HIStalk Interviews Matthew Hawkins, CEO, Vitera Healthcare Solutions

February 11, 2012 Interviews 31 Comments

Matthew Hawkins is CEO of Vitera Healthcare Solutions of Tampa, FL.

Give me some background about yourself and about Vitera Healthcare Solutions.

I’m a technology enthusiast and a big believer that technology can and should enable better practice, both from a business perspective and a clinical perspective. I think that’s one of the reasons I’m very excited to be at Vitera Healthcare Solutions.

As you know, Vitera’s roots are in practice management, with the Medical Manager business and some other practice management solutions. That’s a part of our DNA. Being good at practice management and helping doctors get reimbursed for the services that they’re performing and helping them manage effective practices is part of our DNA. That’s something I’m a big believer in.

One of the reasons I’m also excited about being in Vitera is I believe that software companies are really people-oriented businesses. That’s definitely true here. That’s one of the things that made me gravitate toward working within a software type organization. They’re people businesses. The soul of the business is in helping inspire people to develop and deliver great technology and provide excellent service. I think ultimately the products and services that we offer become an extension of who we are.

I’m excited about being here and excited about what we’re going to be able to accomplish as an organization with the good people that we have at Vitera.

What was the interest by Vista Equity Partners when they acquired the company in this past fall?

Vista Equity Partners acquired the business in November 2011. They’re very excited to be the owners of this business. They were thrilled to win the bid.

They see this as a long-term opportunity to create value for our clients by helping employ best practices that Vista Equity Partners has tested and had proven in a number of different businesses that they owned. They’re very familiar with healthcare, but also more broadly across other enterprise software businesses in other industries. I’ve worked with Vista for nearly five years. I know them to be very good investment partners, willing to make investments in the business and willing to do what it takes to help create value. I look forward to working with them here in this business.

People are always suspicious when private equity firms buy companies that they’re just going to slash and burn their way to flipping the company at the first chance. Have there been any headcount reductions or any other cost-cutting measures, and what’s the long-term strategy of where the company needs to go?

We’re very focused on building a great business, insofar as changing the profile of our company, and we are making investments. Vista Equity Partners isn’t a traditional private equity firm from a cost-cutting perspective. For example, this year we will invest more than $25 million to accelerate our innovation efforts in R&D. We’re investing in new systems, a CRM system so that we have a lot better capabilities and to give that to our staff to improve our customer service and support, and then we’re also investing in skill training for our staff.

All of these are really with one goal in mind — to improve the client experience that people have with Vitera Healthcare Solutions and just to improve every aspect of our service, whether it’s training and delivery or the way we support service requests. It’s definitely investing in the products and extending those to several exciting new areas.

It’s important that we let people know that I’m very focused with our team, and we’re building a fine team. We’ve brought in several people that have healthcare industry experience to help us lead our teams. We also have a good core group of employees here. We are working to change the profile of the company. As I mentioned, we’re making investments. We’ll invest more than $25 million this year while continuing to invest in several products, including the Intergy product suite — practice management and EHR –Medical Manager, and Medware.

We’ll soon launch a full, multi-tenant based cloud solution for practice management and EHR, which we’re thrilled about. We’re investing in a mobile solution that will enable doctors and practitioners to practice healthcare any time, anywhere, and we’re thrilled about that. We’re investing in better analytical solutions so that practices can have insight into how they’re practicing, both from a business perspective as well as in an increasingly important category of clinical perspective.

While we do those things, we are positioning our resources. We’re looking to concentrate some of our resources in Tampa, Florida. We’ll be hiring several people here, upwards of 100 to 200 people here centrally in Tampa, Florida in client service, in training, in development, and in product management, among other areas. We’re also looking to enhance and grow our account coverage model in the field, so throughout the United States, we anticipate growing our sales force by upwards of 40 to 50% so that we can meet the needs of the clients that we serve locally.

It’s a balance of positioning the company, changing the profile of the company, and seeking to optimize the way that we utilize our resources, all focused on helping us deliver great technology and great service to the client practices that we serve.

You mentioned the cloud-based solution, of which I’d heard rumors. Supposedly it came from an acquisition. Can you elaborate on where that product came from and how it will be rolled out?

This occurred before I came to the business and before Vista Equity Partners acquired the business, but there was an acquisition of some cloud technology, I think a year and a half ago or two years ago. We have, since the acquisition in November, worked aggressively to take that product from where it was and enhance it and improve it dramatically.

We are in the process achieving Meaningful Use Certification as well Surescripts certification for the product. We will begin a pilot test among several client practices that are interested in the product, having seen it briefly. We anticipate being able to bring that product to market later this spring.

We’re thrilled about the early feedback that we’ve received on it. We definitely want to deliver a high quality, cloud-based solution for practice management and electronic health records that is interoperable and works very effectively with other products on the market as well.

It seems like with the changing demographics of position practices, where a lot of them are being acquired by hospital or managed by hospitals, that everybody wants either a cheap, good-looking system that’s easy to use in a small practice so they want some giant enterprise system that hospitals like that can tie in to the hospital systems. Where do your systems fit in with what customers are looking for?

I think it’s important to think about our system as being true to the ambulatory market and the office-based practitioners across several specialties. We feel like we have a very full suite, the Intergy product in particular, with practice management and EHR. Several client practices that are large — some hospital systems, multi-doctor multi-specialty systems as well — use the Intergy Suite as well as our Medical Manager products.

We are also working to optimize our products to work with the smaller practice sizes, the one- to two-doc practices. We’ll do that both with an Intergy On-Demand, a hosted solution, and soon we’ll do that with a pure cloud-based solution. We feel like our products can address both ends of the market effectively. We’ll continue to invest to ensure that our products are able to offer great coverage to the larger practice sizes — the multi-specialty, multi-doc practice sizes — as well as the smaller one- to two-doc practices.

But I think the important thing to underscore is we never want to lose our core focus, and that is on creating a great experience for the office-based practitioner and the ambulatory market. Really understanding the workflows, the way that practices operate in that smaller practice or mid-sized practice level, and addressing their needs effectively.

When you took over what was Sage Healthcare, what did you see as the strengths and the weaknesses of the company’s offerings or the company in general?

A real strength of Vitera Healthcare, which was formally named Sage, is the large group of loyal client practices that use the technology, more than 80,000 physicians and 11,000 practices. That’s a strength that we absolutely are focused on. We’ll continue to be focused on earning their loyalty.

I think we have a great competitive set of products. The latest version of Medical Manager is 5010-compliant and ICD-10 ready, and we’re thrilled about that. We’ve got a great pathway forward with Medical Manager. Other great competitive products that are part of this business — the Intergy Suite product, Meaningful Use certified, 5010 compliant. We have some other products that every practice should have in our practice analytics product and a practice portal solution that we offer.

I think the third area that is a strength to our business is knowledgeable, very dedicated, good employees, many of whom have years of valuable experience in healthcare technology.

Those are many of the strengths of the business. Areas where I think we can improve are getting back out in front of our client base and talking about our product vision and sharing with clients who are about to make a technology purchase decision the fact that we are investing aggressively in innovation and in R&D and that we have a clear product message and clear product vision.

I think another area to focus on for us is improving the way we serve the practices that we work with. Coming into the business, I saw service improvement as a real opportunity for us. We have great people. We can do a great job taking care of the practices that we work with, and we are committed to doing that.

When the sale was announced in September, Sage’s CEO implied that the policies of the Obama administration had reduced the attractiveness of the EMR market. I think he said something about Sage Healthcare’s US business was contracting, which seems like a bizarre statement to make. What was he talking about?

I must say I disagree with that perspective. I think this is a very attractive market base. I think the market validates that with the number of vendors focused on this market or the number of stock market type transactions that we’re seeing that are focused on healthcare technology in general. Certainly just with the amount of dollars that are being invested, either by government entities or by private practices themselves, to get themselves to be able to use state-of-the-art technology.

I feel like that it’s just a tremendous market for us to be in right now. We are positioning Vitera Healthcare Solutions to take full advantage of that by getting our clients great products that enable them to take advantage of all the government incentives. We had nearly 900 clients already that have taken advantage of some Meaningful Use incentives, which at $18,000 average incentive, is $15-$16 million in reimbursement that our clients have already procured. We’re thrilled about that. I think that speaks to the attractiveness of this market from a vendor perspective like ours.

I feel like there is tremendous opportunity for continued efficiency gain to be had in healthcare, and in the way healthcare is practiced, and in the way that it’s becoming increasingly patient centric and what patients are expecting from a healthcare experience, what providers are expecting from a technology experience. I think being a vendor in this space, it’s just a phenomenal time to be here, because we can bring all those technology best practices to bear for both providers and patients alike.

As a vendor, do you see Meaningful Use as a long-term strategy or a short-term distraction?

I think Meaningful Use is good for the industry because it’s helping all us be aware that there’s an effective way to use technology to practice medicine. With that being said, obviously there’s an investment focus or a reimbursement focus over the next couple of years. The government is rewarding practices that are investing in Meaningful Use-enabled technology. Our technology is certainly Meaningful Use enabled, so it’s not a distraction at all to us. We like that.

I think longer term, the focus on being Meaningful Use-enabled and certified is just going to lead to better healthcare, from a business perspective as well as from a clinical perspective. It’s going to position practices and practitioners, and ultimately patients, to benefit from the efficiency gains that are able to be had, from affordable care even along to accountable, proactive care to patients. I see it as a good thing.

If you look at the current ambulatory EMR market and where Vitera plays in it, what do you see is important and what do you as happening in the next several years?

I think that speaks very well to our product vision. I’ll talk about some things that I see as just being tremendously important to us.

I think the technology themes that we’re incorporating into this product vision speak to the trends that will be in effect the next several years, including helping practices profitably practice healthcare. Included in that would be our theme around practice profitability, revenue cycle optimization, and being true to the office-based practitioner core, enabling them to practice effective and profitable healthcare.

Next, I think a big trend is in patient engagement. We see the word patient-centric referred to quite a bit. I think maybe that’s speaking to the consumer as in driven by patients and the expectations that all of us have as consumers of information included in our healthcare experience and wanting to know and to be aware of and be included in the decisions being made for opportunities to learn more about the healthcare that we’re receiving. Patient engagement, I think, is a very important trend that we’re focused on and that we’ll continue to focus on.

I think the use of data as a trend .. we would call that as practice insight … and really using analytical information to help improve the clinical care of patients and to help drive to better outcomes for patients. I think that positions both providers and patients to benefit strongly from that. Not just clinical care, but having dashboards and good reporting tools from a practice perspective give practices insight into how better business productivity as well.

Just the last couple of thoughts on trends and themes and why and where I think we’re positioning Vitera Healthcare in this very dynamic market. Connectivity. I think there’s a real important trend toward the need to be interoperable and flexible between our systems and others and making sure that we support IHE and that we are able to enable practices to select our technology, but then position them to know that our technology can be connected to others and integrated and interoperable in a way that makes sense for practitioners. I think that’s an important trend that we’ll be focused on.

I mentioned any time, anywhere access mobile solutions. We’ll launch a true native Intergy iPad solution later this summer, and we’re thrilled about that. That trend is going do nothing but continue, and we’ll be focused as a business on future iPhone and Android access solutions, just mobile solutions in general.

Then I think the foundational element of just being a good software company will continue as trends. Things like having software that is easy to use, having technology solutions that are easy to understand, easy to use, easy to be trained on. I think that will differentiate us as we go forward.

Cloud computing. I mentioned our cloud computing offering as a trend and a way to position us within this space. Having a trusted partner that is there focused on regulatory compliance and security and stability, so that when practices select one of our products, they know that we’re thinking and anticipating regulatory compliance items and being very mindful of stability and security and performance along the way.

I see that as how we position ourselves as we go forward as a company in the future. I’m very excited to be a part of that.

Any final thoughts?

I’m thrilled to be here at Vitera Healthcare Solutions. I look forward to working with you and others in the industry to advance the cause of healthcare technology. I feel like we can play a really important role in making good things happen for practices and patients and the entire community.

31 Comments

HIStalk’s Guide to HIMSS12

February 11, 2012 News 2 Comments

Download a PDF version of this document here.

3M Health Information Systems

Booth 3334

Contact: Jolie Gordon, Marketing Communication Specialist
jegordon@mmm.com 801-560-4788

Best known for our market-leading coding system and ICD-10 expertise, 3M Health Information Systems delivers innovative software and consulting services designed to raise the bar for clinical documentation improvement, computer-assisted coding, mobile physician applications, case mix and quality outcomes reporting, and document management. Our robust healthcare data dictionary and terminology services also support the expansion and accuracy of your electronic health record (EHR) system. With nearly 30 years of healthcare industry experience and the know-how of more than 100 credentialed 3M coding experts, 3M is the go-to choice for 5,000+ hospitals worldwide that want to improve quality and financial performance.

Access

Booth 860

Contact: Cody Strate, Director of Sales
cody.strate@accessefm.com
303.257.3183

Access is the world’s leading electronic forms (e-forms) management, automation and workflow software provider. Our solutions transform any paper-intensive forms process into a paperless, collaborative one. Stop by HIMSS Booth 860 to see how Access can help you achieve paperless:

Registration and consent forms on demand with electronic signatures & barcodes
Human resources, financials and clinical processes, including new employee onboarding, capital requests, and physician referrals
Clinical data bridge to your enterprise content management system

Learn more at www.accessefm.com.

Advisory Board Company

Booth 7310

Contact: Leah Bruch, Senior Manager Strategic Marketing
bruchl@advisory.com
202.266.6775

The Advisory Board Company is a global research, consulting, and technology firm partnering with 125,000 leaders in 3,200 organizations across health care and higher education. Through our innovative membership model, we collaborate with executives and their teams to elevate performance and solve their most pressing challenges. We provide strategic guidance, actionable insights, web-based software solutions, and comprehensive implementation and management services.

Learn more at www.advisory.com.

AirStrip Technologies, Inc.

Booth 870

Contact: Kimberly Kuzawa, Executive Assistant
Kimberlykuzawa@airstriptech.com
832.330.4419

Native applications from AirStrip Technologies securely send critical patient information from hospital monitoring systems, bedside devices, electronic health records and home devices to a clinician’s smartphone or tablet. FDA cleared, CE Mark certified and designed to meet HIPAA security requirements, AirStrip applications are powered over wired and wireless networks, delivering live patient data anytime, anywhere.

ANX

Booth 13429

Contact: Mike Nunez, Director, Healthcare Business Development
nunezm@anx.com
806.797.2923

ANXeBusiness provides innovative solutions that transform the exchange of data throughout the entire healthcare community. This solution set creates an easy, reproducible, cost efficient and secure exchange between hospitals and laboratories. This allows the hospital and laboratory to focus on what they do best; the complete patient continuum of care. To learn more about ANXeBusiness, please visit us at www.anx.com.

API Healthcare

Booth 2617

Contact: Kenny Amburgey, Vice President of Client Strategies
kenny.amburgey@apihealthcare.com
262.385.7732

Solutions designed for the unique demands of the healthcare industry. API Healthcare solutions create the crucial link that allows you to effectively balance the financial realities of healthcare with the delivery of high quality patient care. Robust integration and data driven staffing tools are what make API Healthcare workforce management solutions powerful:

Fully integrated, single platform technology
Complete multi-dimensional insight into all areas of an organization allow for intuitive, cost effective decisions
Data driven staffing tools ensure the right patient and the right caregiver match, every time
Streamlines processes, increases efficiency and optimizes every aspect of your workforce

Aspen Advisors

To schedule a meeting:

Contact: Daniel Herman, Managing Principal and Founder
info@aspenadvisors.net
800-697-4350

Aspen Advisors is a professional services firm with a rich mix of respected industry veterans and rising stars who are united by a commitment to excellence and ongoing dedication to healthcare. Our experienced team is highly skilled in all aspects of healthcare technology. We understand the complexities of healthcare operational processes, the vendor landscape, the political realities, and the importance of projects that are executed successfully – the first time. Every client is important to us, and every project is critical to our reputation. Established in 2006, we’ve grown significantly year-over-year and have earned accolades for our culture and growth.

We were named an “Up and Comer” by Healthcare Informatics in 2010 and ranked #20 in Modern Healthcare’s list of the top 100 “Best Places to Work in Healthcare” in 2011. Our hallmarks are top quality service and satisfied clients; we’re proud of our KLAS rankings and that each of our clients is 100% referenceable. For the last four consecutive years, Aspen has ranked in the Top 5 in KLAS’ “Best in KLAS Awards” report in the Planning and Assessment category and were included in the Top 20 in the Clinical Implementation Supportive market segment. Interested in learning more about how Aspen Advisors can help you address the issues on your top priority list? Or looking to join a firm where healthcare IT consultants aren’t commodities, communication isn’t curbed, and potential never gets stuck in a pigeon hole?

To learn more about Aspen Advisors – either as a prospective client or prospective associate, please consider scheduling an in-person meeting at HIMSS or visit us at http://www.aspenadvisors.net.

AT&T

Booth 3829

Contact: Deborah Sunday Marketing Director
ds823e@att.com
678.230.3440

AT&T ForHealth℠ is committed to serving the technology needs across the continuum of care — from hospitals to physicians to patients. Our suite of innovative wireless, cloud-based and networking services and applications empower clinicians by placing vital patient health information at their fingertips. Learn how to rethink healthcare delivery by visiting AT&T ForHealth in Booth #3829 at HIMSS12 in Las Vegas. Also, be sure to visit and hear AT&T speakers in the HIMSS Knowledge Centers for Mobile Health (#12928, Hall G, Kiosk 14 ), Cloud Computing (#13624, Hall G, Kiosk 5) and Accountable Care Organizations/Value-Based Purchasing (#6466, Hall D, Kiosk 8)

Aventura

Booth 8300

Contact: Brian Stern, VP of Sales
info@aventurahq.com
888.484.4643

Aventura improves the current workflow of doctors and nurses. We give clinicians the information they need, when and where they need it. Our context aware computing intelligence orchestrates technologies already in place making them responsive to the user. The result is improved clinician satisfaction, increased EMR use at the point of care, and an increased focus on the quality of care.

Awarepoint Corporation

Booth 3412

Contact: Merrie Wallace, Executive Vice President, Product Solutions and Marketing
marketing@awarepoint.com
888.860.3463

Awarepoint’s aware360Suite provides intelligent workflow solutions that meet departmental and enterprise-wide patient tracking needs. The solution visualizes patient flow without requiring personnel to manually update care status information. Patient location, movement and interactions with tagged personnel and clinical equipment trigger updates to the web-based software, which employs workflow rules to recognize patient care milestones. By improving patient visibility throughout the enterprise, Awarepoint helps administrators and clinicians to advance the QUALITY of care, the EFFICIENCY of care, the EXPERIENCE of care, and the ECONOMICS of care.

Beacon Partners

Booth 3926

Contact: Katelyn MacKay, Business Development Coordinator
kmackay@beaconpartners.com
781.681.7407

As one of the largest healthcare management consulting firms, Beacon Partners is chosen by organizations in the healthcare community to provide advisory services to improve overall operational, clinical and financial performance with the adoption of information technology. With our strategic approach and depth of experience, Beacon Partners is qualified to help organizations navigate the challenges in healthcare and optimize their potential to deliver the highest possible level of patient care.

BESLER Consulting

To schedule a meeting:

Contact: Jim Hoffman, Chief Technology Officer
jhoffman@besler.com
732.392.8214
Available at HIMSS Tuesday or Wednesday

BESLER develops software tools and provides consulting services that help acute care hospitals get paid everything they deserve. Our BVerified ™ online solutions allow our customers to manage underpayment recoveries that have traditionally been accomplished via a consulting engagement, providing typical saving of 50%. We’ve just launched our two newest products and we’re the only company with an end-user technology solution to address the Medicare IME and Transfer DRG underpayment issues.

Billian’s HealthDATA

Booth 7707

Contact: Jennifer Dennard, Social Marketing Director
jdennard@billian.com
678.569.4872

Billian’s HealthDATA is the leading provider of comprehensive market intelligence on the healthcare industry, covering facilities across the continuum of care – from Hospitals and Hospital-Affiliated Physicians to Long Term Care. Billian’s dedication to providing high-quality data via products like the Portal, coupled with partner company Porter Research’s custom market research services, provides customers with healthcare business intelligence about multiple markets in scaleable formats

Bottomline Technologies

Booth 12928 (Mobile Health Knowledge Center, Hall G)

Contact: Sarah Stevenson, Healthcare Marketing Manager
sstevenson@bottomline.com
603.380.8577

For more than 20 years, Bottomline has been focused on software applications that optimize document-driven processes. As a result, Bottomline possesses both the proven solutions and the tested domain expertise to deliver consistent customer value and significant return on investment. Bottomline’s medical forms solutions are used by 900+ hospitals to reduce costs, increase productivity & improve patient safety. Our goal is to help hospitals, clinics and practices adopt electronic medical records – from registration and consents to clinical documentation – an evolution that has been plagued by counter-intuitive approaches that aren’t as flexible and fast as paper.

CAP Professional Services

To schedule a meeting:

Contact: Chip Perkins, Managing Director
cperkins@cap.org
847.832.7280

CAP Professional Services, a division of the College of American Pathologists, works to align health care information and technology to drive performance and quality. We are advancing health information excellence by focusing on services such as: Health Information Strategies and Management, Clinical Data and Terminology Services, and Laboratory Services. For more information, call 847-832-7700 or email capsts@cap.org.

CapSite

To schedule a meeting:

Contact: Bryan Fiekers, Director of Business Development
bryan.fiekers@capsite.com
802.383.8205

CapSite is a healthcare technology research and advisory firm. Our mission is to help healthcare providers and vendors make more informed strategic decisions.The CapSite Database is the trusted, easy to use online database, providing critical knowledge and evidence based information on healthcare technology purchases. CapSite™ data provides detailed transparency on healthcare technology pricing, packaging and positioning.When it all comes to healthcare technology research, it helps to see all the details. Those details are now available with CapSite™

Capsule Tech, Inc

Main Booth 6141
HIMSS Intelligent Hospital Pavilion Booth 12442
Interoperability Showcase Booth 11000
Medical Devices Integration Knowledge Center Booth 14647

Contact: Heather Hitchcock, Vice President of Global Marketing
marketing@capsuletech.com
978.482.2337

Capsule is the leading provider of medical device integration. Capsule’s Device Connectivity Solution is the most proven, vendor neutral solution available for device connectivity. It features a patient-centric design that is completely flexible and scalable and integrates with existing technologies and clinical workflows. Stop by our booth 6141 to see why over 1000 hospitals have chosen Capsule for device integration.

Care360

Booth 2813

Contact: Joel Williams, Associate Director-Sales Support and Operations
Info@Care360.com
www.Care360.com
888.835.3409

Racing to Expand Your Physician Community? Accelerate your competitive advantage by joining our existing Care360 network of more than 200,000 physicians in 80,000 physician offices. Care360® EHR is a certified EHR solution that can be up and running in as little as 30 days, allowing physicians to transition workflow from paper to electronic management in a modular approach. Care360 EHR with Data Exchange connects hospitals to physician practices with a web-based platform to share information. ChartMaxx® DMI/ECM enables healthcare organizations to see immediate improvements through electronic document and content management, eForms and automated workflows that cross existing sytems. To learn more, visit Care360.com

Certify Data Systems, Inc.

Booth 5934

Contact: David Caldwell, Executive Vice President
sales@certifydatasystems.com
713.446.3376

Certify Data Systems, Inc., is a pioneer in health information exchange (HIE) technology. The company’s Enterprise HIE Platform has been adopted by the nation’s leading hospitals and health systems. The bi-directional HIE platform, provides true interoperability between disparate Electronic Health Record (EHR) systems, enabling hospitals and health systems, their affiliated physician practices and laboratories to exchange essential health information in real-time without changing workflow. Moreover, Certify’s “network approach” is easy to deploy, scale, manage and support. For more information, please visit http://www.certifydatasystems.com. Follow us on Twitter at @CertifyData.

Command Health

To schedule a meeting:

Contact:
Evan Frankel, Director of Product Management
evan.frankel@commandhealth.com
303.301.0430

Command Health is the leader of narrative note technology, focusing on unifying clinical documentation from disparate sources across the continuum of care. Combining verbal interaction with visual integration, Command Health enables the efficient and accurate capture of patient data that is easy to find, use, share and search by converting locked, inaccessible data into actionable, meaningful information. Using proprietary natural language processing (NLP) technology combined with human intelligence, Command Health delivers the most comprehensive clinical data available, helping providers reduce costs, assess risk and manage outcomes.

CTG Health Solutions

Booth 2070

Contact: Carl Ferguson, Jr., Managing Director
carl.ferguson@ctghs.com
214.695.4227

CTG Health Solutions is a leading healthcare IT consulting firm providing strategic, clinical, financial, operational, and technology solutions. Offering advisory services, strategic/tactical planning, vendor selection, implementation, legacy system support, program/project management and advance technology services, CTG helps healthcare organizations address regulatory mandates of meaningful use, 5010, ICD-10, HIE, electronic medical records, accountable care and evolving health reform. CTG Health Solutions is a business unit of CTG (NASDAQ: CTGX) a publicly owned IT services and solutions company founded in 1966 that generated revenue of $331 million in 2010. More information is available at www.ctghs.com.

Experience matters. Over the last 25 years, CTG Health Solutions has provided healthcare IT, and operational and strategic consulting support to over 600 healthcare organizations. Since 2008, CTG has continuously been named to Healthcare Informatics top 100 healthcare IT providers and the Modern Healthcare lists of the largest healthcare management consulting firms. CTG was also cited in the March 25, 2010, issue of Information Week as one of the top three firms for healthcare organizations looking for help in implementing EMRs and other health IT investments.

Cumberland Consulting Group

Booth 5147

Contact: Jim Lewis, Managing Partner
jim.lewis@cumberlandcg.com
615.373.4470

Cumberland Consulting Group is a national technology implementation and project management firm serving ambulatory, acute, and post-acute healthcare providers. Through the implementation of new technologies, Cumberland works with providers to advance the quality of care delivered, and improve business performance. Cumberland Consulting Group offers an invigorating, positive work environment and a commitment to superior talent acquisition, development and retention.Cumberland was named Best in KLAS for IT Planning & Assessment in the 2011 Best in KLAS Awards: Software & Services report, finishing in a first-place tie.

Cumberland Consulting Group Says: Stop by and meet some of our top implementation consultants and learn about Cumberland’s excellent delivery record, straightforward implementation methods and lean operating model that delivers big company results at a very attractive price. Be sure to catch Cumberland’s Erik Howell presenting Physician-to-Physician: Driving Inpatient CPOE Clinical Transformation, Session 184,Thursday Feb. 23 at 2:15pm.

CynergisTek

To schedule a meeting:

Contact: Stephanie Crabb, VP of Client Services
stephanie.crabb@cynergistek.com
512.402.8550 or 954.298.4702

CynergisTek is an authority in healthcare information security management services and solutions. We assist hospitals, payers, vendors and other valued business partners to the healthcare industry with the development and management of standards-based, industry-appropriate, business-driven and compliance-aware information security programs. CynergisTek is a full-service firm offering solutions in the areas of strategy and governance, compliance and risk, technical security management, managed security solutions and partner technology resales and implementation. CynergisTek was chosen to provide advisory and consulting services throughout the organization’s audit experience by one of the first 20 entities targeted by OCR for its HIPAA Audit Program. CynergisTek has led dozens of risk assessment projects for organizations attesting for Meaningful Use. CynergisTek has established its Surveyor program to provide critical third-party review of business associate compliance with HIPAA and to support organizations with independent review of IT security performance as part of their M&A due diligence activities. CynergisTek has led dozens of data discovery and data loss breach risk assessments to help organizations identify where PHI/PII reside in their organizations and how that data is being handled.
CynergisTek is working on the front lines, side-by-side, with our clients to address the most pressing IT security, privacy and data governance challenges. We are visionary. We are practical. We make our clients better.

DrFirst, Inc.

Booth 5456

Contact: Timur Tugberk, Events, Brand, and Media Coordinator
ttugberk@drfirst.com
301.231.9510 ex. 2835

Founded in 2000, DrFirst is the nation’s leading e-prescribing and solutions platform provider to physician practices, major health plans, health systems, hospitals, and EHR vendors. Through its Open Borders Program, DrFirst solutions integrate with over 200 EHR, practice management and HIT systems. A Surescripts Gold Certified solution provider for four consecutive years with its award-winning Rcopia electronic prescription management system, DrFirst utilizes the Surescripts network for pharmacy connectivity, health plan information, and patient medication history. For more information, visit www.drfirst.com.

eClinicalWorks

Booth 531

Contact: Heather Caouette, Marketing
heather.c@eclinicalworks.com
508.836.2700

eClinicalWorks offers ambulatory clinical solutions consisting of EMR/PM software, patient portals and a community health records application. With more than 180,000 providers and 370,000 healthcare professionals across all 50 states using its solutions, customers include physician practices, out-patient departments of hospitals, health centers, departments of health and convenient care clinics. At HIMSS, please visit the eClinicalWorks booth to see the latest in iPad and patient applications, community analytics and ACO capabilities.

Elumin Healthcare Solutions

To schedule a meeting:

Contact: Mark Williams, CEO & President
mwilliams@eluminhs.com
425.369.8211

Elumin works with healthcare organizations across the country to improve quality, efficiency and their bottom line through the use of information technology throughout the continuum of care. Our work ultimately leads to greater clinician, physician, staff and patient satisfaction. Many of Elumin’s consultants are clinicians, and many have worked in hospitals and physician practices as business and clinical leaders. Many are certified and experienced in premier technologies such as Allscripts, Epic, Cerner, NextGen and Siemens. On average, our consultants have more than 15 years of experience. We strive to achieve 100% referenceability among our clients. Elumin is 100% focused on healthcare.

Elumins services include: advisory services, system implementations, data conversions, clinical optimization, revenue cycle management, legacy platform support, ICD-10, 5010 migration, and interim staffing. Our team of experienced healthcare professionals thrives on implementing best practices, optimizing technology and guiding clients through the change management process.

Elumin representatives will be attending the 2012 HIMSS conference Monday Feb. 20 – Friday, Feb. 24. They look forward to meeting new healthcare industry leaders and sharing insight on trending topics. Let us help you bring light to the best of healthcare technologies’ promise.

Encore Health Resources

Booth 123

Contact: Randi Fiedler, Director, Sales Operations
rfiedler@encorehealthresources.com
832.289.0923

Encore Health Resources helps implement and optimize EHRs and complex clinical systems to get value from the data. We do this through our tools, knowledge base and proprietary approach, and by employing healthcare IT professionals with deep operational experience.

Encore was formed by healthcare IT veterans Dana Sellers and Ivo Nelson. We are one of the fastest growing independent consulting firms in the history of our industry. That rapid growth is attributed to our principles’ sterling reputation, our staff’s depth of experience, and our commitment to remaining 100% referenceable with each and every one of our clients. Encore has consistently been named one of the “Best Places to Work in Healthcare” by Modern Healthcare magazine.

ESD

Booth 4616

Contact: Jessica St. John, Director of Business Development
jstjohn@contactesd.com
419.841.3179

ESD is a leading healthcare IT consulting firm that assists organizations implement new or updated heathcare information technology. Experienced clinical consultants provided by ESD work closely with hospitals, clinics and health systems to evaluate current capabilities, establish clinical transformation strategies and assist clinicians in the transition to new or updated solutions, with the end goal being a successful transition to new technology. ESD’s headquarters is located in Toledo, Ohio and has five satellite offices located in Atlanta, Detroit, Cincinnati, New York and Houston.

Whether it’s time to implement a whole new system throughout your organization or just a component to one department, we have the experience and resources to both complement your team, and meet your goals.

Etransmedia Technology, Inc

Booth 13635

Contact: Craig Cane,VP, Business Development
craig@etransmedia.com
845.594.7247

Etransmedia Technology, Inc is a premier provider of information solutions to the healthcare industry, delivering comprehensive integrated software, service and connectivity solutions to simplify critical functions in the healthcare community. Etransmedia is committed to providing the right solutions to build an effective community of care, driving revenues and efficiencies for ambulatory, acute and diagnostic facilities, and increasing the availability of information to providers making critical care decisions.

First Databank (FDB)

Booth 2338

Contact: Denise Apcar, Brand Communications Manager
dapcar@fdbhealth.com
800.633.3453

First Databank (FDB) provides drug knowledge that helps healthcare professionals make precise medication-related decisions. With thousands of customers worldwide, FDB enables our information system developer partners to deliver a wide range of valuable, useful, and differentiated solutions. As the company that virtually launched the medication decision support category, we offer more than three decades of experience in transforming drug knowledge into actionable, targeted, and effective solutions that improve patient safety and healthcare outcomes. For a complete look at our solutions and services please visit fdbhealth.com

Fulcrum Methods

Booth 13247 Kiosk 6

Contact: Rick Beberman, Corporate Programs
rbeberman@fulcrummethods.com
510.287.3927

Fulcrum Methods has developed toolkits to assist hospitals and health systems with project management and meaningful use. We deliver work plans, guidebooks, libraries of deliverables, and online assessment tools to help organizations with vendor selection, systems implementation, long-range planning, establishing a program management office, managing organizational change, and meeting meaningful use requirements.

We have a great client list – Stanford University Hospital & Clinics, Lucile Packard Children’s Hospital, University Hospitals, MaineHealth, University of Kentucky HealthCare, John Muir Health, Community Medical Centers, and NorthBay Healthcare, among others. Our tools are encyclopedias of best practices and designed to develop core competencies, reduce execution risk, accelerate project rollout, and keep organization knowledge in-house.

GetWellNetwork

Booth 7910

Contact: Tony Cook, Vice President Marketing
tcook@getwellnetwork.com
202-321-9396

GetWellNetwork entertains, educates, and empowers patients throughout the patient journey using the bedside TV in the hospital, mobile devices, Web or Cable TV at home. Our patient-centered approach improves both satisfaction and outcomes for patients and hospitals. Additionally, the company extends the value of existing IT investments by integrating seamlessly to leading HIT systems including Cerner, McKesson, Epic, Meditech, GE and Siemens.

GetWellNetwork is recognized by KLAS® as the leader in Interactive Patient Systems and is exclusively endorsed by the American Hospital Association. More information about GetWellNetwork can be found at www.GetWellNetwork.com.

Harris Corporation

Booth 834

Contact: Amy Ferretti, Vice President, Marketing
amy.ferretti@harris.com
925.518.9895

Harris is advancing healthcare for more than 300,000 users at over 2,000 provider organizations delivering care to nearly 13,000,000 patients – by delivering proven solutions that enable healthcare organizations to constantly improve quality of care while containing costs, increasing revenue, and addressing the new world of accountability and value. We provide a portfolio of solutions that promote interoperability, streamlined workflow, and analytics; all of which are adaptable to our customer’s specific care delivery setting and the unique requirements of their physical, technical, and user environments.

Health Information Exchange
Patient Portal
Provider Portal
Business Intelligence
Workflow Management
Image Management
Managed Services
Systems Integration Communications

Hayes Management Consulting

To schedule a meeting:

Contact: Bill Gannon, Director
bgannon@hayesmanagement.com
541.647.0825

Hayes Management Consulting is currently helping clients prepare for Meaningful Use, ICD-10 migration, and other initiatives by providing strategic guidance and hands-on expertise in EHR system implementation and optimization, project management, project resources and more.

Healthwise

Booth 4627

Contact: Dave Mink, Account Executive
dmink@healthwise.org
208.331.6971

Healthwise leads the way with ONC–ATCB-certified patient education that contributes to improved care quality. Helping hospitals meet Meaningful Use criteria today, and tomorrow’s ACO goals, the Healthwise Patient Education Solution seamlessly integrates into EMRs, PHRs, and websites. Ask about our new shared decision-making tools and patient response. www.healthwise.org.

Holon Solutions

Booth 12214

Contact: Sandra Schafer, Vice President of Marketing and Business Development
sschafer@holonsolutions.com
678.324.2039

At Holon we believe that collaboration improves lives. Holon’s CollaborNet™ facilitates collaboration among healthcare providers by creating secure networks that manage the assembly, packaging, routing and delivery of vital health information. Holon’s CollaborNet connects providers regardless of their level of technological sophistication, using the systems in place and with or without standard communication protocols. CollaborNet is flexible and adaptable and can support changes to communication standards and methods as they develop. CollaborNet builds value from the bottom up by delivering information WHEN, WHERE and HOW you need it. For more information please visit us at www.HolonSolutions.com.

Iatric Systems, Inc.

Booth 7905

Contact: Judy Volker
Judy.Volker@iatric.com
978.805.3191

If you’re attending HIMSS12 to find ways to get the most out of your HIS, be sure to visit Iatric Systems booth. There you’ll learn about solutions that can be integrated with your HIS in order to help you achieve interoperability, meet Meaningful Use objectives and support your ACO initiatives.

Recognized by Inc. 5000 as one of the fastest growing privately held companies for the past four years, Iatric Systems helps hospitals and health systems leverage their HIS investment with software, interfaces and reporting services. Since 1990, more than 1,000 hospitals worldwide have implemented Iatric Systems solutions; optimizing patient care and staff workflow in clinical, financial and administrative areas. Iatric Systems was acknowledged on the Healthcare Informatics Top 100 Healthcare IT Revenue list in 2009/2010/2011 and the Modern Healthcare Top 100 Best Places to Work in Healthcare IT in 2009/2010/2011.

Get your chance to win an iPad 2 during the HIStalk Booth Crawl: Be sure to stop at the Iatric Systems booth for the chance to win the perfect, portable tool for checking e-mail, surfing the Web, playing games, reading books and visiting important Websites like Iatric.com.

ICA

Booth 4831

Contact: John Tempesco, CMO
john.tempesco@icainformatics.com
615.866.1465

ICA’s CareAlign® care management solutions connect the healthcare community with proven interoperability technologies enabling health information exchange and improved care delivery. This patient-centered modular approach offers immediate value and return-on-investment to communities, IDNs, hospitals and physicians through the delivery of clinical information to the point-of-care improving quality while reducing costs. Visit booth #4831 for a demonstration of the CareAlign solution suite.

iMDsoft

Booth 4215

Contact: Steve Sperrazza, Vice President, North America Sales
sales@imd-soft.com
866.4 iMDsoft, 781.449.5567

iMDsoft is a leading provider of Clinical Information Systems for critical and perioperative care. The company’s flagship family of solutions, the MetaVision Suite, was first implemented in 1999. It captures, documents, analyzes, reports and stores the vast amount of patient-related data generated in a hospital. Over 125 hospitals worldwide use MetaVision to support their workflow, and arm their healthcare professionals with timely, accurate, and actionable information. iMDsoft products demonstrate 100% implementation success rate and a 100% customer retention rate.

Come visit our booth to find out why 4 of the top 10 US hospitals have decided that MetaVision is the best choice for improving care quality and financial performance. Providing an integrated edge where it matters most, MetaVision delivers high-impact results such as 30% fewer mortalities, 100% billable anesthesia records, total elimination of prescription errors, 99% compliance with PQRS measures and doubled protocol compliance.

Learn more about how MetaVision interoperates with the latest technologies and seamlessly integrates with hospital systems at the HIMSS12 Interoperability Showcase held in collaboration with Integrating the Healthcare Enterprise (IHE), from 21-23 February.

Imprivata

Booth 3160

Contact: Jim Whelan, VP of NA Healthcare Sales
jwhelan@imprivata.com
508.395.2235

Learn directly from hospital CIOs on how they saved their clinicians more than 15 minutes per day and improved workflows with Imprivata OneSign. Hospital CIOs and Directors using Epic, McKesson, Siemens, Meditech and Healthland will be available to answer your questions. After the presentations, you can try a hands-on demo of No Click AccessTM to applications and roaming virtual desktops throughout the Imprivata booth. Imprivata is also raffling off 30 Kindle Fires, which will be raffled off after each theater presentation!

Informatica

Booth 9107

Contact: Jonathan Shafer, Senior Customer Marketing Campaign Manager
jshafer@informatica.com
650.385.5000

Informatica Corporation is the leading independent provider of enterprise data integration software and services. Using Informatica solutions, healthcare organizations can access, discover, cleanse, integrate, and deliver all enterprise data to improve health outcomes, meet compliance mandates, streamline operations, increase agility, and refocus energy on the consumer. More than 4,100 companies worldwide and hundreds of healthcare companies rely on Informatica for their end-to-end enterprise data integration needs.

Ingenious Med

Booth 4663

Contact: Laura DePeters,Marketing Manager
laura.depeters@ingeniousmed.com
404.786.2340

Ingenious Med’s Inpatient Physician Management Platform is the leading charge capture and physician performance solution in the health care industry today. Our cloud-based, charge capture and analytics platform provides real-time data that helps hospital systems and physician groups maximize revenue, improve physician productivity, enhance quality of care, and increase diagnosis and billing accuracy and compliance.

Intelligent Medical Objects Inc.

Booth 1256

Contact: Dennis Carson, Director, Marketing & Tradeshows
dcarson@imo-online.com
636.477.8710

Interoperability For Healthcare Institutions IMO® Vocabulary products provide a common linkage across all electronic patient records, regardless of the standard needed for that particular data set (ICD9-CM, SNOMED® CT, HCPCS, RxNorm, ICD-10-CM). Most code mappings are updated several times per year, including regulatory updates. IMO® removes the burden of managing updates for you. Terminology Mapping For EMR Software Vendors IMO® Vocabulary products let you focus on what you do best: provide great software to the healthcare industry. We furnish up-to-date code and terminology mappings, with expanded search capabilities, across standards needed for EMRs, EHRs and PHRs (ICD9-CM, ICD10-CM, SNOMED® CT, HCPCS, RxNorm). Get ready for ICD-10 now!

Intellect Resources

To schedule a meeting:

Contact: Stowe Blankenship,Business Development Executive
336.790.8724 x 303
sblankenship@intellectresources.com
http://www.facebook.com/IntellectResourcesFan@wespeakHIT

We speak the language of Healthcare IT. Intellect Resources is proud to offer comprehensive consulting, recruiting and hiring solutions within the Healthcare IT market. Our talent offerings include recruiting, project management, implementation, upgrading and optimization of EMR systems, training and go-live support and the revolutionary Big BreakSM hiring process. Big BreakSM is patent-pending American Idol style audition process where candidates compete to become a healthcare IT trainer and instruct healthcare personnel on the use an EMR program. Big Break offers hospitals systems a unique and innovative talent pool at a fraction of the cost of traditional solutions.

For more information visit www.intellectresources.com or www.irbigbreak.com.

Intelligent InSites

Booths 12217, 12442-18

Contact: George Sun, VP of Sales
george.sun@intelligentinsites.com
972.567.2114

Intelligent InSites helps hospitals improve care and reduce costs by transforming automatically-collected data into actionable insights.Through its interoperable, hardware-agnostic, healthcare real-time location system (RTLS) software platform, Intelligent InSites gathers data from real-time location, condition sensing, and other systems; then delivers meaningful information to the right person, at the right time, on the right device.

By leveraging this real-time data and InSites’ applications, such as asset management, patient flow, temperature monitoring, and business intelligence, healthcare organizations are able to achieve meaningful and measurable hard-dollar cost savings while improving patient satisfaction and patient care. The InSites RTLS solution for Patient Flow enables hospitals to improve capacity management and key metrics such as Left Without Treatment (LWOT) and Length of Stay (LOS). It also improves rounding management, along with ED and OR workflow. With the InSites solution, hospitals can monitor patient flow and progress from admission to discharge, analyze throughput and proactively react to potential bottlenecks – all in real-time. The InSites RTLS solution for Asset Management enables hospitals to optimize equipment inventories and equipment procurement, as well as reduce rental expenses. By eliminating time needed to find available equipment, hospitals can increase value-added time for nursing staff, clinical engineering, and facilities management, leading to improved patient and staff satisfaction.The InSites Business Intelligence (BI) solution enables easy-to-use data mining of vast quantities of contextual data stored in the InSites Business Intelligence database, allowing healthcare users to analyze trends, identify process improvement opportunities, and report on Key Performance Indicators (KPIs). This enables hospitals and healthcare systems to achieve powerful and flexible enterprise-wide visibility into their processes and make transformational impacts on their organization’s performance.

iSirona

Booth 12414

Contact: Peter Witonsky,President & CSO
peter.witonsky@isirona.com
610.772.7648

iSirona helps clinicians make more informed decisions about patients by providing an easy to use approach to medical device integration. Using iSirona’s software solution, hospitals can connect virtually any medical device to their CIS, providing clinicians with faster access to more accurate patient information. In 2011, iSirona was ranked #1 by KLAS for medical device integration systems.

Levi, Ray and Shoup, Inc.

To schedule a meeting:

Contact: John Runions, Director, Worldwide Business Development / Alliances
john.runions@lrs.com
217-725-4017. John Runions

Does your hospital struggle with printing issues? For more than three decades, LRS has been helping hospitals meet the need for reliable document delivery of critical healthcare documents. LRS works directly with leading Electronic Medical Records (EMR) software providers to provide a seamless platform for assured delivery of any document from any system — to any destination in your environment. This all managed from a secure central point of control designed to save effort, money and time when seconds count.

Lifepoint Informatics

Booth 153

Contact: Lee Barnard, Chief Business Development Officer
lbarnard@lifepoint.com
201.560.3802

Lifepoint Informatics is a leader in health IT focusing on laboratory outreach connectivity, health information exchange and clinical data interoperability to deliver on its mission to help healthcare providers improve patient care and lower costs through the use of information technology. Since 1999, Lifepoint Informatics has enabled over 200 hospitals, clinical labs and anatomic pathology groups to grow their market share and extend their outreach programs through the deployment of its ONC-ATCB certified Web Provider Portal and its comprehensive portfolio of ready-to-go EMR/EHR interfaces.
For more Information please visit www.lifepoint.com.

Macadamian

To schedule a meeting:

Contact: Didier Thizy, Director of Healthcare IT
didier@macadamian.com
613.219.5708

Macadamian is a global UI design and software innovation studio with significant sector expertise in healthcare and life sciences. We work with Healthcare and medical device companies to create visually stunning, intuitive, and commercially-successful software products. We can help you transform your ideas into market-ready products that will stand out from your competition.

MED3OOO

To schedule a meeting:

Contact: Nicole Contardo, Corporate Marketing Director
Nicole_Contardo@MED3000.com
919.794.5881

Since its founding in 1995, MED3OOO has grown to become a leading provider of healthcare management, operations, and information technology services across the United States. With over 2,100 employees, MED3OOO provides sophisticated management services and innovative technology products which differentiate its physician, hospital, employer, government, and payer clients. The company provides a complete platform of clinical and business performance solutions, including PM, EHR, RCM, population health management, and smart communication systems, along with management, knowledge and operations, and affiliation strategies which help its clients improve clinical and financial outcomes. MED3OOO partners with organizations across the healthcare spectrum who truly understand that Outcomes Matter.

MedAptus

To schedule a meeting:

Contact: Jennifer Crowley, Marketing Director
jcrowley@medaptus.com
617.896.4099

MedAptus is the Gold Standard in the healthcare revenue cycle for achieving effective charge management, compliance and workflow efficiency. With our powerful and easy-to-use Intelligent Charge Capture, many of the nation’s most prestigious healthcare organizations rely on MedAptus for financial optimization. Our solutions increase revenue, enhance EMR investments, re-engineer manual processes and yield substantially improved productivity. For more information about how MedAptus can help you improve your financial performance while helping you prepare for ICD-10, visit www.medaptus.com.

Medicomp Systems

Booth 855

Contact: James Aita, Sr. Product Manager
jaita@medicomp.com
703.803.8080×221

Medicomp Systems innovates and continuously improves medical information technologies that provide clinicians with the power and freedom to focus on the patient. Medicomp’s EHR tools are dynamic and easy to use, based on the way clinicians think and work, and provide immediate access to the total patient picture. At the heart of every product is the powerful MEDCIN® Engine, a robust clinical data engine used by clinicians and hospitals throughout the world.

MEDSEEK

Booth 1345

Contact: Mandi Coker, Director, Corporate Marketing
mandi.coker@medseek.com
205.982.5821

MEDSEEK’s digital health solutions help healthcare organizations predict patient health requirements, plan capital investments, influence patient behavior, activate patients, expand business and manage patients across the continuum of care to find new cost savings and revenue streams. Find out how to strategically engage and manage your patients today – 888.MEDSEEK or sales@medseek.com.

MedVentive

Booth 6466-1, ACO Knowledge Center

Contact: Nancy Brown, Chief Growth Officer
nbrown@medventive.com
781.290.2511

MedVentive provides the tools and experience you need for two key issues faced in evolving into an ACO: understanding patient populations and being financially at risk for the quality and cost of care. MedVentive Population Manager provides the IT infrastructure needed to support FTC required Clinical Integration and overall population management. MedVentive Risk Manager provides the analytic platform to manage your multi-payer risk contracts.

Merge Healthcare

Booth 1023

Contact: Brenda Stewart, Director, Marketing Communications
brenda.stewart@merge.com
773.726.8901

Merge Healthcare is a leading provider of enterprise imaging and interoperability solutions. Merge solutions facilitate the sharing of images to create a more effective and efficient electronic healthcare experience for patients and physicians. Merge provides enterprise imaging solutions for radiology, cardiology, orthopaedics and eye care; a suite of products for clinical trials; software for financial and pre-surgical management, and applications that fuel the largest modality vendors in the world. Merge’s products have been used by healthcare providers, vendors and researchers worldwide to improve patient care for more than 20 years. This year, we are thrilled to showcase our comprehensive enterprise imaging solutions that allow you to image enable your EHR. You will also have the opportunity to register for FREE image sharing via our new cloud platform, Merge Honeycomb™, and learn how to earn Meaningful Use incentives with our specialty EHR solutions. Additional information can be found at www.merge.com.

MyHealthDIRECT

To schedule a meeting:

Contact: Zac Fritz, SVP of Sales and Marketing
zfritz@myhealthdirect.com
262.309.2090

MyHealthDIRECT provides the nation’s only ‘healthcare scheduling exchange’ (HSE) for health plans, hospitals, health systems, ACOs and HIEs.Their SaaS-platform is proven “commercial-grade” and “enterprise-ready” and is scalable, flexible, and secure. The MyHealthDIRECT HSE-platform is the industry’s only technology with proven application across the entire care continuum: from care coordination efforts and call centers to mHealth initiatives or Direct-to-Consumer (D2C) strategies and ACO referral management. MyHealthDIRECT: The nation’s only ‘healthcare scheduling exchange’.

NextGate

Booth 7000

Contact: Richard Garcia, VP Marketing
richard.garcia@nextgate.com
626.262.4010

Information is good. Knowledge is better! The NextGate® Registry Suite for Healthcare goes beyond standard integration to satisfy today’s intricate, multi-entity healthcare data exchange requirements. HIEs, ACOs, IDNs and similar organizations need a dynamic, sophisticated framework to coordinate information from diverse sources to support coherent and meaningful data exchange. The registry suite uses the leading MatchMetrix® data integration platform to analyze and integrate the different data elements of a complex activity, promoting greater efficiency and insight. The suite includes an EMPI, Provider Registry and Directory, Location Registry, Activity Registry, Code Set Registry, Enterprise Transaction Registry, and a Relation service to define associations between objects. With over 75 million unique identities managed by MatchMetrix and hundreds of registry implementations, NextGate offers unequalled expertise in deploying master index and data integration solutions. Be certain about the data you exchange!

Nordic Consulting Partners, Inc.

To schedule a meeting:

Contact: Drew Madden, President
drew.madden@nordicwi.com
608.268.6900

Nordic was founded by former Epic consultants, and is the largest Epic-only implementation firm in the country.We focus exclusively on Epic software implementations. We’re located in Madison, WI, home to Epic Systems, Inc., which gives us access to some of the top EMR experts in the industry. Our team of senior consultants average 6-year of Epic implementation experience; 80% are former Epic employees with an average of four certifications each. They’re seasoned professionals who have worked with hundreds of hospitals and clinics nationwide. Whether you need help with a short-term project, or a team of consultants to oversee implementation from start to finish, our staff will be valuable members of your team.Nordic works with healthcare organizations in 14 states, with clients that include Children’s hospitals, University hospitals and community healthcare providers of all sizes. We understand their dedication to patient care and the high standards their EMR projects must meet. Nordic will help you build the right team for your organization.

NTT DATA Healthcare Technologies (formerly Keane)

Booth 3064

Contact: Larry Kaiser, Senior Marketing Manager
lkaiser@keane.com
631.824.5318

In business since 1975 and based in the United States, NTT Data Healthcare Technologies offers complete IT solutions to hospitals and long-term care facilities throughout the country. NTT DATA’s proprietary software and services help health organizations increase efficiency, reduce medical errors, meet regulatory requirements, and enhance the revenue cycle. An electronic health record (EHR) solution, the Optimum suite of fully integrated certified clinical applications helps hospitals and healthcare facilities reduce medical errors, increase efficiency, and improve the delivery of care.

Stop by for a cup of cappuccino and find out how NTT DATA Healthcare Technologies can help you today.

Nuance Communications, Inc.

Booth 3523

Contact: Mark Erwich, Senior Director, Marketing
mark.erwich@nuance.com
781.565.5000

Nuance Healthcare, a division of Nuance Communications, is a market leader in providing clinical understanding solutions that accurately capture and transform the patient story into meaningful, actionable information. Thousands of hospitals, providers and payers worldwide trust Nuance voice-enabled clinical documentation and analytics solutions to facilitate smarter, more efficient decisions across the healthcare enterprise. These solutions are proven to increase clinician satisfaction and HIT adoption, supporting organizations to achieve Meaningful Use of EHR systems and transform to the accountable care model. Recognized as “Best-in-KLAS” 2004-2011 for Voice Recognition we invite you to learn more at booth #3523.

Orchestrate Healthcare

Booth 4269

Contact: Charlie Cook, President
charlie@orchestratehealthcare.com
970.963.0251

Orchestrate Healthcare won the 2011 Best in KLAS – Technical Services award. Come speak with us about why our KLAS score keeps rising every year and why we continue to win Best in KLAS awards. Orchestrate Healthcare was founded on the principals of: honesty, integrity and hard work.These key principals have lead to triple-digit growth since day one. Orchestrate Healthcare has also had tremendous success with our client feedback to KLAS Research. Orchestrate Healthcare won Best in KLAS – Technical Services in 2008. In 2009, we improved our KLAS score by a full point over our 2008 score, and placed 2nd in the 2009 Best in KLAS – Technical Services category. In 2010, Orchestrate Healthcare again increased our KLAS score to 94.2, but took 2nd place by 1/10th of a point. In 2011, we increased our score to 96.4 and won Best in KLAS – Technical Services for the 2nd time in the last 4 years. Out of 19 companies in the KLAS Technical Services category, Orchestrate Healthcare is the ONLY company to have 100% positive client commentary for the past 24 months. Orchestrate Healthcare has a philosophy of “do what’s right for the client” every day, and the management of the company stands behind you to do whatever it takes to exceed the client’s expectations.The KLAS scores and all the positive client commentary reflect that commitment to quality.

PatientKeeper Inc.

Booth 1045
Mobile Health Knowledge Center booth 12928

Contact: Cristina Christy,Senior Events Manager
cchristy@patientkeeper.com
781.373.6378

PatientKeeper® Inc., the leading provider of physician healthcare information systems, offers hospitals and practice groups highly intuitive software that streamlines physician workflow to improve productivity and patient care. PatientKeeper’s CPOE, physician documentation, electronic charge capture and other applications are used by over 40,000 physicians nationwide, and run on desktop and laptop computers and popular handheld devices and tablets. PatientKeeper’s software integrates with existing healthcare information systems at hospitals and practice groups to create the most effective solution for driving physician adoption of technology, meeting Meaningful Use and transitioning to ICD-10. (www.patientkeeper.com; Twitter: @patientkeeper)

Practice Fusion

Booth 4074

Contact: Kimberly Okazaki, Marketing Coordinator
kokazaki@practicefusion.com
415.992.6462

Practice Fusion provides a free, web-based Electronic Health Record (EHR) system to physicians.With charting, scheduling, e-prescribing (eRx), lab integrations, referral letters, Meaningful Use certification, unlimited support and a Personal Health Record for patients, Practice Fusion’s EHR addresses the complex needs of today’s healthcare providers and disrupts the health IT status quo. Practice Fusion is the fastest growing EHR community in the country with more than 130,000 users serving 30 million patients. The company closed a $23 million Series B round of financing led by Founders Fund in 2011. For more information about Practice Fusion, please visit www.practicefusion.com.

Quality IT Partners, Inc.

To schedule a meeting:

Contact: Donna Eversole, MBA, BSN, RN, CPHIMS, Director Healthcare Practice
deversole@qitp.com
904.610.7933

Quality is a hands-on, technology-driven consulting company. We assist healthcare organizations with complete end-to-end systems planning, acquisition, customization, implementation and maintenance including technical and operational support. We specialize in assisting clients in transitioning from dated, expensive legacy technologies to modern, cost-effective solutions using leading-edge implementation practices. Our implementation professionals are experienced clinicians and financial consultants and have experience with all major HIS vendors. We view each assignment as an opportunity to transfer our knowledge and experiences to our clients’ staff.

Shareable Ink

Booth 7100

Contact: Suzanne Cogan, Vice President, Sales and Marketing
scogan@shareableink.com
877.572.7423 x802

Shareable Ink is the enterprise cloud-based platform that incorporates natural input tools, including iPads and digital pen and paper technology. Clinicians can continue documenting in the fastest, most efficient manner. The resulting structured and clinically-encoded output populates the EHR with discrete data, as if typed in directly. Built-in analytics give hospitals and practices insight into their operations – from a clinical, quality, and efficiency standpoint.

Information Week recently named Shareable Ink one of 12 EHR vendors that “stand out” – out of 1,300 Meaningful Use-certified systems. Visit us at HIMSS for an interactive demo featuring our Physician Progress Notes with Charge Capture and Patient History & Signature Capture solutions. We’ll also have a special unveiling of our iPad App – you won’t want to miss it! For everyone who mentions ‘DOCTOR’ at our booth, we’ll be making a donation to one of our favorite charities, Doctors without Borders.

SRSsoft

Booth 12721

Contact: Evan Steele, CEO
esteele@srssoft.com
800.288.8369

SRS is the leading provider of productivity-enhancing EHR technology and services for high-performance physicians—with a successful adoption rate unparalleled in the industry. Offered via the Unified Desktop™, the robust EHR, SRS CareTracker PM, SRS PACS, and SRS Patient Portal increase speed, boost revenue, free physicians’ time, and heighten patient care and satisfaction. For more information on SRS, visit www.srssoft.com, e-mail info@srssoft.com, fax 201.802.1301, or call 800.288.8369.

Software Testing Solutions

To schedule a meeting:

Contact: Maegan Scarlett, Marketing Specialist
himss@sts-healthcare.com
877.765.0100 ext. 1

You’re not still running those old terminal based legacy applications in your institution for CPOE, lab, blood bank and anatomic pathology – so why are you still testing them the same way? Now you can achieve a predictable time, cost and quality for your upgrades. Software Testing Solutions’ (STS) innovative automated testing & validation products for hospital software systems including Epic, Sunquest and SCC Soft, deliver exhaustive testing quickly and efficiently, saving time & money while reducing risk, increasing patient safety and ensuring regulatory compliance. Contact us today for more information.

Streamline Health

Booth 2058

Contact: Rick Leach, Senior Vice President and Chief Marketing Officer
rick.leach@streamlinehealth.net
513.794.7112

Streamline Health provides healthcare information technology solutions that help hospitals and physician groups improve efficiencies and business processes across the enterprise to enhance and protect the revenues. Our enterprise content management solutions transform unstructured data into digital assets that seamlessly integrate with disparate clinical, administrative, and financial information systems. Our business analytics solutions provide real-time access to key performance metrics that enable healthcare organizations to identify and manage opportunities to maximize their financial performance. Our integrated workflow systems automate and manage critical business activities to improve organizational accountability to drive both operational and financial performance. For more information visit www.streamlinehealth.net.

Sunquest Information Systems, Inc.

Booth 423

Contact: Kymberly Calvo,Marketing Communications Specialist
kymberly.calvo@sunquestinfo.com
408.702.1151

Sunquest Information Systems is committed to patient safety, workflow excellence, predictive medicine, and physician & patient affinity. Utilizing this dedication, Sunquest proudly offers global diagnostic IT solutions that transform the delivery of healthcare for more than 1,400 organizations and 380,000 users worldwide. Come by Booth 423 and discover the value Sunquest’s products deliver to our clients every day. Experience Sunquest’s community-based outreach tour featuring our fully integrated suite of products built on technology that enables and supports business growth and operational efficiency. Sunquest’s closed-loop collection and transfusion management tour will highlight solutions designed to virtually eliminate patient identification, labeling and transfusion errors at the bedside, in the ED or in the surgical suite. Sunquest is your path to the heart of healthcare.

Surgical Information Systems

Booth 1339
Allscripts Booth 3016
Siemens Booth 2423
Interoperability Showcase Booth 11000, Hall G

Contact: Emmy Weber, VP of Marketing
weber@sisfirst.com
678.507.1706

Surgical Information Systems (“SIS”) provides software solutions that are uniquely designed to add value at every point of the perioperative process. Developed specifically for the complex surgical environment, all SIS solutions – including anesthesia – are architected on a single database and integrate easily with other hospital systems. SIS offers the only surgical scheduling system and the only anesthesia information management system endorsed by the American Hospital Association (AHA), and both a rules-based charging system and analytics module that has been granted Peer Reviewed status by the Healthcare Financial Management Association (HFMA). Visit SIS at HIMSS12 to see the latest in perioperative IT including anesthesia, patient tracking and analytics modules.

Transcend Services and Salar

Booth 4674

Contact: Donna Rhines, Director of Marketing
donna.rhines@trcr.com
678.808.0680

Transcend/Salar delivers clinical documentation solutions that are flexible to fit the needs of our clients. We offer the industry’s only physician-centric, single-source solution for advanced electronic clinical documentation. Our full spectrum of services and products include: full- to partial-outsourced transcription services, a world-class transcription platform, dynamic clinical documentation templates and physician charge capture.

Transcend/Salar products have highly-customizable physician interfaces that integrate easily with existing electronic medical record systems. Clients that utilize Transcend experience increased physician adoption through flexible solutions that fit the physician workflow. With Transcend/Salar, physicians and hospitals alike achieve notable productivity, financial and patient safety improvements. Encore™, Transcend’s powerful backend speech recognition transcription platform and Salar’s transformational, physician-centric, inpatient documentation and billing products (TeamNotes™, TeamRelay™, TeamQuery™ and TAP Charge Capture™). Experience a demo or a presentation and see how you can benefit.

Substantial cost savings
Improved efficiency and significant productivity increases
Expedited physician workflow and optimized physician billing
Real-time physician query and concurrent documentation review + Increased inpatient revenue
Meaningful Use Stage 1 certification

Trustwave

Booth: 8805

Contact: Dan Kunkel, Healthcare Solutions
jvickery@trustwave.com
312.873.7659

Trustwave is a leading provider of information security and compliance management solutions to businesses and government entities throughout the world. Trustwave provides a unique approach with comprehensive solutions such as the award-winning TrustKeeper® and other proprietary security solutions including SIEM, WAF, EV SSL certificates and secure digital certificates. Specifically for hospitals, IDNs, insurers and physicians, Trustwave Healthcare Solutions offer customizable data protection, and help safeguard PHI and address HIPAA requirements. For more information, visit www.trustwave.com/healthcare.

T-System

Booth 4012

Contact: Ann Baty,Senior Marketing Coordinator
abaty@tsystem.com
469.791.2445

T-System, Inc. sets the industry standard for clinical, business and IT solutions for emergency medicine, with approximately 40 percent of the nation’s emergency departments using T-System solutions.To meet the individual needs of hospitals, T-System offers both paper and electronic systems. These tools help clinicians provide better patient care, while improving efficiency and the bottom line. Today, more than 1,700 emergency departments rely on T-System’s gold-standard content and workflow solutions. For more information, visit www.tsystem.com. Follow T-System on Twitter (@TSystem) and like T-System on Facebook.

Stop by our “virtual” emergency department at Booth 4012 to see and try our solutions in action. Find out how The T SystemEV has helped more than 42 hospitals attest to Stage 1 Meaningful Use. Learn about how our new revenue cycle management services can boost your bottom line. Document a patient encounter with DigitalShare and T Sheets or try T-System clinical decision support. Answer a question about Continuity, our new ACO solution, for a chance to win an iPad 2.

We will also be demonstrating at the Interoperability Showcase (Hall G, Booth #11000) how the emergency department might contribute information that would enable a smoother transition of care. T-System Vice President of Solution Development Bill Hall will give a presentation, “Interoperability and the ED: Replacing Care Transactions with Transitions,” at the Showcase on Tuesday at 1:15 p.m. Additionally, two T-System clients will be presenting the senior executive session, “Emergency Medicine EHR Helps Drive Meaningful Use Readiness” on Tuesday at 11 a.m. in Marcello 4506. To learn more about these presentations and our industry leading ED solutions, visit us at Booth 4012.

Versus Technology

Booth 5852

Contact: Stephanie Bertschy, Director of Marketing
skb@versustech.com
231-946-5868

Versus gives healthcare institutions the power to locate patients, staff and equipment in real-time, and automate a multitude of clinical tasks. The result: optimized workflow, improved patient care and streamlined processes that set a higher standard in healthcare. Since 1988, hundreds of hospitals have strengthened performance with Versus locating advantages.

Virtelligence Consulting

Booth 720

Contact: JoAnn Simon, Vice President
jsimon@virtelligence.com
952.548.6611

Founded in 1998, Virtelligence is a privately held premier Healthcare IT consulting firm that offers solution advisory and Healthcare IT consulting services to payers, providers, and life science organizations nationwide. In today’s competitive Healthcare IT marketplace Virtelligence stands as one of the most trusted Consulting partners in the industry. Our success comes from a solid understanding of our client’s business and access to the best Healthcare IT resources available. Our personalized approach has given us the competitive edge in providing innovative advice and world-class service to our clients.

Vitalize Consulting Solutions, an SAIC company

Booth 3338

Contact: Cyndi Cahill, SVP Marketing and Sales Support
ccahill@getvitalized.com
610.444.1233

Vitalize Consulting Solutions, an SAIC company (VCS) provides diversified clinical, business, and IT solutions for healthcare enterprises nationwide and in Canada. VCS’ comprehensive programs and services lineup includes system implementation, integration, optimization, project management, custom reporting, education, and knowledge transfer expertise. To facilitate clients’ strategic IT initiatives, our consultants first listen to, then advise, and ultimately strengthen their customers’ IT team. Primarily engaged with Allscripts™, Cerner, Epic, McKesson, MEDITECH and Siemens users, and the Ambulatory and Practice Management arenas, VCS cultivates enduring relationships by supplying experienced professionals who consistently exceed clients’ expectations. Since being acquired by Science Applications International Corporation (SAIC) in August 2011, VCS is now able to provide expanded service lines to its current and future clients, ultimately strengthening our solutions. Please visit us at www.getvitalized.com for more information.

Vocera Communications, Inc.

Booth 2245
HIMSS Interoperability Showcase

Contact: Diana Cropley, Marketing
info@vocera.com
800.331.6356

Vocera provides mobile communication solutions focused on addressing critical communication challenges facing hospitals today. We help our customers improve patient safety and satisfaction, and increase hospital efficiency and productivity through our Voice Communication, Secure Messaging, and Care Transition solutions. Exclusively endorsed by the American Hospital Association, the Vocera solutions are installed in more than 800 hospitals and healthcare facilities worldwide.

Winthrop Resources

To schedule a meeting:

Contact: Dan Many, Director of Business Development
dmandy@winthropresources.com
952.656.7687

Winthrop provides custom technology leasing solutions allowing hospitals to remain independent of technology providers, to refresh technology when needed, and to preserve cash. We believe that spending cash or bank financing to buy technology assets doesn’t make sense since those assets lose value quickly, require increasing expense to keep running, and need to be upgraded and changed to support organizational goals and regulatory requirements.

ZirMed

Booth 3638

Contact: Kent Rowe, VP Sales
sales@zirmed.com
877.494.1032

We’re ZirMed, a leading provider of healthcare revenue cycle technology and information solutions. Serving 113,000 healthcare providers across all care settings who in turn provide services to more than 1 in every 10 Americans, we are a nationally recognized leader in understanding the flow of money and information in healthcare. Addressing the entire revenue cycle, our offerings include eligibility verification, claims management, patient payment estimation, patient payment processing, online bill pay, online and offline statement delivery, innovative lockbox services, analytics, coding compliance, and more. Delivered via a SaaS model, our solutions are compatible with any industry standard Healthcare Information or Practice Management System, and can be used directly within the ZirMed domain or embedded within partner software applications. ZirMed received a “Best in KLAS” ranking for 2011 from independent healthcare IT research firm KLAS, and ranked #1 in overall satisfaction three years in a row. For more information about how our solutions simplify the complexities of payments for providers and patients visit www.zirmed.com.

2 Comments

Time Capsule: Why You Should Root for Cerner, Even if you Hate Them

February 10, 2012 Time Capsule 1 Comment

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 February 2007.

Why You Should Root for Cerner, Even if you Hate Them
By Mr. HIStalk

Cerner announced fourth-quarter earnings of 48 cents a share last week, handily beating last year’s Q4 profits of 34 cents despite sales growth of “only” 17%. That met analysts’ expectations exactly. Even then, the stock shot up nicely. Neal Patterson now has nearly $300 million worth. Nice.

Plenty of people dislike Cerner or its products. Many are competitors envious of their growth or market capitalization. Some don’t like the company’s brashness or its ready-fire-aim product development tendencies.

Even those folks should relish Cerner’s stock performance. In an age of multi-national, multi-industry conglomerates dabbling half-heartedly in healthcare IT, Cerner is one of the few pure plays left. For that reason, their stock is a proxy for the entire industry and our future employment prospects in it.

OK, just between us girls, how is Cerner doing?

Cerner’s most important customer — Wall Street — is fickle. Cerner is a relatively small and narrowly focused company. Continuously increasing profits are required to keep the stock afloat. Once you lose investors and analysts by disappointing them with a slowdown, it’s almost impossible to drag them back.

Signs suggest that Cerner is about to hit an earnings growth wall. The big bubble in hospital clinical systems, their bread and butter, appears to be slowing. Everybody’s installing all the systems they bought and can’t afford to replace for 7-10 years. That’s a nice, steadily profitable business, but it can’t fuel a stock that arouses investors.

Another chink in their armor is Epic Systems. Big hospital selections nearly always involve Cerner and Epic as finalists. In most cases I’ve heard of lately, Epic wins. Few would have expected that back in 2002 or so, when Epic suddenly roared out of the ambulatory systems market with a vengeance, much like Cerner exploded out of its lab system roots to dominate the world (at least just behind Meditech.)

It seems to me that Cerner’s aggressiveness in selling not-quite-ready systems has cost them some reputation points. ProFit financial system problems and rumblings of system performance issues and stalled implementations haven’t helped.

Still, for a company whose products are generally KLAS mid-packers, Cerner sets the standard for broad product lines, a razor-sharp healthcare focus, and outstanding management that skillfully meets Wall Street’s expectations every time (which is nearly unheard of in healthcare and is a core competency that should not be trivialized.)

Cerner’s management is smart. They’re spending their expansion and acquisition dollars on life sciences, non-US healthcare IT, and downstream automation development such as medication dispensing cabinets. Diversification into high-growth areas is good and their rich market capitalization pays for it.

None of this should alarm customers or prospects. Skilled management means that Cerner will either find a way to beat earnings expectations or they’ll sell out to a larger competitor.

(That particular rumor won’t die, of course. Even though GE says they’re finished with acquisitions for awhile, few would be surprised if they picked up Cerner with their spare change. Based on GE’s track record, however, only Epic and McKesson would be cheering. Cerner’s customers and employees would not be nearly as elated.)

Cerner steps on toes, but we need them to succeed. We have darned few vendors already, fewer still that write and install their own systems instead of re-labeling someone else’s, and fewer again who focus on healthcare and keep a lot of healthcare people like you and me productively employed.

I want Cerner to grow. I want them to compete aggressively and win frequently. I want Neal Patterson to keep right on being Neal Patterson, a pig farmer turned Wall Street darling SOB who bootstrapped Cerner out of nothingness and runs it however he damned well pleases, the antithesis of button-down interchangeable bankers-turned-CEOs who manage companies they don’t own as dispassionately as a mutual fund.

If Cerner is neutered one way or another, our industry will be just as boring as it was before they elbowed their way into the limelight. I enjoy trashing them as much as the next person, but I’m secretly rooting for them.

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HIStalk Interviews Richard Cramer, Chief Healthcare Strategist, Informatica

February 10, 2012 Interviews 1 Comment

Richard Cramer is chief healthcare strategist for Informatica of Redwood City, CA.

Give me some background about yourself and about Informatica.

I am Informatica’s chief healthcare strategist. I’ve been on board about 10 months now. Formerly I was the associate CIO for operations and health exchange at UMass Memorial Healthcare in beautiful Worcester, Mass. I was there for a little over two years. I spent the prior 10 years in the software business doing strategy and marketing for software companies, healthcare, and whatnot. I ran a corporate and industry marketing for SeeBeyond for four and a half years.

Before that, I was the director of applications development at the University of Pennsylvania Health System. I’ve been on the provider side and the vendor side, back and forth, over the course of the last 15 years. I’m now pretty excited to see where healthcare is. I’ve waited 15 years for healthcare IT to finally to be cool.

Informatica was founded in 1993. It spent probably the first 10 or 11 years establishing a dominant place in the extract transform load marketplace, supporting data warehousing. We brought in a new CEO from Oracle in 2004, Sohaib Abbasi. Over the course of the last eight or nine years, we have branched out from our core beginnings in extract transform load to being what we say now is the leading independent data integration vendor in the marketplace. We moved from simply doing batch loads into data warehouses to including data quality, real-time transformation, business-to-business, master data management, archiving, and a whole slew of other things.

In its current incarnation, Informatica is a comprehensive data integration vendor with a horizontal focus to date, with 4,200 customers or so. Eighty-four of the Fortune 100 use our solutions in various capacities. Even though we’re relatively new to having a dedicated team focused on healthcare, we’ve got well over 100 healthcare enterprises that are Informatica customers, but have acquired our solutions by virtue of looking for technology and licensing Informatica as much as us having a dedicated focus on the healthcare market, which is really new in the last year.

When you look at healthcare specifically, who would you say are your main competitors?

Looking at healthcare specifically, our main competitor — and it’s not just healthcare specifically — is IBM. If you look at the suite of products that we have and the nature of those products, really the only big competitor we have for ETL or any of those is IBM at an enterprise level. That certainly became even more true when IBM acquired Initiate and brought them into the IBM master data management family. That’s our primary competitor.

We do run across organizations that are very much SQL Server shops and use the Microsoft stack, but those tend to be the smaller organizations, or we tend to be talking to people that have been using that and now see that they need something a bit more powerful, and then it’s really us or IBM.

Healthcare hasn’t been very fastidious about creating and managing information that could be valuable for managing outcomes, costs, and risks. A lot of times the best data anybody has is claims data, which is like a manufacturer trying to run a business using only information from its invoicing system. When you look at all the proprietary systems that are creating and consuming data oblivious to all the others that might need that data, do you think there is any chance all this can get resolved in a way that will allow healthcare organizations to meet healthcare quality and cost expectations?

I could not have described to you more or better why I joined Informatica. I absolutely think that’s going to happen in healthcare, and I absolutely think that Informatica has the platform required to achieve that.

I’ve been in the software vendor side long enough to know that you don’t go to a horizontal technology company and say, “You’ve got to build a bunch of healthcare-specific applications if we’re going to sell anything into the healthcare market.” The fact is that healthcare has finally woken up to the value of the data that they’re going to have. I don’t really think it matters what your political persuasion may or may not be. What the Obama administration did with HITECH and Meaningful Use is to finally get providers to adapt electronic health records. Finally we have the data available to do cool stuff with.

Meaningful Use is a useful microcosm of what’s going to happen on a much grander scale for healthcare data, because Meaningful Use really is nothing more than a data quality standard mandated by the government. They say, “Here are the data elements you have to collect. Here is the format you must collect them in. Here is who must enter those data elements. Here are the relationships between those data elements.“

By doing that, just in that one small section of the data that’s really available, what the government did is say, “Here is going to be high quality data.” What we see in healthcare organizations that previously have never done anything that resembled a quality report or a physician comparison report because the data was never accurate enough. What happens when you have bad quality data? You don’t share it, because you get eviscerated for the data being bad.

Even the most conservative provider organizations — because the Meaningful Use data that they’ve created is pretty good — are publishing those reports for all physicians to see, because the data is actually trustworthy. It is an interesting example of how high quality data in a clinical information system gets democratized because it is high quality.

EHRs are exciting because they actually collect data, not because they replace paper. Once that data is available and accessible, taking techniques and tools and things that were groomed over the past decade following SAP implementation for Y2K and using those to make high-quality, trustworthy data from healthcare systems is the whole opportunity, I think.

You mentioned that Informatica offers the platform, but unlike your previous employers that were really about the nuts and bolts and bits and bytes of moving data back and forth, is there some organizational commitment and expertise of being stewards of that data more than just moving it around electronically?

Yes, exactly. That is a very good counterpoint that if you look and you say, “Healthcare enterprises had been using interface engines for decades.” Healthcare was actually at the forefront of adapting real-time interface technology. It was great at shifting data from one system to the other. For HL7, when is a standard so flexible that it’s not a standard? I don’t know that anybody has any real sense of the data quality problems that exist within those real-time messages, but it worked adequately.

If you look at the larger data integration challenge, though, not all of the data we care about in an analytical context is exposed through an HL7 message. We do HL7 messaging just fine. All of the libraries are supported, and it’s actually relatively easy to do HL7 when you do everything else. But also having the option to say, “I can go directly against the database and pull the data out of the database en masse after profiling it to ensure the quality and all of those sophisticated tools.”

Part of the challenge is we’ve got new electronic systems, but not all of them were designed to even have the triggers within the application to expose the data outbound. We were an Allscripts Enterprise shop when I was at UMass, and three years ago, Allscripts didn’t send any transactions out of Allscripts Enterprise. They just had never considered that their EMR was actually going to be a source of data to other people. I mean, shockingly. A fine company, no complaints about them because I think they are representative on a lot of the thinking three, five years ago. We’ve got a whole series of older clinical applications where they didn’t even have the event model to send data out on HL7 messages.

Being able to connect directly to those databases and those applications and get data out other ways — when it changes in the database, send it out — is the big part of the story. Then the data quality component that says, “How do I do the profiling and the rules-based cleanup and all of those things to make sure that the data that we are transacting and we are getting from one system and moving to another and moving to a database or a data warehouse is of high quality every single time?”

The last component is the idea of master data management. Healthcare providers and even healthcare payers have been very familiar with enterprise master patient indexes. If you said master data management to a provider IT person, they might not be that familiar with it. They absolutely know what an enterprise master patient index is.

Our particular solution for master data management says if you can model the data, we can manage it as master data. If you look at other people, they built very traditional vertical applications on top of a specific domain, like “patient” or a specific domain like “provider.” We think that patient and provider is not adequate in terms of managing of master data in the future. You need patient, provider, organization, health plan, physical location, and a whole slew of different things. More importantly, you also need to manage the relationship between the element as master data.

For example, it’s not enough to know that Richard Cramer is a unique patient and Bob Smith is a unique doctor. We think that it’s important to know that Richard Cramer has Bob Smith as my primary care physician. That relationship data is as dirty as any other data in the enterprise. Being able to do a traditional master data management things where you say, “I’m going to automatically reconcile relationships where I can. Where I can’t automatically reconcile, I’m going to put it in a task list and a data steward is going to look at it and they are going to manually resolve it just like you would patient or provider identity,” we think is key.

The whole idea of pervasive data quality is a key part of what we think is going to be a huge enabler to the healthcare analytics and the data decade in healthcare, as I like to call it.

When you look at your previous career as well as where healthcare evolved from, do you think interface engines have made us complacent about standards and metadata?

I think they did. I think that interface engines allowed us the luxury of sharing data very easily between applications in a transaction-by-transaction way. One of the beauties of coming from the ETL world is that when you’re moving data en masse from one place to another, you have the great luxury of, “Wow, I’m going to move 400 million rows. Let me profile it and look at all of it in its entirety before I move it.” You really get a data quality bent about you starting from ETL.

With real-time interface engines, particularly since HL7 was so flexible and all of the different applications interpreted what an individual field meant in Z-Segments and all of that, you were driven to an approach that said, “When I’ve integrated to one Cerner Millennium, I’ve integrated to one Cerner Millennium.” You looked at it not only at an individual system-to-system level, but you looked at it at an individual transaction level. I worked in my interface engine until it passed the edits to be accepted by the target system. It was a very different style of work when you were focused on passing transactions as opposed to looking at the data in aggregate.

People are trying to exchange data, not just internally, but outside the four walls. Is that raising the bar for people to produce better quality data, or does that just make it obvious that we’re nowhere near where we need to be when it comes to being ready to exchange patient information meaningfully?

I think it’s the latter. I hope it’s going to move to being the former. All of those same problems that you have integrating and sharing data within the four walls — different formats, different standards, and questionable data quality — become much more complicated.

The data is much more fragmented when you try and go between organizations. I think that’s why you see so few organizations actually exchanging discrete data. They tend to exchange paper documents or a document like a CCD, but they don’t standardize the nomenclature in it, so you don’t consume the data into a receiving application through most HIEs yet. It’s all driven by the exact issue that you just raised.

If we wanted to share Meaningful Use data — and I think there is some hope that for the subset of the CCD that needs to be interoperable — I think there will be some real success in sharing that, again, because the data is high quality and trusted.

With HL7 interfaces, provider organizations had to figure out their own solutions and their interfaces really weren’t very transportable. In the case of general data exchange, does patient data need new standards and requirements, or will every provider have to figure it out for themselves?

I think there will be new standards, or there will be an adoption of some standards, with HITECH and Meaningful Use really defining the nomenclature that systems need to exchange data. I think it really was the varied nomenclature within the actual segments of a message that caused so much problems. You know the RxNorm versus the MEDCIN versus the whatever for prescription drugs.

The structural differences in the message are very easily handled. The nomenclature things are very difficult to handle. From an exchange perspective, I think that’s going to help us a great deal. I think I have a great deal of enthusiasm for the CCD being a very good start to interoperability. Certainly it is not all inclusive and complete, but if we can get to the point where we can exchange the CCD, we will have fixed enough problems that exchanging more stuff after that will be easier.

The other piece that’s challenging and an example from my former life is the actual data elements within the applications. This speaks to the whole governance issue within the enterprise, because it’s not just the transaction. If you look at any enterprise system within a health system that’s been around for any period of time, people are misusing the data fields that are in the application to support other purposes that were never intended.

In a perfect example at UMass, in the registration record, there is a time stamp field. You’re going to do quality studies that look at the amount of time it takes from the time a patient is registered until they’re admitted to the floor. You go in and you try and do a report, because there’s a time stamp field in the application. One of the organizations did that report. They spent weeks and weeks, they ran the report, they looked at the results, and said, “Wow, these results make absolutely no sense.” They looked at the data in the time stamp field and said, “That doesn’t look like time.” They talked to the registrars in the emergency department and, lo and behold, they were putting the license plate number of the patient’s car in the time stamp field so the valets could find it.

It’s scary that they could even access a time stamp field.

In a lot of old applications, it’s a character-based field. Nobody was using it for anything else and there was no governance to enforce it, so somebody probably put in a request and said, “Hey, relax the edits on this field because I want to do this with it.” Ten years ago, it probably seemed a good idea, and off it went.

Those examples are rampant within every application that’s out there. Even if you have an HL7 message that’s drawing from the fields within the application, if you haven’t done a good enterprise data governance program and you haven’t inspected all of those applications and have good metadata management and data stewardship, you’re going to constantly run across those particular kinds of issues.

Data quality is about making the simple questions simple to answer. If every time you go to use a data element in an application, you have to go through an enormously laborious effort to confirm that it’s reliable. You have to clean it up, and you do it just for that one project or that one thing. You can’t do even simple questions, much less talk about all of the exciting things that we can do with the data.

From my perspective, one of the most least-appreciated challenges in healthcare is to get to what you started, which is: are we ever going to get to where we used the data to profile quality, identify best practices, and improve value? I genuinely believe we are, but the least-appreciated thing to get us there, I believe, is data quality.

You mentioned the responsibility to manage the data and understand how it’s being used. Who would do that in a typical hospital and under whose governance?

Today, the responsibility doesn’t exist. I think other industries have seen that to do data governance, it needs to be an enterprise initiative with a broad membership and very strong leadership that reports high in the organization. In a healthcare provider organization, by and large those organizations don’t exist. People who have an EMPI have traditionally put data stewardship in the HIM group. That’s fine for patient identity. It’s not fine for all the other data elements.

Payers tend to be ahead of providers in this and have really have stood up an executive level data governance and data stewardship function because that’s the only way to do it. It has to be an enterprise initiative. It has to be senior people. It has to have the highest level of support in the organization, and that doesn’t exist. I have not seen a provider system that does it well yet.

Are hospital data projects strategic enough to merit the funding and effort it would require to do it right?

Not yet, but they have to be. I think part of this is the evolution that says, when the only data you have to work with is claims data, for all the reasons that you said, you’re only going to be able to do so much with it. You’re only going to make so much of an investment and you’re not going to get a lot of horsepower out of it.

Now that we’ve got the keys to the kingdom being captured and generated in those EHRs, the stakeholders — the clinicians who we’ve pounded on for years to say, “Hey, you need to do this” – they’re going to say, “I’m doing your data entry for you at great personal expense of my own. Now I want some results from it.” The providers and the business are going to raise the visibility and say, “We’ve invested all this time and effort in our EHRs and our new financial systems and everything — we want to get some value out of it.” The only way they’re going to get value out of it is to elevate data governance to where it needs to be and invest in getting value from the data. If all we do as a healthcare industry is replace paper with electrons by doing EHRs, we will have failed miserably.

Any concluding thoughts?

An interesting topic for the future is the field of complex event processing. It started in the intelligence business to correlate all of these disconnected events against different data streams to be able to draw a conclusion and give alerts to people that, “Hey, you ought to probably be looking at people taking flying lessons and not caring about whether they know how to land or not.”

I see that there is a big opportunity for complex event processing in the healthcare market. Part of it is driven by our historical success with real-time messaging, because if you look and you say, “Healthcare is going to follow the same dynamic as the rest of industries did when they replaced all their ERP systems for Y2K,” then there was huge renaissance and blooming of analytics and data warehousing and driving value from now all that rich supply chain data they had.

Healthcare is going to follow the same thing on the backs of HER, as I believe, and hopefully do it in a more expedient manner. It’s still going to be counted in years the amount of time it’s going to take healthcare organizations to get the data, ensure its high quality, put it in a data warehouse, and start to do really powerful compelling things with it.

In the interim, CIOs and business executives aren’t going to wait two, three, or four years to start getting value from their investments in all those new systems, particularly given the competitive environment. With access to real-time messaging streams plus access to data that lives in databases, the ability to deliver-real time clinical and business decision support using complex event processing techniques to me is a fantastic way for executives to deliver real value to their business and clinical users before their data warehouse is ready.

An example of that would be something in an academic medical center. One of the most frequently challenging things to be able to do is to say, “When is a patient scheduled or when is a patient in-house that meets the criteria for my study so that I can go in and recruit them to be in my study before they’re discharged or before they leave the doctor’s office?”

In a normal organization, that’s a really difficult challenge to meet, because you’ve got registration data, you’ve got past claims data for billing history, you’ve got the laboratory system for some studies, and you’ve got the scheduling system for when the patient is going to be in-house. In the CEP world, if you can get to any of that data through your regular HL7 transactions — which you absolutely can — you can simply configure a real-time alert to go by e-mail to that end user and solve that question for them.

I think there are probably hundreds of those specific little things that people want to be able to do. I don’t know that there is one grand slam home run CEP use case that everybody would say, “Oh, I’ve got to have it.” But I think being able to put real-time decision support in the hands of clinical analysts and financial analysts six months or a year from now rather than waiting for the data warehouse is an area that the industry is going to look at very closely in the next year.

1 Comment

News 2/10/12

February 9, 2012 News 15 Comments

Top News

The State of New Jersey will hand out $40 million in federal Medicaid money for first-round EHR incentive payouts this week. The largest payouts for hospitals and practices were $2.96 million and $403,750, respectively.

Reader Comments

From Truth Seeker: “Re: attestations. Each time I try to download the CMS attestation stats via your link, I get a 37,500 line spreadsheet that lists all of the vendors and products by state. I cannot find a column that lists the number of successful attestations (which, of course, is what I want to see)! Am I doing something wrong? Maybe this is why there are only 120 downloads.” I have downloaded the same data into Excel and then done various manipulations with groups and subtotals. If anyone has figured out an easier way to analyze the data, please share.

From Dr. Denominator: “Re: attestation data. The information someone sent you was inaccurate on the inpatient side. I don’t blame them since the data is very messy. The mistake most people make is attributing Epic physicians to Epic hospital numbers, because a couple of large, multi-specialty Epic clinics attested on the inpatient platform even though they are EPs. There are also some hospitals that reference multiple Meditech systems and show up on multiple rows, even though it is a single provider. And HCA needs to be folded into the Meditech numbers, because it is Meditech software after all.” And has been stated, none of this includes Medicaid attestation data either, so it’s probably dangerous to draw too many conclusions from it.

From Zen: “Re: animated ads. When are you getting rid of the rest of the animated ads?” With all the HIMSS prepping over the last few weeks, I have not made the time to pester the last few sponsors that have yet to provide us with non-animated ads. I admit I love the change and look forward to the day when there is total stillness on the left side of the page.

From HITandTiaras: “Re: judges. Who are the judges for the shoe and fashion contests at HIStalkapalooza?” For the “Inga Loves My Shoes” contest, RelayHealth’s Lindsay Miller will be returning and will be joined by Timur Tugberk from DrFirst. Our fashion judges will be Health 2.0’s Matthew Holt, the glamorous Rebecca Armato of Huntington Hospital, and last year’s red carpet lovely Jennifer Lyle of Software Testing Solutions. Matt wanted me to let contestants know that due to his poor sense of fashion, he is willing to accept all bribes.

From Carla Tortelli: “Re: HIStalkapalooza. I understand there will be IngaTinis. What exactly is that?” As far as I am concerned, it is any yummy martini-ish cocktail. However, the ESD folks told me that this year’s version is a mix of green tea vodka, orchard pear liqueur, elderflower blossom, fresh pear juice, and vanilla bean-infused honey. My consulting physician Dr. Jayne has advised me of the benefits of green tea and has assured me it increases calorie burning and stamina. I’ll thus be drinking a few.

From Cold in Tampa: “Re: Vitera update. Police were called to the Tampa, Alachua, and Scottsdale offices to ensure the quiet exit of over 300 laid-off employees.”

From SageYouLater: “Re: Vitera layoff. I count 33 gone in my area. Boxes were dropped off and an armed police officer was on site to make sure nobody caused trouble. Some we’d have voted off the island ourselves, but some were really good. Vitera’s parent private equity company made it clear that their goals are to increase revenue 30% in three years, requiring them to make acquisitions (AKA buy growth if you can’t grow it). Freeing up cash to acquire companies is how they’ll get that growth, probably via LBOs since it’s easier and there is no profitability target in their objectives. These guys are not product people, they are finance people.”

From NervousIT: “Re: our little hospital. News of a potential affiliation with a much larger organization broke out last week. Should I be nervous? How do these things typically go?” I’ve been through the process a couple of times from the big hospital IT side of the table, so here’s my experience in a nutshell, which may or may not be representative (OK, it might be a little bit tongue in cheek):

The big hospital sends its mid-level managers, who make twice as much as your highest paid person, to snoop around and try unsuccessfully to hide their contempt of your comparatively simple but more effective operation.
They say they are there to learn and assist, but in reality they are thinking, “How fast can we rip out their stuff and replace it with products that we already know and therefore are less of a pain for us to support, no matter what users prefer?”
The systems they want to put in your hospital are more complicated, partly because big hospitals like big, complicated products, but also because big hospitals have big egos and manage to make everything 10 times harder than it needs to be because all kinds of job-paranoid mid-level IT managers are always trying to justify their existence by increasing the level of specialization and complexity wherever possible.
Every decision is made on the basis of which option presents the least risk to the IT organization. Risk means anything that could require more employees, increase help desk calls, or put the bonuses of the top IT executives in jeopardy.
Any semblance of being a friendly, well-respected IT operation goes down the tubes as the new suits insist that nobody can talk to anybody without a help desk ticket, IT employees aren’t allowed to solve problems or make changes without reams of documentation, and vigorously enforced PC policies ensure that everybody except executives in IT and Finance are using the same hardware and software that has been dumbed down and locked down so that the lowest level employee in dietary or facilities maintenance can’t do anything that might require a help desk call. Think of this as computer socialism.
Endless meetings will be held in which nobody in the room has the authority to make a decision, but everybody is empowered to veto someone else’s recommendation or insist that the issue be studied further with even more people invited to the table. The chairs in conference rooms never have time to get cold before the next set of IT posteriors land on them.
You will for the first time see ambitious, back-stabbing IT managers trying to distance themselves from their humble programmer or networking origins by wearing a suit at all times and riding herd on their tiny fiefdoms like they are Steve Jobs, except without the charm, vision, passion, and brains.
On the other hand, you will probably get better benefits and possibly a raise, at least as long as your job isn’t too closely identified with one of the systems that will be unceremoniously dumped, in which case you may find yourself attached to it. You may not be able to look users in the eye, but your career prospects may improve because of better training, exposure to systems for which experts are needed, and a more recognizable employer name on your resume. If you are lucky, you may even get to stay on the periphery and avoid the soul-sucking part of the IT organization entirely. You’ll also realize that it’s not just IT described above – pretty much all big-hospital departments stack up to their small-hospital counterparts in exactly the same way.

HIStalk Announcements and Requests

From the HIStalk Practice world this week: Epic, Allscripts, and eClinicalworks represent over half of all EP attestations to date. I share the names of a few ambulatory EMR vendors I intend to visit at HIMSS. Proposed legislation would make it easier for providers to practice telemedicine in multiple states. Questions that practices should not send to technical support. Dr. Gregg overviews CareCloud’s EMR. Hayes Management Consulting’s Rob Drewniak shares tips for preparing for data breaches. Thanks for signing up for e-mail updates while you’re checking out the news. And thanks for reading!

Speaking of IngaTinis, Medicomp will be serving up a few when I participate in their Quipstar live game show Wednesday, February 22. The game is designed to demonstrate how quickly providers can be trained on Quippe and how easy it is to use. If you are interested in winning an iPad2 or some other nifty prize, you can register to participate. Before I agreed to play, the Medicomp folks had to meet a list of my diva demands that included IngaTinis for everyone and green M&Ms for my dressing room. I couldn’t refuse when they also agreed to make a hefty donation to my favorite charity. I’ll be playing to win.

I have to hand it to new HIStalk Platinum Sponsor Nordic Consulting for choosing one of the most memorable names I’ve heard, especially considering that they are located in Madison, WI. Nordic is the largest Epic-only consulting firm in the US, with 100+ consultants averaging four Epic certifications each and six EHR projects under their belt. Every Nordic consultant is Epic certified and 80% of them are former Epic employees (being in Madison obviously gives them an advantage in attracting top talent.) They’re prepared to help you run validation sessions, complete your Epic builds, perform system testing, create training materials, and provide go-live support. Eighty percent of the company’s engagements last more than a year and 90% of its placements are renewed at least once. Whether you need one Epic-certified consultant or an entire implementation team, and whether it’s clinical, financial, or interface applications you need help with, Nordic Consulting can help. I appreciate their support of HIStalk.

Supporting HIStalk, HIStalk Practice, and HIStalk Mobile at the Platinum sponsorship level is White Plume Technologies of Birmingham, AL. Their name is memorable as well, referencing the last line in the play Cyrano de Bergerac (“and that is … my white plume”) that symbolizes courage, integrity, and honor. White Plume helps 7,800 physician customers improve their PM/EMR systems (covering “the stuff they left out,” as they say), capturing charges better and faster to the tune of an average net savings of $0.83 per encounter. The company is so confident in its low-risk solution that it will happily sign daily contract commitments, letting its value stand on its own legs. Specific modules in its ePass (Electronic Practice Acceleration Solution Suite) include AccelaCAPTURE (an intelligent superbill on a tablet PC,) AccelaMOBILE (charge capture, rounding lists, and appointments on mobile devices,) AccelaSMART (rules-based management and workflow engine,) AccelaPASS (charge passing and validation,) and AccelaSCAN (a paper superbill with quick-scan processing, up to 1,200 encounter forms per hour.) Some of the vendor systems they work with: McKesson, NextGen, GE Healthcare, athenahealth, Allscripts, Vitera, and LSS. I found a YouTube video called Waiting on the EMR of the Future that provides some background, and they have a Top 5 Things to Know and slideshow on their site. Thanks to White Plume for its support of HIStalk, HIStalk Practice, and HIStalk Mobile.

Acquisitions, Funding, Business, and Stock

McKesson acquires peerVue, Inc., a provider of radiology workflow solutions.

Qualcomm makes a strategic investment in AirStrip Technologies via its Qualcomm Life Fund investment group.

Access signs a partnership agreement with pen tablet vendor Wacom to create a new e-Signature solution that will work with the Access Intelligent Forms Suite.

Revenue cycle management outsourcer Avadyne Health merges with revenue cycle workflow provider Benchmark Revenue Management. The combined companies will operate as Avadyne Health.

Nuance announces Q2 results: revenue up 19%, EPS 0.03 vs. $0.00, falling short of expectations after complicated acquisition costs. Shares dropped over 13% in Thursday after-hours trading.

Shares in CSC, which just announced the hiring of Misy PLC CEO Mike Lawrie as its new CEO, delays its fiscal year forecast and writes down $1.5 billion related to its disputed NPfIT contract in the UK.

Sales

The Arkansas State Health Alliance for Records Exchange selects OPTUMInsight’s Axolotl HIE for its statewide health record exchange.

WellStar Health System (GA) selects Merge Healthcare’s cardiology solution and Advanced Radiology of Columbia (MO) contracts with Merge for its radiology suite.

King’s Daughters Medical Center (KY) selects ProVation MD for its cardiology procedure documentation and coding.

People

Ken Edwards, formerly of GE and IDX, joins ZirMed as VP of operations.

Henry Schein names Gerard K. Meuchner (Eastman Kodak) VP and chief global communications officer.

Former Eclipsys CEO Andrew Eckert, now CEO of CRC Health Corp., joins Awarepoint’s board. The company also also names Carlene Anteau MS, RN (McKesson) VP of product marketing and Erica Davidson (Breg, Inc.) as VP of human resources.

Announcements and Implementations

Physicians at St. Mary-Corwin Medical (CO) begin electronic order entry in advance of the hospital’s May 8 Meditech go-live.

Government and Politics

The VA starts implementation of patient Wi-Fi systems in all of its hospitals.

Other

Weird News Andy rebrands himself as Wow News Andy in apparently excitement over this story. NASA’s implantable Biocapsule can diagnose and treat astronauts on long space journeys, using carbon nanotubes to secrete therapeutic molecules created by cellular metabolism.

A pretty good Forbes article by the CEO of healthcare consumer software vendor Avado says hospital CEOs should avoid the mistakes made by their newspaper industry counterparts. He had this to say about IT:

Just as newspapers were implementing multimillion dollar IT systems while nimble competitors were using low and no cost software to disrupt the local media landscape, health systems are similarly implementing complex systems to automate the complexity necessary in a multi-faceted system. Meanwhile, disruptive innovators are implementing new models at a fraction of the cost and time. For example, it’s well understood that a healthy primary care system is the key to increasing the health of a population. Imagine if a fraction of the billions being spent by mission-driven, non-profit health systems on automating complexity was redirected towards the reinvigoration of primary care. They’d further their mission and lower their costs. Of course, they’d likely see revenues drop but presumably maximizing revenues isn’t the mission of a non-profit.

Healthcare billionaire and healthcare IT dabbler/investor Patrick Soon-Shiong is reported to be interested in buying the Los Angeles Dodgers.

Sponsor Updates

eClinicalWorks provides details of its April 28-29 user group meeting in Chicago.
PatientKeeper announces that Ashe Memorial Hospital (NC) successfully attested for Stage 1 MU using PatientKeeper’s CPOE solution.
EHRScope announces its appointment as the Nuance distributor for Dragon Medical Spanish, v11.
PeaceHealth’s Sacred Heart Medical Center at RiverBend (OR) expands its use of Versus Technology’s RTLS into the labor and delivery area.
Compuware announces a live customer Webcast featuring CHRISTUS Health SVP and CIO George Conklin.
T-System releases a demo of its new ACO solution, T-System Performance Care Continuity.

EPtalk by Dr. Jayne

Medicomp Systems announces their Quipstar game show promotion for HIMSS12. You heard all of us gush about it last year, so be sure to experience it yourself. Those selected will have a chance to compete for cash and prizes. Topics include ICD-10, Meaningful Use, and “other industry challenges.” I wonder if they’ll include such questions as: what clothing item is Inga HIStalk obsessed with? Does Dr. Jayne prefer diamonds or pearls? What medical specialty shares Mr. H’s affinity for the forehead-mounted reflector?

Clinical decision support fans take note: an editorial in the Journal of the American Medical Association this week discusses “The Harms of Screening.” It highlights the varied (and often conflicting) recommendations that providers are faced with daily. If providers can’t agree among themselves what is the best course of action, how can we expect vendors to know what to build? The answer, in case you’re curious: build all of the various recommendations and let your clients turn off the ones they don’t want, rather than asking them to customize in the ones they do want.

Another piece in the same issue titled “Integrating Technology Into Health Care: What Will It Take?” tackles low uptake rates for electronic health records and personal health records. The authors note that “to fit into the lives of patients, technology must help patients do the jobs that they perceive as high priority in their lives.” Unfortunately “many patients perceive financial health and other concerns as more pressing jobs to be done than physical health.” Judging from the patients I’ve seen this week, those more pressing concerns include whether to get a new iPhone or just replace the case that’s losing its little crystal decorations; whether the new Kate Spade purses are really that cute; and whether or not the Super Bowl is overrated.

Early last year, the Office of the Inspector General (OIG) wanted to study why physicians opt out of Medicare. Now they’re ending the investigation, citing a lack of centralized data. Additionally, the poor quality of the data it did receive from Medicare Administrative Contractors and legacy carriers made them unable to “determine the characteristics of physicians who opt out of Medicare, the trend in the number of opted-out physicians, and why physicians choose to opt out of Medicare.” Two thoughts strike me here. First, if I gave bad data to Medicare, I’d be fined with penalties (just an idea? Maybe, maybe not). The second: have they heard of SurveyMonkey?

It’s been a while since I’ve been in the operating room, but unfortunately I’ve seen what happens when something is left in the body. Most surgical sponges have a portion of the weave that is visible on x-ray if the situation arises where one can’t be found. To help prevent lost sponges in the first place though, the University of Michigan is using barcoding technology to scan sponges when they’re used and again when they’re removed.

Only a few weeks left to get your Meaningful Use on for 2011. Have you attested yet? I’m still looking for some understanding of why some of those attestations have been unsuccessful. If you’re one of the unlucky few and are now working through the appeals process, we’d love to hear your story.

Score one for software developers working late nights. The Centers for Disease Control reveals that salty snacks such as potato chips are not the chief source of sodium in the American diet. The culprits include bread and rolls, cold cuts and cured meats, pizza, poultry, soups, sandwiches, and cheese. I didn’t see dark chocolate on there either, so I guess I’m good to go.

Have a question about Meaningful Use, the ideal percentage of cacao in chocolate, or which shoes are less cute (and thus more easily donated to Souls4Soles?) E-mail me.

Contacts

Mr. H, Inga, Dr. Jayne, Dr. Gregg.

More news: HIStalk Practice, HIStalk Mobile.

15 Comments

Readers Write 2/8/12

February 8, 2012 Readers Write 2 Comments

Submit your article of up to 500 words in length, subject to editing for clarity and brevity (please note: I run only original articles that have not appeared on any Web site or in any publication and I can’t use anything that looks like a commercial pitch). I’ll use a phony name for you unless you tell me otherwise. Thanks for sharing!

HIMSS, A Golden Opportunity: Insider Tips for Maximizing Media and Analyst Interviews
By Jodi Amendola

It’s hard to believe that HIMSS is just around the corner. In addition to meetings with new business prospects and partners, networking, and reunions with friends and former colleagues, you can maximize your HIMSS experience by arranging media and analyst interviews during the show.

HIMSS is a golden opportunity to meet one on one with these key industry influencers and differentiate your company from the competition. You can also leverage these meetings to identify and secure opportunities to be included in print or online articles, blog posts, and industry reports.

These industry movers and shakers are incredibly powerful. One positive mention and your sales leads could skyrocket. One negative comment and the opposite can occur. Don’t panic. The following media training “cheat sheet” can help you achieve your goals and generate positive coverage.

Prepare. One of my most embarrassing HIMSS moments was when a client told an analyst that he “really liked his magazine.” The client obviously hadn’t taken the time to read our prep book! Before a meeting, research the background of the editor or analyst and become familiar with his or her areas of expertise and interest. Always customize your answers to address their audiences’ needs and pain points.
Listen. Nothing is more annoying than being interrupted. Listen to the entire question being asked and tailor your responses. Address the questions within the context of the target audience(s) and avoid dominating the conversation with a product or service pitch. Sometimes it will be appropriate to share your knowledge, vision, and thoughts on the industry rather than focus on your company.
Body language. Be confident, enthusiastic, and friendly. Smile, lean forward, and make direct eye contact. Don’t cross your arms or fidget. Remember, how you deliver your message can be as important as the message itself.
Get to the point. Prepare an elevator pitch, a two- to three-sentence description of your company that is easy to understand. In other words, how would you describe your company and its products and services to your mother or the person sitting next to you on an airplane? Make sure it includes the key points you want editors or analysts to remember.
Avoid jargon. Explain your product or service in layman’s terms. It’s your responsibility to make the pitch simple, clear, and memorable.
Power of three. Focus on three main talking points and weave them into the conversation whenever possible. Often a reporter or analyst will ask if there is anything else that you would like to add at the end of an interview. Use this opportunity to restate your three core messages.
Tie to hot topics. Demonstrate that you are a thought leader and can address hot topics such as Meaningful Use, ACOs, and where the industry is heading, not just talk about your product or company. Share the bigger vision.
Zen of interviewing. When asked a difficult question, maintain eye contact, control your gestures, and breathe. Listen to the question and request clarification if necessary. Give yourself time to collect your thoughts and then respond. If you don’t know, don’t make it up. Offer to get back to the reporter or analyst with the appropriate information.
Tell a story. People remember stories. Talk about client successes and lessons learned that highlight how your products deliver real-world value. If possible, include relevant ROI data in your storytelling.
Relationships. Last but not least, it’s all about relationships. Be yourself, be genuine, and have fun. Let editors and analysts know that you can address multiple topics and to feel free to call on you for commentary or to discuss industry trends. Offer your clients as sources for future articles. Remember, these editors and analysts can have an incredible impact on your company’s reputation and marketplace visibility. Take the time to establish and strengthen these important relationships. Your investors, board members, and employees will be glad that you did.

Jodi Amendola is CEO of Amendola Communications of Scottsdale, AZ.

Comparing CEOS – Steve Jobs and Neal Patterson
By Reflective

Interesting comparison of Neal Patterson to Steve Jobs you made.

Neal is, like most true visionaries, a complex person. I worked directly with him for many years, and while he can be quite the PIA to put up with at times, he is also incredibly compassionate and human and generous at others. He is a great leader, but not always a great manager – and those are two entirely different things. He would agree with this assessment and has said as much in the book he wrote – manageIT.

As a leader, he sets clear direction to where he wants the company to go and the role he wants you to play in getting there. He defines aggressive and tangible goals that can be measured – and measure them he does. But he can be an impatient manager who doesn’t like to listen to reasons why goals aren’t accomplished (he views them as excuses). He is incredibly picky about the words you select in presenting your arguments. Words are VERY important to him, nearly as important as your intent. If you use the wrong words, he will come at you ruthlessly until you are embarrassed into retreat – many times, in a public forum.

This is not an easy thing to deal with, and some might view it as unfair. But he does get his point across, and you surely do choose your words carefully the next time. And he has a great radar for detecting bullshit, so I would advising against trying. For your area of responsibility, you better figure out how to be more prepared than him, more informed than him, and have spent more time on the strategy than him – or you will not survive.

I have worked with several truly brilliant folks over the course of my career, and none of them have been easy. The things that they see aren’t always easy for the rest of us to see. The drive that they have to achieve comes from an inner place that we may not ever understand. They are different. They are difficult to be around because they are constantly judging and evaluating everything and everyone – making split-second decisions that can change the course of people’s careers and lives.

The decisions aren’t always fair or even right , but they aren’t afraid to make them and live with the consequences. And once made, they do not live in the past. They only move forward. Leaders have it in their DNA to do this. Many managers do not.

But I have also observed that these truly visionary, genius-type folks are also acutely aware of their own mortality. They feel that they have a lot to accomplish in the short time they are on the planet. They are afraid they will run out of time to accomplish all they want to accomplish. They hear the clock ticking and they tend to steamroller over others that they feel will impede their progress, not always choosing a path that may yield less collateral damage.

They are not always fair, and they sometimes listen to the wrong advice and situation summaries from folks with hidden agendas because they don’t have the time to do everything themselves. Because they are forced to delegate, they can sometimes be manipulated. They may be brilliant visionaries, but they are not always the best judge of people.

But leaders like these accomplish things that the rest of us cannot. They probably don’t like being labeled "genius" because they just see it as working harder than others. Being more driven than others. They have tenacity and a refusal to accept failure. I don’t think that they are necessarily put here to become beloved. I don’t think that is what’s important to them. What’s important to them is achieving their goals. Making a difference, leaving their mark, changing the world. The accolades, awards, and adoration are not what drive them, no matter how big their egos might be.

They can be incredibly charismatic when they want to be. They are successful leaders because, inevitably, their followers believe in the direction they are headed. They are leading their team into battle, and the team goes – because they believe their fight is right and just and winnable.

You don’t always love being around these types of folks. They are not easy. They wear you out. But it is their difference from the average that makes them successful. We need them. And most of us are changed by being around them. We are challenged to be better than we had been. We are less average by working up to their standards. For as long as we can stand it.

Too Much Football Without a Helmet
By Mike McGuire

I’ve managed to spend the lion’s share of my career in healthcare informatics. I’m not sure if that says I’m brain damaged or that I really admire not only the industry, but also the dedicated people I’ve met over the last 30 years.

I’m choosing to believe it’s the people, even though my bride believes anyone working in healthcare is brain damaged. Her view was formed by her experiences caring for her mother when it was discovered that she had cancer. We’re all too familiar with the story. Patient has multiple providers that are treating her, each focused on their part of the care. Between the drug interactions and multiple protocols, she managed to survive almost four years before she passed. While we were grateful for the time, the quality of those years will always haunt us.

Each of us have gone through a similar scenario or have known someone that has gone through it. Some of us have been around long enough to have survived the ‘80s and the introduction of clinical information systems. In the ‘90s. electronic medical records were introduced, and in the ‘2000s we had RHIOS, then CHINs and now HIEs and ACOs with still no solution in sight.

This weekend, like millions of Americans, I watched the Super Bowl. I marveled at the athleticism of the players, the size of the spectacle, and the precision of the execution of the game. When you think about how these are games scripted beforehand and how the coaches anticipate what the other team will do under certain circumstances, you wonder how they make all those pieces come together? And when they put together the plan, how do they modify it when a new piece of data or a new formation suddenly appears?

Like any battle plan, it’s only good until the first shot is fired, and then it’s constant adjustment. What I saw was that the quarterbacks of those teams had the ability to approach the line of scrimmage, access what they saw, and then had the wherewithal to call an audible. An audible is a new or substitute play called by the quarterback or a defensive formation called by a linebacker at the line of scrimmage as an adjustment to the opposing side’s formation. The audible is communicated by a series of hand signals, numbers, or colors called out by whoever is changing the formation. The players at each position then adjust their attack accordingly.

It’s a tribute to man’s ingenuity that the game of football has figured out a way to seamlessly react to change and adapt, yet we in healthcare can’t even exchange or share basic data. Now I hear the healthcare purists shuddering that the mere thought that I had the audacity to imply that somehow the exchange of patient data is analogous and on the same level as an audible in football. No. My point is that the NFL has figured out that in order to consistently win, you have to continually adjust and be able to communicate those adjustments in real time. This is something we cannot easily do in our healthcare environment.

Our healthcare game plan needs to be built around our two quarterbacks, the patient and the provider. Sustainability can only occur when the 880,000 physician quarterbacks can audible the other members on the patients care team, including the patient. Data exchange must be real time, succinct, and cheap. What we’re building is slow, difficult to maneuver in, and expensive.

Unless we design the game plan around the quarterbacks, my grandchildren will be writing articles about why ACOs and HIEs never delivered the expected results. We are better than this.

Mike McGuire is senior VP of sales for Holon Solutions of Roswell, GA.

2 Comments

HIStalk Interviews Andy Aroditis, CEO, NextGate

February 8, 2012 Interviews Comments Off

Andy Aroditis is president and CEO of NextGate Solutions of Pasadena, CA.

Give me some brief background about yourself and about the company.

I started in healthcare about 20 years ago. I worked for a large institution out here on the West Coast called UniHealth. I started off as a programmer and then I became a programming manager. I worked for a company that had an integration engine. I stayed there for quite a few years. That’s when I had my first exposure to EMPIs and patient registries.

The company that I worked for was STC, Software Technologies Corporation. Then we changed our name to SeeBeyond. We got acquired by Sun Microsystems and that’s when I left.

I set up NextGate with two other partners about seven years ago. The first couple of years, we focused on doing integration and doing upgrades of EMPIs. We stayed within the same space, because that’s our comfort zone and that’s where we stayed.

Gradually as things became available to us, either through open source or through creating our own intellectual property, we set up as a product company. We set up NextGate, which is a parody if you know the names — the engine that we put out quite a few years ago under STC used to be called DataGate and then it became eGate, so we thought it would be funny if we called ourselves NextGate.

Those early integration engine companies got acquired multiple times by large and impressive organizations. What do you think those big organizations saw in those technologies that made them want to be become part of it?

To a certain respect, they bought the customer base. The company that we worked for before, SeeBeyond, had a very large customer base. According to our ex-CEO, we had about 70% of the market. Maybe we had 60% of the market. So we had a lot of the customer base and therefore it made it easier for them to get in there.

If I can just go off on a tangent just for a couple of seconds, it also made it easier for us working for that company to generate new products. That’s how we generated the first EMPI back in the early ‘90s. We went back into our own customer base, and our own customer base guided us through the maze. That’s what makes the product successful, I suspect.

Who are your main competitors?

Obviously the main competitor is Initiate, which got acquired by IBM, which makes it even bigger for us.

When you look at what’s changed since those early days of the ‘90s when everybody was working on these different ways of integrating systems, what are some of the newer challenges and what are some of the solutions for patient identification?

If you remember in the early days, doing integration — and that’s where we spent most of our lives, doing integration –we were lucky to find systems that actually pushed out HL7 messages. The ones that didn’t didn’t really concern themselves too much with patient identification. When I was first asked to set up an EMPI or a master patient index outside the realm of the existing systems, it was unique in a sense because it hadn’t been done before, but looking at it from the integration perspective, it was really necessary.

A lot of the systems pushing out these transactions, HL7 or not, were not exactly accurate enough. They needed some kind of accuracy, because if you remember back in the early days, we all preached the same thing — buy best-of-breed, best-of-breed, best-of-breed and we will bring in an integration engine and integrate this.

But the integration engine wasn’t sufficient, because now you had Andy Aroditis and you had Andrew Aroditis. Trying to figure out how to match those two people wasn’t that easy, meaning matching the order going out from maybe an HIS system to receiving the results back. That’s how we first came up with the first EMPI system, in order to do that, believe it or not.

That’s really almost a simple problem comparatively because people were using the engine just for their own patients. They had multiple systems, but a fixed body of patients. Now with all the emphasis on population health, anybody could be your patient.

Absolutely, and try to deal with patient discovery now over multiple institutions. They used to compete in the past, and now they’re asked to play nicely with each other.

The biggest thing that we rely upon as an EMPI service is how well the data is captured. A lot of the inaccuracies that you see in terms of the patients and actually maybe even introducing them to or exposing them to treatments that they don’t need is because each system has its own unique way of capturing the data if you can’t figure out how to merge all that and get to the accuracy that you’re looking for. I think that’s the biggest problem that we had in the old days. Imagine now that you didn’t wait 10 or 15 or 20 systems. Imagine how much worse it is today.

I would think it’s also a challenge because at least when it was just a hospital keeping their own records, they could make rules to say, “Here’s when we use a middle initial” or “Here’s how we spell things out instead of abbreviating.” But now that they’re being asked to share data with physician practices that may have a completely different set of data validation rules on the front end, it’s going to be tougher to say, “I’ve got 20 medical practices out there and I need to match those up with my inpatient records.”

You’re absolutely correct. The biggest issue now is if you go to a physician office, depending on how big the physician office is, it’s highly like that they would know you personally. They might have a little bit more accurate data or they have your home phone number because they’ve known you in the neighborhood.

Whereas now if you walk into a hospital, there are two huge scenarios. If you present yourself and you’re on a gurney unconscious and they’re trying to figure out who you are, the way they register you within a system varies from institution to institution. For example, you can go in as John Doe or **Unknown, and then at some point in time when they’ve gone through your pockets and discovered who you are, they will attach a name to you. By then it might be too late because they’ve already done six or seven tests, or they need to do six or seven tests. Imagine if you do that 10 times because now there’s 10 institutions that are trying to participate within the same HIE. Imagine how much worse it is.

Patients can never figure out why it’s so hard when they say, “I gave you my new address, why don’t you have it?” But if you’ve got different points of presence all using different systems, how do you figure out who’s got the most current copy of the address or the phone number?

That’s usually one of the biggest challenges that we have when we implement an EMPI. There’s a couple of phrases that we coined way, way back at the beginning where you installed an EMPI or a registry of some sort — passive mode or active mode.

If you install it in a passive mode, you do the clearing as an afterthought. That’s when you get yourself into a whole lot of trouble. Think of what is happening with NHIN Connect and the engines that they’re coming up with. They’re trying to do the patient discovery up front, and that’s what the active integration is all about.

For example, if you are within Siemens and you’re looking for a patient, instead of just looking at that, you’re actually looking at an EMPI which is an external to your system. You have better accuracy, because obviously the matching algorithms are more sophisticated in the software that we have. We also introduce fuzzy logic to play into it. When we present a set of patients or a set of names back to you, we can actually rank them and even color them or do something that will attract you and get your attention so you can pick the right person.

Obviously you can never let people click and say, “I’m going to register a new patient” because they can create havoc. But at the same time, if you make it so easy for them not to generate a new patient, they won’t, and they will pick one from the list that you present to them. That makes it easier and more difficult at the same time, depending on how many patients you have to deal with.

I would think the cleansing after the fact is unacceptable now, where you’re trying to take on financial risk and you need to know what tests and treatments have already been done. Or whether this a readmission, where the patient is being seen by multiple facilities. Is that something that can even be tolerated by practices or hospitals going forward?

It’s still tolerated because that’s the foundation of everything, whether you do it as an afterthought or you do it as the point of entry within the healthcare organization.

Think of it like plumbing. In all cases, you have to have it in place, even though you’re only doing it as an afterthought. Because remember, even if you’re doing an active integration where I hand over the patient’s demographics to the registration system, they still have the luxury of actually messing it up. What I mean by that is they can turn around and say, “Hey, even though your name is Andy Aroditis, now I decided that I’m going to change your address, I’m going to change your phone number, I want to change your cell phone number.”

When it arrives back at the EMPI, because all these records have to be looked at through the passive integration and the plumbing, we can still go through the same identification and say hey, we have certain overlays. For example, I handed you over Andy Aroditis and now you’ve changed everything including the gender and you’re sending that record back to me. You’re creating a situation where you’re putting the patient’s health at risk because now you’ve changed them totally. Or, you’re using the same medical record number, which is totally inaccurate and you shouldn’t be. Which again it puts the patient’s health at risk.

How does the whole idea of patient identification fit into the Nationwide Health Information Network?

The way that it works, at least from my vantage point, is that the moment that you walk in, they can issue what they call a patient discovery, and they can actually broadcast that. There’s been a couple of schools of thought as to how they do that and how they improve the accuracy. Because as you can imagine, if they broadcast it to maybe 50 or 60 different institutions at the same time, imagine all that traffic getting onto whatever network, trying to get all those responses back. There are different ways to do this.

For example, if I show up in an institution on the East Coast, it’s highly likely that I’m an East Coaster. Obviously there’s people that do travel from the West Coast to the East Coast, so therefore they would search maybe the local one, so they do a patient discovery to the local participants before they begin to launch those patient discovery queries across the states, going from East Coast to West Coast. There’s some logic that goes into this before you can actually do it in a nice way, or do it in a way that it would serve your purposes.

Do you think that there’s enough sophistication within that process that it will be reliable? That if one facility updates a patient’s allergies, let’s say, that everybody else will accept and use that information?

There is, but also the warning is, what if I capture the data somewhat differently? Penicillin allergy to me means ABC whereas to you it means FEG. The data capturing and how you apply those quotes to specific cases even though we do have the ICD-9 and the ICD-10 to make life easier. I’m not quite sure if you can get down to that level in order to improve the accuracy, with people capturing it the same way.

You work with provider registries. Describe what those are used for.

The question that we were asked over and over again with a lot of these HIEs is that the we want to deliver results to a specific provider on a specific day or even on a specific time of that day. In order to discover where the provider provides — no pun intended — the service for that specific day, we need to have some central location to do that. In order for us to know which provider to deliver the results, we need to have the relationship between the patient and the actual provider or the PCP or the person that will receive it, because obviously we can’t just broadcast it to every single provider that is out there.

That was the premise of, how do we identify people, and at the same time, how do I identify the caregivers to those people? We set up the provider registry. The provider registry has the same kind of confusion that a patient registry would have where people are described differently, but it’s more of a deterministic nature. The reason for a provider registry is in order for us to provide a reasonable answer in terms of somebody asking us where do we deliver the results for Dr. Andy, where would he be on Wednesday between 9:00 and 11:00, and what is his fax number?

That’s the reason why we created a provider registry. In addition to that we also have the relationship that says that, “PCP Dr. Tim is Andy’s PCP and I can deliver results because some other external system tells me that I can and I know where to find Dr. Tim.”

You mentioned that Initiate is a significant competitor. What capabilities differentiate your product from theirs or others?

In terms of functionality — if I can be modest enough, I’m also biased — we have every piece of functionality that they have and then some. The reason that I’m saying that, though, is because a lot of the NextGate employees that are currently working on the product and the delivery of it have been in the EMPI space well before even NextGate came on the scene, meaning we started our work for the company in—and I don’t know how long you’ve been in healthcare – but we used to use an algorithm by a company called Alta, which was up in Northern California. People would deliver tapes, and then the company would deliver reports in terms of the potential duplicates.

It was two guys who wrote a bunch of Pascal routines that would go through tapes and would identify the potential duplicates in those tapes. They would return paper reports back to the medical records department so the medical records department could merge the charts. I happened to discover them quite a long time ago because of my work that I did for UniHealth back in my early days — we used them at the hospital. We managed to get that algorithm and get it embedded within the first EMPI that we developed. All that processing that used to happen in batch, we could actually do it in real time. That’s how our system stood up. We do all the processing in real time and we deliver the accuracy in real time.

Any concluding thoughts?

We started with the EMPI, and we started with the provider registry and the provider directory. All these components and all these registries and the way that they play with each other — we see that as the healthcare data integration platform where you can integrate a lot of disparate systems as the engines used to do in the past, but now we can actually integrate your data from the outside looking in, as opposed to from the inside looking out.

What I mean by that is the whole design and the whole structure of our EMPI is designed to stand alone and be a feeder system from all the HIS systems that are out there, whether it’s a MedSeries4 or an Epic or a Cerner or what have you. Whereas a lot of the Epics and the Cerners and the Siemens, their EMPI is just central to their own operations, and therefore it’s really difficult for them to have that exposed to the outside world.

That’s the space that we’re in. We think that with the HIS industry growing, we will grow with them.

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API Healthcare Acquires Concerro

February 8, 2012 News Comments Off

Workforce management systems vendor API Healthcare announced this afternoon that it has acquired Concerro, which provides hospital staffing and scheduling solutions.

J.P. Fingado, API Healthcare’s president and CEO, said in a statement, “Concerro’s products and client base are the perfect complement to API Healthcare’s existing solutions and markets. Working together we will reinforce our mutual commitment to innovation and dedication to the healthcare industry. This strategic move allows us to leverage a larger number of talented, diverse and clinically-based staff to deliver the high quality of service that separates API Healthcare from our competitors.”

San Diego-based Concerro offers SaaS solutions that include RES-Q (staffing and scheduling), ShiftSelect (shift bidding), ShiftPredict (predictive scheduling), CommandAware (emergency preparedness), and CareConnect (patient acuity). The company is on the Inc. 5000 list.

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News 2/8/12

February 7, 2012 News 6 Comments

Top News

Cerner reports Q4 numbers: revenue up 23%, EPS $0.52 vs. $0.41, with adjusted earnings of $0.55 beating expectations of $0.53.

Reader Comments

From MU Jackie: “Re: latest CMS attestation data. It’s incredible that the CMS data has been downloaded only 120 times – it’s out there on a silver platter for vendors, consultants, press, etc. I did some quick and dirty pivot tables. For inpatient, if you add Meditech and HCA’s customized version of their product, they are the clear winner, with almost twice Epic’s numbers. For ambulatory, Epic has 2.5 times more than #2 and 10 times Cerner, probably because hospitals do ambulatory first to replace a mixed bag of junk. Coming in at #12 of 250+ vendors with at least one attestation, Practice Fusion shows that it’s real. It would be interesting to do a study of one-doc practices of how little you would have to change your paper ways to ethically attest.”

From Jon: “Re: eHealth Nigeria. Good for this audience.” A couple of young Americans, one a technologist and the other a medical student, form eHealth Nigeria, working in that country (which has a population of 150 million and 50,000 women die from childbirth complications each year) to digitize healthcare records using the free OpenMRS. They’ve added SMS capabilities for both patients and caregivers since low-end cell phones are the ubiquitous technology rather than broadband-connected PCs. Their poster from the recently concluded mHealth Summit is here.

From Maren: “Re: question. We’re choosing a new HIS vendor and my boss keeps asking how many screens a nurse would use for her daily operations. Any way you can help me? I’ve never seen that statistic.” Neither have I, and I’d have to question its relevance to choosing a system. If it were me, I’d look at how long it takes to document the same activity on each system, then spend time walking with nurses and write down every single time they need a piece of information and where they were at that time. That will give you some idea of how much navigation they will have to do, which may be what your boss is really asking. Perhaps readers can help.

From 143: “Re: digital checklists. Electronic medical records are mentioned.” A detailed article on patient safety checklists mentions Holy Cross Hospital (MD), which has seven employees who review electronic patient records to see if doctors and nurses are following safety standards, which one doctor calls an “in your face” checklist that works even when she is tired or busy.

From SCCM Nurse: “Re: Cerner. Epic must be hurting sales – they just had Domino’s pizza delivered to a high-end Houston steakhouse. They were promptly asked to remove it. How do I know it was Cerner? A very large group of them were wearing their Cerner shirts.” Unverified and hard to believe, but I’ve learned not to argue with someone seeing something first hand (no pun intended.)

From Guillaume-Robert Montagne: “Re: Quebec EMR. Québec is set to expand its Dossier de santé du Québec EMR project to Montréal. The project, almost $1 billion over budget and ‘on track’ to be six years late, was called a ‘failure’ by the province’s auditor general in a report last year. The expansion will create a basic digital record for about 40% of the regional population, and will initially allow for electronic prescribing and the exchange of lab results and radiology data.” I notice they use the tired “unconscious patient in the ED” story to make it sound attractive.

From Woz: You Are Not in Cupertino Any More: “Re: Apple co-founder Steve Wozniak’s visit to Perceptive Software. He talked for about 15 minutes at an all-employee meeting where the software engineers especially just ate it up. He told the engineers that ‘to be a software engineer, have passion … repetition is always helpful to be better than anyone else … and you should mix pleasure and entertainment with your work.’ Having lured away a number of what Perceptive Software believes are some of Cerner’s best and brightest, and a very different culture that includes having a dodge ball court on-site (he autographed one of their dodge balls), it was not surprising that someone quipped ‘we really appreciate his insight, but that advice would have been especially helpful 20 miles to the southeast (the Cerner software engineering center)’.” I should mention that this comment came from an old friend of HIStalk who has no connections to Perceptive Software or Cerner other than having a family member who was there for the visit. Woz’s talk to the employees was captured on a YouTube video.

Speaking of Apple, this newly published Steve Jobs photo comes from the collection of original Mac team member Andy Hertzfeld. If you’re reading this on one of Steve’s smaller-screen devices, I’ll provide a hint as to why the picture is fun: he’s not pointing at the IBM logo, at least not in a polite way.

HIStalk Announcements and Requests

Your HIMSS prep to-do list:

Gather up shoes to donate for the Souls4Soles shoe drive.
Mentally and physically prepare yourself for the HIStalk Booth Crawl, where you have a good shot to win one of 55 iPads. You will need to schedule a couple of hours in the exhibit hall Tuesday or Wednesday to gather up the details, so make room on your calendar.
Find the perfect outfit that will put you in the running for HIStalk King, HIStalk Queen, Best Elvis Impersonator, and Best Left-in-Vegas attire. Fabulous prizes for the winners!
Pack your suitcase with shoes that will make you a winner in the Inga Loves My Shoes contest. Categories include the Poker Face (you can’t tell this one works in healthcare); the Russian Roulette (you won’t wanna mess with this shoe); Off to the Races (best boot in town); What Happens in Vegas… (this shoe should stay in Vegas); and the High Roller (this shoe always wins BIG.) The generous Mr. H is throwing in great prizes for shoe fashionistas as well. Dr. Jayne, by the way, tells me she is a shoe-in for one of these five categories.

Welcome to DrFirst, sponsoring HIStalk and HIStalk Practice at the Platinum level. The 12-year-old Rockville, MD company is an e-prescribing pioneer, offering Rcopia-MU, the ONC-ATCB certified modular EHR for practices that aren’t ready to commit to an EMR, who need to attest, or who need basic technology that doesn’t require a lot of implementation headaches or workflow changes in order to qualify for HITECH incentives. The company also offers solutions for hospitals, such as an acute care medication management system that gives hospital EDs the ability to create an immediate 12-month patient medication history by collecting e-prescribing data, along with a discharge module that performs clinical and eligibility / formulary checking of discharge prescriptions before sending them via Surescripts to retail and mail order pharmacies. A brand new offering is its EHR Advisor tool for choosing solutions from among its 200+ EHR vendor partners. Thanks to DrFirst for supporting HIStalk and HIStalk practice.

I checked YouTube for DrFirst videos that describe the company and ran across this one, which we’ve mentioned before. If you’re a “what’s in it for me” type and are going to the HIMSS conference, the company is free offering foot massages and a grand prize for commenting on the video over on YouTube.

Welcome to new HIStalk Platinum Sponsor Health Data Specialists, LLC. The company offers competitively priced consulting services to hospitals that use Cerner, Epic, Meditech, and Siemens, as well as offering assistance with project management, ICD-10, and Meaningful Use. Their consultants are highly experienced, with its Cerner consultants, for example, averaging 10 years of experience with Cerner applications and 21 in healthcare (even its Epic consultants average eight years of Epic experience and 23 in healthcare.) Their long list of clients includes Spectrum, VCU, Carolinas, and North Broward (Cerner); Children’s Omaha, Driscoll, Cleveland Clinic, and Sentara (Epic); and Alegent, KUMED, BayCare, and Yakima Valley (Siemens.) You may know CEO Bob Hayden since he’s been in the industry for 38 years, including serving as a large health system CIO and founding and running First Choice Consulting. Thanks to Health Data Specialists, LLC for supporting HIStalk.

Acquisitions, Funding, Business, and Stock

Revenue cycle solutions vendor Recondo Technology acquires Trilogi, Inc., a revenue recovery firm.

Health Evolution Partners and Verizon Enterprise Solutions form a relationship to encourage companies to develop technologies related to mobile health, telemedicine, and health data management. Health Evolution partners chairman David Brailer is quoted in the announcement as saying:

The next generation of health IT will not be anchored to a desk. Clinicians and patients will expect technologies that support mobility and virtual care. Advanced broadband, video-based technologies and wireless devices that incorporate geo-location capabilities and sensors will change the landscape of health care from development to delivery. Our relationship with Verizon demonstrates the importance of bringing these innovations to market.

Radiology center operator Foundation Radiology closes on a $2 million offering led by Chrysalis Ventures. The healthcare IT connection is that the company’s CEO is former Misys Healthcare CEO Tom Skelton and one of its directors comes from David Brailer’s Health Evolution Partners.

Mediware reports flat Q2 earnings of $0.21 per share, despite an 18% increase in revenues to $15.6 million.

As part of its Q4 earnings report, HCA reveals that it received $306 million in EHR incentives for 2011 and spent $77 million in EHR-related expenses.

University of Washington spins off TransformativeMed, which uses Cerner’s MPages mobile data access technology to create add-ons to Cerner PowerChart. Modules include a rounding application and a quality dashboard.

Sales

Advocate Christ Medical Center (IL) selects PerfectServe’s clinical communication and information delivery platform.

Memorial Hospital of Converse County (WY) chooses Summit Healthcare’s Express Connect interface engine technology to connect Meditech with Avera Health’s eICU solution.

Southern California Hospitalist Network purchases PatientKeeper Charge Capture solutions for its network of physicians.

Radiology Ltd. (AZ) selects Merge Healthcare’s suite of radiology solutions for its nine imaging centers. Also, Southern Illinois Healthcare will implement Merge Healthcare’s cardiology suite across its six hospitals and clinics.

People

HIMSS honors Carol Bickford PhD, RN-BC, CPHIMS and Kathleen Smith MScEd, RN-BC, RHIMSS with its Nursing Informatics Leadership awards. Russell Leftwich MD is awarded its Physician IT Leadership award.

John Calabro joins Cognosante as managing director of HIT offerings for state and federal clients. He most recently served as HIT coordinator for the State of Oklahoma.

CSC names Misys PLC CEO Mike Lawrie as president and CEO.

Don Bauman (Isabel Healthcare), Andre duPlessis (Tulane Medical Center), and Gary Ferguson (TIBCO) join VoiceHIT’s board of directors.

Announcements and Implementations

Presbyterian Healthcare Services (NM) implements MRO Corp.’s release of information and audit tracking software and services.

Geisinger Community Medical Center (PA) will move to Epic as part of a five-year, $159 million capital improvement project funded by its new owner, Geisinger Medical Center.

T-System introduces T-System Performance eRX, an e-prescribing solution for EDs and urgent care clinics.

CarePartners Plus announces Wellby, a kiosk that collects patient perceptions immediately after their encounter to allow timely intervention and education.

Government and Politics

AHRQ announces a new Questions are the Answer public education initiative that encourages patients to talk to their healthcare providers. Practices can get free materials, including a video, brochure, and notepads. Above is a fun public service announcement that got me wiggling in my chair in time with the music.

A USA Today article says that Newt Gingrich’s Center for Health Transformation hired lobbyists and some of its employees used their experience there to land lobbying jobs, although Gingrich insists the organization performed no lobbying for its clients.

The British Government releases a mobile app to help citizens find hospitals and clinics.

Other

Massachusetts eHealth Collaborative president and CEO Micky Tripathi is featured in a Bloomberg Businessweek segment on healthcare data security. He first discussed the data breach on HIStalk Practice.

Alpha Financial Solutions files a $1.6 million breach of contract lawsuit against Wheeling Hospital (WV), claiming the hospital’s termination notice for the company’s billing services contract was not delivered in writing as required. The company also claims that the hospital made copies of its intellectual property, locked out its managers, and improperly hired 20 of its 24 on-site employees. It also says that he hospital “seized” its servers that contained the PHI of other customers.

Hospitals are using patients’ clinical and financial information stored in their systems, along with databases sold by consumer marketing firms, to selectively pitch profitable services to patients with private insurance. St. Anthony’s Medical Center (MO) spent $25K on targeted mailings for mammograms, personalizing each piece with a photo of a person of similar age and gender to increase response rates, and brought in 1,000 patients and $530K in revenue.

Sponsor Updates

Kern Medical Center (CA) selects McKesson Revenue Management Solutions to interface with its existing Horizon Practice Plus.
Healthcare IT professionals say that disaster recovery is their top priority for investment, according to a BridgeHead Software survey.
Elsevier releases SimChart, a simulated EHR designed for nursing students.
CareTech Solutions added 22 hospital service desk clients in 2011 and grew its revenues 22%.
iSirona announces its successful interoperability testing at the IHE 2012 North America Connectathon. iSirona will also participate in the HIMSS12 interoperability showcase.
Practice Fusion earns a nomination for “Biggest Social Impact” in the fifth annual Crunchies Awards.
Campbell Clinic (TN) selects SR for its 43 orthopedic physicians.
Mac McMillan, CEO of CynergisTek, will serve on the faculty of the inaugural Canada-United States Healthcare IT Summit.
Barbara McNeil MD, PhD of Harvard Medical School joins Humedica’s Scientific Advisory Board.
A Billian’s HealthDATA and Porter Research Webinar on healthcare business intelligence and analytics is now available for on-demand viewing.

Contacts

Mr. H, Inga, Dr. Jayne, Dr. Gregg.

More news: HIStalk Practice, HIStalk Mobile.

6 Comments

EHR Design Talk with Dr. Rick 2/6/12

February 6, 2012 Rick Weinhaus 11 Comments

Why T-Sheets Work

Disclosure: I have no financial interest in T-System, Inc.

There is nothing particularly high-tech about a T-Sheet. A T-Sheet (designed by T-System, Inc.) is a particular design for a double-sided, single-page printed paper form used to chart patient visits. T-Sheets are extremely popular and have been widely adopted by emergency department and urgent care physicians.

Why do many physicians prefer using T-sheets to the more technologically advanced EHR solutions that they are increasingly being required to adopt?

There are of course many reasons. One is so basic — and is such a defining property of the paper form in general — that we tend not to even notice it: T-Sheets assign each category of data to a box of fixed size and fixed location on the page.

A second reason T-Sheets are popular is that each presenting problem (chest pain, abdominal pain, headache, and so forth) has its own customized T-Sheet template. But regardless of the specific problem and the specific data collected, the spatial layout of data categories is kept exactly the same.

Here is an example of the front side of a T-Sheet for an emergency department visit that I have redrawn and greatly simplified to emphasize its high-level spatial design.

Regardless of the reason for the emergency department visit (in this case, chest pain), the box on the top right has a fixed size and location. It is always set aside for the review of systems (ROS). Similarly, regardless of the reason for the visit, the box on the bottom right has a fixed size and location. It is set aside for the family history. And so forth.

This means that once I learn where each category of data is situated on the page, I can just glance at that box to retrieve the desired information. Its position doesn’t change depending on how much data is written in the boxes above or next to it. The information remains readily available when I’m viewing a different box. I don’t have to carry it in my head.

The locations become automatic after a while. I don’t have to read the box headings. And if I need to compare the current visit to a previous one, I can just place the two T-Sheets side-by-side and glance at the same location on the two sheets to find the comparable data.

In my last post, Computer-Centered versus User-Centered Design, we saw how the spatial arrangement of data allows us to solve certain problems visually with minimal cognitive effort. But even if our task is just to take in and organize a large amount of data, a fixed spatial arrangement is a very good design.

Humans are visual animals par excellence. The human visual system is very good at organizing objects in space. T-Sheets and similar paper forms work because they enable us to use our extraordinary visual and spatial processing abilities to make sense of abstract data, even though these abilities evolved to help us organize physical objects in the real world.

Despite its simplicity, the paper form — with every data category assigned to a fixed location on the page — is a powerful cognitive tool. By allowing us to use our perceptual visual system to organize and retrieve a large body of information, it leaves our finite cognitive resources available for patient issues.

This all may seem obvious. Unfortunately, many EHR designs did not go in this direction, only in part because of technical constraints. Instead, clinicians often are required to navigate to multiple screens in order to enter or view different categories of data, as in the example below:

Of course paper forms have their own problems — how do you record more information than fits in a particular box, bring historical information forward to the next encounter without laboriously re-entering it, read illegible handwriting, and so forth? But still, assigning each data category a fixed screen location is a good model. So in rethinking EHR design, one strategy is to retain fixed spatial location as a high-level design element, but improve the paper design by making it interactive.

We need interactive T-Sheets.

Next Post:

Humans Have Limited Working Memory

Rick Weinhaus MD practices clinical ophthalmology in the Boston area. He trained at Harvard Medical School, The Massachusetts Eye and Ear Infirmary, and the Neuroscience Unit of the Schepens Eye Research Institute. He writes on how to design simple, powerful, elegant user interfaces for electronic health records (EHRs) by applying our understanding of human perception and cognition. He welcomes your comments and thoughts on this post and on EHR usability issues.

11 Comments

Curbside Consult with Dr. Jayne 2/6/12

February 6, 2012 Dr. Jayne Comments Off

The past week has been crazy, and unfortunately the crazy spilled into the weekend as well. I had visions of the perfect thought-provoking topic for this week’s Curbside Consult, but every time I tried to flesh something out, it escaped me. Instead, I found myself musing on what I planned to do at HIMSS and which vendors I wanted to be sure to check out. Mr. H and Inga are hard at work on their “must see” vendor list and I’m working on my personal CMIO hit list.

For the CMIO (or anyone involved in evaluating new products or making purchasing decisions) it can be a great way to sort the proverbial wheat from the chaff. Many products look great in brochures or on the Internet but pale when you see them in person. Last year one of my “hot items” (sad that I think this is hot, isn’t it?) was wall-mount swing-arm brackets for monitors. The true test of quality and sturdiness is being able to check them out in person rather than trust a marketing slick.

You may ask, why does a CMIO care about brackets, and should she? The answer is yes. If I have to use it every day, I want to make sure it’s going to work for me and for the hundreds of physicians I represent. That’s not to say that the CMIO should be out personally investigating everything that needs to be purchased. Generally I prefer that the engineering and purchasing folks work their magic first, culling the herd down to their top choices, then allow a small group of providers to make the final call.

This year I have a laundry list of things to look at. Some are a bit gadgety (washable keyboards, COWs), others are more esoteric. I want to see how vendors are progressing with natural language processing and where they stand with clinical decision support. Are they going home-grown, or incorporating third-party solutions? How are the attendees responding to them? Who has incorporated Medicomp’s Quippe product that blew our minds at HIMSS11?

Like last year, I hope to have some time to cruise the exhibit hall with Inga, but I will also have some time to peruse the booths with a few other CMIOs and share their opinions and thoughts. One of my friends is a first-time attendee, so watching his expression as he sees some of the people out there will be interesting. A note to ChipSoft: I see you’re exhibiting again. If you’re giving away the clog slippers this year, please stash some for Inga and me because we’ll be looking for them and you ran out last year.

The marketing materials from exhibitors are arriving much more slowly than I remember from last year. So far, my favorite marketing piece is from CDW Healthcare, with their “What happens at HIMSS definitely won’t stay at HIMSS” tagline and accompanying poker chip. Although I like the idea of taking home things I learn, based on the potential for Inga and Jayne to have a good time, I’m sure some things will be staying well within the 89109 zip code.

Speaking of marketing, I received quite a response to my comment on why the soles of Christian Louboutin shoes are red. One reader shared his shame:

I must know. During a Battle of the Sexes trivia contest, I and my fellow male panel of knowledge brokers failed to identify the maker of the famed red sole shoe. It was the tipping point in a tight contest that found us falling to the gals. I now must know why the soles are red…

A certain savvy reader provides the answer:

Just a quick comment to say I thoroughly enjoy your commitment to giving your readers a well-balanced education. Not just what’s up in healthcare, but why CL shoes have their distinctive red sole! A mundane process turned into a brilliant marketing differentiator. I’ll be looking out for them!

In short, it’s all about branding. Louboutin trademarked the red-soled look in 2008, fighting to protect the distinctive look when Yves Saint Laurent came out with a red sole in 2011. YSL claimed in court documents that red soles existed long before Louboutin trademarked them:

Red outsoles are a commonly used ornamental design feature in footwear, dating as far back as the red shoes worn by King Louis XIV in the 1600s and the ruby red shoes that carried Dorothy home in The Wizard of Oz.

There’s your fashion moment of the day, and hopefully some of you can leverage this newfound knowledge to win the hearts of your lady-friends who might have a thing for shoes, not to mention to triumph in the next battle of the sexes trivia night.

Have a favorite HIMSS (or other show-related marketing piece) to share? Does it belong in the Hall of Fame or Hall of Shame? E-mail me.

E-mail Dr. Jayne.

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Monday Morning Update 2/6/12

February 4, 2012 News 5 Comments

From Kit Carson: “Re: Fletcher Flora. I’m interested in knowing what’s going on with shareholders. The final distribution statement was supposed to go out in November 2011.” We broke the news in November 2010 that Merge Healthcare had acquired the LIS vendor (I forget how I found out, but it must have been sneaky since I worded it as “HIStalk has learned,” which means I was snooping.) I don’t know anything about its shares, but I’ll run an update if anybody has one.

From Adele: “Re: HIStalk. As a sponsor, thanks for all of your hard work toward making HIMSS as productive as possible for your subscribers and for your sponsors. We are grateful that you all actually make the time to track our news and offer your suggestions to us when there are so many larger ‘fish to fry’ in your universe. HIStalk is one of the only places that provides for an equal voice for all of its sponsors, regardless of size, revenues, or politics. As a smaller company, we just can’t write a fat check simply to pay to play in some other channels. Moreover, we wouldn’t. For us, that is just not responsible stewardship of our clients’ resources.” Sometimes Inga and I need a little boost and this gave us one. Thanks.

From Vendor_Neutral: “Re: Epic. Wondering if you came across the online discussion spurred by the NYT piece?” I did see it, but like a lot of Internet discussion, I found it to be mostly hot air pontificating by industry sideliners and self-referencing, self-appointed experts who have never used Epic, aren’t clinicians, and don’t even work in healthcare IT (if you’re going to criticize a restaurant, at least eat there a couple of times.) Some of the least-informed comments drone on about Epic’s outdated technology, a clear signal that the authors have no experience in a business software environment, where customers value applications that are solid, scalable, and expertly managed over the latest iPad app or cool Web site. To dismiss the business and software savvy of hospitals that are buying Epic in droves is ludicrous, even if you (as I) doubt that most of them have the organizational fortitude to get the rosy ROI and patient benefits they expect when they fork over mega-millions. Somehow I doubt that Judy is losing sleep worrying that all the armchair quarterbacks will redirect their expertise into building a better mousetrap that will renders hers as obsolete as the company’s persistent detractors claim it already is.

From CDS Observer: “Re: FDA regulation of clinical decision support. This could be serious since it could involve a wider range of systems to be regulated, such as EMRs and simple apps. This would be a big blow to many smaller companies. Our company has joined CDS Coalition to make our voice heard and to keep members informed in case their product ends up getting included in the regulatory net.” I found the CDS Coalition’s Web page here. Companies pay $1,200 to $30,000 per year to join.

From Ambergris: “Re: KLAS scores of publicly traded companies. Didn’t you post something at one time?” That was actually Evan Steele of SRS, who made the point in October that five of the six top-rated EHR products are offered by privately held vendors, while eight of the nine lowest-ranked products are offered by publicly traded companies. To be fair, he’s only looking at customer support rankings of a specific ambulatory EHR category. However, I will add from experience, having had a few incumbent vendors go public or be acquired by publicly traded companies, that every one of them got worse afterward (I’ve written many times on the KLAS “first to worst” product phenomenon.) Investors replaced me as the company’s most important customer. I’d like to say it doesn’t have to be that way, but I can’t think of many exceptions. On the other hand, if you buy from the company after they’re public, at least you know what you’re getting and have less reason to be disappointed compared to the folks who knew them before.

From Jess: “Re: fast track clinic model for expediting medical services to patients coming to the hospital. I was hoping I could tap into your vast knowledge base to see what you know about this model.” I think you are overestimating the vastness of my knowledge base since it’s coming up empty on this topic (although come to think of it, “vast” usually means big but empty.) I will call in the assistance of expert readers to fill my void.

From The PACS Designer: “Re: Jobs biography. The biography Steve Jobs by Walter Isaacson has some interesting comments. Jobs said of Microsoft’s Bill Gates, ‘Bill is basically unimaginative and has never invented anything, which is why I think he’s more comfortable now in philanthropy than technology.’ Isaacson said this about Steve: ‘He was not the world’s greatest manager. In fact, he could have been one of the world’s worst managers. He could be very, very mean to people at times.’" I think that’s what I enjoyed most about the book – trying to figure out how someone so narcissistic, uncaring, and downright nasty could not only create arguably the world’s greatest company, but run it as a publicly traded company CEO almost until the day he died despite seemingly lacking all the important skills for the job. The only other example I could think of was Neal Patterson of Cerner. And Bill Gates. I guess the bottom line is that if you’re a visionary who started the company (see: Mark Zuckerberg), you can mold it to your bizarre personality, unlike the typical gunslinger, committee-vetted musical chair CEO that big corporations love who are loaded with MBA school bean-counting competency but short on anything resembling risk-taking, innovation, and vision.

The good news about offshore programming is that half of responding readers don’t automatically assume it means shoddy work. The bad news is that the other half do. New poll to your right, and this should be fun: who is most responsible for the glut of clinically useless EMR information?

Inga and I forget ever year just how busy we get in January and February in the HIMSS build-up period: interviewing, plowing through increasing numbers of pointless press releases to find the occasional newsworthy tidbit, adding new sponsors, and planning HIStalkapalooza. If we’re slow to respond, that’s why. I came home from a nine-hour day at the hospital Friday, chowed down the Wendy’s salad and baked potato helpfully provided by Mrs. HIStalk on her way home from work since she knew I was overwhelmed and had approximately 15 minutes of free time to eat, and worked eight straight hours on HIStalk stuff without even leaving my chair. Six hours later, I was back up and at it for another long day Saturday, where emerged like Punxsutawney Phil only long enough to see my own shadow during a brief lunch with Mrs. H, then get back to work. That grind won’t end for us until the conference is over. I will need (and am taking) a vacation afterward, assuming I survive until then, and Inga will be away the week after. The worst thing is that, like a crack user, I enjoy it and can’t see cutting back even though it’s probably unhealthy. While I’m away, I’ll plan my self-improvement for the rest of the year, so if you have ideas of books I should read, conferences I should attend, or things I should do, let me know.

Speaking of HIStalkapalooza, thanks again to ESD for putting together an outstanding event. It’s a big effort to have planners visit potential sites, work out food and entertainment details, handle logistics like registration and decorations, and of course write a huge check when it’s all over. They have been outstanding to work with, and since they get what HIStalk is about, they suggested some fun surprises that I heartily approved. If you need consulting help with your clinical systems projects (training, implementation, support, optimization, Meaningful Use, etc.) I’m sure they wouldn’t be opposed to taking your call. If you got an HIStalkapalooza invitation, please thank them when you get there. I wasn’t even sure I wanted to do another event this year, but I think it’s going to be cool.

Also fun: Medsphere is bringing over its 1971 VW open source bus, which Chairman Mike Doyle tells me will be available “to shuttle HIStalk groupies to your event on Tuesday.” I don’t know what they’ve planned for routes and all that, so maybe just flag it down if you see it if you need a ride to the Palazzo.

I’ll put in just a brief placeholder for our Booth Crawl, which will offer provider attendees of HIMSS what I would guess is their best chance to impress the fam by bringing home an iPad 2. Think of it as a scavenger hunt where you visit the designated booths to get the answers to secret questions (you’re visiting booths anyway, so you might as well hit these and get in the running for a swell prize.) You enter those answers online by Wednesday evening and watch HIStalk to see if you are one of the randomly drawn winners. You don’t have to get stickers or stamps on a card, you don’t have to drop your entry into a hopper, and you don’t have to be present to win. We have 55 iPads to give away, so the odds should be pretty good, plus you’re supporting our sponsors just by playing (not to mention that I noticed that a couple of sponsors have added prizes of their own.) I’ll be posting the form shortly. Nobody’s making money off this since we’re doing the work on our end for free and the sponsors happily donated the prizes, so for everybody involved it’s all about putting iPads into the hands of readers.

One last HIMSS note: if you aren’t attending, we will try our best not to make you feel left behind even though we have to write a lot about it. I think I speak for most readers in saying that the more years you go, the less you enjoy it and the more it becomes work instead of fun. I stay up until all hours each night at the conference writing everything up so you won’t miss anything important. The educational sessions are always iffy if you don’t research the presenter’s credentials in advance – I should hire someone to help me put on independent Webinars that would provide similar education without the travel and time off expense, which I’ve been talking about doing for years.

I verified that RelWare has closed its office and let half the staff go, having lost the client for which it developed its EXR EHR, Henry Ford Health System. HFHS went live on the $100 million system, then decided less than a year later to have a $350 million fling with Epic instead (note to self: don’t ask HFHS for long-term IT strategic planning help.) RelWare is sitting on a certified EHR (Inpatient and Modular Ambulatory) that is running in six hospitals and 100 clinics that will soon be homeless, so they’ll consider licensing arrangements or outright sale of the source code to interested organizations. My RelWare contact is somewhat informal, so I guess you can e-mail me if you’re interested and I’ll forward.

Travis has been writing some really good stuff on HIStalk Mobile lately. The fun mixture of pieces includes, in the three most recent posts, (a) a hands-on review of the Zeo Sleep Manager; (b) a new post that contains a lot of items that I hadn’t seen elsewhere; and (c) his take on mobile strategies for pharma. He’s a doctor and an mHealth startup guy, so while I’ve seen splashier sites covering similar ground, I haven’t seen any doing it better.

Thanks to the following new and renewing sponsors that supported HIStalk, HIStalk Practice, and HIStalk Mobile in January (click a logo for more information). You have to admire them for mailing off a check to a post office box to an anonymous, smart mouth blogger without so much as a phone call to sooth any concerns they might have. They either sign up after reading the information sheet or they don’t, and we appreciate those who do.

Epocrates earns Ambulatory Complete EHR certification for its EHR v2. I had forgotten they had one, to be honest. They acquired the iChart mobile app a couple of years ago and rebuilt it into a full product, announcing GA in July 2011.

TrustHCS names Dianne Haas PhD, RN as executive director of its consulting services division.

Morton Meyerson joins the board of Encore Health Resources. He’s the former CEO of Perot Systems and runs Dallas investment firm 2M Companies, Inc.

Office for Civil Rights has cranked up their HITECH-mandated spot-check HIPAA audits, with the first 20 lucky organizations being notified in December that they had been chosen (with 130 more planned for 2012.) CynergisTek and ZixCorp are running a free Webinar next week featuring former HHS HIPAA enforcer and attorney Adam Greene and some folks who participated in those first 20 audits. If anybody has time to sit in, let me know the gist.

Vince’s HIS-tory lesson this week gets a bit more personal, honoring former SMS VP Jim Carter. Vince’s stuff isn’t just for the long-timers – whippersnappers can learn from the HIT history books, too.

McKesson acquires the oncology clinical decision support tools of Proventys.

Lawson announces that its Cloverleaf integration technologies have met the highest industry standards at the IHE Connecthon.

Joint Commission investigates a complaint against University of Michigan Health System that says it waited six months before telling police that child pornography had been found on a medical resident’s flash drive in the ED. Joint Commission is considering whether the delay qualifies as a sentinel event.

Revenue cycle vendor Accretive Health, already being sued by the State of Minnesota over a lost laptop, has its debt collections license suspended by the state until it provides information about how it was using patient information for collections and how its collectors interacted with patients.

Apple CEO Tim Cook, showing more support for charitable activities than his predecessor, says the company has donated $50 million to Stanford’s hospital, most of it for new building construction. Maybe he should have looked for charities that don’t run a hugely successful business already given that Stanford Hospitals and Clinics reported a profit of $186 million in its most recent government reports, paying its president almost $2 million and the CIO $680K. I’ll say this: when I donate to charity, it’s never to a hospital, including the several I’ve worked for. They are making plenty of money already, wasting significant amounts of it, and not really helping improve health as much as just providing more episodic healthcare encounters. I’d rather support public health causes that keep people from becoming their customers, such as those addressing obesity, disease management, and preventive care.

HIE vendor Sandlot Solutions names Joseph Casper, formerly of MedPlus, as CEO.

We asked readers to let us know if they were presenting at HIMSS after one expressed concern that as a first-time presenter, she might be standing in a nearly empty room. Here are those who submitted their information.

Session # 55: Tale of Two Health Systems: Implementing an Enterprise Data Warehouse

Two major health systems (Orlando Health and Essentia Health) present their lessons learned and benefits achieved via an enterprise data warehouse initiative.
Rick Schooler, Orlando Health Ken Gilles, Essentia Health
Tuesday, February 21, 12:15 PM – 1:15 PM

Session #31: Marketing the Healthcare IT Project

Effective marketing is a crucial part of any IT project- We will discuss innovative ways you can market to end-users and provide real examples from premier health systems to amp up the marketing initiatives within your organization.
Chuck Christian, CIO Good Samaritan Hospital Steve Bennett, VP Kirby Partners
Tuesday, February 21 @ 11:00-12:00 Murano 3303

Session # 42: EHRs: The New Drug Safety, Liability and Efficacy Battleground

The rapid adoption of EHRs by U.S. providers creates a new and powerful platform to improve patient safety, professional liability protection, drug efficacy and regulatory compliance.
Edward Fotsch, MD, Chief Executive Officer, PDR Network David Troxel, MD, Medical Director, The Doctors Company
Tuesday, February 21, 12:15 PM-1:15 PM (Marco Polo 803)

Session # 110: A Community HIE that Makes Cents while Improving Health Location

MyHealth Access Network, a Beacon Community in Tulsa, is focused on improving health with a community-wide infrastructure for healthcare IT learn their approach and associated ROI evaluations.
David Kendrick MD, MPH, CEO MyHealth Access Network, a Beacon Community
Wednesday, February 22, 1:00 PM – 2:00 PM

Session# 211: Increasing Nurse Leaders’ Informatics Skills: Building from the TIGER Competencies

Provides a discussion of the application of TIGER competencies to create institutional education programs to increase nurse leaders’ informatics skills.
Melissa Barthold, MSN, RN-BC, CPHIMS, FHIMSS IT Senior Clinical Solutions Consultant University of Mississippi Medical Center Jackson, Mississippi
Friday, Feb. 24th, 2012 10-11 AM

Session #66: Extreme Makeover – ICD-10 Code Edition: Demystifying the Conversion Toolkit

ICD-10 translation engine tools, code mapping tools, crosswalks, GEMs, code simulation tools, medical language/content management tools, computer-assisted coding software, and more — what’s a healthcare organization to use?
Deborah Kohn, MPH, RHIA, FACHE, CPHIMS Principal Dak Systems Consulting
Wednesday, February 22; 8:30 – 9:30 am

Session #153: How to Create a Care Coordination Team Using Spare Parts

Learn about a primary care group’s innovative model of care coordination which combines standard EMR functionality + clinical checklists + low cost staff to make life easier for physicians and patients, while improving quality and saving time and money for everyone!
Lyle Berkowitz, MD, FACP, FHIMSS Medical Director of IT & Innovation, Northwestern Memorial Physicians Group (NMPG) Associate Professor of Clinical Medicine, Feinberg School of Medicine at Northwestern University.
Thursday, Feb 23: 9:45 AM – 10:45 AM (Marcello 4502)

Session #32: The New Millennium of Enterprise Patient Centric Care across the Revenue Cycle

This presentation will review how the Cleveland Clinic is transforming traditional revenue cycle management by implementing an enterprise patient administrative management system, aligned to their Patients First Initiative.
Lyman Sornberger, Executive Director Revenue Cycle Management, at Cleveland Clinic Health System, and Dawn Mitchell, Principal, Aspen Advisors
Tuesday, 2/21 – 11:00am – 12:00pm

Session #406: IT Governance for Hospitals and Health Systems

Learn how to create an IT governance process that increases the number of projects that support your organizational strategy and are completed on-time and on-budget.
Roger Kropf, PhD, Professor at New York University, Wagner Graduate School, and Guy Scalzi, Principal at Aspen Advisors
1 of only 12 HIMSS eSessions

Session #9: The People of Clinical Decision Support

I’ll present results of a qualitative study I conducted along with OHSU’s POET research team at seven hospitals and health systems across the US focused on the types of people needed to carry out a clinical decision support program.
Adam Wright from Brigham and Women’s Hospital in Boston
Tuesday, February 21 @ 9:45 AM in Veronese 2503

Session #163: Applying Lean Principles to Ensure Clinician Productivity while Securing PHI

In this session we will explore the process and results of applying Lean principles at Mahaska Health Partnership to measure clinician productivity and minimize waste when implementing security technologies.
Kristi R. Roose Information Technology Director, Mahaska Health Partnership Dan Nikkel Continuous Improvement Director, Mahaska Health Partnership
Thursday, February 23, 1:00 PM – 2:00 PM in Lido 3103

E-mail Mr. H.

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Time Capsule: What Paul McCartney Can Teach Providers about Contract Penalties

February 3, 2012 Time Capsule Comments Off

I wrote this piece in February 2007.

What Paul McCartney Can Teach Providers about Contract Penalties
By Mr. HIStalk

This is top-secret provider stuff. If you work for a vendor, why not skip on down to the news items? I’m about to tell your prospects to take actions that you’ll dread.

As a hospital IT person, I would never sign a vendor’s software contract without including a variety of specific and severe performance penalties. From recent Inside Healthcare Computing articles, many or most hospitals will. I’m shocked. I like vendors, but money makes people (and companies) behave badly. Be friendly, but get everything in writing.

Vendors (software or otherwise) can say anything they want about their product’s performance and reliability. Those statements can have one of three possible outcomes:

If the company is both knowledgeable and honest, you will be pleasantly unsurprised when their product works as advertised, but at least you won’t be caught unaware by a major meltdown. That’s the best (but not necessarily the most common) outcome.
If the company is honest but doesn’t have broad enough experience with their product in a setting like yours, you’ll probably be miserable together, hoping they’re as responsive as they are honest. That’s bad. Sometimes you hit architecture or design flaws that can’t be fixed, in which case you’ll use resources to work around the problems.
If the company is lying or has wildly oversold their wares, nothing else matters because you’ve been suckered into a long-term, expensive, and contentious relationship with a vendor that has already demonstrated its willingness to take your money under false pretenses. That’s the worst case.

The biggest mistake hospitals make is uncovering problems with previous implementations, but then buying the product anyway. The most common rationalization: “We’re smarter than those rubes who couldn’t make it work, plus we really like the product and the salesperson.” That combination of naiveté and misplaced bravado has lined many a sales rep’s pocket. It often benefits an executive recruiter, too, since the CIO who ignores a product’s well-known, spotty history often has plenty of free time to reflect after he or she has been shown the door.

Vendors may not be thrilled to see the list of penalties you want, but they aren’t your best buddies. They have their bottom line price and terms. You’ve got yours. Negotiation is meeting somewhere in that middle ground, fighting for the bigger chunk of the unclaimed territory on the table. If the vendor doesn’t visibly hate you during negotiations, you’re not pushing hard enough. Nice guys and gals don’t get good deals.

Contracts without penalties are binding only to the customer. If the software fails to provide value, crashes constantly, or can’t be used like you were told, you still pay unless you were smart enough to write in penalties. Your want their skin in the game with yours.

The most important eventualities to cover with penalties:

If the software doesn’t do what you were promised in a way that makes it unusable.
If you have problems that will cause you the most harm: downtime, poor response time, or cancelled development plans.
If the software or vendor has weak areas that sound like trouble. If the salesperson’s teeth clench up when you lay out penalty terms for failing to deliver a richly functional ED package or a CPOE-to-pharmacy interface, maybe you haven’t heard the truth.

A hard-hitting, predefined penalty is your best hope for getting undivided attention when a problem arises. The cash won’t be much consolation, but it does create an automatic escalation path respected by all.

I know we all like to throw harmless little love words around like “partner” and “shared vision,” at least until you’ve signed the deal. Vendors pretend to be wounded when you sully the honeymoon bed with legal requirements. Take a lesson from Paul McCartney – maybe the vendor is a wonderful partner who loves you for something other than your money, but make them sign an air-tight prenuptial agreement just in case. Secretly, they’ll admire you for it.

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HIStalk Interviews Brian Sherin, President, Besler Consulting

February 3, 2012 Interviews Comments Off

Brian Sherin is president of Besler Consulting of Princeton, NJ.

Tell me about yourself and about the company.

I got started in healthcare accidentally. I was doing an internship while I was in college, in an accounting department of a hospital. I can still see the face of the controller who I worked for at the time when I walked in, that look of, “I’m going to deal with this kid all summer?” But we got along well and I did that for two summers. I got involved in a lot of aspects of accounting, although my major was finance, not accounting per se.

When I came out of grad school, I ended up in a very a bad economy, pretty similar to now, and I didn’t have a job. One of the guys I worked with in the accounting staff there called me and said, “Are you interested?” and I said, “Well, sure.” So I did that, and then about eight months later the controller asked me if I wanted to take the business office manager position. I lost a lot of respect for them at that point [laughs] –I thought he had better judgment than that since after, all I had virtually no experience. But he told me he had confidence in me and I could do it, so away we went.

Over the next 11 years, I moved from patient accounting to managing the overall revenue cycle, worked closely with HIM and other clinical departments. I eventually I took over on more administrative responsibilities. To this day, I’m really grateful for the guy having confidence in me at the time. He gave me an opportunity to learn so much and to set me on my career path.

As you can tell by now, I’m not an IT expert in any way, but I think from the business perspective I am very much an advocate of using technology to every advantage possible. I guess I could stretch it and say that I’m an IT user expert, or maybe advocate is a better way to put it. As I look back at my career, some of the more positive and exciting experiences I had were overseeing several HIS system implementations for the hospital. I just found them really very rewarding once completed. I’d like to do some more of that, but I haven’t been involved with those for a while.

While still at the hospital, I talked to Phil Besler one day. He had founded the firm back in 1986 — this was probably the early ‘90s. I joined him. It was really a reimbursement firm back then. That’s all we did except some charge master work. We began to expand that and we moved into doing hospital revenue cycle consulting in the mid ‘90s. Those areas grew pretty quickly. Finally we established a coding accreditation compliance service line, which rounded out our service offerings.

Now I would define us as a financial and operational consulting firm. We have about 200 customers in 20 states and roughly 50 employees. Most of our clients are hospitals, though we count physician groups as well as other types of providers as clients. A majority of our business has been traditional consulting.

In 2002, we did a former company called Innovative Healthcare Solutions, which we began by taking the charge master review software we had developed in-house — which I believe was in FoxPro at the time — and we developed a Web-based tool that we marketed. It was pretty exciting. We’d never done anything like that. Eventually we developed other decision support products. IHS was eventually sold to Accuro in 2005, then Accuro became part of MedAssets, I believe in 2008.

In the last two years, we began to focus on software again. We launched our BVerified line of solutions last year. Our latest two products were launched early in January. The idea behind getting back into software and creating these solutions is that we want to be able to provide our customers these software products that allow them to receive the benefits of our expertise we’ve developed over the years, while at the same time creating the potential to drive additional benefits for our client through that software.

Between your consulting opportunities and now you’re more productized offerings, what revenue opportunities do you typically find that even pretty good hospitals and even your competitors might miss?

Most of what we’ve been doing is on the consulting basis with regard to some of our revenue recovery opportunities. We do the majority of our work as the primary vendor. However, we have found pretty significant opportunities going in either behind just solely internal processes on the part of hospitals or after other vendors. Depending on the particular issue, whether it’s on the DRG transfer rule or IME, very often we find up to 30% or so of additional revenue.

I think a lot of that has to do with just our approach. We’ve refined it very much over the years. We’ve identified some areas that we think are often overlooked either through internal processes or by other vendors. But at the same time, we’ve focused very, very heavily on the compliance aspects of it. We also have seen some processes that are not very compliant. We had a lot of input from our clients that they wanted something that they could be assured was entirely in compliance with all the rules and regs. We put a lot of effort and resource into that.

Is there a lot of concern out there about the RAC audits and all the other audits that the CMS is talking about doing?

I think there is, but my sense is it depends on what part of the country you’re in. Here in the Northeast, we haven’t seen a lot of RAC activity, but it’s almost like everyone’s waiting for the other shoe to drop. They know it’s coming — they just don’t know when. With their hands full with what they already have — with all the organizations out there doing audits and all the other demands they have on them, especially from the IT perspective — they’re very concerned, yes.

Do you think it will be like the IRS, where they will take a small sampling and make a high-profile example of any problems they find?

I don’t think that’s the way it’s necessarily going to go. Even on the RAC side, they’re still finding their way as well. I think some of it will come to that, where they’re going to realize that it’s so labor intensive to get through some of this. If you look at the recent demonstration project that CMS put out where if you want to join on, you’re essentially giving up your right to appeal short stays that are denied as inpatients, but they will allow you to bill them as outpatients. My guess is that one the reasons they’re going forward with that demonstration project is just because of the volume of appeals they’re experiencing.

I think it’s going to take some time for everything to settle out. Eventually, you may find more of the old style initial teaching hospital audits from way back in the ‘80s, when they looked at 30 claims or 100 claims and decided that they were due $18 million. I don’t think it’s going to be quite that bad, but I think there’ll be more of that practice as we go forward.

Describe the problem with hospital readmissions and what clients are asking you to do to prepare them for that.

CMS is going to begin looking at data with regards to readmissions. They’re going to essentially identify the top quartile in hospitals in terms of unnecessary readmits or related readmits. It’s going to reduce your overall Medicare-based payment. A lot of hospitals are looking at that. It’s fairly easy to look at the Medicare data that’s out there to determine where you fall yourself within the three categories of diagnosis they’re going to be looking at. It doesn’t really necessarily tell you where you fall in relation to what quartile you’re in.

It seems to us from talking to a lot of hospitals, those who have a problem know they have a problem. In a lot of ways, they feel like they’re in a situation where there’s not a whole lot they can do to effectuate any real change in those patterns quickly. Another factor is that a lot of people don’t realize is that the readmissions include if you discharge a patient and they get readmitted to another facility. You don’t even know that, but that counts towards your readmission number. And that data is not generally available to everybody.

I think it’s something that everyone is trying to do a better job of coordinating care. Once patients leave the hospital, they’re trying to do a better job of communicating with patients, making sure patients are following through on physician orders and seeing their physician within a specified timeframe and so on. But there’s limited resources to be able to do that, and there’s limited ability to really change people’s behavior in that way.

With the emphasis on making clinical care delivery less episodic, the billing stayed episodic and only now is moving toward billing for non-piecemeal work. Are hospitals going to be able to adjust quickly with the emphasis on ACOs?

I think that’s a real problem. Physicians have had that issue over the years too, where in some situations, they’re expected to manage care well beyond when they see the patient. It’s difficult. There’s really no reimbursement for that aspect of it. I think that ultimately hospitals understand that that’s the way it’s going. Whether you believe in ACOs or feel that they’re going to be the panacea some people think they’re going to be, nonetheless, that is the way things are going.

I don’t think anyone will argue the fact that a better process to manage patients once they leave the hospital — make sure they are following certain care plans, make sure they are seeing the right types of providers in the proper timeframe — is going to reduce readmissions, it’s going to reduce inappropriate admissions, it’s going to cut down on emergency room visits, and it’s going to overall have the great potential to lower the cost of healthcare. But we’re asking a lot of providers out there that are not going to be reimbursed in any way for a lot of those activities to take that on. I think that the funding for that is going to become a really critical issue.

There’s probably not much appetite to pay more for care, and not much ability since the government’s such a large payer. I guess it’s the equivalent of telling a steakhouse, “As of next week, you’re going to offer the same menu except as a one-price buffet.”

I agree. I don’t think there’s going to be much appetite at all for the government to put out any more money for this kind of thing. I think they feel that through some of these programs such as ACOs, with some of the incentives and whatnot, that’s going to effectuate some of this. And it may, for those who decide to become ACOs or maybe are positioned to do that.

The fact is that most providers are not really positioned to become ACOs and the incentives that are there for them. Even some of the premier facilities in the country have indicated that they don’t see the advantages to going to that ACO model and getting involved in that whole program. If they don’t see the value, it’s hard to believe that any inner city hospital is going to have the funds or the abilities to be able to put any kind of model like that in place unless they’re somehow funded for it.

Hospitals are imitative. If one does it, everybody does it. If a consultant starts recommending it or it shows up in a magazine, everybody jumps in line to do it. Do you think they’ll experiment with the ACO and either back out quickly or lose their shirts before they realize maybe it wasn’t as good as it sounded?

I don’t know. I’ve done some speaking engagements and have been in a number of meetings where someone would ask, “Who here from a provider side is going to plan for being an ACO?” Almost everyone raised their hands. I think that was just because it was early on — the rules weren’t defined.

As more and more comes out with regard to what’s expected from ACOs and what the cost is going to be and the type of infrastructure you had to have in place to effectively manage an ACO, I think you’re seeing more and more back away from it. My guess is there’s not going to be a whole lot of organizations that actually go all the way through and become an ACO and actively participate in that project. So we’ll see. My guess is that as providers dig through it, they’re going to realize that there’s really not a whole lot of advantage to them.

Do you have real-world examples of what you’ve found with your BVerified process?

The very first client we had for the screening verification tool, which was really the first BVerified product we put out there, we immediately found something which looked … I won’t get into the details, but it looked very questionable. We immediately called them and it was something that they were aware of. They were actually pretty impressed that we came up with it so quickly.

Everyone’s had some kind of finding. Sometimes as you go through those, you identify that there are things that were corrected or maybe it was incorrect information that was submitted to do the verification and whatnot. But our clients have been very happy with it thus far. To them, it’s a one-stop shop. They don’t have to have multiple screening tools in place. They’ve been happy with the product and the results they’re getting out of it.

It’s to check the HHS’s database for excluded parties, correct?

Yes. It goes through and checks both federal and state databases. We can adjust that, because with regard to some state databases, there are timeframes and “how often” rules in terms of how often you have to check. We built all of that into it. Essentially it’s looking for excluded individuals. It also has some additional functionality — it allows you to verify licensure and things like that as well.

You’ve done services related to point-of-service collections. Money is being left on the table by letting patients walk away without, but consumers are pushing back about being asked for a credit card before they’re seen. How do the hospital know that they’re ready to initiate that planning for point-of-service collections and what’s involved with transitioning to that?

The time is well past when those programs should be in place. In talking to our clients, I’ve always maintained – and this goes back quite a ways – you need to start this now, because it’s not like you just put someone with a cash register at the door. It doesn’t work that way. Most hospitals serve a pretty much a specified community, and it’s a matter of changing that community’s understanding of how you function. There’s a lot of communication that has to go on with both the patient population as well as the referring physician population. They need to understand what you’re doing and why you’re doing it.

Physicians have been doing this very effectively for a long, long time. Maybe it’s not some of the same dollars that are involved in terms of physicians who are merely collecting co-pays, but I defy you to find anyone who’s covered by any kind of a managed care or a PPO plan who’s gone to their physician who’s gotten to see that doc without paying their co-insurance first. They’ve done an effective job of that, so physicians understand the need for it.

The dollars are significantly more on the hospital side, but that can be worked through in terms of an arrangement with the patient. It takes a long time. It’s an educational process, it’s a community educational process. It’s not something you just turn the switch on overnight. What I’ve seen mostly is that hospitals have implemented it in maybe a few different areas within the hospital, but not universally. They do get pushback.

There has to be a commitment all the way up the management string, right up to the CEO and the board, that this is what we’re doing and this is how we’re going to do it. They’ve got to resist those calls that come in and say, “I was there the other day and I’ve been coming there for 30 years and now you’re asking for payment up front.” Everyone has to be on board, because as soon as you start making exceptions, it quickly loses its effectiveness.

What do you see as major areas of concern in the next five years and what should hospitals be doing now?

We’re addressing a lot of things on our end. With some of the other software tools we’ve developed, we’re trying to come up with ways that hospitals can take our expertise and our experience with a lot of things. We put them into a software tool so that the hospital can internalize them and gain greater control over some of those functions. Instead of doing it on a consulting basis, they have the ability to do it on their own. That works for some, doesn’t work for others.

We understand that a software solution isn’t automatically the solution for everybody. We’re trying to do that because what we’re hearing from some of our clients is that they need to bring some things internally and they want to reduce their costs a little bit. That’s why we’ve done those things with the transfer DRG tool and the Medicare advantage IME tool and our revenue integrity auditor.

At a higher level, my feeling is that over the next five years, hospitals have to begin to fully integrate their clinical and their financial operations. There’s still a separation there to a large degree with a lot of hospitals. While everyone’s moving in that direction, I think it needs to be looked at more as a business. There has to be a way to bring together those two aspects of the operation in one cohesive whole.

While obviously patient care is the business you’re in and you want the highest possible quality you can get, there needs to be some control over that, in terms of how you best do that. I think that’s the whole ACO concept, which is good. I’m not convinced on the ACO model, but I think the ACO concept is good in that it makes you bring it all together, operate more cost-efficiently, and coordinate care across the whole spectrum of the services the patient’s going to receive in their inpatient, outpatient, physician, physical therapy, specialists, whatever it may be.

The most important thing over the next five years is to start looking at healthcare delivery – and I don’t mean this in any kind of impersonal way — as a business, bringing together the financial delivery of care and the clinical delivery of care so that you’re getting the most sufficient product you can.

Any concluding thoughts?

We’re experiencing the most interesting and fast-paced changes we’ve ever seen in this industry. More so than ever, the changes we’re seeing now will dramatically alter the way healthcare is delivered and managed from this point onward. Everyone’s got to be ready for it, because I don’t think there’s any turning back. There may be some stumbling along the way, but everything that’s been started now is going to move forward. As Bob Dylan said, “You better start swimming or you’ll sink like a stone, because the times they are a-changing.”

We’re changing our approach and trying to meet the changing needs of our clients. We continue to focus on trying to find all the revenue we can for our clients. We won’t stop that. That’s the reason for developing some of these software tools — to give something to our clients that has a demonstrable, compelling ROI.

It’s pretty exciting times, but they’re also very challenging times. I think the pace is only going to pick up. We’re going to see incredible rate of change over the next few years.

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News 2/3/12

February 2, 2012 News 6 Comments

Top News

Shares of EHR vendor Greenway Medical Technologies rise 30% on its Thursday IPO, making GWAY the day’s biggest gainer on the New York Stock Exchange. Shares closed at $13, valuing the company at $358 million on revenue of $90 million. The company had revised its IPO price downward from $13 to $10 at the last minute, obviously leaving money on the table in hindsight.

Reader Comments

From Mr. Hospitality: “Re: HIMSS schedule. Do you know if there is a way to drop the HIMSS schedule into Outlook? Didn’t there used to be a way to do that?” I don’t use Outlook, but I couldn’t figure out an easy way to create a schedule in general from the HIMSS website. However, the HIMSS folks say an app is coming next week. I actually found it here, though it looks like it’s not quite complete since some sessions still lack specific details. The HIMSS12 Mobile Guide does allow you to select favorites and thus create a personalized schedule, though it’s not integrated with Outlook or other calendars.

From IT Guy: “Re: Reliance Software Systems. RelWare. the company that was developing the EMR for Henry Ford Health System, is no more. HFHS announced that it would implement Epic and sunset RelWare’s EXR product, leaving the company with no clients other than Ford. They have closed their doors and let their staff go.” Unverified. I e-mailed the company and received no response. Henry Ford went live less than a year ago on EXR.

From Randy Lugano: “Re: EMR character limit on assessments. Is this a common feature in popular EMRs?” A physician’s article in The New York Times in December bemoans her EMR’s 1,000-character limit as she tries to compose a usable assessment of a complicated patient.

I nip and tuck my descriptions of his diabetes, his hypertension, his aortic valve stenosis, trying to placate the demands of our nit-picky computer system. Nevertheless, I am still unable to fit a complete assessment into the box. In desperation, I call the help desk and voice my concerns. “Well, we can’t have the doctors rambling on forever,” the tech replies … Nobody, for example, leafs through a chart anymore, strolling back in time to see what has happened to the patient over many years. In the computer, all visits look the same from the outside, so it is impossible to tell which were thorough visits with extensive evaluation and which were only brief visits for medication refills. In practice, most doctors end up opening only the last two or three visits; everything before that is effectively consigned to the electronic dust heap. Most importantly, the electronic medical record affects how we think. The system encourages fragmented documentation, with different aspects of a patient’s condition secreted in unconnected fields, so it’s much harder to keep a global synthesis of the patient in mind. Now I’ve learned that file-size restrictions will limit the extent and depth of analysis. What will happen to the tradition of thorough clinical reasoning?

From CDMer: “Re: HIT testing. Another can of worms along the path of standardization.” NIST solicits bids for a Health Information Technology Testing Infrastructure that will “harmonize the efforts of healthcare standards test development and delivery to meet the demands for conformance and interoperability within the healthcare domain.”

From NYizMee: “Re: McKesson’s huge profits. I can’t understand how this company keeps making money. They do nearly everything so badly.” Healthcare has been very good to the company and its customers chose it willingly, so they must be doing something right.

From David Chou: “Re: Cleveland Clinic Abu Dhabi. Would love to share a Forbes piece on what we are doing.” David is the senior director of IT operations there. The 2.3 million square foot, 364-bed facility will open at the end of this year.

From Looking Out for the Little Man: “Re: CPSI. The little guy down in Mobile seems to be helping smaller hospitals meet MU, right behind Epic in the number of hospitals to attest.” The company’s fact sheet says 134 of its hospital clients have attested, giving it 22% of all attested hospitals, second only to Epic’s 164 hospitals.

HIStalk Announcements and Requests

Here’s a few things you might already know if you are a faithful HIStalk Practice reader: first-fill medication adherence improves when physicians e-prescribe. Doctors still prefer desktop PCs over other devices for accessing patient data in the office or at home. Some common problems causing 5010 rejections. CareCloud CEO Albert Santalo gives the low-down on his company in our interview. Dr. Gregg shares the inside scoop on the startup Health Care DataWorks. If you haven’t been a faithful HIStalk Practice reader, it’s not too late to change your ways and see the light of the ambulatory HIT work. Thanks for stopping by.

Listening: reader-recommended Rodrigo y Gabriela, a duo of former itinerant street musicians who play amazing guitar that includes everything from classics to heavy metal (one YouTube commenter called it “thrash metal flamenco.”) Check out Gabriela using her acoustic guitar like a drum kit.

Acquisitions, Funding, Business, and Stock

Clinical communications vendor PerfectServe closes on $10.9 million in Series C financing, led by PJC Capital.

Staff scheduling systems vendor OnShift closes on $3 million in Series B financing led by a client of West Capital Advisors.

TELUS Health Solutions announces the acquisition of Wolf Medical Systems, Canada’s largest cloud-based EMR vendor, and the creation of a new business line, TELUS Physician Solutions.

Trademark filings suggest that a possible name of the GE Healthcare-Microsoft joint venture is Caradigm. That trademark was held by Santa Barbara Regional Health Authority, but appears to have expired.

Canon Europe acquires Netherlands-based PACS vendor Delft Diagnostic Imaging, saying it plans to focus on medical imaging for future growth.

Medical payment processor MediSwipe acquires the assets of ReachMeDaily.com, a private social media platform that connects senior citizens in residential centers with their families.

California startup TigerText, which offers HIPAA-compliant text messaging for hospitals, raises $8.2 million in a second round of funding.

Telehealth vendor InTouch Health, which claims 400 hospital customers of its FDA-approved remote presence devices, gets a $6 million investment from iRobot Corp., best known for its Roomba vacuum cleaner.

The Advisory Board Company reports Q3 results: revenue up 33%, EPS $0.46 vs. $0.24.

Sales

MedLabs Diagnostics (NJ) chooses the Ignis Systems EMR-Link lab outreach solution to provide area practices with lab ordering and reporting capabilities.

The Danish health system selects InterSystems to develop and support its national HIE.

Upper Chesapeake Health (MD) picks Forerun’s FlexChart physician documentation software for its emergency departments.

Rush-Copley Medical Center (IL) selects Medicity’s HIE technology to facilitate affiliated physicians’ access to clinical results and reports.

NorthCrest Medical Center (TN) chooses Allscripts Sunrise Clinical Manager, adding to its previous deployments of the company’s ED and ambulatory EHR solutions.

Merge Healthcare signs 10 new Merge RIS customers, raising to 30 the number of radiology practices using it as a Complete EHR.

Scripps Health (CA) selects MEDSEEK’s enterprise software suite.

St. Mark’s Medical Center (TX) selects McKesson Horizon Medical Imaging for use with its Paragon HIS.

The Nebraska Medical Center expands its use of products from Streamline Health Solutions, adding its Epic integration suite to the content management and HIM workflow solutions it was already using.

People

Greater Houston HIE changes its name to Greater Houston Healthconnect and names James Langabeer PhD, formerly of the University of Texas Health Science Center, as president and CEO. He replaces Kay Carr, who became CEO last March.

API Healthcare appoints Peter Goepfrich (Vital Images, PwC) as CFO.

Brad Swenson rejoins technology financing company Winthrop Resources Corporation as SVP, chief product strategy and business development officer. He was previously with Surescripts. We interviewed him in May 2011.

Announcements and Implementations

Awarepoint signs 191 contracts for its aware360Suite in 2011, increasing its client base to 123 healthcare systems and 186 hospital sites.

Telehealth and remote monitoring solution provider Cardiocom and Delta Health Technologies, a provider of IT systems for homecare and hospice agencies, announce completion of a bi-directional telehealth interface between their systems.

St. Joseph’s Hospital and Medical Center (AZ) announces its deployment of MobileMD for the exchange and communication of clinical information.

Government and Politics

MGMA sends a letter to HHS Secretary Kathleen Sebelius outlining problems that practices are having with the 5010 transition and urging an additional delay in enforcing the change. MGMA warns that unless the government takes the necessary steps to resolve issues, many practices will face significant cash flow disruptions for practices and operational difficulties, a reduced ability to treat patients, staff layoffs, and even practice closure.

Other

Anthelio partners with Healthland to provide migration and implementation services for Healthland clients migrating to Healthland Centriq EHR.

The defunct St. Vincent’s Hospital – Manhattan (NY), obligated by state law to maintain medical records for six years after discharge, petitions the bankruptcy court to force Allscripts to help the hospital transfer its data from its own servers to a less-expensive system. The former hospital says Sunrise Clinical Manager is costing it $17K per month and another company offered to extract its store it for $1,200 per month, but Allscripts won’t help unless the hospital keeps paying the monthly tab.

UMass Memorial Healthcare announces plans to lay off 700 to 900 employees, under the gun to trim $50 million from its budget to avoid a loss for the year.

Sponsor Updates

Billian’s HealthDATA reports that 35-45% of doctors are affiliated with hospitals in 10 states, with internal medicine ranked as the top specialty.
CapSite’s SVP and GM Gino Johnson will present an overview of the HIE market at this month’s ZirMed’s Thrive User Conference.
T-System announces that 42 hospitals have attested to Stage 1 MU using its T SystemEV emergency department information system.
GE Healthcare introduces the latest version of its Centricity Patient Online portal.

EPtalk by Dr. Jayne

CMIO magazine publishes its 2012 Compensation Survey. No surprise: 87% of CMIOs are men, although women are increasing in the field – up from 8% to 13% this year. Apparently I fall into their target demographic since the majority of those surveyed work at multi-hospital organizations in the south.

For those of you who may be just a teensy bit behind in your ICD-10 implementations, my favorite Geek Doctor John Halamka offers the request for consulting assistance that his organization used. Also included is a letter to stakeholders to identify which applications use ICD-9 and need to use ICD-10. He promises to share as much as he can as their project plans and timelines unfold, so stay tuned.

I wonder if ICD-10 has a code for this? Physicians report an increase in cyberchondria. Patients reading online information are increasingly displaying unfounded anxiety about their health. To combat the increased worry, physicians report spending more time in office visits to discuss why patients think they have particular diseases and convincing them that it may be unlikely.

Some websites have recently caught my eye. AdverseEvents has gathered information from the FDA’s database. Users can search over 4,500 medication records. Clarimed is similar, but has information on medical devices as well as drugs and procedures. I’m sure the cyberchondriacs found them long before I did.

I just have to laugh. Earlier this month, the Department of Health and Human Services published new standards for electronic funds transfers (EFT) in healthcare as required by the Affordable Care Act. This is supposed to result in billions of dollars of administrative savings for physicians, hospitals, insurers, and states over the next decade. HHS Secretary Kathleen Sibelius is quoted as saying, “Thanks to the Affordable Care Act, healthcare professionals will spend less time filling out paperwork and more time focusing on delivering the best care for patients.” Unfortunately, the recent federal initiatives have actually increased burdensome busywork for me, as I am forced to review mind-bogglingly annoying reports about how many times I’m checking or not checking a particular box required for Meaningful Use calculations. Additionally, any reduction in paperwork due to EFT changes will likely be offset with increased mounds of insurer paperwork trying to deny care for sick patients.

A new study reports that “the majority of U.S. physicians are moderately to severely stressed or burned out on an average day.” That’s not good news for the people caring for you and your loved ones. Only 15% of physicians feel their organizations are helping them deal with the situation. Burnout has been shown to increase the risk of medical errors. Physicians cite their top stressors as the economy, healthcare reform, Medicare/Medicaid policies, and unemployed and uninsured patients. No surprises there. Executives, take note: show your docs some love and get those severely impacted staffers some help before it’s too late.

Medical Economics publishes its must-have gadget guide. One of my favorites is the MobiUS SP1 hand-held ultrasound unit which can transmit images via cell phone or Wi-Fi. Another favorite is the SleepView Monitor, which allows home testing for sleep apnea. If I would have had one in my little black doctor bag during a recent trip, I’d have slapped it on the gentleman near me on the plane. I seriously thought I was going to have to resuscitate him.

Hints on the Microsoft/GE venture’s name from Weird News Andy: “So, a portal-like product that allows information to flow between logical entities. Drawbridge is a little too intimidating. Hatch is too nautical. Aperture is too esoteric. Gates. That’s the ticket.”

Speaking of little black doctor bags, I’m still looking for the perfect little black dress to go with mine (and with the shoes!) for HIStalkapalooza. I thought I had my date squared away, but in a surprise last-minute showing, one of my secret crushes has agreed to attend (sorry, Farzad, I waited as long as I could – but if you decide to attend, I’m sure we’d be accommodating.)

Have a question about home monitoring devices, Las Vegas bail bondsmen, or why the soles of Christian Louboutin shoes are red? E-mail me.

Contacts

Mr. H, Inga, Dr. Jayne, Dr. Gregg.

More news: HIStalk Practice, HIStalk Mobile.

6 Comments

CIO Unplugged 2/1/12

February 1, 2012 Ed Marx 17 Comments

The views and opinions expressed in this blog are mine personally and are not necessarily representative of current or former employers.

The Bad Boss

New town. New job. I was stoked over what was essentially a startup within an enterprise. As a visual learner and teacher, I asked the office manager for a whiteboard.

No go. The president wanted to keep corporate operating costs low. No worries. I went to Staples, and for the cost of a Starbucks Grande Red Eye, I bought myself a whiteboard.

Before I had a chance to hang my would-be art piece, my boss stopped in and frowned. “What’s this?” After I explained my reasoning, he said, “Take it out.” He wanted all the offices to have the same minimalist look and feel.

Well, my kids loved it. That whiteboard became central to their homeschool activities. I’ve used it over the years for meetings at home.

Little did I know, the rejected whiteboard was only an omen of the legalistic reign under which I was now employed. I was tempted to pack up and head back south. After all, I had a 90-day “get-out-of-jail-free” card from my former employer who would graciously welcome me back. Our old home had not yet sold.

Tempted as I was to escape, I knew running away was wrong. If I quit now, I would never learn perseverance. I had made a commitment and I would keep it, no matter how aggravating. I knew I would use this challenging experience to prepare for the future. Angry and disillusioned, I stuck it out.

Most of us have had a manager who’s aggravated the heck out of us. National employee engagement scores from Gallup suggest that many are presently in such situations. Web sites such as Really Bad Boss are extremely popular. Numerous best-sellers have been written on the subject. And did you ever ask yourself why The Office and Dilbert are such big hits? Because we can all relate on some level to bad bosses. I suspect all of us will have the opportunity to encounter one along the way. This was mine.

I make an effort to understand these concerns because I don’t want to be a bad boss. And I’m very aware of my potential to become what I hate. We’re all susceptible.

That said, I’ve been blessed to work with predominantly good bosses. So here is what I learned to make the best out of bad-boss situations:

Honor leadership. Part of my career plan is based on the premise of honoring those in authority over me. This can be tough. Clearly, you should never turn a blind eye to unethical behaviors or abuse. I am solely referencing a difficult and disagreeable boss. Actively give honor to them. It may not change them, but it will change you.
Make your boss famous. Another toughie. Why would you make a bad boss famous? Because if you can make them better, there’s a chance your situation will improve. Don’t talk up how wonderful your division outcomes are, but give the glory for good things to your boss and take your lumps when things are not so good. Leadership demands humility. “There’s no limit to the amount of good one can do as long has he doesn’t care who gets the credit.” Author unknown
Take the good. Most bosses are bosses because they have done something good and have the capacity for more. Seek out the good and apply it to your career. My anti-whiteboard boss taught me the importance of having a “kitchen cabinet,” developing key informal relationships that serve as a sounding board and advisory committee. Life is too short to not learn from all circumstances.
Check the mirror. Take inventory of the bad and look for signs of these traits in yourself. If you find one, pull it out. Guard against bad-boss behaviors creeping into your own style. If your boss is inclined to knee-jerk reactions, don’t start flailing your arms every time you are faced with a challenge. Recognize bad-boss behavior and never replicate.
Leading up. This might seem impossible, but keep faith that you can influence a change in your boss. Lead by example. Although your voice may not be heard, your actions will be noticed, subconsciously or otherwise.
Think long term. Look ahead and remind yourself that today’s actions dictate tomorrow’s decisions. If you quit when things are tough, you will become a quitter. Stick things out. Don’t tap out too quickly.
Speak no ill will. Avoid the trap of complaining about bad boss to other people. This will only exasperate the situation and make it worse than it is. Speak blessing instead.
Seek first to understand. Figure out the drivers for bad boss behavior. They are likely stress induced. Most bad bosses are well-intentioned leaders who’ve lost their way because of personal and/or professional pressures. Identify the sources of stress and you might help reduce or eliminate it. At the very least, you will sympathize and realize the behavior is not a vendetta against you, albeit it feels like it.
Avoid a bad boss. Forbes shares five tips to spot a bad boss in an interview. Gather your own references. Call the person who most recently held the position. Call on the other direct reports. If you are well networked, get the internal buzz on your potential boss. Many a bad-boss situation could be avoided if you research diligently and listen to what you hear. Don’t believe things will change because you believe you are better than your references. They won’t.
Joy in suffering. This is the toughest one for me, but the most important. “Suffering produces perseverance; perseverance builds character; and character produces hope.” It’s an upward, spiraling cycle throughout life.

So if you have a bad boss, you have a choice. Life is too short to be in a bad boss situation, but you owe it to yourself, your people, your boss, and your organization to make it work.

I persevered with the anti-whiteboard boss. I established a “kitchen cabinet” as I’d learned from him. I was promoted out of that division and into corporate, where I became CIO. Hope never disappointed me.

And then I purchased the biggest damned whiteboard ever made.

Ed Marx is a CIO currently working for a large integrated health system. Ed encourages your interaction through this blog. Add a comment by clicking the link at the bottom of this post. You can also connect with him directly through his profile pages on social networking sites LinkedIn and Facebook and you can follow him via Twitter — user name marxists.

17 Comments

News 2/1/12

January 31, 2012 News 6 Comments

Top News

McKesson reports Q3 numbers: revenue up 9% to $31 billion, EPS $1.20 vs. $0.60, beating estimates. The company announced that it will buy back an additional $650 million worth of its stock. Shares rose 4% on Tuesday, making MCK the third-best performing S&P 500 stock of the day. Technology Solutions revenue was up 4% with an operating profit of $69 million, although the company took a $42 million pre-tax charge against the termination of development on Horizon Enterprise Revenue Management and the move to Paragon as its go-forward platform. From the conference call:

The company reiterated that it has no plans to sunset Horizon Clinicals, but also made it clear that customers will probably either choose to move to Paragon at some point or switch vendors.
McKesson paid $6 million in severance related to the shutdown of HERM.
The company talked up its payer and transaction businesses (like RelayHealth) in a manner that suggests it likes the steady, predictable revenue they generate compared to the sales-driven revenue swings of the software business.
The company admitted that “as you know, we’ve had some challenges with the Horizon Clinical implementations.”
My overall impression is that the company is being fairly open in describing its challenges with HERM and Horizon Clinicals, although in the last couple of quarterly calls they were quite upbeat about both. Publicly traded companies aren’t very good about warning investors of potential bumps in the road.

Reader Comments

From Baystatehockey: “Re: Mark Gorrell, VP/CIO of Baystate Health. Gone and replaced by Heather Nelson as interim CIO.” I think I can safely call this rumor verified based on Mark’s exuberant and obviously recently updated LinkedIn job title, which is darned cool. Here’s his blog with sailing photos and some really interesting thoughts about pursuing something he and his family always wanted to do, even though he says he’s risk-averse and prone to motion sickness.

From Duxelles: “Re: IBM. To acquire [publicly traded vendor name omitted] – any truth to this?” I haven’t heard anything and it doesn’t seem likely. Then again, neither did the rumor at HIMSS time awhile back about this company that turned out to be true, which made me glad that I at least mentioned so I didn’t look clueless. It is likely that quite a few big announcements of various flavors are being embargoed by several companies until the HIMSS conference, so I’m sure we’ll have lots to talk about in three weeks.

From Amish Boy: “Re: Epic’s support teams. At my previous hospital, I got to know our application’s assigned support person very well. I’ve worked with Cerner for years and they don’t have the same personal attachment. We used to joke that Cerner’s Immediate Response Center number was busy because the middle school bus hadn’t dropped the IRC employees off at Cerner HQ yet.”

From Bill Rieger: “Re: Flagler Hospital, St. Augustine, FL. Kicked off its Meditech to Allscripts SCM transition at a well-attended campus event. The IS department broke out in flash mob just before the CIO spoke about how hard it would be to tear down the walls of poor processes that have been built up over the years. We are engaged and involved and want to be dancing when we go live in June 2013.” Bill is CIO at Flagler Hospital. Nice video.

From The PACS Designer: “Re: FuelBand. A new mobile application from Nike that is worn on the wrist and can track your daily activity with an accelerometer. It tracks calories expended, steps taken, and the time of day, as well as your NikeFuel score viewable on an LED display. Your score is based on an algorithm that assigns points to various movements.”

From BuffaloWings: “Re: Sandlot and Santa Rosa Consulting. To merge?” Santa Rosa already was a partial owner of the HIE technology vendor Sandlot (the other owner is a Texas physician group). I haven’t heard if they are taking that relationship further.

HIStalk Announcements and Requests

Mr. H and I were commiserating last night about our pre-HIMSS overwhelmed-ness. The last few days I have been working on the HIStalk Guide to HIMSS12, which includes an overview of what our sponsors will be featuring this year. We are also including contact information for at least a dozen sponsors who are not exhibiting, but that are available for one-on-one meetings with attendees. Look for the Guide to be published the week before HIMSS. Sponsors, make sure to send your information.

If you are attending HIMSS, you only have about 20 more days to prep. It’s not too soon to go through your old shoes (including your kids’ old shoes) to bring for our Soles4Souls shoe drive. We will have drop-off boxes on the exhibit floor at the DrFirst booth (5456) and possibly one other location. We’ll also accept donations at HIStalkapalooza for those who received invitations (with a free IngaTini for every pair you donate.)

We like highlighting cool vendor events at HIMSS since readers are always looking for fun stuff to do there. Here’s one: CSI Healthcare IT is offering cocktails and dinner at the Canaletto Ristorante at the Venetian on Wednesday evening (February 22) from 6:30 until 9:30. It’s invitation-only and you can RSVP by e-mail.

Speaking of HIMSS events, ours is full. We have a lot of friends and loyal readers, and if we had endless space and money, we would happily invite every one of them to the ESD-powered HIStalkpalooza. Since we don’t, we have no choice but to turn down requests, even for invitees who want to bring a guest (I’d estimate that we have close to 1,000 people who want to come that we don’t have room for.) Maybe next time I should also run a secondary event that’s cheaper to produce so that lots and lots of folks could come as a backup event, like renting some big New Orleans field, hiring a band, setting out pallets full of beer and wine, and passing out hot dogs and marshmallows to roast over a bonfire. That’s my kind of networking event.

Your honey-do list from Inga: (a) search our sponsors in the Resource Center; (b) take five minutes to get your consulting RFI request in front of several companies at once with the RFI Blaster; (c) click on some sponsor ads just to see where you end up; and (d) send us rumors and cool stuff. And while Inga, Dr. Jayne, and I don’t want you to feel like a number, you are, in a good way that we appreciate: one of almost 5 million HIStalk visitors since 2003 and over 110,000 this month; one of 7,861 subscribers to our e-mail updates; one of the 2,165 members of the HIStalk Fan Club that Dann started; or one of our LinkedIn connections or Facebook friends. Unlike HIStalkapalooza, those numbers can scale infinitely, so feel free to increase them. Sometimes we screw up in running an erroneous rumor or being slow in responding to e-mails, but one thing we never do is take readers and sponsors for granted, so thank you for being part of what we do.

On the sponsor-only Job Board: NextGen Training Coordinator, Epic Go-Live Support, Cerner Go-Live Support. On Healthcare IT Jobs: Senior Technical Advisory Consultant, Epic Certified Clinical Analysts, Epic Hospital Billing.

Welcome to new HIStalk Platinum Sponsor Lifepoint Informatics, which offers vendor-neutral data integration solutions, with an emphasis on lab outreach. Its EMRHub provides fast, easy LIS-to-EMR connectivity (Web-based middleware with only one LIS interface required) for hospitals and any type of labs interested in strengthening physician relationships, developing new revenue streams, and earning Meaningful Use incentives. Its LPI CPOE ensures clean, valid CPOE lab/rad orders that meet medical necessity and ABN requirements. Its LPI Web Provider Portal is a cost-effective way to deliver a complete patient picture to providers, providing a unified clinical inbox, flowcharts, and reports using information from systems such as clinical labs, pathology, micro, AP, cyto, and cardiology via any Web browser, helping hospitals, labs, and groups meet the IT needs of their clients. The company just landed a big deal in providing Sparrow Laboratories, one of the country’s top outreach labs with 15 labs in Michigan, with solutions to extend its reach to current and potential customers. Other customers include Indiana University Health, Continuum Health Partners, Memorial Hermann, and New York-Presbyterian. Drop by Booth 153 at HIMSS for two reasons: (a) to see their tools in action, and (b) to get one step closer to bringing home an iPad 2 in the soon-to-be-announced HIStalk Booth Crawl, of which the company is a sponsor. Thanks to Lifepoint Informatics for supporting HIStalk.

Acquisitions, Funding, Business, and Stock

IT professional services firm NTT DATA Americas announces that its Keane, Intelligroup, MISI Company, The Revere Group, Vertex, and Agile Net organizations will start doing business under the NTT DATA brand.

ADP acquires small-practice revenue cycle management company PhyLogic Healthcare of Springfield, MA and will offer its outsourced billing services to its ADP AdvancedMD customers.

Greenway Medical goes public Thursday, with its $80 million IPO providing a market cap of $330 million.

Sales

BCBS of Kansas City selects InterComponentWare to implement a master patient index to address demands for aggregated patient data in the HIE environment.

Shriners Hospitals for Children selects the MedeAnalytics Clinical Performance Manager solution.

Oswego Hospital (NY) contracts for Wolters Kluwer Health’s ProVation Order Sets.

Acadia Healthcare (TN) selects Healthcare Management Systems Inc.’s (HMS) financial applications for its 25+ facilities.

Banner Health contracts with MEDSEEK solution to deploy its patient, physician, consumer, and employee engagement platform.

Riverside Medical Group (VA) licenses Streamline Health’s physician workflow management solution to manage A/R and denials.

People

PwC US hires Andrew Kemmeling, formerly with Phoenix Health Systems, as a partner in its enterprise resource planning and business transformation practice.

Providence Health & Services, Southern California promotes Elizabeth Petrich-Kennedy to chief nursing informatics officer.

Former CSC and First Consulting CMO David Classen joins patient safety solutions vendor Pascal Metrics as CMIO. Former TheraDoc CEO Stanley Pestotnik also joins the company as a senior advisor.

PerfectServe hires former Krames Healthcare sales executive Michelle Piel as a VP of sales.

iSirona promotes Mary Carr, RN, BSN, CPN to Chief Nursing Officer.

Quantros promotes Gerard Livaudais MD, MPH to chief medical officer and SVP of content and product management.

Alerting vendor Extension hires Tom Berger RN as chief nursing officer. He was previously with Vocera.

Announcements and Implementations

Resource Anesthesia deploys the Shareable Ink Anesthesia Suite across multiple states and facilities.

KishHealth System (IL) implements the Pharmacy Xpert clinical surveillance and intervention solution from Thomson Reuters.

CynergisTek releases Surveyor for Business Associates, a risk management solution for demonstrating HIPAA/HITECH compliance.

The US Patent and Trademark office awards Medicity a patent for locating, indexing, matching, and sharing patient records among healthcare organizations. It’s the company’s third patent issued in two years.

Macadamian will launch its Usability Maturity self-assessment checklist at the HIMSS conference, building on previous work that found that easier-to-use EHRs increase productivity, decrease errors, and provide cognitive support to users.

DrFirst launches its EHR Advisor online tool to help physicians find a solution from those offered by the company’s partners.

HealthStream and Laerdal Medical, through their SimVentures collaboration, offer SimManager, a SaaS-based system for managing simulation-based healthcare training.

Government and Politics

In a Congressional subcommittee hearing, a VA official says its new paperless claims processing system will help reduce the department’s claims backlog and take out months of processing. The current number of pending VA claims is over 854,000, which is 100,000 more than a year ago and 500,000 more than three years ago.

A Congressional Budget Office report predicts that the cost of government healthcare programs will more than double over the next 10 years to $1.8 trillion, or about 7% of the nation’s economy. It predicts that Medicare spending will increase by 90%.

The COO of the West Virginia Health Network is named by a legislative auditor as being one of several retired public employees who are exploiting a loophole that allows them to collect both a pension and paycheck at the same time.

Conservative group Judicial Watch calls on Newt Gingrich to release the full client list of his Center for Health Transformation.

Innovation and Research

Oracle Health Sciences Institute announces its first group of research projects, including a Brigham and Women’s/Harvard study that will use EMR and claims data to analyze treatment alternatives and a University of Maryland project to visualize longitudinal EMR and claims data to detect adverse events.

Other

The Robert H. Smith School of Business at the University of Maryland announces the “Innovate 4 Healthcare Challenge,” a nationwide contest for college students to develop HIT tools to improve patient engagement with healthcare providers. The challenge is supported by ONC and includes $30,000 in prize money.

I was amused to read that people lie more when texting than when communicating by other methods, including video chat. I wonder if that carries over to clinical interactions, since I’ve only had one text conversation with a physician and I think we were both pretty honest. However, I’m now wondering about the text from an old boyfriend who said he couldn’t meet for dinner because he was moving to South America.

The 2012 CMIO Compensation survey finds that the typical CMIO is male, works at a multi-hospital organization, earns between $200,000 and $250,000, and spends only 24% of his time on CMIO duties.

Eric Van De Graaf MD, a cardiologist who wrote an EMR critique on the official blog of Alegent Health awhile back, follows it up with An Open Letter About Electronic Medical Records, in which he is even more critical in a tongue-in-cheek way. It leads off with, “Dear computer programmers and EMR developers. Your product stinks. The whole world of medical communication took a great big nosedive the moment you and your binary code inserted yourself into the business of medicine.” That was just an attention-getter, I suspect. He says the purpose of doctors’ notes (electronic or paper) is not to get paid or to comply with regulations, but to communicate, and EMRs diminish that capability by inserting boilerplate text and other junk needed for non-communication purposes (billing, malpractice avoidance, and government requirements, which is really more of an indictment of today’s medical practice than the tools that support it). He has a big finish:

Someday there will be a Steve Jobs of the EMR world who will come along and produce a system that listens in on my office visit with the patient, uses voice recognition and AI to produce an extremely accurate summary of the discussion, and schedules all necessary tests and medications based on what I explain to the patient—all without me having to even interact with a computer keyboard. The note will be instantly dispersed to the patient and all other caregivers. The program will suggest any useful therapies that I may have missed and provide educational resources to the patient based on the subjects discussed. And, of course, it’ll hit all the high points needed by the coders and Medicare overlords. When this happens it’ll put every other EMR out of business; because, finally, we’ll have a system that actually helps us rather than hampers us.

A California hospital is fined $100K after a nurse in its long-term care unit replaces a comatose woman’s breathing tube, but forgets to remove the cap, suffocating the 81-year-old woman.

Six employees of the Food and Drug Administration who tipped off Congress about what they claim was the agency’s corrupt push to approve unsafe medical devices file a complaint against their employer, saying that FDA violated whistleblower protections by intercepting their personal e-mails and installing spyware on their PCs.

Sponsor Updates

Kareo announces the opening of its Indianapolis office and its plans to add 50 new sales and customer service positions.
Practice Fusion hires Jonathan Malek as SVP of technology and John Hluboky as VP of technical operations.
OptumInsight announces that its HIE and computer-assisted coding solutions achieved the highest industry standards for interoperability at the IHE North American Connectathon.
T-System launches Care Continuity, a Web-based patient referrals tool.
The 37-provider Mendelson/Kornblum Orthopedic and Spine Surgeons (MI) selects the SRS EHR.
Concerro hosts a webinar on disaster preparedness and emergency management.
Hayes Management Consulting offers an EMR optimization webinar.
A PatientKeeper survey finds that preparation for the ICD-10 transition is the highest priority of finance professionals in healthcare provider organizations.
Allscripts facilitates a meeting with Surgeon General Regina Benjamin MD and 20 North Carolina business leaders.
Altoona Regional Health System (PA) selects Access Intelligent Forms Suite for its three locations.
Merge Healthcare adds six practices to its Merge OrthoEMR client base.

Contacts

Mr. H, Inga, Dr. Jayne, Dr. Gregg.

More news: HIStalk Practice, HIStalk Mobile.

6 Comments

Going to ask again about HealWell - they are on an acquisition tear and seem to be very AI-focused. Has…

If HIMSS incorporated as a for profit it would have had to register with a Secretary of State in Illinois.…

What I wondered, after reading this? Could a single physician want to shift back and forth, dynamically, between workflows with…

I read about that last week and it was really one of the most evil-on-a-personal-level things I've seen in a…

Thank you sir

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