 12 months? That is downright laughable and borderline reckless.
CEs are doing precious little to evaluate, interrogate, or assess BA risk or compliance performance. Again, the absence of evidence is not the evidence of absence. If a CE responded to this question based on the BA’s self-report to them alone, that should not be enough information to give that BA a clean bill of health. We have to hold them to more rigorous criteria than that.
The certain truth is the universe of BAs is exponentially larger than that of CEs, and BAs have only recently received the formal mandate to fully comply with HIPAA. We have a long way to go in the BA community and CEs should be guarded, probative, and assertive in the management of their BAs. We cannot wait 10 years for our BAs to catch up.
What really matters in this discussion is what has changed under Omnibus. One of the most significant changes is that the Omnibus Rule replaces the “risk of harm” test that was so contentious in the interim final rule with a default presumption that any acquisition, access, use, or disclosure of PHI in a manner not permitted by the HIPAA Privacy Rule is a breach unless the CE or BA “demonstrates that there is a low probability that the [PHI] has been compromised based on a risk assessment.” [78 Fed. Reg. at 5,695]
Kudos to the organizations that have employed a breach risk assessment process and have implemented it consistently. Interestingly, they seem to be the ones reporting their breaches in real time, even the small ones that they could have reported later. They have a real process and are actively demonstrating a posture of continuous compliance, which is the desired state according to OCR.
However, there are a whole bunch of organizations that are just winging it. They have no process, no criteria, no tools, and no commitment. We see it all too often and it is just not enough.
Take the five-month window before you must comply with Omnibus to shore up this part of your program – all things related to breach risk. Consider working with an expert consulting firm to help you. This is probably an area where a little investment can go a long way.
Wellness is a legitimate term but a wellness journey requires a long-term commitment from both patients and medical providers. Many…