News 2/15/12

Top News

Acting CMS Administrator Marilyn Tavenner tells an AMA audience that she is committed to re-examining the pace at which ICD-10 is implemented in order to give providers more time to make the transition. She says her office will make a formal announcement about regulation changes within the next few days.

---

Reader Comments

From Don Pablo: “Re: data breaches. I saw where you are not relaying the stolen laptop breaches since they have become commonplace. I used to work in financial services and watched for reports of breaches. This was my favorite site to check a couple of times a week. I bring it to your attention as not every breach is easily found.”Great site to check out, unless you are obsessively worried about your personal data getting into the wrong hands, because lots of organizations seem to be losing our data.

From WellHeeled: “HIStalkapalooza. I just want to be sure it is as black tie and glamorous as last year (so I pack the appropriate Red Carpet attire)…is that the case?” There may not be a red carpet this year, but readers have assured me they are packing their sequins, high heels, and more than one black tie. SmyrnaGirl, for example, tweeted that she is bringing her A game with these hot shoes.

 

From Lucky Jackson: “Best dressed at HIStalkapalooza. Tell me what I have to do to win one of Mr. H’s big prizes.” In the fashion categories, we have HIStalk King (best-dressed man), HIStalk Queen (best-dressed woman), Best Elvis Impersonator (based solely on attire, so choose your favorite young or old Elvis outfit and don’t worry about the singing), and Best Left-in-Vegas Attire (think showgirl or over-the-top glitz; Mr. H is hoping for a lot of showgirls.) If you want to be in the running for the fashion or the shoe contests, arrive early because our judges will be selecting finalists between 6:30 and 7:30 pm.

From Former CIO: “Re: booth crawl. I hope the sponsors will have the answers readily available in the booths. With 50+ answers to get in around 11 hours of booth time, there won’t be much time for sales pitches.” We’ve asked the sponsors to have their booth crew prepared with the answers. I expect some will just post the answer on their wall. As a refresher to the detailed instructions: (a) download the form here and print it off, (b) get your answers from the booths and Web pages listed; (c) post them to the online entry form by Wednesday evening at 7:00, and (d) watch HIStalk Wednesday evening to see if you won. At minimum, you get good exercise and flaunt a confident, purposeful stride as you move from one booth to the next on a Apple-seeking mission instead of just meandering around following the scent of some vendor’s freshly baked cookies. With luck (and the odds should be decent), you’ll pack home one of 55 iPads. And as I mentioned last time, I’m the one grading the entries, and if you miss a question or two, I’ll most likely be lenient because I really want you to have an iPad. I was indifferent to the device when I won mine at HIMSS last year, but it has totally replaced my iPod Touch for around-the-house stuff: checking the weather, looking at e-mail, doing a quick order on Amazon, and reading Kindle books.

From Elaine: “Re: HIMSS. Any word on a McKesson event? It would be fun to let loose a bit after hours.” I’ll be honest in saying that I don’t even open any of the HIMSS-related mail I get (sorry, companies who pay big bucks to send it) so I don’t know anything about their event. The only ones that have risen above the noise for me were from companies that contacted me directly: a cool-sounding Cerner event at the Bellagio (called me at work), a great-sounding Iatric Systems lunch (e-mailed), and and SCI Solutions get-together (sent to my Mr. HIStalk e-mail). I’ll make this offer: for companies throwing an event that’s open to anyone (and that includes vendor people, just to be clear) let me know and I’ll mention it here, as long as you’re OK with the possibility that gregarious HIStalk readers will overwhelm you with interest, which we have to re-learn every year with HIStalkapalooza. Everybody ought to have a party invitation or two, don’t you think?

From MJOG: “Re: GE Centricity Advance. Discontinued with no warning and very little time to transition. They are offering Centricity CPS, but at $1,500 it is too pricey for the small practices that used Advance. Even their own VARs can’t guarantee a transition within GE’s timeframe. Practices that went live with Advance in January 2012 have to pay in full for implementation of dead software. GE is really out of touch.” I think what you are seeing is what lots of people predicted: when EMR certification turned out to be too easy to achieve and everybody earned it, that left it up to the market to weed out those products and companies that have a less than a fully competitive position in the face of disruptive companies that are happy to sell hosted, easily implemented systems for a few hundred dollars per month. The MU carrot is forcing practices to choose their dance partners nearly simultaneously, so the consolidation writing is on the wall as the rich get richer. It’s painful for existing customers, but is both desirable and inevitable over the longer term. Maybe we should have a mandatory Y2K every 10 years to thin the herd.

From All Hat No Cattle: “Re: electronic problem lists. What do you think of this idea?” Reported in a JAMIA article, Brigham and Women’s sets up EHR alerts to prompt the physician to review the problem list if patient data in the EHR suggests that any of 17 specific conditions (asthma, hypertension, diabetes, etc.) might be present but undocumented. The alerts were accepted 41% of the time, more problems were documented, and interventions and quality improvement work could presumably be more specifically targeted. I like the idea only because it has the potential (although modest, I expect) to improve the care of individual patients, unlike the similar adverse drug event triggers that have always seemed to me to be a complete waste of time except as a learning tool that nobody ever seems to learn from. On the other hand, pestering docs with alerts that are not helpful almost 60% of the time indicates a need for algorithm refinement. That’s where these projects end a lot of the time – the available information just isn’t good enough to improve the hit rate.

---

HIStalk Announcements and Requests

Thanks to Streamline Health, supporting HIStalk as a Platinum Sponsor. The Cincinnati, OH-based company offers the AccessAnyWare document management system, which supports hybrid document-electronic hospitals (which is the vast majority) by organizing their information to streamline processes and improve patient care. Its OpportunityAnyWare business analytics solution aggregates information from disparate systems so that users can perform data mining and collaboration using dashboards that can include an unlimited number of key performance indicators, metrics, and alerts. Its Patient Access solutions integrate document workflow related to referrals, pre-op documentation, and financial forms to eliminate delays and process barriers, accelerating the billing process and increasing employee productivity. They even have a solution (CharityWare) to manage the need-based financial assistance screening process. Before and after stats for several clients are here. The executive team has a ton of healthcare experience and the company’s chairman of the board is our old HIStalk friend Jon Phillips of Healthcare Growth Partners, who I interview once a year or so because his healthcare IT business predictions are uncanny (and it’s about time to do that again.) Thanks to Streamline Health for helping us do what we do.

I realized today that I have listed the exotic recipe for the IngaTinis to be served at next week’s event, but forgot to mention the other custom-created specialty cocktails that will be served (the bartenders at First are seriously legendary craftspeople of the alcoholic arts.) The Mr. H Incognito is a rum punch with ingredients that are, like its namesake, best left undisclosed. For you root beer fans – and you know who you are – the ESD Activation Sensation is a mixture of IBC root beer with whipped cream vodka (who knew?) with a brandied cherry garnish. And while I’m on the topic, I should repeat that we are ecstatic to host those lucky folks who received an invitation, but we regretfully cannot accommodate anyone who didn’t (guests, co-workers, hastily propositioned showgirls, etc.) You are welcome to swing by at 8:00 p.m. to see if no-shows have freed up space, but otherwise we’re packed to the rafters.

Thanks and welcome to HealthMEDX as a new HIStalk Platinum Sponsor. The Ozark, MO company offers an integrated clinical and financial system that covers all post-acute care settings: long-term care, home health, hospital, rehab, and Continuing Care Retirement Communities (if you’re a hospital person and think this doesn’t pertain to your organization, it definitely does – the comfortable lines between acute care hospitals and all these other important venues of care are getting blurrier by the minute.) When ACO-type arrangements put you on the hook to coordinate care with these other providers, solutions from HealthMEDX ensure that best practices are followed to meet regulatory requirements, reduce cost, reduce errors, and (pay attention here) reduce those hospital readmissions that come right out of your pocket. Every one of HHS’s favorite programs requires unheard-of levels of data-sharing and coordination to give patients coordinated care at the most cost-effective location. HealthMEDX has solutions running in more than 3,000 facilities and has earned CCHIT certification for Home Health and SNF in addition to ONC-ATCB modular certification for both hospitals and EPs. And lastly, if you’re thinking, “I know I’ve heard of HealthMEDX somewhere,” it’s the company that former McKesson Technology Solutions President Pam Pure joined as CEO right before Christmas. Thanks to HealthMEDX for supporting HIStalk.

Inga is interviewed by the folks from Dodge Communications, in which she downplays her role in HIStalk and makes me seem way more interesting and virtuous than I really am. Feeling uncharacteristically affectionate after reading it because she was so sweet in her comments, I wanted to have Valentine’s Day flowers delivered to her, but the florist reacted with a combination of a contemptuous laugh and and annoyed snort when I called up Tuesday morning and cheerfully asked if they could deliver that same day (I may offer her and Dr. Jayne a spa day at HIMSS instead.) Anyway, here’s a quote, which I can verify as accurate because I’ve hung out with her at HIMSS:

I have met quite a few people in HIT over the years and I love the opportunity to catch up with former co-workers and meet new people. I’m always on the look-out for HIT rock stars and always get excited when I see a big-name CIO or certain vendor CEOs. It’s totally a nerdy reaction and I have to remind myself to act cool and not like a 14-year-old who catches a glimpse of Justin Bieber. I also enjoy the exhibits. It’s fun to see what the buzz is and what new things vendors are promoting. I like seeing which vendors are over-the-top in terms of their marketing efforts and enjoy chatting with the smaller vendors assigned to small booths on the outer edges of the show floor. It’s a circus but I wouldn’t miss it.

---

Acquisitions, Funding, Business, and Stock

Imprivata announces that it added 160 healthcare customers in 2011 and increased its healthcare revenue by 103%.

Lexmark’s Perceptive Software unit posts an operating loss of $4 million for 2011, although Q4 revenue grew 41% from a year ago to $31 million. Lexmark CEO Paul Rooke says the company acquired Perceptive for growth and is pleased with the numbers.

Lumeris, Highmark, Horizon BCBS NJ, and Independence BC sign an agreement to acquire NaviNet, which offers a real-time communication network for physicians, hospitals, and health insurers.

Medicity will announce Wednesday that 2011 was its busiest year ever, with 43 contracts signed (22 by new customers, 21 by existing customers expanding their use.)

GE Healthcare and Microsoft announce the name of their new joint venture as Caradigm, also announcing company executives and a board of directors comprised of company insiders. We cited a Geekwire article on February 3 speculating that Caradigm would be the name. The companies confirm that they’re working with the CenCal Regional Health Authority in Santa Barbara, CA to obtain permission to use the Caradigm name, which that organization trademarked years ago (their website still comes up at caradigm.com.) GE and Microsoft admit that they invested a lot more due diligence in choosing the Caradigm name than did CenCal RHA, which picked it in an employee “pick a name for our new company” contest 2002. The employee who came up with it got $50 and a pizza party.

A New York Times piece says that Essence Healthcare, financially backed by legendary Silicon Valley investor John Doerr, is finally bearing fruit. Two of its holdings are ClearPractice (EMRs) and Lumeris (analytic software.) Lumeris was just announced as one of the purchasers of healthcare communication network provider NaviNet, where Lumeris software will help physicians answer administrative questions sent via NaviNet.

Meditech kills its contested $65 million project to build an office complex in Freetown, MA, moving on to other location possibilities after a protracted archaeological fight with the state’s historical commission. Freetown gets to keep an empty lot that may or may not contain Native American remains, while somewhere else gets 800 high tech jobs.

---

Sales

Humility of Mary Health Partners (OH) signs an agreement with Care Logistics to implement the Care Logistics Hospital Operating System at three of its hospitals.

RegionalCare Hospital Partners (OH) selects MediClick’s supply chain and accounts payable solutions.

Community Health Alliance (VA) partners with MEDfx to create a statewide HIE.

Hawaii selects Medicity to provide the infrastructure for its statewide HIE.

Children’s Hospital and Medical Center (NE) selects iSirona’s device connectivity solution in conjunction with the launch of its Epic EMR.

---

People

Diversinet Corp. appoints interim CEO Hon Pak, MD as CEO.

NexJ Systems appoints Eric Gombrich as SVP and GM of its Health Sciences Group.

Elsevier promotes Jay Katzen to managing director of its Clinical Decision Support group within Elsevier Health Sciences.

Randy Drawas joins M*Modal as chief marketing officer.

PerfectServe names Optum Accountable Care Solutions CEO Todd Cozzens to its board.

William G. Bithoney, MD joins the healthcare business of Thomson Reuters as the national provider business medical leader. He was previously interim president, CEO, COO, and CMO at Sisters of Providence Health System (MA).

 

Healthcare consulting firm WPC names Ray Guzman (Microsoft) as SVP of sales and business development and Brad Hutson as  chief security officer.

Fletcher Allen Health Care (VT) hires Healther Roszkowski as chief information security officer.

MedHOK appoints David Butterworth (Emdeon) as SVP of business development.

Glenn Yarbrough joins the Health Information Partnership for Tennessee as director. He was previously with Ardent Health Services and was the CTO of the State of Tennessee.

---

Announcements and Implementations

Saratoga Hospital (NY) deploys DigitalPersona Pro and U.are.U Fingerprint Readers for identity authentication.

Norma Tirado, VP of HR and HIT for Lakeland Healthcare (MI), discusses her organization’s implementation of Epic, which goes live this month.

HIMSS and the nonprofit trade association Open Health Tools announce a collaboration to promote the use of open source tools in healthcare.

Optum launches a cloud-based healthcare environment and Optum Care Suite, a set of applications that provide detailed health intelligence on patient, system, and population health. We interviewed Optum SVP Ted Hoy about the announcements this week.

VistA provider DSS launches a mental health kiosk for behavioral health hospitals.

---

Government and Politics

Federal authorities say they recovered $4.1 billion in healthcare fraud judgments last year, up about 50% from 2009.

President Obama’s fiscal year 2013 budget proposal includes $66 million for ONC, an 8% increase over FY2012. That includes $12 million for standards and interoperability work for data exchange, $7.8 million to support EHR adoption, and $5 million for health privacy and security efforts. The proposed budget also includes a 5% cut for the Office for Civil Rights.

The VA wants a 7% increase in its FY 2013 IT budget, looking for $3.37 billion. It wants $169 million to continue development of a shared EMR with the Department of Defense, $53 million to develop a Virtual Lifetime Electronic Record, and $1.45 billion for hardware maintenance. The VA seems to be less optimistic that it seemed previously about turning over its VistA data centers to DoD, saying that unless DoD carves out specific space within its data centers to allow VA personnel to run its own systems, they will pursue setting up interim data centers. Nice digging by the folks at Nextgov.

In Canada, the illegally accessed medical records of a high-ranking member of the country’s Veterans Review and Appeal Board are used in a smear campaign by fellow agency members who disagreed with his review decisions. Up to 40 officials accessed the files of the decorated veteran in order to use his service-related disabilities to discredit him.

---

Technology

The US Patent and Trademark Office awards DR Systems a patent related to methods of matching medical images according to user-defined matching rules.

---

Other

KLAS examines medical device integration systems, focusing on Capsule’s DataCaptor, Cerner’s iBus, and iSirona’s DeviceConX.

CapSite’s 2012 US Smart Infusion Pump Study finds that 34% of hospitals are in the market for new infusion pumps.

The Tulsa newspaper profiles a BCBS Oklahoma project in which physicians at University of Oklahoma in Tulsa who offer a patient-centered medical home can review the medical claims data of covered patients to get a better picture of their health status.

A Bloomberg article says that TV cable carriers are building up their broadband revenue from hospitals and practices, offsetting declining residential cable subscriber counts by charging medical users higher prices for using their networks. Cox says telecommunications companies such as AT&T and Verizon have 80% of the healthcare business, which it estimates at $460 million in the areas it serves. Comcast says healthcare represents a big chunk of the business services market that it estimates is worth $10-15 billion per year. Cable companies can offer lower prices through bundling, but they are less competitive in the areas of data security and wireless communications. AT&T says its healthcare revenue is $5 billion per year.

In the UK, an orthopedic surgeon criticizes thieves who steal live communications cable, which in repeated incidents has taken hospital systems offline, caused surgeries to be postponed, and forced hospitals to deal with downtime of telephone systems and PACS.

Rice Memorial Hospital (MN), preparing for a computer system conversion, offers patients a 25% amnesty discount to pay old bills so the hospital can shut down its retired billing system earlier.

This isn’t really healthcare related, but it’s too funny not to mention. A Marshall University student files suit against a fraternity and one of its members after a party at the fraternity house, in which the allegedly intoxicated fraternity brother tried to shoot a bottle rocket out of his rear. The plaintiff says the bottle rocket exploded in the brother’s rectum, which according to the suit, “startled the plaintiff and caused him to jump back” and fall off the deck, with the resulting injuries costing him playing time with the baseball team.

---

Sponsor Updates

• WellPoint (CO) selects Health Language Inc’s LEAP I-10 to transition to full ICD-10 compliance.
• SRS releases an enhanced version of its certified EHR.
• Heritage Valley Health System (PA) enhances its mobile iPad app using the dbMotion platform.
• Fletcher Allen Health Care (VT) will deploy MEDSEEK’s patient portal and optimization services.
• Wellsoft launches its redesigned website.
• Orion customer Inland Empire HIE launches its pilot running six hospitals, seven practices and a health plan.
• CareTech Solutions releases an interactive brochure explaining the capabilities of a hospital-specific help desk.
• A Vitera Healthcare survey finds that 25% of practices are not aware of the required transition to ICD-10, though larger organizations appear more aware and have a greater sense of urgency.
• Beacon Partners’ Ben Tobin provides tips for managing revenue cycle and cash flows in the midst of health reform.
• The Advisory Board Company announces a webinar highlighting its Crimson Critical Advantage platform.
• Trustwave partners with John Gomez’s JGo Labs to enhance and evolve Trustwave’s healthcare product line.
• Tri-River Family Health Center discusses its use of RelayHealth to  communicate and reduce non-emergency phone calls.
• Caremore (CA) purchases PatientKeeper’s Charge Capture software.
• UMass Memorial (MA) standardizes on Informatica’s data integration platform for integrated views of patients, providers, and encounters.
• Intelligent InSites announces that its RTLS solution supports ThingMagic Astra passive RFID readers.
• Emdeon joins the Interoperability Showcase at HIMSS.

---

Contacts

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

More news: HIStalk Practice, HIStalk Mobile.

An HIT Moment with … Ted Hoy

An HIT Moment with ... is a quick interview with someone we find interesting. Ted Hoy is senior vice president and general manager of cloud business platforms at Optum. The company just announced the rollout of its secure, cloud-based environment and its Optum Care Suite application suite that include care plans, care coordination, quality, and population health.

Describe the cloud-based platform Optum is launching and how you see it being used.

As you know, there are many cloud platforms out there. Some are general purpose, with limited ability to support health care applications. Others serve a single set of constituents. Optum is introducing the first open, comprehensive, cloud-based environment built from the ground up specifically for healthcare and for the all the participants within the health system.

Our clients have asked for a solution that makes it easy to integrate all the various information resources and tools they need to drive faster decisions, better outcomes, and lower costs. Moreover, they’ve asked for an environment that supports their work and the work they do alongside others in the health system. All integrated, fully secure, and easily accessible in one place. 

The other thing we learned from our clients is that innovation can happen all over the health system, but those with creative ideas lack the tools and resources to bring them to life. We designed our cloud platform to unlock that potential for innovation and be equally accessible to individual innovators and large, sophisticated organizations

The Optum health care cloud platform brings all these things — including secure voice, video, and chat capabilities — together to help users manage their work and time more efficiently, to spur innovation across the health system, and to dramatically reduce health IT costs and complexity.

What are some examples of how providers might use the cloud-based platform to improve patient outcomes?

When care providers collaborate on patient care, the patient wins. We designed the Optum health care cloud to make collaboration among physicians and their patients easy. But what is truly groundbreaking is the ability of the Optum cloud to combine information from thousands of sources, run analytics against them, and deliver health intelligence to those who need it to make better, more effective decisions quickly.

Data from EMRs, genetics databases, and even local weather information, among other sources, can be harnessed to support a more responsive health system. For example, health administrators can anticipate spikes in ER visits due to worsening conditions for those with asthma and take preventive measures with their patients.

Optum has over 20 years of expertise delivering this type of analytics through user-friendly applications. Through the Optum health care cloud, we will dramatically accelerate the ability of users to access and apply this health intelligence to their most pressing decisions, from patient care to population health management.

Software developers will be able to turn ideas into applications. How easy will it be that to do, and what’s in it for the developer?

To quote one of the great technology innovators of our time Bill Joy, “The only way to get close to state of the art is to give the people doing innovative things the means to do it.” Unlocking innovation throughout the health system is a core tenant for the Optum health care cloud. It delivers tools and capabilities essential to creating health care applications – an open SDK, analytics tools, security protocols, and more. It also features a waiting marketplace that makes it simpler and less expensive for innovators to deliver their applications to clients.

For example, you can develop an app for the health care cloud with HIPAA compliance and interoperability with other apps baked right in, along with compatibility and connectivity to major health IT systems and networks. These capabilities stand to accelerate innovation while lowering costs.

How can physicians use the new Optum Care Suite? How will be it licensed and where will its data come from?

Physicians will be able to use Optum Care Suite applications through the Optum healthcare cloud, which they can access them from any Internet-connected device. This cloud will bring together data from a wide range of sources, including databases run by Optum, from third parties, and from clients. 

We foresee offering Optum Care Suite applications on a subscription basis and through enterprise licensing agreements. One of the exciting opportunities made possible by the cloud is the ability for app developers to create different models for selling their applications. As such, we anticipate a variety of licensing arrangements to be available. 

How is Optum’s cloud similar to or different from Medicity’s iNexx platform, and what industry trends does the availability of these platforms reflect?

You raise an important question about what industry trends these platforms reflect. From our cloud to the iNexx platform and the pending Caradigm venture from GE and Microsoft, it’s clear that the health system is craving simplicity and demanding widespread interoperability. We believe there is room for a variety of healthcare cloud environments. Some are taking a limited approach, using the HIE as hub from which to extend applications to small provider groups.

Optum’s approach is comprehensive and our healthcare cloud and its applications and networks are compatible with a range of platforms. We know the most important feature is the ability to support better patient care decisions and to help health professionals transition to new healthcare delivery and payment models. This is going to require open, platform-neutral technology that is responsive to the needs of those who use it, regardless of the health IT they’re currently using.

Our strategy is to unlock the potential of newly digitized information and analytics and to support rapid, widespread innovation. That’s why we’ve built the health system’s first comprehensive health care cloud, one with unparalleled scale and scope, and one seeded with a powerful collection of applications that simplify the health system for those who live, work, and depend on it every day.

Curbside Consult with Dr. Jayne 2/13/12

Care and Feeding of the CMIO

I frequently receive calls, e-mails, and LinkedIn messages from recruiters looking to fill CMIO positions. This might be a good thing – a sign that hospitals and health systems are figuring out that they really do need a CMIO after all and are looking to fill newly-created positions. A wise man once told me that it’s a good idea to spend 10% of your time looking for your next job, so I do read or listen to everything that comes my way. Who knows? Someone could be offering a CMIO position in a tropical location with excellent benefits and an assistant to deliver a slushy adult beverage every day at 5pm.

Unfortunately judging from many of the position postings I see, not all of them are new positions. In fact, some of them have been vacant for a long time and the postings have remained unchanged despite being unfilled. Some employers are just not understanding what CMIOs are looking for as far as scope of work, compensation, and job satisfaction. Let me give you a few examples.

Ability to continue practicing medicine. This is important for a variety of reasons. Credibility is often linked to actually using the systems that we’re advocating for our colleagues. Being an actual user of the system is important in understanding the reality and magnitude of issues raised by physicians. I’ve been able to shoot down the “it takes 17 clicks to do this” rhetoric spouted by some of my colleagues because I’m a user – and I know for a fact it’s a gross exaggeration or an example of a provider not following the best practice workflow.

Additionally, requiring a current active medical license of applicants can also screen out physicians with drug problems, failure to pay child support, failure to pay taxes, criminal records, and other undesirable employee attributes. I recommend that potential employers offer this as an option rather than a requirement, though. Keep in mind there are a lot of good candidates out there who don’t have licenses – many never thought they’d practice again and let their licenses lapse – so don’t use it as an absolute yes/no test. On the other hand, watch out for resumes that show people were in practice until recently and or have unexplained gaps in their work histories.

Travel and after-hours commitments, meetings, etc. One recent job description I saw stated that the job involved 50-75% travel – mostly regional, but some national. Considering that most employers are looking for people that have not only a medical degree but also either an advanced degree (MBA, MHA, etc.) or an informatics certificate, plus three to five years clinical experience and three to five years CMIO or medical director experience, this could be a problem. You’re talking about a potential applicant pool that will be in their late 30s to mid-40s age-wise at a minimum. These are going to generally be people who have families, often with small children, and your position may not be very attractive to them.

Continuing education and meetings. This should be part of the offer. It’s extremely helpful to be able to have not only the time (either on the clock or as dedicated continuing education time) but the budgetary resources to travel to a couple of meetings a year. Although we’re all increasingly good communicators in the virtual world, there is still value in face-to-face interaction with colleagues and peers, especially if your organization is in a town where there are only a handful of CMIO types. An offer I recently considered had not only less vacation than my current package, but I was explicitly told that as an IT employee (rather than a physician employee) I was not entitled to continuing education days or funding because “only the physicians get that.” I decided right away that they didn’t “get” what a CMIO was all about, and that was the end of my looking there.

Administrative support. With everything your CMIO is going to be tackling along the lines of Accountable Care, Meaningful Use, and the acronym soup that is our lives, he or she is going to need some help. Even if it’s just a shared administrative assistant, it can be a huge benefit to not have to spend time each day juggling calendars and handling daily office “stuff.” At a minimum, I’d expect some of the same things I’d expect from a good practice manager – opening / sorting / prioritizing mail and phone messages; ensuring regulatory compliance (completing license renewals and credentialing if those are required for practice); coordinating support resources, and handling other ad hoc requests. I would never consider a position without some kind of administrative support. The ability to tackle spreadsheets, flow chart software, project management software, and the ubiquitous slide shows is almost mandatory as well.

Benefits and salary. If you’re committed to finding an experienced CMIO who can hit the ground running, you’d better be willing to pay for it. Someone with ten years’ experience is not going to settle for an entry-level physician wage. The same group I mentioned above was offering a salary that was barely commensurate with the guaranteed salary they were paying new physician grads who were joining practices. When asked for the rationale, this was the answer: the CMIO doesn’t see as many patients or generate as much revenue. Again another indicator of an organization who doesn’t “get” the CMIO role. We may not be seeing 95% of the MGMA statistics for patient volume, but what we do can allow your physicians to reach that level in a much more efficient fashion as well as to assist in increasing the quality of care provided. Government and payer requirements are increasingly complex, and if you expect your CMIO to be able to bob and weave along with the myriad of changes, you better be willing to pay for it.

Culture and autonomy. CMIOs may report to a variety of people – CIO, CEO, or someone else entirely. Some organizations have complicated dual-reporting structures. Yet others have a clear chain of command but a parallel network of “informal” governance that makes it difficult to get things done. The best way to alienate a new (or potential) CMIO is for them to feel they’re in a place without clear direction or support for their initiatives. Making them obtain approval for every little thing is another good way to disenfranchise your CMIO. For those organizations that refuse to use the CMIO title, making your director of medical informatics (or whatever you want to call it) feel like a second-class member of the leadership team because they don’t have the title is another good way to encourage your CMIO to leave.

I worked for a group like that for a while. It was unpleasant, and each day I felt like I had just played 20 rounds of Whac-A-Mole. Because there was no real organizational culture, there was little room for strategy and great need for firefighting skills. Everything was a crisis that had to be dealt with and the leadership was constantly in transition. It seemed like I had five different bosses at any given time and everything was a priority. Initially I thought it was just me trying to adjust (I was a Padawan Learner then rather than the Jedi I am today) but it turned out it was a vacuum in leadership and culture.

If you have a handle on these things, you’ll probably do pretty well trying to hire your first CMIO. If you’re an organization where that role is well established, it might be worth taking a little time to see how your CMIO thinks you measure up in these areas. The CMIO is still a relatively new addition to the corporate team and it’s certainly OK for the position to change and evolve over time.

I’m pretty happy in my current role. But if you do happen to be located in a tropical or otherwise fabulous place and can provide the aforementioned fuzzy drinks, e-mail me.

E-mail Dr. Jayne.

HIStalk Interviews Marc Willard, CEO, Certify Data Systems

Marc Willard is founder and CEO of Certify Data Systems of San Jose, CA.

Let’s start off with a brief description of yourself and the company.

I’m from England. I’ve been here for 12+ years. I’m one of those serial entrepreneurs. I’ve been in technology for most of my career. 

Certify was founded by myself in 2004. We had a vision, very early back then, of connecting physicians with hospitals or health systems. We’ve been doing that ever since. We’re in the enterprise health information exchange market.

Who would you consider to be your main competitors?

It’s changing rapidly. I would say for sure we would see Medicity. Sometimes IT units within health systems developing their own products, but that’s not really very common any more. Maybe a company like a MobileMD as well.

The market is in two segments now — state or public HIEs and enterprise. In enterprise, there aren’t too many companies at the moment. There’s a lot in the state-based, though.

Describe how you see the market shaking out and the difference between the enterprise ones and the public ones.

The public ones are normally driven by public funds or grants. They tend to try and encompass a whole state or a whole county. Their goal is to try to create a common medical record. The challenge with the public ones is that they’re driven unfortunately by politics. I think in the past we’ve seen CHINs and RHIOS all try to do a similar sort of thing.

The enterprise market is something that I’d say in the last two or three years has become very interesting. It’s probably is the fastest-growing segment now. That is where a health system is trying to enhance its relationships and exchange data with its physician community. They protect and increase their revenues for all members involved. It’s a much more sustainable business model because it doesn’t rely on  grant funding. It tends to have a much stronger ROI.

The public organizations had a challenge getting providers to sign up. Are enterprise ones more successful, and what reasons are causing providers to either sign up or decline to?

It definitely has more success. Unfortunately, it’s politics. When you try and bring everyone together in a public HIE, everyone has a different agenda. England is the best example of how a free HIE just doesn’t work.

The reason the enterprise does work is that healthcare is local. Most of the time we’re within 20 miles or 15 miles of our healthcare systems. It’s very rare that we’re even 50 miles away. Physicians feel very compelled to help in their community. It just makes a lot of sense to receive information electronically from the hospitals who they refer with. They do not feel there’s any hidden agenda. 

I think today with Meaningful Use coming on board, that’s helped as well. With some of the things going in healthcare reform, in medical home, I think the emphasis is shifting where the physicians feel a lot more comfortable.

Your model also may have helped with that since you have the federated model, where you’re not insisting that all the demographics be pulled into a third-party system that practices can’t control, instead placing the HealthDock server inside the practice’s firewall. Are customers aware of that as an advantage and are any of your competitors following that lead?

We call it a network approach, and you’re exactly right. By not asking all the providers to centralize their patient information — they feel threatened by that — but the ability for them to control it within their environment and not only share and offer up the information they want. Some offer everything. Some, if they are split between two health systems, a little bit. It’s definitely appeased their issues. 

We are at the moment about the only vendor around that’s got this true hybrid edge server model that will go down to a one- or a two-doctor office. I mean, 75% of the physicians today are less than five docs in a practice, and unless you can bring those primary care guys in, the small practices, you don’t really have a true health information exchange. You’re not really looking up the complete medical records.

Yes, absolutely it’s definitely helped. I spent between ’04 and ‘07 90% of my time in very small physician offices. We had focused user group meetings where we’d understand their requirements, their concerns. This is the way Certify has been designed — to meet that challenge. It definitely helps an awful lot.

Do you think centralized data made it attractive for other companies to buy up most of your competitors?

Yes, I do. There’s nothing wrong with a centralized model. I just think we all just need to understand the kind of dynamics that happen within an HIE. 

For example, even with us we’re a hybrid, we will bring information into the middle if you want to run analytics on it. And yes, definitely I think there are many companies today looking at companies like mine and Medicity and Axolotl that see the value of having access to that data.

The key is to make sure that the owners of that data are happy to share it. With the ACO structures being formed and now the medical home plans, a lot of the information is able to be shared. There are many, many companies out there that see value in it.

I saw some examples of things that hospitals might choose to pull in from those connected EMRs of the practices that they’re affiliated with. What are hospitals doing with that analytic capability?

Quality measures are a great example. We have a very nice health system that’s built an ACO and really believes it’s the better kind of environment. They’re pulling information in for quality measures.

Analytics to me is broken down into two segments. One is a rules-based engine — quality measures — and then the other is population management, which is more predictive analytics. I would say the rules-based stuff today, especially in rev cycle management, is pretty popular out there.

But as health systems connect more and more and more physicians in the community and really start to see that the data from the inspection of care … when I walk into my primary care office with a cough and they can have access to that information, predictive analytics become something that is very, very real and doable. I expect in the next couple of years that will be a really nice product line for Certify in the marketplace.

How does that work when you have a hospital attached practices using a bunch of different EMRs? What’s the technology involved in trying to pull all that data from all these different systems into a single database for analytics that takes into account differences in the way their data is used, stored, and defined?

That’s a big question. You’ve got two types of feeds at the moment. You’ve got an HL7 feed, and now you’ve got some of the popular XML feeds, like the Continuity of Care Document.

We spent eight years working with EMR vendors and finding ways of allowing for easy connections and trying not to make every single connection from every single health system a custom integration. That is the kind of power what our product does. Once you can achieve those connections, then we can pull out patient summaries, scheduling information, ADT, admit /discharge / transfer information, patient summaries. 

Once we have that information on our platform, we can then dice and slice it, and in some cases maybe we’ll ship an XML file to an analytics engine, and in other cases maybe we’ll ship a couple of Continuity of Care Documents to a central repository that the health system has. Once you’re in there and connected it, it’s actually fairly easy for us to manage and pull up data.

Of course, then as you start to run analytics, you’ll get into things like a vocabulary server to make sure that a blood lab test doesn’t have five different ontologies. You need to go do mapping, and that gets a little bit trickier.

Is there any potential for a standard from ONC or NIST that will eliminate the need to dig into the data to understand everything about it before you can actually have systems talk to each other?

If everyone just jumped onto LOINC and SNOMED and ICD-10, then life would be real simple, but we know it’s not that way. I think maybe 10 years down the road possibly, but at the moment not really. You’re always going to need to have some sort of vocabulary server in there. But the IP is out there. We’ve got access to great technology to do that. It’s all very solvable.

The government licensed SNOMED for everybody.

Yes, you’re right. The problem is not everybody uses SNOMED.

So that wasn’t enough encouragement? Or do EMR vendors have no incentive to use it?

It’s not really the EMR solution at the edge. It’s the human interaction. 

The lab is the easiest example. Quest or LabCorp back in the day would use different terminologies for the same thing. Then the health system would say, LOINC is the standard, and we would have to map for LOINC. The technology already exists. It’s just getting humans to adopt it and to agree to it.

I guess we’re kind of back to the age-old problem of asking people to do more work or spend more money for someone else’s benefit.

Absolutely. Absolutely. Today I would say that most of the health systems would just like to connect with their physicians. Just for the things that you and I are talking about, I see that some health systems could be three to five years out.

But the majority of health systems today would just like to connect with their physicians. They would just like to push out a clinical summary. Just like to be able to do a query for a patient record if the patient unfortunately is in the ER. All of the analytics and everything else for them is probably two or three years down the road.

But we IT companies have to prepare for the future. The market today is in a different place than maybe we’ll see at HIMSS, but I think it’s going to get there pretty quickly. It’s going to change pretty quickly.

Do you think ONC is putting the carrot out there through the Meaningful Use requirements?

I do. I think they’ve softened it, which is good. They’ve realized it’s a carrot and a stick. I think the carrot was too small and the stick was too big, so they’ve changed it a little bit now.

A number of our health systems are doing it for Meaningful Use, but most of them are doing it because it’s the right thing to do — increase quality of care. I think the energy around forming ACOs — I think that created more enthusiasm to pull HIEs together than even Meaningful Use.

That was one of the problems with Meaningful Use. It wasn’t a huge incentive, but it got everybody’s attention and they missed the whole Affordable Care Act, where maybe they should have been putting some energy into looking at ACOs instead of chasing what wasn’t much money comparatively.

You’re right. It’s what — a $40,000 reimbursement to a physician? But if they have no EMR, they’ve got to build an EMR. 

The healthcare reform stuff – the ACOs and medical homes — that one is very interesting. You create an organization where everybody can win. If we can all focus on wellness and not illness, then suddenly we’ll win. That’s a really clean example for the physicians, for the payers, the hospitals to all get on board. 

That to me is probably one of the most exciting things that’s happening. I really hope that it stays true and it stays on its course and more and more health systems create ACOs and there’s a good balance between the payer and the health system and ultimately we’re going to solve it.

Companies like Certify will end up empowering that network. Just be the veins underneath, where the information is flowing clean, and also cherry picking information off all these quality measures and so forth. But to me, that’s the exciting times over the next couple of years I’m going to personally watch.

I don’t think I asked you the question when I asked you about the company. How many customers do you have and what are they doing with your products?

Today we have, I believe, just over 70 health systems that have taken our products on board. All of them are health systems. They’re using it for exchanging clinical data in their communities. Some of them are using it to build out ACOs. But everybody’s marching down the same path. We’ve seen tremendous growth in the last two years. I mean, it’s just been phenomenal.

You have a relationship with Cerner that I don’t really understand. How does that work?

Every small company either needs to raise a fair amount of capital or they need to find a very good strategic partner or do both. We decided back in ’09 that wouldn’t it be great if we could sign up a strategic partner that could just introduce us to a large client base? We met with Cerner and our visions were aligned, and now Cerner has a relationship with Certify where they sell our products and services into their client base.

It’s been a great relationship. It still is a very good relationship. Certify now has a direct sales force and marketing team that will actually go out and sell to the rest of the world, which is the Epic, Meditech, McKesson, that kind of stuff. Most people think that we’re a Cerner company and we’re not. We just decided — and I think it was very clever for us to do it — to use Cerner as a channel to get it out to the market.

Do you have a way to share data other than just in one direction, so if you have a bunch of practices and hospital or two all connected, can any of them update things like allergies and insurance information and share that?

They definitely could. But the way our platform is designed is health systems can connect to health systems, physicians to physicians. You can have a healthcare community all aggregating up. They can all share information around. It depends on how transparent they want to be.

We have some scenarios where the health system wants the ADT data in from the practice to populate their own systems. Other health systems won’t,  and vice versa. We have controls. We have consent and data controls everywhere, but basically it’s, “OK, how comfortable are you with sharing information?” and setting the product to the conditions that you feel comfortable with. But ultimately, they could share everything with anybody. Obviously all according to HIPAA and it’s all encrypted — I don’t know want to make it like it’s a Yahoo Mail program.

We have the apparently declining RHIO model, the enterprise HIE, and some providers connecting to each other via their EMR vendor’s closed network. How do you see that playing out for the patient’s benefit in five years?

As I mentioned at the very beginning, healthcare is definitely local. I think it would be absolutely awesome for a patient to travel within their county or its state and have peace of mind that if something happened, duplicate tests won’t be performed, they’ve got basic information about who they are and what’s happened to them. I think personally if we get there in the next five years, then we’ve already created something very powerful.

It’s ultimately all about patient care and trying to reduce the cost around it. With healthcare being incredibly expensive, I think the faster we can there, then ultimately the better it’s going to be.

To do that, we also have to make sure that all of us vendors play well together. I’m a big advocate of that. We can’t create these silos. We all have to work well together. I think things like these IHE standards are very important. I think ONC’s driving stuff is very important. But I also think the healthcare vendors need to make sure they perform their part as well.

Any concluding thoughts?

We’ve spent a number of years flying underneath the radar screens and decided last year that we’re not going to do that any more. I think what you guys do is very exciting as well, giving a lot of people a voice. I appreciate your taking the time to get to know us.

Monday Morning Update 2/13/12

From Nasty Parts: “Re: Vitera. I hear the total headcount was 337. Word is that they’re dumping Intergy and putting all their efforts behind the MedAppz SaaS product they bought. People who have seen it were unimpressed.” CEO Matt Hawkins covers that ground in the interview I just did with him.

From Vitera Product Vixen: “Re: Vitera. I heard the number was closer to 75, and based on the people I know that were selected, they definitely got it right. Time to cut out the people who weren’t pulling their weight and recognize those of us that have been doing great work. CEO held an all-hands meeting in the afternoon, and gave us a preview of what’s to come – $25 million investment in R&D and new internal systems, new product launches, an iPad app, a Tampa center of excellence, etc. I’m psyched!”

From Carumba: “Re: Epic. I hear their sales folks are telling people that they are live in Abu Dhabi and the Netherlands to sound globally successful. Here’s the Cleveland Clinic hospital in which they are ‘live.’”

From Chayote: “Re: Scott & White. I’m hearing from both inside and outside that they may be merging with Baylor.”

From The PACS Designer: “Re: Hadoop. There’s a new search technique developed by the Apache Software Foundation called Hadoop that may draw some interest from healthcare institutions. While it is currently only being used as a web search tool, the possibility of using it as a tool for searching unstructured patient data files and their related image files presents a golden opportunity to get consolidated information in front of caregivers.  InformationWeek has a more detailed description of Hadoop for those interested in this new concept.“ I actually had Hadoop on my interview question list for Richard Cramer of Informatica, but ran out of time to ask him. They offer Hadoop connectivity and I was going to ask how that might be used in healthcare.

From Nick Barkley: “Re: sponsorship. Our company has been acquired, to be announced February 20. Having a sponsorship with your site has been enormously helpful in initially getting our name out there and gaining (and maintaining) credibility. HIStalk put us on the map and helped make this happen.” Nice, thanks. I don’t know that companies sponsor HIStalk with the hopes of being acquired, but I know it happens pretty often (Inga keeps a list.) That Monday of HIMSS week (the “sort of” first day of the HIMSS conference — it’s actually like the Sunday of previous conferences since the opening sessions are Tuesday) is going to be press release heavy, judging from the announcements I know about and the multiples of those that I don’t. As a vendor public service, I’ll repeat the unsolicited advice I dispense every year: if your announcement doesn’t affect your HIMSS participation, save it until 1-2 weeks after the conference. Unless yours is a big acquisition or new product announcement, it will get lost in the madhouse during the conference, but will run nearly unopposed afterward because your competitors will have shot their PR wad trying to build conference excitement.

My Time Capsule editorial from 2007 for this week: Why You Should Root for Cerner, Even if you Hate Them, where I say, “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.”

Listening: new Van Halen, which sounds darned good for guys in their late 50s who spent most of the decades since their last big splash fighting with each other and rehabbing. Check out their tour, but I’d be cautious about buying tickets for anything after the Boston show since tours seem to bring out the squabbling between the Van Halen brothers and whoever their lead singer is at the moment (Roth, Hagar, Cherone, lather, rinse, repeat) and the whole thing could go down in flames (think The Eagles without the concert-dollar greed that makes them pretend to get along.) Eddie may not still be gazing romantically over Jenny Craig meals at the still-adorable Valerie Bertinelli, but he plays seriously smoking guitar (live dress rehearsal video here.)

Here’s Vince’s latest HIS-tory, with some fun history of the first bedside terminal, the PNUT.

We should hit the 5 millionth visitor to HIStalk somewhere around Friday of this week. I can’t give a prize since I don’t have any way to know who that reader is, but it will still be fun to watch the counter roll over. That’s a lot of visits even after almost nine years, especially since early on I was thrilled to see a few hundred in a month.

Welcome to new HIStalk Platinum Sponsor Certify. The San Jose, CA company says it’s the leading and fastest-growing enterprise HIE vendor (71 health systems, 258 hospitals) because it has solved the “last mile” problem for health systems that need to connect to the EMRs of community-based medical practices quickly to deliver immediate value. Setup is a snap: (a) Certify ships the practice a HealthDock edge server; (b) Certify’s Physician Services team walks the practice manager through the 30-minute setup by phone; (c) HealthDock connects to the health system’s Gateway server; (d) the interface is activated and tested; and (e) the practice is up and running with results distribution, order processing, and patient summaries. Physicians get value, hospitals meet Meaningful Use requirements, and the the Certify community eMPI is builds a master patient index in the background for more sophisticated data sharing and analytics projects down the road. For the technologists, Certify supports IHE standards PIX, PDQ, and XDS queries, with HealthDock service as an XDS.b repository and registry, with an end-to-end audit trail, alerts and messaging, failsafe encrypted delivery, and community analytics reporting cubes. One SVP/CIO is quoted on their site as saying, “This is the easiest IT implementation I have ever done,” while hospitals also like the minimal support requirements (less than 0.5 FTE) and all-inclusive fees. They’ll be in Booth #5934 at HIMSS. Thanks to Certify for supporting HIStalk.

Inga has put together our HIMSS Guide, which contains information about what our sponsors are doing their (booth and/or contact information, what they do, etc.) I put a PDF version here. You can help us out by supporting our supporters, as it were, by dropping by their booths and saying you read about them on HIStalk, even if only to say hello and see if they have any cool free stuff.

For you provider-employed folks (hospital, medical practice, etc.) attending the HIMSS conference, let me explain this Booth Crawl thing we’ve been talking about, because it will give you an excellent chance of bringing home a shiny new iPad (your family will be much more impressed than if you return with the usual assortment of note pads and stress balls.) We made the whole thing up at the last minute with the idea of putting iPads in the hands of readers, so forgive any lack of polish on the idea or its execution. Here’s what you do:

1. Download the player form, print it off, and take it along to the conference.
2. Visit the booths and Web pages listed by Wednesday evening, February 22, to get the answers to the questions on the form (the exhibits are open Tuesday from 1:00 to 6:00 and Wednesday from 9:30 until 1:00, then 2:30 until 6:00).
3. Transfer your answers to the online form by Wednesday evening at 7:00 Las Vegas time.
4. Later Wednesday evening, while everybody else is out having a good time, I’ll be holed up in my hotel room doing a manual draw of the winners, making sure you got the answers correct (OK, I may cut you some slack if you miss a couple of questions because I’m just that kind of guy and because I’ll be woozy from working like a dog and eating bad room service food so I can do the drawing and entry-checking, which I’m not looking forward to, but do your best.)
5. I’ll post the names of the winners on HIStalk Wednesday evening and include the name of the sponsor that has your iPad. You swing by during exhibit hall hours Thursday (9:30 to 1:00, 2:30 to 6:00) to caress the iPad’s supple curves and inhale its bewitching scent for the first time, then take it away to its new home for your happy life together. Unlike those lame paper-based contests, you don’t have to be present to win (what’s that all about, anyway?) – the sponsor will ship the iPad to you if you can’t make it Thursday.

Being an objective sort, I asked myself why you should play in our Booth Crawl:

1. Because we look kind of stupid to the companies sponsoring it if nobody plays. We’re not charging them, but it would still be encouraging to them as sponsors of HIStalk to see some folks drop by so they don’t think I’m just making up readership numbers.
2. Because we have 55 iPads to give away, which is good odds for players, maybe the best at the entire conference.
3. Because you’re going to visit booths anyway, so you might as well visit those of the Booth Crawl sponsors and make a fun game out of it that you might win.
4. Because some of the Booth Crawl sponsors are doing other unsanctioned fun stuff for players that you’ll like and that we pretend not to know about.

Baptist Health System (AL) names Chris Davis MD as CMIO to lead its Epic implementation. He was previously with Sisters of Mercy Health System.

A good point to note from my most recent poll: don’t blame your EHR vendor for the clutter of worthless information contained in their product. You can get rid of it at any time, provided you stop dealing with the federal government, insurance companies, and litigious patients. New poll to your right, inspired by NervousIT’s question to me last week: when a big hospital takes over the IT operation of a small one, what’s the impact on the IT influence on patient outcomes?

An article in the local business journal says Cerner brought on 1,700 new employees in 2011 and will hire almost that many in 2012. That must be keeping the parking lots full and the pizza delivery guy busy.

I keep getting cheery HIMSS breakfast invitation e-mails from one of the other sites. I feel kind of honored thinking I’m on some kind of exclusive list until I click the registration link for details, then click again for the registration page, then scroll down to the very, very bottom in small print where I see that I’m to be charged $89 for my presence. Above is what I would get (one or the other, not both) after traipsing to the hotel by 7:00 a.m. and listening to a panel discussion, which is a format that I don’t like at all. I also don’t like being “invited” to something that I have to pay for. 

I’ve mostly stopped running “lost laptop” breach articles since they are common and no longer all that interesting, but here’s an exception: a laptop containing information on 500 patients is stolen from the car of nurse who works for Lakeview Medical Center (WI). Why is that newsworthy? Because the laptop’s hard drive was encrypted. Nice going, 40-bed Lakeview Medical Center.

E-mail Mr. H.

HIStalk Interviews Matthew Hawkins, CEO, Vitera Healthcare Solutions

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.

HIStalk’s Guide to HIMSS12

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.

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

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.

HIStalk Interviews Richard Cramer, Chief Healthcare Strategist, Informatica

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.

News 2/10/12

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):

1. 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.
2. 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?”
3. 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.
4. 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.
5. 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.
6. 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.
7. 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.
8. 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.

Readers Write 2/8/12

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.

HIStalk Interviews Andy Aroditis, CEO, NextGate

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.

API Healthcare Acquires Concerro

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.

News 2/8/12

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:

1. Gather up shoes to donate for the Souls4Soles shoe drive.
2. 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.
3. 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!
4. 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.

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

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.

Curbside Consult with Dr. Jayne 2/6/12

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.

Monday Morning Update 2/6/12

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.