News 3/9/11

We’re trying a new way of organizing our posts in response to reader survey suggestions, so don’t panic that you flipped to the wrong channel.

We tried to figure out an orderly way to arrange everything to allow quick skimming while letting you know whether Inga or I wrote a given item (thus our names at the end of each) since that means we can’t have separate sections a la HERtalk by Inga and you may want to respond specifically to whomever wrote something. We may ditch that later, or shorten the identifier. We’ll see.

You get a little more white space on the page, which is nice. Easier on the eyes.

I’m sure we’ll be fine tuning and getting comfortable with it. It’s extra work for me, so you can help me decide whether it’s worth it. Comments welcome. UPDATE: vote your preference below. We’ll go with the majority starting with Thursday’s post.

Top News

The Children’s Hospital Informatics Program (CHIP) and Harvard Medical School make their SMART platform and interface available. The app store-like system, built with a $15 million ONC grant, is open to developers to create Web applications with specific applications that are scalable and substitutable. They’re offering a $5,000 prize to developers who build the best application as reviewed by a panel of judges, with the winner to be announced in June. Project co-leaders are Kenneth Mandl, MD MPH and Isaac Kohane, MD PhD. [Mr. H]

Paul Concocenti, CIO of NYU Langone Medical Center, steps down as SVP, vice dean, and CIO to “pursue broader healthcare IT opportunities that simply are not available at one medical institution.” Nader Mherabi will move from his current role as VP and CTO to serve as interim CIO. NYU Langone is in the midst of a $200 million Epic implementation. [Inga]

Even though nearly 83% of office-based physicians are eligible for Medicaid or Medicare EMR incentives based on the number patients seen, over 70% of eligible physicians don’t have a basic EHR. A Health Affairs study also finds a disparity in eligibility among different specialties, with the vast majority of family practice and internal medicine providers likely to qualify, but fewer than two-thirds of pediatricians, OB/GYNs, and psychiatrists. Researchers recommend broader eligibility requirements to help more specialists qualify and encourage more EHR adoption for smaller practices. [Inga]

Reader Comments

From Walking in Memphis: “Re: booth babes. Let’s see…your avatar is a nubile, stylish, attractive female whose passion is shoes of the spiked variety and your problem with booth babes is the exploitation of their gender? Really?” Really, and this really is going to be my final comment on the subject. I am pretty sure Walking in Memphis is suggesting that I am a hypocrite and I won’t argue that point. However, I will add that just like my avatar, I am a nubile(ish), stylish, attractive female. I also happen to have a passion for shoes of the spiked variety. The difference between me and booth babes, however, is that the lovelies’ raison d’etre is eye candy. I do hope that I offer more value than that. [Inga]

From Steve: “Re: FirstNet problems. What has struck me toward the end of the article is that it sounds like this health system doesn’t have a good change control process in place. I got that impression reading the part about ‘constant minor setting changes’ leading to changes for everyone. I think of the change control process as something like taxes. Everyone hates it, and yet it is also insanely important for proper running of the system. Outside of that, I can also see many truths in the problems they are having with Cerner’s own departments not talking to each other to coordinate build, etc.” I don’t doubt technical and vendor issues contributed to the situation there, but I’d bet any amount of money that the client isn’t guilt free. First and foremost, they’re the ones who bought FirstNet, so complaining how it works now implies lack of due diligence (not to mention that it works fine in a lot of other places, with the variability being the driver, not the car). The decision was made top-down from what sounds like an out-of-touch bureaucracy, a sure predictor of user pushback whether it’s Cerner or SAP. I’d bet the schedule was pushed, the communication was poor, and the project oversight left to IT or other departments out of touch with what people really do. Not to mention that everybody loves the system that’s going away and being the new stepmom brought home by a beaming dad to meet the kids is a tough situation. [Mr. H]

From BeKind: “Re: University of Cincinnati. HIStalk said 8/2/10 that they would spend up to $100 million on a clinical system. The decision: Epic.” No surprise there – if  you had $100 million to spend, what else would you buy? UC says they’ll be live everywhere in 18 months. [Mr. H]

From England Dan: “Re: Ohio Health Information Partnership. Announced today that Medicity will be their HIE vendor.” Unverified. I couldn’t find a press release, but I knew a state announcement was coming up this week. I’m told it went out via a statewide telecast. [Mr. H]

From Toledo: “Re: NextGen. Acquisition announcement coming, maybe more than one.” Unverified. [Mr. H]

From Mogall10: “Re: Rob Seliger. Rumor has it that the former CEO of Sentillion has resigned from Microsoft.” Verified. Moving to Redmond was imperative, yet undesirable, we hear. [Mr. H]

HIStalk Announcements and Requests

We have found video of the stage portion of HIStalkapalooza, including the full HISsies presentation with Jonathan Bush that people keep asking for. Coming soon. [Mr. H]

Acquisitions, Funding, Business, and Stock

Clinical documentation service provider Transcend Services enters negotiations to acquire medical transcription company DTS America. The purchase price is expected to be $7.9 million in cash, plus an earn-out of up to $4.2 million payable in 2012. DTS generates annual revenues of approximately $12 million. [Inga]

CPSI shares hit a 52-week-high Monday. The market cap of the small systems vendor is $628 million. [Mr. H]

Cerner will take over parts of the electronic medical records projects at two hospitals in Ontario, resulting in a 27 FTE reduction in hospital headcount with an additional nine IT positions eliminated. Opposition parties had criticized the arrangement claiming it allows Cerner to sell the hospitals’ de-identified patient data for a profit. [Mr. H]

Sales

Wake Forest University Baptist Medical Center (NC) will upgrade its radiation oncology technology with Elekta, adding the MOSAIQ EHR, oncology information system, practice management, and oncology PACs, plus the SYNERGISTIQ workflow management system. [Inga]

People

Continuum Health Partners names Mark Moroses CIO and corporate VP of IT. [Inga]

Athenahealth CEO Jonathan Bush is featured in an Economist panel discussion called It’s a Smart World. The whole think is worth a listen, but I’m a sucker for the pop culture references. “The idea of ownership of data … it’s like that guitar in Spinal Tap that you’re not allowed to look at because it’s just too fragile or too special. It’s just a guitar, right? It’s just some information. The thing that I think we worry about is somehow being outed or treated poorly and I think that if you are given information under certain conditions, that’s why it’s important that there be buy-in through every layer of intelligence that gets added to the healthcare cloud that those conditions be honored.” [Mr. H]

CareFusion appoints Carlos M. Nunez, MD as chief medical officer. He was previously with Picis. [Mr. H]

Vendor Announcements and Provider Implementations

Eastland Memorial Hospital (TX) implements Prognosis ChartAccess Comprehensive EHR and readies for participation in the Texas RHIO. The 52-bed hospital anticipates a rapid implementation: software installation was scheduled for March 1 and the hospital plans to start its Meaningful Use attestation May 31st. [Inga]

Greenwood Leflore Hospital (MS) implements DBTech RAS e-forms and converts 500 paper forms to an electronic format. The hospital estimates the conversion will save $145,000 annually. [Inga]

Reliance Software Systems (RelWare) says it raised over $1,000 for TEAM FOX at HIMSS, benefitting the Michael J. Fox Foundation for Parkinson’s Research. RelWare had the Back to the Future DeLorean Time Machine parked in its booth and accepted visitor donations. [Inga]

SCI Solutions announces GA of its Arrival Manager kiosk, which provides patient check-in, registration, card swipe, demographics and insurance validation, document review with signature, and wayfinding. It integrates with SCI’s access management solutions for order processing, enterprise scheduling, revenue cycle, and self-service. [Mr. H]

UCSF goes live with robotic pharmacy dispensing and IV preparation, said to be the most comprehensive in the country. [Mr. H]

RiverView Health (MN) partners with Sanford Health to deploy Epic’s EMR. Unless the community-owned RiverView partnered with an entity like Sanford, the health system would be an unlikely Epic shop: RiverView includes a 25-bed critical access hospital, 22 employed providers, a 70-bed LT care facility, homecare, and lab services. [Inga]

Altru Health System (ND) also wants to share its Epic EMR with smaller hospitals. Altru is in discussions with nine hospitals across North Dakota and Minnesota.[Inga]

Government and Politics

A study by the HHS’s Office of Inspector General finds that 92% of nursing homes have at least one employee who has been convicted of a crime, with nearly half having five or more such employees. I can’t say I’m shocked since Mrs. H was a director of nurses in a pretty good facility and even the RNs there often had records, not surprising given the low pay and the bad working conditions. My advice: stay on good terms with your kids so you can reduce your chances of requiring one. [Mr. H]

Innovation and Research

A regenerative specialist who has found a way to create human tissue using an inkjet printer with cells as the ink uses the technique to build a biocompatible model of a human kidney on state at the TED conference this week. [Mr. H]

A self-taught inventor who has earned FDA approval for his medical imaging system that uses NASA satellite imaging technology lacks only one thing to bring it to market – the $500K needed to build a manufacturing facility. The MED-SEG system, built in his basement from scrap computers, enhances existing images. He claims it can reduce false positives in mammograms by 80%. [Mr. H]

Technology

Syracuse area hospitals are embracing the iPad for remote OB monitoring, documenting observational handwashing monitoring, and remotely controlling the heating and air conditioning systems. One hospital will give iPads to board members “so they can access online documents during board meetings,” which in my experience means they’ll get cool gadgets and superb IT support (at home if they need it) just to make sure they provide their rubber stamp approval to whatever the hospital executives have already decided to do. That’s what I’ve seen, anyway. [Mr H]

Microsoft will pay Nokia a reported $1 billion to convince it to use Windows Mobile on its phones instead of the free Google Android, which was announced this week as the leading US smart phone platform with 31.2% of the most recent quarter’s market share, followed by BlackBerry (30.4%), iPhone (24.7%) and Microsoft (8%). [Mr. H]

GE partners with MedHelp to provide free apps (iPhone, iPod Touch, iPad) for pregnancy, diet, sleep, and moods. [Mr. H]

Other

From KLAS: an increasing number of providers are heading towards enterprise scheduling solutions that integrate with EMRs versus best-of-breed solutions. Best-of-breed solutions average higher customer satisfaction, but aren’t necessarily part of providers’ long-term plans. Unibased ranked highest in satisfaction scores, followed by Epic and SCI Solutions. [Inga]

Healthcare organizations added 34,000 workers in February, including 17,000 in ambulatory care centers and 2,100 in hospitals. [Inga]

A hospital claims HIPAA wasn’t violated when a doctor faxed the names of 12 high school students involved in a bus wreck to a local law firm. He got off with mandatory privacy education. [Mr. H]

Strange: a female paramedic and former Firefighter of the Year who took a man’s foot from an I-95 crash scene is sued by the man, who claims his foot could have been reattached if the paramedic had taken it to the hospital. She says she took it to train her body recovery dog.

Sponsor Updates by DigitalBeanCounter

• Greenway Medical’s PrimeSuite 2011 EHR, practice management, and interoperability suite is selected for ONC’s Direct Project.
• maxIT Healthcare launches a Canadian division and names Bob Betts as head of business development for the operation.
• Resurgens Orthopaedics selects Merge Healthcare for its enterprise imaging solution.
• North Highland continues to expand in the Midwest, adding a St. Louis office.
• Coastal Connect HIE selects Medicity for its community-wide HIE across five independent hospitals in eastern NC.
• UniNet chooses MedVentive to support its ACO initiative.
• MED3OOO is offering a Webinar, Steps to Successful Physician Affiliation, on March 16, featuring Tenet COO Stephen L. Newman, MD.

Contacts

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

Curbside Consult with Dr. Jayne 3/7/11

Welcome to HIStalk’s new Monday feature, Curbside Consult. For those of you not familiar with the term, a curbside consult happens when another physician wants to ask your opinion about something, but doesn’t want to write a formal consultation request in the chart or actually send the patient to see you.

Curbsides have a certain appeal for both sides. When busy subspecialists like infectious disease (ID) docs are in short supply, they don’t want their time wasted by what they consider simple questions, like validating an antibiotic selection for a hospitalized patient. If the request is made formally, they have to see the patient and write a note, when often it’s an answer they can just give off the top of their heads (and are happy to do so).

My favorite ID consultant requires that you call his cell phone to curbside him prior to writing a formal consultation request. Eighty percent of his business is in curbsides, because he likes to save the “real” consultations for patients who are truly complex. I think it’s also his way of having some semblance of a home life. If he formally consulted on everyone he was called about, he’d never see the outside of the hospital. (It probably would be a different story if there were ID specialists around every corner, but there aren’t, at least in my market.)

For those of us that ask for the occasional curbside, often the question is one that we know the answer to, but want a colleague to validate. Maybe it’s not something we see every day, or we want to confirm that we’re operating with the latest and greatest information.

The worst kind of curbside is when a non-physician tries to ask for one — also known as the Supermarket Consult. Definitely to be avoided, as no physician ever wants to try to diagnose a rash in the frozen foods aisle.

The worst one of these I ever experienced was when I worked for a small-town hospital that had a float in the town’s Founders’ Day parade. Waving and throwing candy from my Astroturf-covered perch (wearing a white coat and scrubs, no less) a patient stepped out of the crowd in the middle of the parade route and asked me if I had an update on new medications for constipation. (With patients like that, who needs HIPAA, anyway?)

On HIStalk, Curbside Consult is about sharing physician opinions on the hot topics, not only from me (Dr. Jayne), but from the HIStalk Medicine Cabinet. Response from potential Cabinet members has been good. I haven’t gotten back to everyone yet since I worked entirely too much this weekend, so stay tuned.

When Mr. H offered to run my posts on their own night, it was exciting, yet a little bit nerve-wracking. I appreciate the opportunity and think it will be a chance to have more focus on CMIO/CIO/CMO/physician topics independent of the news, rumors, and updates. And so, here we go!

A Study of an Enterprise Health Information System

Mr. HIStalk opened the door on this one in his Monday Morning Update, so I’m going to walk right through.

For those of you who haven’t seen it: Jon Patrick, Professor at the University of Sydney’s Health Information Technologies Research Laboratory, wrote about implementing Cerner FirstNet in emergency departments in New South Wales. 

(As an aside, you can take the CMIO out of clinic, but you can’t take the clinic out of Dr. Jayne. The author also had an article about extracting data from narrative pathology reports on melanoma patients, which I downloaded to read on my way to the beach later this month. Using optical character recognition and concept tags to gather data and improve care? Fabulous!)

I agree with Mr. H though. Forget Cerner, as this applies to vendors and applications that are too numerous to count. Being the person who often has to have the less-than-pleasant conversations with vendor CMOs and physicians when there are issues at my hospital, I’d like to share my observations.

Although there are some significant defects out there, many vendors are working hard to remedy these and to implement aggressive protocols to bake quality into their products and design defects out. The best of these organizations are adopting techniques long used by manufacturing to ensure quality. This is still a relatively emerging industry, though — some folks are building Model T Fords, while others are building models that will go for 200,000 miles.

Vendors are under the gun from clients and prospects to make their products pretty, which translates too frequently into something that might look nice but isn’t clinician-friendly, usable, or safe. Vendors are also pressured to make their systems “fully customizable,” which often means allowing users to do things which are, for lack of a better word, stupid. I’d love to see a rebuttal of the article addressing what parts of the system were implemented against Cerner advice or best practices.

Some additional thoughts:

• Too many systems allow clients to “customize” patient safety out of the implementation. When I learned that there was a preference in my system to disable allergy and drug interaction checking, I cringed. (This was years ago when I was but a mere Physician Champion, before some of my colleagues decided I was an “IT sellout” and had crossed from “us” to “them.”) Within a few months, some of my colleagues demanded that we allow users to turn it off. Their reasons (no kidding) included “I know what medications interact with each other” and “I know what the patient is taking, I don’t need the computer” and “I hate it, turn it the [bleep] off.” There’s no class in medical school that teaches you how to deal with peers who act like this. The only thing you can do is make sure your patients and loved ones don’t go see them.
• User errors can be reduced, but they can’t be eliminated. At our hospital, we aggressively track errors in documentation and look at trends between physician offices and across the system. Good staff training, low turnover, and accountability all lead to fewer errors. Surprise!
• Patients give bad information, which no amount of decision support or application design can fix. Until we have fully integrated interoperable platforms that remove human memory or manual data entry from the equation, this is going to be an issue. On the other hand, when everything is fully automated, errors can become magnified and nearly impossible to fix. Talk to anyone who’s been the victim of medical identity theft and you’ll know immediately how horrible this can be.
• The ability to review longitudinal patient data is sorely lacking in many systems. In this world of accountable care and shared risk, the concept of episodic care needs to die a quick death.
• Data integrity has to be paramount. It doesn’t matter how slick your user interface might be or how few clicks it takes to document — if the data gets vaporized, it’s game over. My first EHR had this handy little feature: the templates accommodated unlimited input, but the documents only accommodated X number of characters. Not knowing any better, I trusted my vendor (ha!) and didn’t discover this undocumented functionality until patients came in for follow up visits and many Assessment/Plan sections (traditionally done at the end of the note) were missing. My risk management consultant loved that one, let me tell you. On the other hand, that EHR was extremely easy to use, was highly standards-based, and had a workhorse scanning solution that I still miss. But it ate my notes, so it had to go.
• Several vendors still use design philosophies that revolve around the individual visions of key leaders regardless of user needs. Granted, they’re baking in the Meaningful Use requirements because they have to, but the world has changed and what was cool 20 years ago is no longer what healthcare needs. There are peer-reviewed studies on usability and user interface design, and some of these folks must never have seen the articles. HIMSS did a piece on EMR Usability a couple of years ago and I know the systems that have design elements that hopscotch all over the place or color schemes that induce vertigo are designed by people who haven’t seen it.
• Vendors should spend the money to hire medical proofreaders to look at their products. Nothing screams “we rushed this to market” like misspelling medical words. I saw this more than once at HIMSS in the nether reaches of the exhibit hall. Once you lose providers’ trust with something like that, it’s extremely difficult to get it back.
• Allowing existing users to beta-test your product, if they’re willing to donate the time (or if you’re willing to pay for it) can make a huge difference in the quality of releases. This allows for detection of those issues that are particular to the way individual clients use a system. Otherwise, there’s no place like production.
• Vendors need to disclose their defects. More and more are doing this in a meaningful way. On one hand, I understand the call to have the FDA regulate systems. On the other hand, as a physician, I know that the FDA is, in many ways, a joke. Deserving products can’t get to market because of the complexity of the process, manufacturers with deep pockets continue to slipstream their products, and the vitamin/supplement industry got themselves classified in a way so they can say what they want, produce what they want, and generally get away with it.
• Hospitals and practices need to thoroughly test their systems prior to go-live, regardless of what the vendor says or how many clients they have live. Your staff will find shortcuts and features that no one has seen and will rapidly become dependent on these, much to the consternation of your call center, trainers, analysts, and the vendor. The only way to trust the system is to test the living daylights out of it before taking it live.

Unless physicians and their IT teams understand these points, they aren’t ready to leave paper. Those who do understand need to play an active role pushing vendors to improve and vendors need to address core functionality.

If progress isn’t made, the likelihood of a federal mandate increases. We’ve already seen what Meaningful Use has done to the industry. As Scotty once said, “She can’t take much more of this, Captain.”

E-mail Dr. Jayne.

Readers Write 3/7/11

Meaningful Use Does Not Have to Burden Physicians
By Evan Steele

As the CEO of an EHR technology company, I am driven by an unwavering dedication to physician productivity. As readers no doubt recall, the preliminary version of Meaningful Use generated an outcry from physicians — specialists in particular — regarding the burden they would have to shoulder to qualify for the government’s EHR incentives and the resulting effect on their productivity. Many physicians decided that they would not comply, and would simply forgo the incentives.

In response to significant lobbying efforts and to the more than 2,000 comments the government received last summer regarding the Proposed Rule on Meaningful Use, the Final Rule included considerable easing of the requirements for physicians in general, and significant accommodations for specialists in particular.

I want to share with HIStalk readers my view of Meaningful Use from a workflow perspective. The pie chart above illustrates how Meaningful Use is achievable without negatively impacting physician productivity, taking advantage of the exclusions available (to most specialists) and shifting the bulk of the burden away from the physician to the staff.

The implications of demonstrating Meaningful Use vary by specialty. For most specialists, the available exclusions make it relatively easy for a physician to comply. For primary care physicians, there is more to do to meet the requirements.

However, the pie chart illustrates how everyone can achieve Meaningful Use through a practical and efficient use of staff resources, combined with a productivity-focused EHR. This chart is for a typical orthopaedist, but similar charts for other specialties and primary care are also available.

The physician him/herself has four areas of responsibility. The act of ePrescribing alone addresses five of the Meaningful Use measures, and good ePrescribing software increases physician productivity. For example, we have documented that it takes to 23 seconds for a physician to prescribe on paper and a mere fraction of that time using our ePrescribing module.

Maintaining a problem list could be done by the nurse or MA, but we recommend that the physician at least review it, so he/she can view the clinical decision support alert at the point of care.

For some specialties, there are no (or few) relevant clinical quality measures, but where there are relevant measures, most of the work is done in the normal course of the visit: documenting the problem and ordering tests and/or medications.

As illustrated, the rest of the Meaningful Use measures can be handled by clinical and support staff, and some measures are excludable. So, with the right EHR and the right workflow, Meaningful Use is definitely achievable by specialists and primary care physicians alike.

Evan Steele is CEO of SRSsoft of Montvale, NJ.

Usability = Adoptability: What if Facebook and Amazon Built an EMR?
By Dale Sanders

Below are screen mock-ups based on Facebook’s and Amazon’s user interfaces. Borrowing ideas from them is comfortable because they parallel healthcare processes quite nicely, but also because the user interfaces on today’s EMRs are abominable, and adoption rates are terrible (without financial coercion) as a result. People flock to Facebook and Amazon by the millions, without financial incentives. Why? Because:

Total Value of Software Applications = Functional Value x Usability

If either Functional Value or Usability drop to zero, the overall value of the application drops to zero as well. EMRs might be functional, but they are not user friendly, so their Total Value to healthcare is very low.

In Facebook, we have a perfect framework for longitudinal documentation, collaboration, messaging, and scheduling between a patient and members of their entire care team, including family and friends. We also have a framework for easily integrating data from other sources to enhance the value to the patient’s healthcare — there’s no equivalent of HL7 interchange going on in Facebook. It references data located in other sources and systems. Can you imagine Facebook surviving if it required itself to house all the data that it presents? Facebook takes great advantage of referencing and pointing to data in the source systems to build rich content.

In Amazon, we have a perfect and familiar metaphor for ordering tests and procedures; tracking them; assessing their costs; rating them and seeing how other clinicians rated those orderables and referrals; and adjusting orders based on the behaviors and ratings of other clinicians, etc.

Here are the screen shots.  Let’s start building these, eh?  Think Mark Zuckerman or Jeff Bezos would help? 🙂

(Note: click the pictures to enlarge them).

Dale Sanders is CIO of the Cayman Islands National Health System. He writes about healthcare IT on his blog.

Monday Morning Update 3/7/11

From Harvey: “Re: Mediware. Shares of MEDW popped 15% after hours Friday on no news.” That is interesting, especially on a down market day and for a stock that trades in a fairly narrow range. Maybe a deal is in the works and word leaked out. Or, maybe someone is buying up shares after the company’s recent good performance. I haven’t heard anything, but if you have, let me know. The two-year share price chart is above. Shares nearly tripled in a steady run despite poor market conditions.

From ClinicalWonk: “Re: Wayne Smith, CEO of for-profit hospital operator Community Health Systems, quoted from a Wednesday investor conference.” Here’s what Wayne, who holds $37 million worth of CHS stock and makes $10 million a year, had to say.

We’re all working on Meaningful Use. We’re working on it in terms of IT piece of this, which I absolutely think is a black hole when it’s all said and done. Everybody is talking about they have a zillion dollars worth of expense here or cost here, and the government is going to give them back a half a zillion. I don’t know how that works for other people, but it leaves you half a zillion short as far as I’m concerned, when it’s all said and done. And return on investment here is not all that great. We are very careful about how we think about how we deploy our capital, so the return is not all that great, either. So, that’s one piece.

From Dave Magadan: “Re: VITL chooses Medicity for Vermont’s HIE. That means GE Healthcare lost their contract in a state where they have a big footing. This wasn’t just a new contract – it was a complete replacement.” GE Healthcare was announced as the technology provider for the RHIO (as HIEs were known back then before they gave themselves a bad name that needed changing) back in 2006. GE is strong in Vermont because of its IDX acquisition.

From CMIOFlorida: “Re: AT&T. Looking for a CMIO to run its healthcare solutions division.”

From Luke O’Cyte: “Re: Dilbert. Today’s strip sums up many of the booth babe comments about HIMSS.” Nice! Maybe Scott Adams was writing from experience – those few folks who stuck around until Thursday of HIMSS 2005 in Dallas saw his keynote presentation that year (the other keynotes were John Chambers of Cisco, Barbara Bush, David Brailer, and the no-show Scott McNealy of Sun).

From Peter Groen: “Re: COSI Open Health site. It provides information on open source or public domain health IT solutions and might be of use to some of your readers.” I’m not big on giving sites free PR, but I’ll allow it in this case.

From Punxsutawney Phil: “Re: Pennsylvania Health Information Exchange (PHIX). Medicity won the contract. AT&T protested like they did when they lost the Florida bid to Harris. PA state procurement turned them down so AT&T sued the state. They cancelled the contract and will re-bid it, but project work has stopped and PHIX’s ONC money is threatened because the state hasn’t finished its selection.” Unverified.

Listening: the not-yet-released new album from R.E.M., streaming free on NPR until its Tuesday release. They had a dull spell in their 30+ years, but they’re sounding good again. Watching: a depressing commercial featuring Jamie Lee Curtis, who went seemingly overnight from a scream movie hottie to a gray-haired, Activia-swilling AARP cover girl.

I’ve posted the hot-off-the-press results of my reader survey. It’s a fun read, with some interesting stats (my favorite being that 87% of readers say reading HIStalk helps them perform their jobs better), some great suggestions for changes (improving the mobile device format and giving Dr. Jayne her own post, both of which I’ve already done as a result), and comments (“I’ve always wondered if you had a deal set-up where your identity will be revealed after your death. Similar to Deep Throat of Watergate fame.”). Thanks to all who responded, except for that last comment which forces me to contemplate my own mortality, especially since Inga just innocently asked me, “What happens if you get hit by a bus?” Bloggers don’t usually have succession plans, so I have no idea.

Here’s a to-do from the survey. If you want to help, let me know. The real value in this suggestion is requiring a new company looking for exposure to provide at least one happy client’s testimonial, which goes a long way in separating the wheat from the chaff:

Open a channel for "new" companies to provide a brief description of what they do. Kind of a "what’s hot or what’s new" type section. Companies would have to be small (five or less clients?), have proven success (one client testimonial), and be ready to expand. Might give the company and your audience a chance to connect. Would also allow the rest of us to learn about new things and maybe push us all to be better. I would offer to help edit/review submissions and I bet others would as well.

Lots of people went to HIMSS without attending any educational sessions, which is easy to do since the schedule encourages heading off the exhibit hall profit center. Few of those who did found the education sessions excellent, but most said they were at least OK. New poll to your right: of the booth features people have complained about, which (if any) should HIMSS ban? You can choose multiple answers and the poll will accept your comment.

Here’s a virtual tour of the Nashville Medical Trade Center, where HIMSS is the big signed tenant on the fourth floor, right next to the vendor showrooms (in a seamless and slightly uncomfortable blending of a supposedly patient-centered non-profit flanked by its purely commercial members). From the video: “Visitors for hospitals, clinics, professional practices, and other provider organizations move swiftly toward activities and informed purchasing decisions.” Sounds like a cross between the HIMSS conference exhibit hall and Cerner’s hard-selling Vision Center. Somehow as a HIMSS dues-paying provider member, I keep feeling more and more like a fresh meat prospect for its higher-paying vendor members in the business model that I always call Ladies Drink Free.

DrLyle wraps up HIMSS with a list of innovative companies to watch (congratulations to the several HIStalk sponsors who made his list) and a wrap-up of the HIT X.0 sub-conference, including winners of the HIT Geeks Got Talent competition.

Speaking of HIMSS wrap-ups, several people e-mailed to say that I needed to read that of the PACSman, a friend of HIStalk and master of radiology (a Black Sabbath pun that just popped into my head) trying to find his place in the IT-centric world of HIMSS. Pretty funny stuff.

Also funny: a high-ranking exec of a big vendor that was the subject of a unverified rumor I ran awhile back chastised me by e-mail, saying that “tabloid-type rumors” threatened the integrity of HIStalk. I responded nicely, saying (a) at least 80% of the rumors I’ve been running for eight years now turn out to be true to some degree; (b) if I’m hearing the rumors, chances are everyone else is, too; (c) rumors are, from the reader survey, the #2 most-liked HIStalk feature, barely behind the news; and (d) quite a few big industry news items came to light only because I’d run a rumor that turned out to be true. I liked the exec’s follow-up admission: “I am truly a fan of the service (and yes, I follow the rumors). It just sucks when it’s about us :-).” That’s an honest answer – every company loves reading rumors as long as they’re about someone else.

In a remarkably bold marketing campaign, the vendor of a system that transmits ECG readings from ambulance to hospital boasts that its product actually makes heart attack patients wait longer for treatment. That or the headline writer for the San Antonio paper isn’t very good.

Amcom Software, which provides paging and messaging software for a large number of hospitals, is acquired for $163 million by USA Mobility, the largest wireless medical paging operator.

Image Stream Medical raises $2 million in funding. The Massachusetts company sells OR video solutions that include a server-based video repository and broadcasting. Other than the new money, it must be pretty quiet there since their latest news release is from 2006. I’m not sure I’d trust a technology company that can’t keep its Web site updated.

Medical waste handler Stericycle apparently acquires NotifyMD for $50 million. The company provides call center services and automated calling applications for physician practices.

E-mail me.

From Aussie: “Re: Jon Patrick’s article. Mr. HIStalk, I have never seen a dissection (without anesthesia) of Cerner going to this depth. Unbelievable, although in the USA, one would be professionally dead in the HIT industry if even contemplating talking about these long known issues. Hope you will have the courage to publish something about it.” Professor Jon Patrick of the Health Information Technologies Research Laboratory of University of Sydney expands his writeup (currently in draft) about problems with the implementation of Cerner FirstNet in emergency departments in New South Wales.

You’ll love it if you sell against Cerner because everybody from doctors to software validation experts tears into FirstNet (and, by implication, Millennium in general) from every angle — usability, software and database design, and implementation methods. FirstNet competitors could create a fat anti-Cerner prospect piece just by excerpting from it.

On the other hand, I wouldn’t say it’s necessarily unbiased, it focuses on implementation of a single department application that didn’t go well for a variety of reasons (despite many successful FirstNet implementations elsewhere), it uses the unchallenged anecdotal comments of unhappy users who make it clear they liked their previous EDIS better, and it nitpicks (I wasn’t moved to find a pitchfork when I learned that the primary keys in the Millennium database aren’t named consistently).

But it is interesting when it tries to associate user-reported problems with observed technical deficiencies, such as why information known to have been entered sometimes disappears (problems with non-unique primary keys and referential integrity are mentioned – certainly the latter is a problem with many systems). 

In other words, it’s not just about Cerner or some ED project in Australia. The real message is that design and support patient care software is the Wild West at this point since we’re arguably still in the first generation of systems claiming to be clinical (even though they often are really business systems masquerading as such).

Products have long-uncorrected design flaws that were created in an urgency to get product to market regardless of the required compromises, all known to clinicians who work for those vendors (clinicians are often the booth babes of the vendor world — hired to attract prospects but given no real authority). There’s no oversight or accountability beyond what vendors choose to provide and that decision is often made based on vendor staffing, budget, or individual managerial prerogative. 

Here’s my conclusion. Start with Part 7, which is definitely worth a read. Forget Cerner specifically and focus on sloppy software design practices and poor usability. We know it exists throughout the industry and this is a good primer on what can go wrong. Examples:

• Using time values as unique database keys, such as the assumption that a single patient could not have multiple lab orders with the same timestamp
• The problem whereby even integrated systems build modules in silos, which can make them as inconsistent and fragile as interfaced systems
• Free text entries are allowed for problem lists, allowing staff to create entries that nobody will be able to find
• Mandatory terminology selection doesn’t match common usage, such as staff looking for “CTPA” when Cerner calls it “CT chest PE”
• Entered information is lost when users get pulled away and the system times out for security reasons
• The application shows only the clinical notes of the current episode, giving clinicians no longitudinal feel for the patient
• Trainers advise that users never use available functions because they will cause problems (happens all the time at our non-Cerner place — “don’t do that even though the system allows you to”)
• Staff found they can change some information and re-save under the original doctor’s name

The takeaway is that patient care software is far from perfect, but we already knew that. What’s more interesting is how vendors respond to well-documented reports of specific software problems that impact patient care.

I see it every day. My hospital’s vendor has a huge list of problems we’ve reported that don’t get addressed for a variety of reasons: the problems are limited to sites that use a system in a particular way (i.e., the vendor doesn’t think it’s worth fixing since few clients are complaining), they don’t want to tackle the issue because doing so would require an expensive rewrite of a badly designed system, or they don’t have the resources. All of these are logical answers unless you are one of our patients harmed as a result.

I spend a lot of my time on looking at patient safety related to IT and it’s not pretty. Much of it relates to user error, but that, too is a reflection of software design. If IT systems were drugs, you’d see quite a few black box warnings and probably some recalls. The resulting negative publicity would push the vendor in ways no single hospital can do.

I’d like to see mandatory public disclosure of known patient-impacting software defects using a standardized classification system, whether vendors do it themselves or someone else (FDA) has to step in. We customers and our patients often find out about known problems the hard way, and we don’t have much clout to get problems addressed since we’ve already signed on the line which is dotted. This article, if nothing else, is a good reminder of where the industry stands and a reminder that we have the opportunity to make it safer.

Like clinicians, vendors don’t harm patients intentionally, however, and nothing is ever as easy as it looks from the cheap seats outside of vendor-land. The same naysayers who predictably and monotonically chant the “HIT is evil” mantra at every opportunity haven’t been all that effective because their only implied solutions are naive: every software vendor should just drop everything (including profits) and rewrite systems with the involvement of self-proclaimed experts such as themselves, thereby fixing everything (they obviously haven’t seen the horrors of newly written software or applications designed by ivory tower informatics experts).

Somewhere between “we vendors are doing the best we can given a fiercely competitive market, economic realities, and slow and often illogical provide procurement processes that don’t reflect what those providers claim they really want” and “we armchair quarterbacks critics think vendors are evil and the answer is free, open source applications written by non-experts willing to work for free under the direct supervision of the FDA” is the best compromise. Obviously we’re not there yet.

That’s why I advocate transparency before anything else. Let the industry know the extent of the problem and let that information drive the solution. This article (and others) are building a case for that level of openness about patient-impacting systems.

HIStalk 2011 Reader Survey Results

I run a reader survey once a year, right around HIMSS conference time. It helps me see the big picture better. I get a lot of good ideas, although I don’t have the time to implement all of them.

I consider HIStalk yours as well as mine, so I always share the survey results. Here are some points from this year’s survey that interested me.

• 32% of readers have worked in the industry 10 years or less, 29% have 11-20 years, 24% 21-30, and 15% more than 30. That’s a nice mix of fresh faces and hard-won gray hairs.
• 33% of readers work for a provider organization and have purchasing authority greater than $10,000.
• 78% of readers get the e-mail update when I publish something new.
• Most readers read HIStalk whenever they get the e-mail (38%), although 24% read daily or more often. Only 3% read less than weekly.
• The most important elements to readers are news, rumors, humor, and Inga (all had similar scores).
• Interviews were the lowest-scoring element (3.58 on a five-point scale) but I’ll add this: the interest tends to be selective based on who I’ve interviewed. I also consider interviews to be essential since nobody else runs full transcriptions of answers in response to questions asked by someone who actually knows the industry, so I think of them as a public service to some extent. Some are duds, of course, and I don’t like reading those either.
• 83% of readers say they have a higher interest or appreciation for companies I write about.
• 35% of readers say they have a higher interest or appreciation for companies that sponsor HIStalk.
• HIStalk’s influence on the industry: none (1.7%), not much (6.6%), some (43.9%), a good bit (40.3%), a lot (7.6%).
• Always my favorite stat: 87% of readers say reading HIStalk helped them perform their job better in the past year. Magazines would kill for that number.

Suggested Changes

• Change nothing. This was by far the most common of the 155 suggestions. I really appreciate the ideas below and will implement some of them, but I’m also aware that the majority of readers like HIStalk just fine as it is and would rather I not tinker with it too much. That works out well since I don’t have time to get ambitious.
• Make the Web page look better. I have to say that I’m neutral on that, as are those readers who urged me not to try to slick things up and design by committee. I like being amateurish in appearance but expert in content.
• Layout is awful! Make it easier to read, sometimes I can’t figure out what story belongs to what pictures.The text is always below the picture it goes with.
• Make ads less annoying. I give sponsors a strong hint not to use annoying animation, which some take to heart and some don’t. I have a lot of sponsors and I can’t apologize for that since I don’t solicit sponsors in the first place, but maybe it’s time to implement stricter guidelines on ads (limited transitions, no animation within a single frame, etc.) I’m comfortable doing that as long as the effective date gives them time to re-make their ads when necessary since I know that takes time and costs them money.
• Implement an RSS feed, tweet links on updates. Both are in place and have been for quite some time.
• Don’t let the sponsors influence the news. Sponsors get one editorial benefit only – I’ll mention their not-so-newsworthy news on occasion without comment (and we usually put those mentions in the Sponsor Update, making them easy to skip if you’re not interested). They get no advantage otherwise, but I can understand how those non-newsworthy mentions could give that impression. I choose the news items without regard to who sponsors and who doesn’t.
• Better mobile site for BlackBerry, iPhone, Android, etc. The content is perfect – wouldn’t change that for the world. I acted immediately on this suggestion, especially when I checked HIStalk out in an iPad. The mobile layout should work now for all major devices.
• Categorize news by topic. I’m mixed on this because I tried headlining stories before and it was pretty miserable to read. I cover dozens of stories in a single post (to make it an easy and fast read) and there’s just no good way to logically segregate the stories. I’ve considered running a second version of the site with one post per story tagged by topic. Sounds like a lot of work, though. Here are a couple of less drastic ideas – let me know what you think: (a) start off with a fast read of only a one-sentence-each summary of the top “real news” stories (maybe 3-5 of them), then drop into the usual format, or (b) break out the post by broad topic, such as Rumors, New Deals, Stock News, etc. Both would give a more consistent format without requiring much extra work on my end.
• CIO profiles with real-world info. I really like doing this, but my appeals to CIOs to be interviewed or write articles don’t yield many responses. Everybody likes to read, nobody likes to write.
• Do shorter interviews. I agree totally and continue to shorten the conversations that get transcribed. I started out with 50 minutes or so, dropped to 30, and now shoot for 20 minutes. If someone gets long winded, I wrap it up without finishing my prepared questions. I may drop to 15 minutes since it takes up a big chunk of my time to write the questions, conduct the interview, clean up the transcription, post, etc. I’ve also been sending out a “How to Do an HIStalk Interview” before each interview so the subject is clear on what I need, i.e. stop pitching product and your background and let’s talk broad industry ideas. That has worked pretty well.
• Love the new column from Dr. Jayne. She has been excellent at connecting with readers, both physicians and others, and I think she adds a very nice dimension that Inga and I couldn’t really do, just like Dr. Gregg does on HIStalk Practice.
• Move Dr. Jayne’s column to her own day like Ed Marx. I like that idea a lot. I needed to get a feel for her style and acceptance and I now know that both are excellent, I’m moving her to a Monday post on her own. Thanks for the suggestion.
• Tighten up the prose. We have to wade through a lot of stuff to get to the meat of the articles. Every story is one paragraph long and I do my best to summarize accurately in that space, which isn’t easy to do when the original article ran dozens of paragraphs. Sometimes I get on a fatigue-induced roll when I’ve worked 9-10 hours at the hospital and then sit down for another five hours of writing HIStalk, so it comes out just like I think it. I barely finish by bedtime, so a first draft is all I have time to do. I’ll try to run fewer less-important pieces to trim the overall length. Even that’s not a slam dunk since every item is important to someone.
• I don’t find much value in Readers Write. I don’t either all the time. It’s like the interviews – some are really good, some blow. Most of the vendor-written pieces are self-serving, but I’ve learned that anyone who takes the time to write, vendor or not, has an agenda of some kind (pitching product, angling for a new job, etc.) I may put up a survey on whether Readers Write should stay or go since I’m indifferent to it, although there have been some nice posts that I would have missed reading. I could accept only provider-written pieces, which might cut down on the pitches. Good idea?
• Organize the sponsor ads so I can find companies offering something specific. I like that idea. It would be hard to organize the ads themselves since many companies serve multiple product categories, but I can see some kind of an online guide sorting them out. Thanks – I like that and have already started working on it. I know some readers are conscientious about supporting HIStalk’s sponsors when searching for vendors (because they’ve told me so themselves) and I appreciate that.
• Axe daily e-mails. Most people read when they get an e-mail and I send one only when I’ve posted something new, so I’d be cautious about just not e-mailing even with a new post up. I’m open to suggestions, but I’ll toss this out: some readers want more frequent posts and some want less, so that may be the issue rather than the e-mails themselves.
• When performing a search at your site, sort it by date. Great idea if anyone can help me figure out how to do it. I’ve worked on this after reading this suggestion and found that there’s no way to do that automatically since HIStalk “pages” are generated dynamically from the database – they are not static HTML pages. Apparently the only way to incorporate a reliable date is to manually tag each post inside its HTML source, which would be a lot of work.
• Have a focused section on M&A and private funding of companies at all stages (especially the early ones). Maybe once per month. There are a number of incubators (they’re back) and angel communities that are funding early stage companies and it would be nice to have an easier way to see what’s happening in this area. Knowing who the healthcare focused VCs, Angels and Incubators are would be nice as well. I love the idea and would need help figuring out how to do it. Input welcome.
• Perhaps open a channel for "new" companies to provide a brief description of what they do. Kind of a "what’s hot or what’s new" type section. Companies would have to be small (5 or less clients?), have proven success (1 client testimonial), and be ready to expand. Might give the company and your audience a chance to connect. Would also allow the rest of us to learn about new things and maybe push us all to be better. I would offer to help edit/review submissions and I bet others would as well. Brilliant. I’m going to do this. If you want to help, let me know.
• Skip telling us what you’re listening to. Aw, c’mon, are you so pressed for time and so laser-focused on work that you’re not willing to let me have one easily skipped sentence out of the thousands in a week’s worth of posts? I mean, it’s some guy’s blog, not JAMA.
• More on HIStalk about financing – the best series you have is Health IT From the Investors Chair! That’s not my area of expertise and I don’t know how much free time Ben Rooks has, so I’m open to volunteers. I should mention, too, that my experience with even well-intentioned volunteers isn’t so good. Everybody likes the idea of helping me write until they realize that it’s a multi-hour commitment on a set schedule, not a “when you get some free time” thing. I know from the incoming domain names that I have quite a few readers from Wall Street investment banks, private equity firms, etc. If you are one of them, can write well, and want to pitch in (anonymously if necessary), let me know.
• Stop being so damn addictive. Making me stay up too late. Me too.

Some Representative Responses to “If You Have Thoughts to Offer About HIStalk, Please Let Me Know”

I promise these are representative even though they are mostly positive. There just weren’t many negative comments.

• Absolutely love it – and your rumor posted about my current client really made an impact at the site, so your work has actual consequences. Keep it up!
• Conversational, respectful of your readers, open to clinicians’ involvement.
• Overall, LOVE IT. Huge fan and read all the time.. definitely helps in the sales process to know the scoop about the industry, competition, and trends
• You are a creative, humorous, bright spot in this industry. Thank you for choosing to spend your valuable "off" time to generate this very entertaining blog!
• Great publication. You are the current standard in the industry.
• I would be interested in hearing about healthcare providers’ experiences with their use of consulting firms.
• Since this isn’t your ‘day job’ it’s amazing how well supported and well-written this site is.
• HIStalk is priceless and I want you to know that your dedication and devotion does not go without notice. I know what you must go through to constantly update your blog and bring your brand of sophistication to the HIT world. I only hope you take some time for yourself as well. You are truly appreciated from this guy.
• Love this site!! I have recommended to many colleagues and customers as it is a realistic view of our crazy industry
• Would prefer less-biased reporting and comments from Mr. H, but I understand the nature of blogging….
• I’ll admit it, I’m surprisingly hooked on EPtalk with Dr. Jayne. She provides good insights and her "pieces" are well written.
• HISTalk has helped me to be knowledgeable on a broad range of topics, one stop shopping shall we say? Thank you!
• Might be fun to consider holding HISTalk events in different parts of the country throughout the year – not necessarily tied to HIMSS. Would give sponsors a chance to strut their stuff, and readers a chance to connect.
• Create a HIStalk white paper link, sort of like ‘readers write’, where you can post HIStalk approved white papers. You could solicit white papers on specific subjects, for example "Checklist/Considerations for purchasing hardware for EMR implementation". To make it valuable and avoid ‘salesy’ submissions, you could require that customer and vendor/product names be left out.
• Hugely valuable, just very well done.
• The new sponsors are getting out of hand – a wall of ads and now a weekly commercial "within the lines" for each new sponsor and an even longer sponsor update section that includes mostly very unimportant updates. The signal to noise ratio is being thrown off – I’m starting to skim more and more to find all of the gems that used to jump out at me.
• I love, love, love the humor! Not only is Mr, HIS Talk an accomplished healthcare IT professional, but he’s a really funny guy. I know I’m feeding your ego now, but the infusion of humor in reading this blog is what makes my day. The color commentary at HIMSS or other tradeshows is wonderful, especially for those of us who are not able to attend. Keep it up – love the blog!
• I really appreciate the level of the writing that is done. I am not a techie person, nor do I want to be. TPD’s comments are way above my head (although I’m sure they serve a good purpose for many), but the majority of your writing is understandable. It also makes me look smart when I can send information to answer a question to my bosses (of course, I credit you). HIStalk is actually something I read on my days off and I typically avoid email like the plague when I’m off. Thank you (all) very much.
• It’s difficult enough to keep up with the information you are putting out. No way I could possibly sift through the raw information that you distill into digestible nuggets. You’re the best, and cheapest, personal assistant I have. And for someone learning the business of HIT, you’re indispensible. Thanks!
• I’m amazed and so appreciative of the fine job you’ve done. Who knew? There really is no other source I rely on for important info. A couple observations….you do seem to pander more to sponsors than I think you realize (sorry, what are friends for?). I’ve also noticed you’re working more hours over the last months (and I confess, I worry about you, and no, Mrs. H did not put me up to that!)
• Attempt to do interviews with members of the Office of the ONC.
• Publish more often.
• Keep up the good work. I’m an in-the-trenches grunt and I really like HIStalk. It’s not just for vendors and management types.
• Love it. Don’t stop
• Excellent! Not sure how you keep it all going, but please, please don’t stop.
• I just wanted to let all of you know – Tim, Inga, Dr. J and Ed – you do a fantastic job and it is greatly appreciated. Thank you!
• Twisted humor is best.
• I like the way that you stay pretty neutral on topics – objective, fact based and or present an opposing opinion to show two sides.
• Keep up the great work! I love Inga! (i’m female). Not sure about Dr Jayne yet? She sounds like she’s trying to impress us.. hey we’re already impressed she’s working with you guys – she should be herself.
• As a CIO, HISTALK was one of my best sites to visit and helped me manage vendors, alerted me to some solutions. Now I’m in consulting and it is helping me stay up to date with the industry happenings without having to read extremely boring online magazines.
• Congratulations on getting the help of Inga and Jayne (and others); you had been working far too much. HIStalk is not the only blog I read, but it *is* the one I read first (usually as soon as the facebook note comes out); whereas the other blogs are more of a "when I have time to look at them". Thanks
• Great work. I really like your take on the academic articles that are published. I know it is hard, because I used to try and do it, but your reviews of these articles are my favorite bits on the site.
• The reports of wins by big EMR vendors is a major leg up (e.g. EPIC wins Cedars & UCLA). In one instance you knew before I did about my own enterprise’s plans. Keep up the great work.
• Remain objective and do not forget the smaller health care IT companies who are struggling to survive in the MU clinical sales crush.
• I really enjoy the quick read and the fact that you point out "unverified" comment.
• CIO Unplugged – hate it one week, love it the next – keeps me coming back.
• Reduce the number of sponsors to keep the sense of "unbiased" as true as possible. Cut down on the use of first person pronouns from Mr. HISTalk. The only blogger in healthcare that uses more I’s, me’s, my’s, and mine’s in their writing is John Halamka. It makes it sound like you have an inferiority compensation complex. 😉 But, on the positive side, keep shaking things up. Healthcare and healthcare IT is the most self-congratulatory industry in the world, especially considering the horrible state of affairs of both. Keep rocking the boat and calling a spade and spade. You’re good at that.
• Spend more time with Mrs. H.
• Incredible effort – especially as part-time. Always informative, usually something to smile about and terrific contributors. What ever you do, do not add open reader forums where trolls and vendors trade insults and "IMHO" BS tirades. Stay on HIMSS’ a$$! They are such a lovely target.
• It may be interesting to have more discussion about the state of the industry from the point of view of the employee. For example, myself and friends are being squeezed to do more work with less, all while taking multiple years of no pay increases.
• Thank you for handling the trolling from late last year so very well. Oh! And for being nice over e-mail. You’re a sweetheart.
• LOVE your blog. There isn’t another industry news source that’s worth reading.
• Less Epic cheerleading; maybe more on consulting (I’m biased as a consultant);
• I love this blog. Seriously. I read it more consistently then anything else I keep up with on the web. It is smart, funny, opinionated but not preachy, and ethically done. Awesome job!
• The content is succinct, accurate, and as non-biased as one could hope for. most importantly it is witty and lighthearted. We work in a fast moving, dynamic and challenging industry where it’s hard to catch your breath. It’s hokey but you remind me to have fun
• HISTalk has introduced us to ProVation order sets and the news/rumours I read about vendors that we have interacted with has helped! I’m new to health IT and stumbled upon your blog by chance. I have learnt a lot from leadership to vendor to product talk. Keep up the good work (but don’t sacrifice your family doing it!) as I don’t look forward to your emails! Thanks a bunch!
• Not only do I love your news and fodder, as a fellow music lover I appreciate your taste. Please don’t ever stop telling us what you’re listening to. You’ve turned me on to a few great bands and reminded me of some forgotten ones as well
• I absolutely love you guys. You’ve made me laugh, you’ve helped me do my job, and my customers & colleagues think I’m a knowledgeable and insightful person because of you. Please continue to keep up the good work, I hope that all of your readers appreciate you as much as I do 🙂
• I’ve always wondered if you had a deal set-up where your identity will be revealed after your death. Similar to Deep Throat of Watergate fame.

News 3/4/11

From KoolAidKid: “Re: vendor market share. Numbers I’ve heard suggest that Epic gained 100 new hospital customers in the past year. Nobody else was close and GE and Meditech both had a net loss of sites.” Unverified.

From Mintonw: “Re: Allscripts ED standalone. Receives certification as a Complete EHR for version 7.0, the first and only best-of-breed EDIS to be a Complete EHR.” It’s listed on CCHIT’s site as such.

From Genius Bar: “Re: GE. Searching for a new CTO to drive innovation, also looking for strategic partners and acquisition candidates. Good timing since they are freezing development of some of their products.” Unverified.

From @cascadia: “Re: Sarah Kramer of eHealth Ontario. Is it coincidence that the comments about her were followed by a picture of women’s shoes? Wonder if the recent negative press is the reason her LinkedIn profile was deleted and exists only in a cached version?” Here’s the story we linked to that mentioned her involvement in UCLA’s EMR implementation. I don’t assume she did anything all that wrong given the general fiscal fuzziness that seemed to envelop eHealth Ontario (and who knows what pressure she was under to get work done, even if it meant going with consultants you know instead of going through government procurement processes). Her boss quit the day before the auditor’s report came out, so I’d say he was involved. I think we should let the woman make a living – nobody said she wasn’t a good EMR advocate and she’s not in a management role at UCLA.

From Sharlie Cheen: “Re: AdvancedMD. Can your investor guy inspire us daydreamers with an estimate of how much CEO Morgan and VC Francisco made for less than two years’ work flipping AdvancedMD?” Winning! I’m waiting to hear back from Ben Rooks, although I’m sure the best he can do is guess like the rest of us.

From Curious George: “Re: Jonathan Bush’s Sam Kinison-esque rant at the HISsies. I keep hearing about it – is there any public video available anywhere?” I know Medicomp filmed it from multiple cameras, but I don’t think it’s been posted. He was definitely on, and most impressively, was up the next morning and on national TV at 7:30 talking business.

From Peter the Rock: “Re: Dell Services. Has frozen all Meditech hiring for an undetermined amount of time for them to review their financial stability.” Unverified. Update: Dell says this isn’t true. I’ve offered to run their response if they want to provide one.

From Mitigator: “Re: Medicity. Big plans, looking to branch out into the apps business. Rumor is they are working on an app store model. Given the recent Allscripts announcements, will we see app wars in HIT?” Verified. Medicity started work on an app model for its iNexx platform two years ago. They’re piloting a free referral app, a free virtual care team record that is similar to a provider’s social network centered around the patient, and a fee-based Meaningful Use app. Third parties have expressed interest in writing to the iNexx API. I found the above on Medicity’s site.

From Lawrencium: “Re: Siemens. They are gaining momentum, especially in small hospitals looking to replace Meditech and considering Soarian. New deals coming toward the end of this quarter and new key talent being recruited.” Unverified.

Dr. Jayne is doing a fine job, don’t you think? So much so that I’m moving her to her own post on Monday nights, although she’ll continue to write here on Thursdays. That excellent idea came from a reader responding to my survey. This will give her the space to create her own identity and will shorten the always-full Tuesday posts. She’s looking for advisory board members who can give her quick feedback on ideas (she calls it “the HIStalk Medicine Cabinet” – isn’t that cute?), so if you are a CMIO, CMO, CIO, physician, or other clinician interested in swapping ideas with Jayne, shoot her an e-mail or connect on Facebook. I’m really happy that she joined Inga and me. You never know how someone will work out, especially if you hire them without so much as a telephone conversation first (OK, I’m the trusting type) but she’s smart, sassy, and has a commendably dry and cynical sense of humor, not to mention that she and Inga were quick to advance to BFFs. She’s been an HIStalk fan for a long time and therefore gets what we do. What more could you ask?

Listening: Iced Earth, The Glorious Burden: patriotic, American history heavy metal that sounds like Iron Maiden. Not many metal bands would do an 30-minute, multi-part composition about the Battle of Gettysburg. Trivia: Richard Christy from the Howard Stern Show was the drummer on that album.

Jobs on the HIStalk Job Board: Performance Management and Revenue Cycle Director, Healthcare Informatics Analyst, Implementation Project Manager (Remote). On Healthcare IT Jobs: Systems Administrator III, Senior Software Engineer, Senior Systems Analyst – Clinical Apps.

Reminders of stuff you can do: (a) sign up for e-mail updates like 7,117 of your peers have done; (b) send me stuff: rumors, news, photos, or anything else that would interest readers; (c) use your social networking power in friending Inga, Jayne, and me on Facebook and liking HIStalk so we can brag to our mothers that we have an Internet following; and (d) support our sponsors by looking over the ads occasionally and clicking those of interest. Thanks for reading.

Thanks to Chris Rauber of the San Francisco Business Times, who cited HIStalk in today’s writeup about McKesson’s planned acquisition of System C. Lots of press people and online sites get their ideas and information here, but few give credit. Thanks!

I wouldn’t say you missed much if you weren’t at the HIMSS keynote of HHS Secretary Kathleen Sebelius, but the full text is here if you’d like to decide for yourself.

Everybody’s weighing in on HIMSS – the booth babes, the giveaways, and the general silliness in the exhibit hall. My take: it doesn’t bother me. Surely nobody’s naive enough to think that traipsing through the exhibit floor constitutes any kind of research or due diligence, not that all that many research-driven decision-makers go to the conference seeking vendors anyway. Vendors and freebie-seeking non-prospects might as well make it fun without lofty expectations either way. I do feel bad for the rent-a-babes (and female attendees who feel demeaned by their presence, which I get totally), but like most cases of the non-involved protesting bad working conditions, I’m pretty sure the subjects themselves would not be in favor of even a well-intentioned ban on their presence (good news, you get your dignity back; bad news, you now have no income.) I keep thinking exhibit hall excesses will be self-limiting since they have no ROI and don’t impress prospects, but vendors are so scared of each other that nobody will blink first in cutting down on booth sizes, doing product demos instead of card tricks, and letting people buy their own cookies and popcorn. Vendors are providing what prospects (or at least booth-cruisers) respond to, rightly or wrongly. At least I saw no mimes or Richard Simmons this year. Next year I may ask the youngest and cutest booth decorations outright – are you an employee of this company, and if so, what’s your job the other 51 weeks of the year?

Speaking of exhibitors, above are the top 10 vendors by HIMSS points, which lets you pick a better booth location by spending money elsewhere with HIMSS. If you don’t play the game, you get to be one of those vendors in booth Siberia, wondering where all those 31,000 attendees are since you won’t see more than a handful and those will be directionally challenged, not product curious.

Nine of the 10 companies above either sponsor or are in the process of sponsoring HIStalk, I just noticed (all but Epic), so I can’t get too self-righteous about their payments to the not-for-profit HIMSS. At least I don’t charge much and I think I probably appreciate it more.

Vermont Information Technology Leaders selects Medicity’s HIE solution for its statewide project.

Thanks much to new HIStalk Platinum Sponsor MediServe. The 26-year-old Chandler, AZ company focuses on specialized software for inpatient and outpatient rehabilitation (documentation, functional scoring, intake, scheduling, charge capture, and order management), respiratory (staffing management, protocols, clinical and financial reporting tools, charge capture, electronic documentation), and a specific application for managing Spontaneous Breathing Trials to improve patient outcomes through protocol compliance, electronic documentation, and reduced ventilator length of service. You may have heard of a few of its customers: Hopkins, Cleveland Clinic, Vanderbilt, Duke, UNC, University of Michigan, Sutter, and Baylor. Thanks to MediServe for supporting HIStalk.

Vanderbilt launches My Cancer Genome, an online tool for physicians and researchers that allows them to look up tumor profiling results to find the clinical implications of the specific gene. Lung cancer and melanoma are up and running, with capabilities for breast, colon, and other cancers coming soon.

Saint Barnabas Health Care System (NJ) is enforcing content control restrictions on its PCs using Symantec’s policy-enforcing hosted data loss prevention agent. I found information on Symantec’s site about its product, which I assume it obtained in its 2007 acquisition of Vontu.

We new iPad 1 owners (thanks, HIMSS vendor contests!) aren’t missing too much with the just-announced iPad 2: it has faster video, dual cameras, Facetime, a gyroscope, and a lighter and thinner case. Same price. Otherwise, there’s not much new – no improved video resolution or anything major that would make you want to toss your new one to buy an even newer one. My iPod Touch has all those new features already plus the Retina display and longer battery life, so if you don’t already have one of those, that’s where I’d spend $225 instead of putting $500 and up into a new iPad – I still use the tiny iPod Touch 10 to 1 over the iPad. The fact that tons of people will be clogging up Apple stores next week and victoriously waving their expensive replacement of a product less than a year old tells you all you need to know about Apple as selling a vicariously hip lifestyle instead of technology. People gripe about spending $100 to replace a ten-year-old Windows XP, but can’t wait to muscle through the line to conspicuously consume anything that Steve Jobs has touched on a stage.

An incubator formed to commercialize software and other technology from Mayo Clinic is being disbanded after blowing through all of its $8 million in funding in 18 months, mostly on excessive corporate headcount, not to mention that Mayo charged Healthcare IP Partners with misusing Mayo’s name to raise money. “Distance medicine services” vendor Rainwater Healthcare already appears to have been shut down. Another portfolio company is Kardia, which sells a cardiovascular imaging and information system. The only good news is that an audit found no evidence of rumored financial shenanigans, which a former director says came from an employee he fired for indecent exposure.

A man who scammed Medicare for $10 million in phony medical equipment claims says it’s “incredibly easy” to commit such fraud, saying anyone with basic computer data entry skills can do it.

E-mail me.

HERtalk by Inga

From NotFromTheAgency: “Re: trade show models. I work for one of the large HIT companies. About six years ago, one of our company lawyers was walking the floor at HIMSS when he was approached by a couple of very attractive representatives from another large company. They asked him if he wanted to come in and learn about ‘Sorio.’ When he told them he worked for the other guys and offered to helped them learn the name of their own product, they confessed that they didn’t care – they wanted to talk to him because he was ‘young and good looking’ and they were tired of being friendly to other people they described in not as kind terms. Turns out they were professional models. This might not be a surprise to many, but it was to us — we had never hired people to work in our booth. After learning this it was fun to watch the models from Company A congregate in the halls with other nice-looking ‘employees’ of Company B & C during breaks, apparently friends from the same agency.” I’ve been trying to decide how I really feel about this whole booth-babe-for-hire thing. There’s a part of me that believes that if a company is spending hundreds of thousands of dollars on exhibiting, they better figure out a way to draw prospects in. In general I don’t take issue with the companies who hire appropriately dressed attractive women or hunky guys if they think it makes a difference. On the other hand, I find it degrading as a woman to witness the girls in the company-sanctioned (and paid for) super short skirts and skin-tight jumpsuits. It says something about how these companies value women and lead me to conclude that I would never want to work or do business with one of these organizations. Wow, sounds prudish, especially coming from someone who likes fancy clothes and all. But, there is a time and a place for everything, and the time and place for a skin show does not include the HIMSS exhibit floor.

From Lady In Red: “Re: John Halamka. I noticed this image posted by Engadget during their live blogging coverage of the iPad2 event. It was shown in the segment of the presentation where Apple was talking about how much of a success the iPad1 has been. Is there anywhere the man in black *doesn’t* turn up?” Now that you mention it, I don’t think I ever had a John Halamka sighting in Orlando. I believe I heard that he was in Japan and not at HIMSS. However, when I was with Mr. H at the opening reception, we spotted a Halamka wannabe in one of those black, mandarin collar shirts.

The Indiana HIE announces that its Quality Health First Program has enrolled over 1,500 physicians in 50 communities. It provides summaries of clinical patient information and flags patients needing provider intervention.

This week on HIStalk Practice: the full interview with AdvancedMD CEO Eric Morgan, whose company was acquired this week by ADP. The AMA wants more flexibilty with Stage 2 Meaningful Use. New iPad options from Practice Fusion and GE. An Arkansas doc opens a barter clinic (Chickens for Check-Ups.) Dr. Gregg pimps HIStalk Practice to the industry. Show a girl some love and sign up for e-mail updates while you are there.

The VA awards Harris Corporation a multi-year contract to continue providing software engineering and enterprise support for the VistA Imaging System.

Axial Exchange, a provider of clinical data sharing tools, raises $1.15 million from a $1.5 million offering. Axial CEO Joanne Rhode is the former CEO and director of HIT strategy at Red Hat.

IBM introduces its Patient Empowerment System, a “next evolution” patient portal.  The portal is designed to be hosted by health systems and includes such features as drug interaction warnings, alerts, and examination of genetic profiles. IBM will continually enhance the system by adding analytics from public sources. IBM is previewing the system at CeBIT in Germany this week, leading me to wonder why they chose not to preview at HIMSS. Or did they and I just missed it?

Two senators, including Mr. H’s man-crush Chuck Grassley, introduce legislation that would require Medicare to publish what individual physicians earn from Medicare. The bill would overturn a 1979 court injunction barring the public to see what individual physicians receive from Medicare. The court ruling was designed to protect physicians’ financial privacy, but Grassley and Senator Ron Wyden are pushing for more government transparency and more provisions to fight Medicare and Medicaid fraud.

A Birmingham paper chats with Boyd Douglas, the hometown CEO of CPSI. He explains why he is bullish on continued market growth beyond 2015:

I am confident we will see sales of our electronic medical record system continue for some time beyond 2015, which is when the stimulus fund payments are scheduled to end. First, I don’t believe there is sufficient capacity amongst all the health care information technology vendors combined to implement EMR systems in every hospital in the United States by 2015. In addition, moving the medical records for an entire nation from paper to an electronic record that is both standardized and secured, yet can be shared as needed, is a massive and complex undertaking. I believe it will create additional demands and opportunities beyond 2015 as the whole dynamic of how clinical information is captured, stored, and communicated continues to evolve. Finally, my feeling is there are a number of EMR systems that will be put in hospitals that satisfy the letter of the requirements to receive stimulus fund payments today, but are not necessarily satisfactory long-term solutions. They lack the integration with other information systems that is essential for a seamless flow of information throughout the hospital and to their physicians.

Congrats to Jill Krcatovich, manager of nursing informatics & infusion center at Allegan General Hospital in Allegan, MI. She won a Sonos Music System, courtesy of the wonderful folks at Enterprise Software Deployment who held a special HIStalk reader-only drawing at HIMSS.

Kane Community Hospital (PA) goes live on Healthland EHR.

Twenty years ago today, Rodney King was caught on video being beaten by LAPD officers. After ensuing riots, King spoke the famous words, “People, I just want to say, you know, can we all get along?” Perhaps that is what members of the Tri-City Healthcare Board of Directors (CA) are saying to themselves after fellow board member Kathleen Sterling had to be physically restrained by five guards during a recent meeting. Because of frequent outbursts and verbal assaults in recent months, Sterling was made to stay in another room during board meetings and communicate through a speaker phone. When she attempted to walk into a recent meeting, she fought body guards to be allowed entrance. Hospital administrators intend to file a restraining order against Sterling so if she tries to walk into another meeting, she can be arrested. All members of the board are publically elected, by the way.

E-mail Inga.

Sponsor Updates

• SCI Solutions tells us that one of their customers, Atlanta Medical Center, has increased their CT appointments 46% since their November go-live of Schedule Maximizer in replacing STAR. Part of the reason is the flexibility of setting appointment slots for times less than 30 minutes. They’re offering a series of Webinars that includes Physician and Patient Connectivity: The Southwest Airlines Way, How Can I Make My Customers LOVE Accessing My Hospital, and Creating a Patient Financial Access Center-If you build it, they will come! Many of their Webinars are presented by their customers.
• e-MDs reports that 2010 was a record year in terms of revenue and employee growth. Employee count grew 31% to 275.
• Happy 10th anniversary to sponsor maxIT! Founders Parker Hinshaw, Robert Moore, and Jennifer Arthur are still with the organization, which now supports over 550 consultants and recently earned a spot on the Inc. 5000 Fastest Growing Private Companies.
• Resurgens Orthopaedics (GA) selects interoperability and surgical planning software from Merge Healthcare. The solution will allow Resurgens’ physicians to view images directly from within their EHR.
• Brielle Orthopedics (NJ) picks the SRS EHR for its 12-provider practice.
• Erlanger Health System (TN) will implement GE’s eHealth Information Exchange platform.
• Albemarle Health (NC) chooses the MetaVision AIMS from iMDsoft for its pre- and intra-operative environments.
• Baylor Medical Center at Frisco (TX) purchases PatientKeeper’s clinical and documentation software products, including PatientKeeper CPOE and NoteWriter. Baylor will integrate the PatientKeeper software with its existing Meditech system.
• Advanced Pain Centers (MO) selects McKesson’s Practice Complete for physician billing, coding, and reporting.
• Henry Mayo Newhall Memorial Hospital (CA) chooses Access Universal Document Portal (UDP) to integrate EKG results from its Epiphany system into its EHR.

EPtalk by Dr. Jayne

American Medical News reports that “degree of patient’s online access” is a new vital sign, based on data from the Pew Research Center’s Internet & American Life project. Apparently searching for health information on the Internet is the third most common online activity. Most of us who see patients regularly already know that, based on the volume of Internet printouts patients bring to their visits, along with “ask your doctor about our drug” ads ripped from the pages of Reader’s Digest.

Although the piece initially elicits moans and groans from those of us who have been on the receiving end of a consult request from what the article jokingly calls “Dr. Google”, the point it tries to make is that those of us delivering healthcare should not assume all patients have Internet access. An interesting thought, since Meaningful Use is driving us to provide more and more information electronically (and doubly so based on what seems like every hospital and health system’s initiatives to have patients access their patient portals).

Ultimately, I was relieved that this was the spin of the article. For a minute there, I thought there was going to be some new federal agency making me score online access in the chart along with blood pressure and BMI, much like JCAHO did with “pain score” as an additional vital sign. There is some interesting data in the article, though, looking at demographics and how income, race, ethnicity,and  gender correlate with access. Worth a quick peek.

Their other headline was “EMRs, quality efforts key to viability of practices, Obama officials advise.”  Whether you agree with the changes that have come to all of us recently or not, this is the new world we live in. Unless you’re a physician ready to switch to a concierge practice, practices that want to continue to see Medicare and Medicaid patients will have to comply. And for those who have already opted out of those programs, the commercial payers are lined up right behind them, cloning the programs, but with their own unique twists.

Looking at some managed care contracts the other day was almost enough to make me contemplate the benefits of a single-payer system. With vendors barely able to keep up with federal guidelines and policies, what is it going to look like when every payer (and their regional variants) has their own pseudo-MU program? I guess on the bright side, it’s some degree of job security for many of us in the healthcare IT trenches.

Save of the week: my HIE helped identify a patient who showed up in my office and failed to mention the controlled substances he had received from several other providers in the region. Oops! I always love the looks on their faces when you ask them, “So, tell me about the Percocet you got last week from Dr. Smith — how’s that doing for you?” It gives me a thrill every time. Hooray for discrete data and medication reconciliation!

Funny thing, the HIE rarely finds that situation for antibiotics, or blood pressure / cholesterol meds. I guess there are not many people looking to score those.

In other news, as Mr. H mentioned, I’m hoping to keep you entertained and informed on Mondays. I’m looking for CMIOs, CIOs, and physician informaticist types to share advice and ideas. Whether you have the title or not, if that’s what you do, we need your opinions on fast-breaking issues and hot topics. E-mail me if you’re interested in joining the HIStalk “Medicine Cabinet.”

E-mail Dr. Jayne.

McKesson To Acquire British Software Vendor System C

McKesson announced Thursday morning in Europe that it will acquire British IT vendor System C Healthcare in a $140 million cash deal. The price represents a 51% premium to System C’s closing price last week before the company announced that it was in takeover discussions.

System C offers the Medway suite used in 40 NHS and private hospitals. It includes electronic medical records, patient management, departmental, business intelligence, and portal applications. Its Liquidlogic subsidiary sells software for social services agencies involved with children, domestic violence, housing, and mental health.

System C was in the news recently when a modified version of Medway was implemented as part of the Whole Hospital Information Systems project of the Ministry of Defence, supporting UK military and NATO personnel in the Camp Bastion hospital in Afghanistan.

The company lost money in the first half of the year after NHS changes affected its revenue.

System C had made a string of its own acquisitions, including IQ Systems Services (software for private treatment centers) in 2007; Care Records Unlimited (clinical systems) in 2008; Bluestar UK Group (healthcare RFID) in 2009; Conscia Enterprise Systems (web portals) in 2009; and Liquidlogic (social services software) in 2009.  

With the NPfIT decision to decentralize its system selection process, NHS trusts are no longer obligated to buy systems from approved vendors iSoft and Cerner. McKesson, whose patient management and administrative systems are run in several UK hospitals, had previously announced plans to localize its Paragon system for use there.

More HIMSS Wrap-Up 3/2/11

HIMSS: A Vendor’s Perspective
By Reefdiver

It’s interesting to read the reviews of others who endured the combination Iron Man / Survivor / Amazing Race / carnival / musical chairs / walkathon that is called HIMSS. Over 1,000 exhibitors, 31,000 attendees (do those two numbers overlap?), dozens of hotels, a virtual whirling vortex of shuttle buses, limos, taxis, and rental cars. What, no planes with banners overhead?

Of the many who have published articles reviewing HIMSS, each had his/her own way of parodying (is that a word?) the excess, the overkill, the awesome size yet questionable utility of the show. Or in the case of Dr. Alexander, whether it has meaning at all for practitioners in smaller practices. We’ve heard the reviews from bloggers, journalists, a few clinicians, some industry celebrities, a Palooza-event organizer, and even a dignitary or two. Is it more ironic or revealing that an unabashed CEO-cum emcee is more memorable than a Cabinet member’s speech?

So far, everyone’s perspective seems to converge around the notion that it is too large, too broad, too unfocused and too spread out to have much value. That it lacks the innovation or creativity it once touted. That it is most memorable for the after-hours events. These reviewers have commented that food, magicians, games of chance, or even a sports bar is what attracted them into the endless matrix of booths. Are these the criteria by which the event should be judged?

I’d just like to offer a vendor’s perspective for a moment. Not that anyone would really care, but perhaps offering a vendor’s view may help to shed light on why this fertility rite called HIMSS continues on, against any logic worthy of a Harvard Case Study.

First, we vendors pay a fortune to exhibit at these shows. At more than $33/square foot for just the footprint (a small 20 x 20 booth is over $13k), plus between $15,000 and $1,000,000 for the booth construction, the tab is just beginning.

Don’t forget all the rental furniture, phones, and $1,500/day for Internet hookup (can you believe that?). Shipping each booth from storage to the show costs thousands of dollars – the larger ones must run $50,000 or more. Dealing with the crews that do setup and delivery (including the “game” to get priority among the laborers)

Second, there’s the travel costs, living costs, and time away from doing what we do every other day — serve our clients and work hard to create new ones. For those in sales, a trade show is a torture chamber by another name unless there are new business opportunities to pursue or clients to entertain (at night). For “the brass,” it’s pushing the corporate image with the media and “looking for mindshare”.

Whatever. Spending a huge amount of money normally expects a greater return. Love to survey all the vendors to see how many actually get a major ROI in a tangible way.

Third ,there’s the show itself. Attendees have the option to wander wherever they like and even go outside to take a break to relax, play golf, or see an attraction. They can dress how they please, whether they are comfortable in jeans and a T-shirt or prefer something more upscale.

Vendors are locked to their booths in the prescribed uniform. Many have an assigned station or function. And don’t think of leaving it! Taking even a 10-minute break for lunch to inhale something can lead to evil eyes, a recall by cell phone, or a scolding by the Booth Nazis in charge. Somehow, you are told that the booth is always jammed just after you decide you need coffee, a smoke (ugh), or to make a phone call to a customer in need of something back home.

A vendor’s world is the size of the booth and a walking path around it, hoping for someone looking for YOUR product. The clock moves very slowly when traffic is light, when classes are in session, or when it’s sunny and warm outside. It’s agony. The feet and backs ache.

But we are counting down to closing time each day, for whatever event is happening that night. Mostly a place to sit, relax, and talk about something other than product. Enjoy a beverage without guilt. To eat something besides a $20 stale sandwich or tasteless salad from the hall vendors, all graduates of the Cooking with Cardboard academy. 

Of course, there is a shuttle bus, a long taxi line, or a long walk to the parking lot to redeem the rental car and some horrendous traffic to get back to the hotel first. Do you dare lay on the bed for a short nap before heading out?

By the time the evening is over, it’s late. Feet are still barking and the head may be hurting. But the booth opens again early next morning. Got to be there for that ONE prospect who could make the whole trip worthwhile, knowing that most wander in for the pen, the chocolate, or the chatchka intended to lure them. And the cycle begins again. It’s a good day if you are 20th or less in the Starbucks line. The caffeine main-line to chase the cobwebs. And the new day begins.

Most vendors don’t know much about what goes on in the other booths. The Booth Nazis like it that way. They want you to think that it’s not about having fun, it’s hard work. We need to make this look like a place of business and that we are serious about our customers and are better than our competitors. And we try.

It’s a pleasure to spend time with those very few who are seriously looking for good information, who recognize the need for a product like ours, but aren’t sure how to choose. Those are the gems we live for, the chance to fight for. And for every 20 ID badges we scan, we know probably only two or three will be serious potential for us. But we live for them. We conduct a painful, all-day vigil for them.

And we keep paying the price and coming back to be there for them. Because if we don’t, our competitors probably will!

Dr. Gregg "1 to 3 Docs" Goes to HIMSS (Part 2)

For an all-around overview of the healthcare tech tools world, HIMSS is perhaps the best remaining venue. But unless some refocus by the HIMSS planning peeps is implemented, it probably isn’t a very good investment of time and dollars for the majority of 1-3 provider practice folks. Other venues, though not as complete, provide a better understanding of the 1-3’ers’ needs.

Right up front, I need to say that I may have a bit of bias when it comes to making such a statement. As the director for the American Academy of Pediatrics’ Pediatric Office of the Future exhibit at the AAP’s annual conference (NCE), it is just exactly that hole in the end users’ educational options which we seek to fill. Our exhibit – which is growing by leaps and bounds, I’m happy to say – is designed specifically to supply a hands-on, interactive, educational opportunities, exposure, and functionalities overview.

We try to make it very clear to our sponsors that it is all about the educational value for attendees. Of course, we know vendors sponsor us in order to drive sales, but we ask them to try to keep sales pitches subtle, directing attendees who may be interested in deeper sales or product-specific chats to their company’s primary exhibit hall sales booth or to post-conference follow-up.

From what we’ve seen, and from the responses to the post-conference surveys we’ve received – an extra special thanks here to Dr. Eric Fishman and EHRconsultant who did one of the best – it appears that the 1-3’ers are more than interested in learning more. Indeed, they seem more interested than ever, but they also have some very specific needs, few of which would be met by a junket to HIMSS.

Here are a few quotes from attendees to bolster that assertion:

• “Hands-on experience was the best way to learn the EMR.”
• “Although we have not adopted EMR, it was very helpful to see the advantages and utilization of the EMR.”
• [It enhanced my understanding of HIT by seeing] “different formats for EMR organization – both information entry options and options for how the info entered in the past can be easily accessed and reviewed in a way that supports medical decision making.”
• “It is obvious there are better solutions than the ones we are using.”
• “A small part of a steep learning curve.”

1-3’ers are not slow, resistant to tech, or Luddite. They are just providers who want to provide the best care they can. Their focus is health — the world of medicine. They want the advantages of high tech tools, but don’t have any interest in going back to college to gain a degree in Informatics. There just aren’t many booth or educational session combos at HIMSS which would be of any use for such folks. Most are just too tech-heavy or too tech-specific for 1-3’ers’ needs.

If HIT is as smart as some want us to believe, providers shouldn’t have to pass HITECH 501 just to use an EHR. Indeed, healthcare providers are some of the biggest users of smart phones, but I’ll bet very few docs spent more than twenty or thirty minutes before they were texting, e-mailing, and apping away happily with any new iPhone, Droid, or Pre. And, these “phones” are powerhouses, capable of tons of techno-wizardry. If HIT is so smart, EHR adoption shouldn’t really take so darn much time to learn how to deploy.

So, between a relative dearth of relevant and easily digested content, the costs of attending coupled with the costs of taking premier days away from the office, the snobbish disdain many vendors evidence toward anyone without a massive checking account, and the tremendous amount of time it takes to find “1-3’er value” amidst the mainly big toy shows on the exhibit hall floor, is it any wonder the 1-3’ers are so few and far between at HIMSS?

Top that off with the massive learning hurdle that most EMR/EHR implementations require and the answers to those questions circulating about how to engage the 1-3’ers’ interest in HIMSS, and in EMRs in general, seem to become clearer:

1. Hold more of HIMSS, including the exhibit hall stuff and not just the pre-HIMSS stuff, on the weekend (maybe including Friday which is usually more doable than Monday for 1-3’ers) so that it isn’t as financially prohibitive for us grunts.
2. Hold some super-friendly-for-super-small-practices seminars. Grunts don’t typically find much use for keynotes highlighting the wondrous things HIMSS has accomplished or panel discussions on NIST and NICE.
3. Establish some sort of positive reward system for vendor reps who actually talk with 1-3’ers, not just VCs, reporters, and other vendors.
4. Consider a cooperative between HIMSS and any and all medical academies and organizations to help spread the HIT message across more shows, in more towns, at more moments in time. (The Medical Records Institute tried this with their “EMR Road Shows,” but the shows were too small, too few vendors attended, and scope was too narrow to be sufficiently advantageous or enticing.)
5. Smarten up HIT and make it smart phone-esque. (I’m still so in awe of how Medicomp’s Quippe has really made a quantum leap along this path.)

Two cents from the 1-3’er trenches…

“Be faithful in small things, because it is in them that your strength lies.” – Mother Teresa

E-mail Gregg.

News 3/2/11

From Less Than Grand: “Re: Dr. Gregg’s HIMSS review. I could not agree with you more. The show is lopsided with regards to the audience they are targeting. Though I have attended HIMSS many times in the past, it never fails to disappoint me that the show continues to leave out the physicians who represent the majority of physicians practicing (NOTE: these physicians also represent the majority of those without an EMR.) Great summary!”

From Kubrick’s Rube: “Re: Blue Cat Girls at HIMSS. I thought HIMSS had sunsetted those displays ten years ago, when an exhibitor no one remembers had a small Asian woman in a practically transparent body suit doing mind-blowing contortion. I heard HIMSS got the word out that this kind of entertainment wouldn’t be allowed, but I guess anything to fill the halls …”

From RIFeree: “Re: Vanguard Health Systems. The for-profit laid off 10% of corporate employees on Tuesday.” Unverified, but what appears to be the CEO’s internal e-mail is above (click to enlarge).

From Rockville: “Re: HIStalkapalooza. What a fantastic event! I have never laughed so hard at a trade show in all of my career. Jonathan Bush was one of the funniest, irreverent, and most ‘real’ executives I have met in a long time. I would enjoy working for him. The HISsies and other awards were very entertaining. Thanks for giving healthcare a personality!” His employees in attendance were sure having a swell time, I’ll say that, and that’s a good sign. He looks good in a sash, too (but doesn’t everybody?)

From StatMan: “Re: HIStalk stats. What’s the February number?” I don’t pay too much attention, but it was a record and greatly increased over February 2010. I’m beginning to think it’s like running a publicly traded company – you start to suck once you fixate on the numbers instead of doing whatever it is you’re supposed to be good at. I will have detailed reader survey results up shortly, though, which I do pay attention to. Otherwise, we just do our thing and anyone who wants to read is welcome.

From Art Vandelay: “Re: iPad. Awesome work on the iPad-themed version of HIStalk. You always amaze me with how current you continue to be with trends, news, tech, and I like your music picks too!” Art is observant. I upgraded the mobile format of all three sites (HIStalk, HIStalk Practice, and HIStalk Mobile) this week to provide a rich, functional, fast presentation for iPad, Android, BlackBerry, Palm, and Samsung (it was iPhone and iPod Touch only before). Once I pulled HIStalk up on the iPad I won at HIMSS, I was like, “This looks crappy,” and then realized I could probably figure out how to fix it in my vast amount of spare time. Which I did, and happily so since I know quite a few of you new iPad owners from HIMSS will be checking out HIStalk on your new toy.

From July Johnson: “Re: consumer group’s letter to ONC. I may be overly dramatic, but I believe this is a watershed moment. The battle lines have been drawn between the consumers of all walks of life who won’t accept the system as is any more and expect more for their $30B vs. the providers and IT vendors who want to get billions of $$$ to deliver what they should have delivered without incentives years ago. Reading these positions, it make all the flash and boat showmanship of HIMSS seem extremely hollow when you see what consumer/patients actually want from the system. Now that the mighty consumer/patient has been awakened, providers, vendors, and HIMSS will have no idea what hit them.” The groups include AARP, AFL-CIO, Consumers Union, SEIU, and several others. Their most interesting recommendations:

1. Make all Stage 1 Menu items required as Core for Stage 2.
2. Improve e-prescribing by encouraging fill-status messages from pharmacy back to the physician.
3. Raise the bar for use of evidence-based clinical decision support.
4. Require documentation of advance directive.
5. Raise the secure messaging bar in Stage 2 to 50% of patients who prefer electronic communication.
6. Hold providers accountable for using, not just offering, a patient portal.
7. Raise the bar on use of electronic tools for communicating with patients from 20% to 30%.
8. Add required experience of care patient and family surveys to Stage 2.
9. Require in Stage 2 a care plan that includes a list of team members, problem list, medication list, allergies, advance directive status, and patient preferences for language and communication.
10. Don’t let providers meet the HIE requirement in a “test” – make them provide a summary of care record for 30% of their patients who are transitioning to another care setting
11. Advance the incorporation of lab results into EHRs.
12. Provide a mechanism for patients to flag and correct their health information.
13. Encourage accessibility and usability standards so that disabled people can consumer health IT innovations.
14. Don’t be tempted to let providers slide on Meaningful Use just because their quality scores are good because quality measures aren’t meaningful to consumers and patients.

Also writing to ONC: eHealth Initiative, which wants increased emphasis on HIEs and better coordination between CMS and ONC on timelines. They make good points about needed clarifications (who’s a license professional when it comes to CPOE? how do you define “structured” lab data?”)

From The PACS Designer: “Re: Apple’s iOS 4.2 release. Apple’s iOS 4.2 has many new features that users will most likely want to use to expand the capabilities for their remote viewing activities. The free iOS 4.2 update brings all-new features to not only your iPhone 4, but also the iPad and iPod Touch.” Above is a video that TPD found.

From Privacy Concerns: “Re: EMR. This represents a creative use.” A PGY1 resident at Christiana Care performs unauthorized physical exams on six women and throws in some no-extra-charge fondling, all undocumented in the chart. Investigators found that he had checked out the electronic medical records of the women before the grope-fest. He’s been fired and warrants are out for his arrest on charges of unlawful sexual contact and patient abuse.

From MarylandSnow: “Re: RealAge. Not news, but since you mentioned it, they sell patient data to pharma along with ads.” I knew that upfront (it’s clear in the sign-up agreement) but I’m actually OK with it. I’m not so gullible that just getting a drug company’s e-mail pitch is going to make me doing anything I don’t want to do.

From Flatlander: “Re: reader’s comment about Lewis & Clark Health Information Exchange (LACIE). Since it wasn’t even mentioned in the article about Kathleen Sebelius, that probably came from the Cerner PR machine. LACIE uses a heavily subsidized HIE platform in exchange for being a national sales reference, and with all participants except one being from Heartland’s normal referral area, it’s hardly impressive and bears no resemblance to a self-sustainable HIE. MU’s Stage 1 HIE requirement is so low (strap a USB drive with one patient’s data on a pigeon’s leg), the one other LACIE participant (St. Luke’s) will be out of there once the incentive check is cashed since its northernmost hospital is a direct competitor of Heartland. St. Luke’s probably got a no-cost deal for the name recognition – they check the HIE box, take the money, and avoid system entanglement and getting their patients recruited.” Unverified.

Also from MarylandSnow: “Re: National eHealth Collaborative. Funding on the line? Although set up with a membership model, their sole funding is ONC – grandfathered in prior to HITECH. Standards and Policy committees with their own multi-million dollar funding have effectively taken over NEHC’s role.” That’s the AHIC Successor that does NHIN stuff.

From Without a Trace: “Re: Usability Symposium Sunday of HIMSS. The whole day was great, but Dr. Friedman from ONCHIT started the day with some big news: usability would be included in Stage 2 of Meaningful Use. The symposium also included speakers from AHRQ, FDA, NIST, Access Board, and big names like Dr. Rob Kolodner and Dr. Dean Sittig. The HIMSS Usability Group announced the release of a new white paper. I expected to read about the ONC’s announcement and news form the symposium in the HIMSS newspaper, but nothing. I can imagine that big vendors wouldn’t be happy about this – I wonder if they were behind squashing the news?” I’ve been darned impressed with the HIMSS Usability Task Force, especially since I bet the HIMSS suits grit their teeth every time they observe that the usability of current clinical software, much of it produced by their cash cow Diamond Members, isn’t very good. I found what appears to be the new white paper, Promoting Usability in Health Organizations: Usability Maturity Model, on the HIMSS site. I haven’t had time to review it yet, so jump in if you’d like to summarize (or I suppose I could try to swing an interview with someone involved in creating it). I still recommend a more dramatic first step: hire an independent firm to evaluate the usability of the top three EMRS in each of the hospital and practice markets and publish the results (you don’t need the permission or involvement of the vendor). Think that wouldn’t put the debate in the public eye?

From HISJunkie: “Re: Texas Health Resources offering HIT consulting services. Epic is doing what IBM did 35 years ago, turning every client into a hosting site (see SHAS circa 1975). Epic is allowing / encouraging the large medical centers to distribute its app on a host basis to almost any remote client (particularly if they are under 150 beds) without incurring a new acquisition or license fee. Just add more work stations and pay a small seat license increment and you can buy them in ‘bulk’. I spoke to several CIOs at HIMSS that are doing this for owned, managed, and non-affiliated facilities. All other vendors require you to pay a sizable new facility license fee. Epic says … not necessary. Oh, but along with the seat charge, they bump up your monthly support fee. How can Epic do this? If you’re a private company, cash is king, not revenue recognition. That’s why you do not see Cerner, McK, Allscripts, etc, do this — Wall Street wants the rev NOW! Epic can wait. Why would Epic forego a possible meaty license fee? They view this as incremental revenue that they would otherwise never see since it’s too costly to sell and support the small or mid-sized facility. (Watch out Healthland, CPSI, HMS, et al.) I predict in the next year you will see many IDNs that are running Epic do the very same as THR. Only trouble is, running a software / service operation is very different than running a facility-focused HIT department. I know, I’ve done both, and the balancing act can make you pull your hair out!” Even Judy critics have to admit she’s brilliant in turning high-paying customers into dealers who can make a little of their money back selling their services to small sites, and in doing so, spread Epic’s reach wider. It’s like creating an Amway sales downline – let someone else do all the sales work on your behalf. I bet the number they watch isn’t revenue or profit, but rather the number of beds or encounters covered – if that number keeps ramping up, the company has endless ways to monetize it down the road. It’s like viral marketing with high switching costs, not to mention that customers aren’t likely to complain publicly about Epic’s solutions when they’re trying to sell them themselves, either internally or externally.

Here’s the Siemens announcement of the hiring of Marc Overhage from Regenstrief and the Indiana HIE as the CMIO of Siemens HSBU under John Glaser.

Capitol Regional Medical Center (FL) will pilot a consumer smart phone app from Healthagen that lets patients who are headed to the hospital fill out information forms and indicate any special needs on their way. Not while driving and clutching their infarcted chests, hopefully.

Bethesda Health Group (MO) is working with Cerner to implement its BeyondNow software in a skilled nursing facility. Cerner acquired BeyondNow in 2003.

Megan provided this pic of her HIStalkapalooza prize-winning shoes since I know the ladies are following that intently. Inga posted a gallery on Facebook.

I ran the news blast earlier that ADP has acquired PM/EMR vendor AdvancedMD. That’s big news because it’s ADP’s first foray into healthcare, other than doing HR administrative work for practices, and they’re a huge company. AdvancedMD had arranged an interview with us beforehand. Below are some snippets from Inga’s notes of her call with Eric Morgan, president and CEO of AdvancedMD. I’m sure she’ll have more later.

I wanted to let you know you were the first ones we thought of. ADP, a company that most of us know, has done a lot of homework in looking at the marketplace and made a decision. They have had a strategy in place to look at adjacent opportunities to grow their business and this is one they have been looking at for well over a year … meaning the smaller to medium-sized physician space AdvancedMD targets and serves.

The matchup between the two companies is very strong. They are certainly focused on our cloud-based, SaaS offering. In fact, they narrowed the field of opportunities down pretty quickly by saying that was the way they wanted to go. They were not going to offer an on-premise approach, so this is very much compatible with what they do with the rest of their business.

The key is they saw value in the business we built here in serving these smaller physician offices. What we do is not easy to do efficiently and effectively. Certainly a lot of vendors in this space have struggled in this. They saw tremendous value in that. This is a big statement for healthcare IT that a company the likes of ADP has made a big commitment and investment in moving into the space from outside the traditional list of folks that you and I are used to talking about.

We will look how we work together and integrate products. All that is part of the plan. We are going to be rolling that out over time. For an ADP client who is interested in practice management or EMR, this makes a very good opportunity for the client to connect very quickly … physicians, much like on the hospital side, more and more will be looking to a trusted leader and a trusted brand. And that scaling of an organization is going to matter more and more … we believe this puts us in a very strong position to be able to give our customers the confidence that they are going with a very, very strong reputable organization like ADP and know that they have a long-term commitment and relationship and investment in the marketplace.

The reaction from the employees has really good. A lot of excitement and buzz here …We are of a size now that they are only a handful or two of folks that are actually bigger than us, yet there are hundreds and hundreds that are smaller than us. I think this puts us in a position to stake a claim among the leaders of the industry.

Inga and I expressed our mutual amazement at how many of our sponsors have been favorably acquired in the last year or two. She wants to get tee shirts made with a list. We can’t decide whether (a) desirable companies disproportionately sponsor HIStalk; (b) we help raise the interest level slightly among potential acquirers; or (c) companies intentionally raise their profile by sponsoring as a signal they are willing to talk, knowing that we have a lot the money people as readers (VCs, private equity, and investment bankers). Regardless, the number is a significant chunk of the total industry acquisitions. Not good for us, of course, since sometimes one sponsor buys another and that means we lose one.

Scottish charge master vendor software vendor Craneware, fresh off an acquisition that gives it a broader US presence, announces record performance for the first half of the year: revenue up 25%, profits up 30%. 

Deborah Gage is named president and CEO of MEDecision, replacing founder David St. Clair, who will remain on the board. She was previously CEO of healthcare payment technology vendor GTESS.

HERtalk by Inga

From DrLyle: “Re: Post-HIMSS. I agree with you about noticing that the buzz is shifting away from the big vendors and we are seeing the rise of the ‘peripheral companies’ which are creating products that build an ecosystem around the bigger HIT infrastructure. The base level is being set (just like Microsoft and Apple did with operating systems) and it’s time for the next generation of HIT companies to start creating the products that actually move the pointer from ‘up and running’ to actually usable and useful. The good ones will thrive and likely be acquired) while the bad ones will fade away quickly. There are books to be written and movies to be filmed about it all in the years to come.” I like the idea of movies being made about the thrilling world of HIT in the age of MU. Maybe Mr. H and I could cameo (for a large fee). I think I failed to say much about DrLyle as the Ryan Seacrest of the HIT Geeks Got Talent session. He was terrific and the brave souls who pitched their product in something like three minutes were all impressive. DrLyle will have to let us know who won.

ScriptRX raises $1 million of a $2 million offering. The 12-year-old company’s products include ScriptRx Writer, ScriptRX Discharge, and ScriptRx EMR for clinical documentation.

Madison County Memorial Hospital (FL) purchases Healthland’s EHR system. The 25-bed critical access hospital expects to be live and achieving Meaningful Use by July.

Elsevier/MEDai and dbMotion partner to provide dbMotion users with Elsevier/MEDai’s reporting and modeling tools.

HealthShare Montana partners with Covisint to for its statewide HIE.

Just another day at the office: a Georgia pain clinic patient becomes angry about her medication and chases her doctor and his female office manager down a hallway with her cane, threatening to rip the manager’s throat. The patient shoves another doctor trying to intervene before a second doctor is finally able to restrain her.

Gilbert Hospital (AZ) begins its implementation of Prognosis ChartAccess.

Surescripts, AHA, and the College of American Pathologists are awarded a grant by the CDC to connect hospital labs with public health agencies to electronically transmit data on reportable lab results. CDC is calling the initiative the Lab Interoperability Cooperative.

Anyone remember Sarah Kramer, the eHealth Ontario exec who left amidst charges of frivolous spending? ($25,000 to have a speech written; $50,000 to refurnish her office; $192,000 to a single consultant for five months of work.) She left eHealth a couple of years ago, taking her $317,000 severance package with her. She is now executive director of Strength to Strength, a third-party consulting team bringing Epic’s EHR to UCLA Health System.

A reader asked for some pics of the fabulous shoes at HIStalkapalooza. Here is a sampling. Not bad, huh?

New from KLAS: a first-time report on the infrastructure market, with an initial report on wireless communication systems. Execs at provider organizations are adopting VoIP cautiously and physicians are embracing new ways to use their mobile VoIP phones. Vendors included in the study are Ascom, Avaya, Cisco, Polycom and Vocera.

KLAS introduces two offerings that I wouldn’t mind having. KLAS Alert will give providers or vendors a monthly snapshot of satisfaction rating of one vendor or multiple vendors, depending on the subscription level. KLAS Connect will facilitate the connection between providers using similar technologies, giving them the chance to network or compare best practices (or perhaps collectively complain).

E-mail Inga.

Sponsor Updates by DigitalBeanCounter

• Greenville Hospital System (SC) selects Oacis Health Data Warehouse from TELUS Health Solutions to provide analytics and reporting.
• Joe Mason joins Enterprise Software Deployment as VP of Strategic Alliances.
• Riverside Community Hospital (CA) chooses ProVationMD software for its gastroenterology procedure documentation and coding.
• Healthcare innovative Solutions introduces Pillars, a web-based CPOE workflow planner tool.
• Imprivata announces its integration with Epic’s authentication API.
• Lake Regional Medical Group (MO) will implement eClinicalWorks using implementation services from GroupOne Health Source.
• St. Joseph Health System (CA) joins with AT&T to implement a new telehealth project that will allow patients to consult with physicians remotely using AT&T Telepresence Solution.
• M*Modal partners with Greenway to integrate speech recognition into PrimeSUITE2011.
• DIVURGENT releases results of hospital industry’s first survey on business intelligence maturity.
• Novell partners with CynergisTek to create the industry’s first unified compliance and security monitoring solution for healthcare.
• St. Joseph’s Health System (CA) selects Allscripts’ Care Management and Homecare solutions to streamline patient movement through its 14 hospitals.
• Health Language launches LEAP I-10, a cloud-based ICD-10 conversion solution.
• University Health Systems of Eastern Carolina reduces labor costs using Concerro’s ShiftSelect.
• Madison Memorial Hospital (ID) chooses PatientKeeper’s CPOE to achieve ARRA-HITECH compliance.
• CapSite releases new research reports on PACS and teleradiology, with 21% and 31%, respectively, of providers looking to switch their current systems.
• Billian’s HealthDATA profiles Florida Hospital CIO Andy Crowder.

EPtalk by Dr. Jayne
 
There was an “Ask Dr. Jayne” question awhile back about those pesky doctors who insist on wearing their stethoscopes and white coats even though they rarely see patients. As I was camped out in the Orlando airport trying to catch a much-delayed flight to my frozen home, I witnessed not one, but TWO episodes of Health Professionals Gone Wild.

The first was an actual medical situation, where an inebriated would-be passenger took a spill and whacked her head on a large planter, splitting her forehead like a melon. An angel in pink scrubs jumped to her aid, applying Starbucks napkins to the wound until the gate agent arrived with first aid supplies, followed by the paramedics and lots of security folks who documented the event on film (alas, I didn’t, though, because that would be tacky). After the cleaning crew completed their multi-step decontamination process (which I was able to explain to several of the curious travelers around me who wanted to know exactly why it took so many people and so much stuff to clean it up).

I was waiting for something else to keep me from a post-HIMSS stupor when what to my wondering eyes did appear but three passengers coming off a flight wearing matching green scrubs, one of whom was actually wearing the white coat. Now this I had to photograph. I looked carefully and didn’t see any transplant coolers and they were loitering quite a bit before heading to baggage claim, so I don’t think they were in the organ procurement business. 

I never did figure it out. Maybe I should have one of those “submit a caption for this photo” contests. If you look closely, you can see one of the planters in the foreground. Sorry the second one is fuzzy — I was laughing too hard to take a decent picture.

After finally clearing the snow from my car (those of us who work in non-profit land park uncovered) I drove home through precipitation that was exactly the consistency of a frozen margarita. Hard to believe that a few hours earlier I was soaking up rays (with sunscreen, of course) in Orlando. As I went through the mail that had accumulated during the trip, I chuckled at the number of vendor and HIMSS-related mailings that were delivered on or after Monday the 21st. Nuance, SuccessEHS, and CapsaSolutions: you should ask for your marketing dollars back.

Now it’s back to the CMIO grind, with PQRS (aka PQRI) registry reporting at the top of my list. Having done claims-based reporting previously, many organizations are trying our hands at registry reporting this time around. It’s always interesting to wade through the data as it’s pulled out of the system, arguing with the doctors who insist they really did do everything for every metric on every patient even though the data says otherwise. It’s always the data that’s faulty, rather than the physician or the office processes, right?

Although some providers loathe clinical data reviews because it points out what they aren’t doing, I take the opportunity to remind them of the studies that have been done showing the sheer number of hours it would take a physician to deliver all the services that each patient could receive, based on the varying recommendations, guidelines, and mandates.

Frankly, without automated systems, I’m not sure how we kept it all straight. I used to have to wade through multiple flow sheets for multiple diseases rather than having a single cohesive presentation of the patient’s health status that could be graphed, manipulated, extracted, and e-mailed to the patient via a secure portal.

I’m hoping that my physicians who are “passive” participants of registry reporting enjoy the CMS payments they receive based on our data submission. Many of them have never participated in PQR-anything before, due to the annoying nature of claims-based reporting. Some of them have no idea that the hospital is reporting on their behalf.

I think once we go electronic, we tend to forget how painful it could be to document on paper and how arduous it was to extract data. (Not all of us, of course. I still have a couple folks begging to go back to the Golden Age of paper.)

And once the PQRI checkbox is complete, it’s onward to Meaningful Use. I’ll have to dust off my riot gear (and my favorite martini glass) because it looks to be an interesting year.

E-mail Dr. Jayne.

ADP Acquires AdvancedMD

HR, payroll, and benefits services provider ADP announced this afternoon that it has acquired AdvancedMD from Francisco Partners. The 200-employee, Salt Lake City-based AdvancedMD is a leading provider of practice management, revenue cycle, and electronic medical records systems. It has more than 10,000 physician users in 4,100 practices.

In the announcement, ADP positions itself as “an integrated, single-source provider of Medical Practice Optimization” for small- to mid-sized practices. The company’s Small Business Services group provides HR, payroll, and benefits services to 45,000 physicians in 13,500 practices.

ADP Chief Strategy Officer Jan Siegmund was quoted as saying, “With a trusted brand, best-in-class solutions, and experienced management team,AdvancedMD is a highly strategic fit with ADP and will enhance our offerings to small- and medium-sized medical clients.   A partnership with ADP means that physicians can dedicate themselves to what they care about most — patient care —while letting ADP take care of the rest.  With our newly combined team, ADP and AdvancedMD will compete effectively for the small- and mid-sized physician practice market, which is going through a rapid technology adoption cycle and moving aggressively toward outsourced solutions—clearly ADP’s strength.”

AdvancedMD was acquired by Francisco Partners in January 2008.

The acquisition appears to mark ADP’s entrance into the PM, EMR, and physician billing market. The company has $9 billion in annual revenue and a market cap of $24.5 billion.

More HIMSS Wrap-Up

Unlike other sites, I don’t re-run anything that has appear elsewhere. I’m making an exception in this case, however. Brad Dodge at healthcare marketing and PR company Dodge Communications did a fun writeup of the HIMSS exhibit hall that I thought deserved a broader audience. He gave the OK to run it here.

Did You Make the HIMSS Best and Worst List?
By Brad Dodge, Dodge Communications  

One of the most challenging elements of marketing communications is that it can be VERY subjective. When vendors are considering their investment to exhibit at a conference like HIMSS11, how important is it to have a brand new booth? Sure, it’s cool, but also expensive. Does the incremental investment bring in a commensurate number of leads into the booth? And how on earth do you measure that? How about a question like, “Thanks for coming into our booth. Would you have come by if our booth was 20% less cool? 40% less cool?” Didn’t think so.

So, no disrespect intended, let us acknowledge our best and worst of HIMSS awards. Don’t forget, there were more than 1,000 exhibitors, so if you think you were the worst in a category that we awarded to someone else, it’s probably because we didn’t see you. Which is for another conversation altogether on visibility.

WORST IMAGERY: The see-through head with colored veins running down to the spine at Cattails Software. Turns out that the entire brand identity is centered on the see-through head. Maybe it appeals to physicians. Not us.

MOST SURPRISINGLY NICE THEATER AREA: CDW. Very engaging, close to the aisle, nice little talk-show-interview area off to the side and very clean presentation technology.

WORST SIGNAGE: Merge Healthcare. A whole backdrop of patents that the company holds, we guess. They were too small to read, but big enough to look like we were supposed to be able to read them. If we hadn’t asked the guy what they were, we’d have never known. Lost opportunity.

MOST OBVIOUS CASE OF LITTLE-BOOTH-IN-A-BIG-SPACE: Healthwise. Refer back to our comments in the opening paragraph. Our opinion: if you’re going to the black tie event, you gotta spring for the tux.

MOST OVERUSED BRIBERY TOOL: The Apple® iPAD®. We lost count of how many vendors had stacks of them that they’d give/raffle to attendees who’d listen to the pitch. And don’t get us started talking about the misuse of the trademark.

WORST FASHION STATEMENT: As in the shortest skirt. As in who thought that was a good idea? We saw her at the ACS booth. We thought that booth babes had toned it down? Maybe their parent Xerox forced them into it.

WORST FLOOR PLAN FAUX-PAS: HIMSS interoperability showcase was WAYYY at the end of the hall, and it was a really cool exhibit. If you went a little bit past it, you’d be at Cape Canaveral. We think it should be the absolute center of the show floor.

HONORABLE MENTION FOR LONGEST USE OF THE TRUSS BOOTH: We’re sure there were OLDER booths in the hall, but nothing says 1990 like a booth built using trusses. We guess they’re still paying off the loan. Award goes to  ESRI. At least the booth staff wasn’t wearing leg warmers.

MOST OVERUSED ICON: The world. As in global healthcare. Get it? ESRI wins it again. Mainly because we didn’t write down the others.

MOST BLATANT DISREGARD FOR TRADEMARKS: This list is entirely too long to publish. For a taste, go here. What was so surprising is that every one of these companies would go ballistic is their own IP or trademarks were compromised similarly.

BEST GIVEAWAY THAT THE DODGE TEAM WANTED TO WIN: The waverunner at the SCC booth. We’re looking up SCC on Google, and once again are stumped by the acronym that’s shared by a zillion other organizations. Is it Spokane Community College? (first result) Scottsdale Community College? (second result) Seminole State College? (third result, and it’s not even an SCC!) Did you already see our opinions on the strength of acronyms in healthcare brands? So, we had to go to the HIMSS pocket guide to figure out who the winner is. SCC is SCC Soft Computer.

FRESHEST GRAPHICS: IBM. We know it’s a challenge to have noticeable graphics at a behemoth conference like HIMSS. We think IBM did a nice job. Colorful. Different. Link to healthcare.

BEST NOT-FEELING-THE-THEME: Epic. The stacked stone, jewel tones, solid-walled booth is obviously very expensive to build, ship and store. We felt like we were in the past. Does anyone care?

BEST NEW BOOTH DESIGN: We have to say that we liked the way that the long, narrow Moss headers were used in a number of new booths to pull the exhibits together without cramping the space. Allscripts and Ingenix both did a nice job at this.

All in all, we were thrilled to have a dozen of our employees at HIMSS11 meeting with clients, editors and others. We thought it was a great show and look forward to 2012 in Las Vegas.

Dr. Gregg "1 to 3 Docs" Goes to HIMSS (Part 1)

Amidst the ACO, ACA, MU, ONC, and HITECH BS buzz these days, it seems there is also a lot of chatter amongst HIT vendors, HIMSS helpers, and REC-related registrars about how to reach the 1 to 3 provider practices, how to get the bit players biting on the digital bait.

If my numbers are still accurate (I haven’t checked them in a few years,) the majority of healthcare in our country is still being delivered in the small practice and small community hospital setting. As I’ve long ranted, you can’t build a national health information network if over 60% of the network is ignored. Granted, we don’t have the glam and glitter of the giant groups and grandiose medical conglomerates, nor can we write those big, beautiful, multiply-zeroed checks that they can. But, we have one thing they don’t, one thing they need that only we can provide:

Us.

And, “they” need us. And, they’re starting to get that point. And, it’s about to get really interesting here in the trenches.

With that in mind, I thought it might be worthwhile to share a trench-eye view of the world of HIMSS11.

There’s really no other showcase for HIT left now that TEPR is pushing up digital daisies, no place else where you can see, en masse, what might be possible for a practice considering health IT options. And, what makes that sort of sad is the fact that the HIMSS conference doesn’t hold much draw for anyone from a 1-3 provider practice.

First off, HIMSS is an industry show, a vendor’s show. Even its timing during the work week bespeaks this. Unless you have a sugar daddy awaiting in the wings (or, unless you’re a committable geek like me,) you simply cannot justify losing thousands of dollars of income generation for the one or two or three work days that you’d need to sacrifice in order to go. Without a corporate expense account upon which to lean, it’s a bear trying to go to a conference held during work days. Most grunts prefer to save those times off for family vacations, not stuff which is essentially more work.

Secondly, HIMSS isn’t really 1-3 doc friendly. Seminars and educational sessions are targeted toward CIOs, CMIOs, CTOS, CEOs, other “O”s, and informatician-types who have no, or very little, interaction with or awareness of the little "o"s in the 1-3 provider world. I truly doubt many "1-3’ers" who are just considering the whole EHR thing would find much of value at their level during HIMSS. I doubt many of them think about ONC or HITECH unless they have to, which likely isn’t too often. I doubt many of them care a smidge about server-based versus SaaS. They mostly want to know how to do this digital redirection with as little pain as possible and get on about the business of being patient care providers.

Third, as others have opined, walking the HIMSS floor without "VC" stamped on your head or a green "PRESS" banner flying below your HIMSS badge may limit your ability to get a conversation started, at least in some vendors’ booths. I have had the notion that HIMSS exhibit hall exhibits are more designed for inter-exhibitor intercourse than any product promotion to potential end users. (Plus, just a little side note here: I understand how boring it can be in an exhibit booth with no visitors, but if I were a corporate CEO and saw someone representing my company’s interests with as much neglect and disrespect as some I saw on the HIMSS exhibit hall floor, there’d be a post-HIMSS Pink Slip Thursday pending.)

Bitch, moan, bitch, moan. As I said in my last post, I despise non-constructive whining. So, in keeping with that credo, and after a few more observations, I will be offering up some potential remedies next time in “1 to 3 Docs” Goes to HIMSS – Part 2.

From the trenches…

“Not engaging in ignorance is wisdom.” – Bodhidharma

E-mail Gregg.

From the standpoint of a clinician (a.k.a. "doctor"), HIMSS was — and usually is — a great opportunity to get an idea of the underlying forces that are shaping the development of health IT, whether substantive or faddish. However, these forces are all operating on a scale, and in an environment, pretty far removed from where actual healthcare happens, e.g. the doctor-patient relationship.  

To look at it in a more cynical fashion, make no mistake – this is a trade show where vendors of large information systems and hardware attempt to sell them to frequently non-clinical IT personnel. That said, I found many of the booth personnel to be reasonably friendly, but I can’t rule out a bit of selection bias.

At least in name, there were many educational sessions addressing operational and organizational challenges, but many of these ended up just being information-light or thinly disguised case studies of Vendor X’s product that lacked much depth. You’ll have to look elsewhere to learn about process innovation, re-engineering healthcare, etc.

That’s not to say that the conference is bad. Certainly not. You just have to keep in mind what it is and what it isn’t. HIMSS is kind of like Home Depot. It might be a great place to see new tools, but it’s not where you to go to learn how to build a house.  

As a clinician, I came away with an appreciation of a few things. In an effort to chase after the $$$($$$$$) sloshing around healthcare these days, many vendors have created products that clearly demonstrate a lack of understanding about what end users actually want and need.  Of course, given their real target audience, this might not matter to them.  Moreover, for the large subset of back-end systems and products, their application to healthcare is almost an aside. 

(Speaking of asides: yeah, we know you all create value and whatnot, but how are you different and/or better than the other 20 vendors in the exact same space? For that matter, what exactly is it that you do?) 

This shortcoming is often compounded by the fact that decisions regarding clinical systems are often — if not usually — made by non-clinicians looking out for their own interests. They’re not out to screw the clinicians, but if there’s any trade-off between the clinicians and the admin/IT side, we know who will win the tug-of-war.  

HIMSS provides great insight into understanding the what, how, and why of health IT development. Though unintentional, it’s also a good reminder that healthcare is rapidly shifting from small(er) collections of independent providers to large systems with a corresponding shift of decision-making away from the clinicians to a concentrated group of often non-clinical individuals. It’s a real bummer for people like me, but instead of denying reality we might as well learn how to play the game.

HIMSS Recap
By Evan Frankel

HIMSS ’11 is now officially behind me. Originally tasked with reporting on the HIStalkapalooza party, there was a conflict with my desire to punish my liver. Therefore, after a couple of days of recovery, feverish work to network and saunter the exhibit hall, all that is left is a newbie’s recap of the conference.

The last HIMSS I attended was quite some time ago. I was a much different person and the industry was in a much different place. What was once an informational and educational experience to be shared with industry peers and HIT professionals has warped into a testament to the power of marketing dollars and a commitment to further the sales of vaporware and roadmaps.

I thought I was prepared. I believed that my conviction to spend the entirety of each day in the exhibit hall (bless you Exhibitor badge, you keep me from winning prizes, but enable me to loiter whenever I please) was well meaning as I knew that I could easily download and review all sessions at a later time. In hindsight, I wish I wore a pedometer.

Clearly this is a rapidly evolving industry, what just a couple of months ago was a drive to Meaningful Use, federal inducement and incentive, and a push to make digital every last granule of data has altered course to focus on the eternally long list of problems already encountered. It seems like vendors wanted to talk about their few happy clients and wouldn’t admit to any struggles or lessons learned.

I visited, in one way or another, 84% of all of the booths on the floor (yes, that means I am without a voice today and shook almost 850 hands). I asked everything from the most basic question, “What do you do?” to engaging in hour-long conversations about the challenges companies have in retaining talent and clients. I am always impressed to see passion and conviction, it goes without saying that being in love with your company is an engaging trait.

I saw some things that not even ‘brain bleach’ can remove from memory, which is a shame. Not only is the overtly obvious booth-babe phenomenon here to stay, but the desire to at least make them conversant in their employer’s product or mission seems to no longer be even a slight priority. I am not leering at you, I am just floored that you are not able to help me in any way.

Even the most senior of executives were forced into booth duty, which could have been very refreshing, but in certain cases was both scary and cringe-inducing. Case in point: I was told by more than one vendor, in reference to long and close-to-failed EMR implementations, that they are a good thing since the vendor collects pay by the hour. I had another vendor tell me they sell implementation support and training time by the 100-hour block because anything else would nickel-and-dime the customer. When asked about small practices, there is not a per-hour rate (which would help me understand the profit margin on implementations, since the same company was hiring project managers and implementation staff). But at least they were honest, which couldn’t be said for all.

I did find a partner in crime on Tuesday. Armed with the exact same questions for the exact same vendor, we were able to get completely different answers to the same question. “Can I run this in my data center?” shouldn’t elicit both a Yes and a No. But I guess we could chalk that up to, “it’s all customizable”, which may be the mantra that I take to every meeting I ever attend. It sure beats committing to one answer or solution, I suppose.

To the gentleman who stood next to me at the Google booth and asked the employee what “this Google thing does”, as if he had never heard of them, thank you for being the funniest guy in the room. But it also made me sad, as their answer wasn’t, “Oh, we are here to take over the world, at least all of it that isn’t Europe.” That would’ve been super cool and probably more honest.

The best attraction that a booth could present, in my novice opinion, is the soft, ultra-plushy carpet. I have no idea if that was an up-sell from the convention center or not, but after logging 5+ miles each day on the concrete covered by a millimeter of carpet, a soft booth floor was welcome respite.

I tried to muster the energy to engage all of the hired booth talent as possible. I watched a man duct-tape his eyes shut and guess the serial numbers on a dollar bill. There is a lot of talent in that trick, but was it worth losing most of an eyebrow?

I saw comedy, three-card monte, and a bunch of artistic impressionism. Then I got tired of standing at the NHINDirect/Connect/Interoperability showcase and went back to the booths.

I don’t want to come off as angry, jaded, or a naysayer that we are getting further from solving most of our healthcare woes than we were before. However, if another person tells me all about the value they create with their solution without understanding the basic premise of entropy in the universe, I may beg HIMSS to administer an IQ test as part of registration. As a quick lesson, in order to create value, you must eliminate something, and I highly doubt it is your profit margin, so riddle me this — where did you get that value?

The booth demo on a large scale is a brilliant concept; it is akin to auditing a college course. You can come and go as you please and no one grades you on paying attention. In fact, if we were to require an assessment at the end of every 10 people or larger group demo, I would wager less than 1/3 could even get the product name right. Luckily next year is in Vegas, as I hope to actually find some action on these wagers (but I have a feeling I won’t be allowed back).

Speaking of Vegas, HIMSS executives predict a sharp increase in attendance in response to the location. I hope they market this correctly, as they should expect more registrants, not attendees. Vegas has a wonderful way to make you forget why you are there.

I will need to check, but I believe HIMSS will continue to be the same weekend as the “Great American Race”, which would have been a nice thing to know before I booked my travel plans. Not only would I have trekked to Daytona to see what the hubbub is about, but I am sure I could have had some easy pickings on making analogous the driving fast cars in circles to the current state of the HIT industry. Spinning tires until they explode? Banged-up, dented, smoking heaps of metal? That it takes 16 people to change a tire and fill a tank of gas? 100,000 people half-drunk standing in their own sweat? This is almost too easy.

Undeniably, HIMSS ’11 will be considered a success: record attendance, millions of dollars poured into the local taxi and livery economy, a significant dry-cleaning bill upon return for all those in attendance, and a chance for the industry to look inward and see how far we have come and have to go to increase adoption of tools that will improve patient care and health insurance company dividends.

For this naïve newbie to the industry, it was an overwhelming and underwhelming experience. I guess I ended up being whelmed in the end. There is so much noise, so much fear-mongering, so much confusion surrounding just about everything, that is no wonder we are going to Vegas next. For practices and hospitals making any technology decision these days, it is practically a crap-shoot. I would put my chips on another year of consolidation amongst vendors and a mix of success and horror stories from the institutions that adopt more technology.

In the end, it is what it is, no more or no less.

Pictures of HIStalkapaloozans
By David Polivka, Developer, Medicomp 

Pictures of HIStalkapaloozans
By Anthony Istrico

Monday Morning Update 2/28/11

From Terry: “Re: Oracle. We talked to an Oracle contact at HIMSS and their HIE vendor partner will be…Orion.” Unverified. 

From BurnedOutFromHIMSS: “Re: Tom Niehaus, president of CTG Healthcare. Just heard he’s joining Encore Health Resources. That’s a big blow to CTG and a great catch by Encore. I think very highly of him and he’ll be a good fit for the culture Ivo and Dana have built.” Verified by Ivo. Tom will be executive VP of business development reporting to Dana Sellers at Encore. Ivo says he’s known him for a couple of decades, thinks he’s one of the most effective executives in the industry, and says he has the integrity and character to fit well into Encore’s culture.

From McLean: “Re: McKesson. Rumors about that they will open source their platform and focus on solutions and services. Given the lack of market expansion they have experienced, this may be a sound decision, making them the Red Hat of IT as a compelling alternative to overpriced offerings from other vendors.” Unverified.

From Marlow Gates: “Re: Certify Data Systems. CEO is Mark Willard, a Brit. Last year he supposedly bagged some huge hospital systems with a system that doesn’t make the usual suspect list of HIE solutions because it doesn’t have a portal. They seem to be flying under the radar for as long as possible. They have some sort of arrangement with Cerner, but are doing direct deals as well. The management team is long on technical skills with not a lot of long time HIS regulars.” Inside Healthcare IT e-mailed to say they’ve written a couple of articles about the company, including one in the current issue that they’ll make available to the reader who asked about the company (assuming it wasn’t a company plant looking for PR).

From All Hat No Cattle: “Re: Cignet HIPAA penalty. Not a rumor, but a shocker.” The Office of Civil Rights fines Cignet Health (MD) $4.3 million for HIPAA violations, the first-ever civil penalty levied against a covered entity. The Cignet idiots not only refused to give 41 patients copies of their medical records over a one-year period, they then ignored OCR’s subpoena while making no effort to resolve the patient complaints. Cignet operates four clinics in southern Maryland and insurance operations in the UK, Nigeria, and Ghana. The Web site is pretty seedy-looking, I’d say, and includes a prominent link to franchising information, bragging that, “With Cignet health plan and Cignet discount card, Centers are sure to have a good percentage of cash paying, insurance claim free patients.” I can see the attraction of cash customers — some online sources say that Cignet was the subject of a Maryland Insurance Commissioner’s cease-and-desist order for selling phony insurance. Owner Dan Austin’s medical license had been revoked in 2000 after conviction of mail and loan fraud — I found the above in Maryland court records. He was running a student loan scam.

From Bob: “Re: HIMSS writeups. I certainly appreciate your writing up what you think are the most important, interesting, and amusing aspects of HIMSS. Indeed, I felt (almost) like I was there and didn’t really miss anything (of importance) … well, except for the Blue Cat babes, perhaps ;-)” It’s funny about the conference … you know going in that you’ll miss 90% of it, so you try to pick and choose wisely. That means you could randomly pick 10 attendees and none of them were probably in the same educational sessions, attending the same parties, or picking up the same valuable nuggets. Maybe that’s my niche for next year – debriefing a bunch of people on what they saw that was important just to get a collective opinion. Every year I feel like an outsider who missed the good stuff and I bet I’m not the only one.

From Kyoto: “Re: Allscripts good and bad news. The integration work is not only on the mark, but far exceeded client expectations during previews. Gomez came up with a new approach that allows seamless integration, going well beyond the usual tired approach. It’s also making its numbers. On the other hand, Enterprise EHR clients continue to complain about product quality and sales leadership is leaving. Lack of SCM sales is causing fear in its ability to expand in the community space, part of its key Connected Community strategy.” Unverified.

From InteropNotSilos: “Re: HHS Secretary Sebelius. After all the hot air at HIMSS, she goes home to see the Lewis and Clark Information Exchange, the only one operational in Missouri or Kansas.”

Listening: Pepper, Hawaii-based reggae/funk, sometimes reminiscent of Red Hot Chili Peppers.

These poll results don’t mean much since Allscripts encouraged its employees to vote for Stephanie Reel, but if you throw her out, it’s a pretty close race between John Halamka and Bill Bria. New poll to your right: if you went to the HIMSS conference, how was the quality of the educational sessions?

Jobs on the job board: VP Sales Central Region, Senior Software Engineer, Project Manager – Healthcare Implementation. On Healthcare IT Jobs: Senior Software Engineer, Senior Systems Analyst – Financial Systems, Project Manager.

Welcome to new HIStalk Gold Sponsor TeleTracking of Pittsburgh, PA, celebrating its 20th anniversary this month. The company focuses on patient flow automation, offering a variety of products for bed tracking, transport tracking, patient milestone tracking through procedure areas like OR and cath lab, the NaviCare OR perioperative solution, a work order management system, and the RadarFind RTLS for asset tracking. Conclusion: TeleTracking is all about squeezing out inefficiency, adding as much as 20% more capacity and collecting a wealth of operational data for making decisions. It’s the #1 KLAS-rated patient flow system and is used by 92% of US News and World Report’s Best Hospitals. Thanks to TeleTracking for supporting HIStalk.

Here’s a TeleTracking video I found on YouTube for my fellow visual learners.

Revenue cycle vendor MedAssets turned in Q4 numbers Friday: revenue up 17% to $106.9 million, EPS -$0.87 vs $0.17, wildly missing expectations of $0.22. Its 2011 forecast also missed expectations. Shares were punished, dropping 34% of their value by Friday’s market close.

In thinking about the lack of wellness emphasis at HIMSS, I thought a model I’ve used myself that works: RealAge. I took its test once, got hooked on the idea of getting a “you’re this old based on life expectancy” number, and started following some of its suggestions for changes to diet, exercise, and stress. I get an occasional e-mail recommending some course of action or product. Best of all, there’s a great business model since it sells advertising (it’s owned by Hearst). I know it’s ad-based, but I still find the information useful. Any wellness technology will need to be this user friendly to succeed, and may also need to blend social networking into its capabilities (which RealAge doesn’t really do as far as I know).

UNC Health Care (NC) chooses IBM for its private HIE. It’s funny how the definition of HIE has changed – now it takes one for UNC’s own doctors to share information with each other. Next thing you know it will take an HIE to send physician orders to departments. I guess choosing a single system was out of the question. 

MED3OOO had an iPad drawing Wednesday of HIMSS for HIStalk readers only. Congratulations to the winner, Susan Murray, director of application services for HCA. Nice! I have to say I’m liking mine quite a bit, too, although I’m just getting started with it. I have the iPad for a nice-sized screen and keyboard and then my iPod Touch that allows accessing everything from a tiny footprint, so I almost don’t need a desktop any more.

Inga found this HIMSS presentation disturbing. Wonder what was going through the minds of the Lawson suits when they green-lighted it?

Our shoe judge Lindsay has a day job with RelayHealth when she’s not evaluating footwear, but she obviously keeps her HIStalktapalooza responsibilities on her mind even there, showing the burdens of office inherent in wearing the Official Shoe Diva sash.

Tiny Schoolcraft Memorial Hospital (MI) will lay off 13 FTEs, a sizeable chunk of the 25-bed hospital’s 250-employee workforce. The reason: Medicaid reimbursement isn’t going up and they have to pay for an EMR upgrade. Says the CEO, “With this somewhat gloomy forecast, the hospital must continue to implement, at significant capital cost, an improvement to our Electronic Medical Record system, meeting additional criteria set by federal law … We qualify for EMR funding both for the hospital EMR and our Rural Clinic once we meet all of the (HHS) ‘meaningful use’ standards. We expect to meet the requirements with a 90-day qualifying period in both the hospital and the clinic by the end of the year. We hope to get most of our costs covered by the funding. Unfortunately, you must spend the money and meet the requirements before you get reimbursed. If the standard in not met by 2015, Medicare will reduce your payments.”

System integrators try to appease open source advocates who blame those companies for ignoring the British government’s call for more open source applications. The companies say it’s not their fault that the government signs enterprise software license agreements and lets vendor alliances dictate software stacks that exclude open source components. Examples given all pertain to healthcare: the Department of Health’s enterprise agreement with Microsoft and NPfIT’s Cerner contract that required the Oracle database, IBM hardware, and IBM’s WebSphere application server. One company’s rep threw out the FUD that open source software shouldn’t be used for anything mission critical, but the government said that talk needed to stop considering that the London Stock Exchange runs on open source software.

Thanks to Healthwise, a new HIStalk Platinum Sponsor. The Boise, ID company offers consumer-friendly patient education content for care managers and health coaches; an EMR-integrated patient education solution that helps meet Meaningful Use requirements; and health information content that integrates with personal health records, call center applications, portals, Web sites, and wellness applications. The content library is extensive: a health encyclopedia, decision aids, virtual coaching, medical illustrations, calculators, and slideshows. Mobile access content and tools are coming soon. Founder, chairman, and CEO Don Kemper and SVP Molly Mettler created the concept of “information therapy” in their 2002 book. The company offers a white paper called Getting Patients to Meaningful Use: Using the HL7 Infobutton Standard for Information Prescriptions. I have to say I’m impressed that the 36-year-old company’s mission is simple (empower people to care for themselves, give them a way to ask for help when they need it, and let them decline care they don’t need), that its executives are recognized public health experts, and that it’s a non-profit (!!) I forgot to look them up at HIMSS, so I might have to add Don Kemper to my interview list to learn more. Thanks to Healthwise for supporting HIStalk.

The folks at HealthHarbor e-mailed to say that HIStalk is their favorite industry blog and they recommended that their readers follow our daily HIMSS reports, so here’s a link back to their HIMSS writeup from a price transparency standpoing, just for being nice.

GE Healthcare and Capsule sign a deal to link GEHC’s Carescape patient monitors to Capsule’s Enterprise Device Connectivity Solution and Mobile Vitals plus.

This week’s company-wide e-mail from Kaiser’s George Halvorson focuses on HIMSS, mentioning that 35 of the 55 Stage 7 hospitals are Kaiser’s. He also mentioned a global HIT strategy document the company presented at the Davos World Economic Forum in Switzerland last month. The link provided was invalid, but I Googled and found what I assume is that PDF document here.

Ohio State University Medical Center’s CITIH (Center for IT Innovations in Healthcare) will convene its one-day HIT summit, Bridging Health IT Innovation, on April 18.

GE Healthcare announces iPad/iPhone access for Centricity Advance and Centricity Practice Solution.

A 27-year-old doctor in China using the alias Snooky is fired for comments she made about patients on a microblogging site, including, “The blood pressure of one patient has been dropping, and it seems that I might have to get up at midnight to dispose of the corpse. It’s not easy for me to keep my bed warm in such cold weather, so please don’t die until I get off work.”

Mass General will pay HHS $1 million to settle a HIPAA case in which a billing manager taking paper HIV/AIDS records home accidentally left them on the subway.

KLAS says 35% of ambulatory EMR users are replacing their systems. Most often considered to buy are Allscripts, Epic, and NextGen.

Imprivata announces vmWare View authentication and single sign-on agreements with Teradici and Dell. It also announces OneSign Anywhere for mobile devices as well as integration of its OneSign single sign-on and authentication platform with EpicCare.

Oracle announces Health Sciences Information Manager, an HIE solution that includes record location, information security, auditing, and NHIN Connect integration.

E-mail me.

2011 HISsies Winners

Smartest vendor strategic move
Allscripts buys Eclipsys

Stupidest vendor strategic move
McKesson’s Horizon Enterprise Revenue Management struggles

Best healthcare IT vendor
Epic

Worst healthcare IT vendor
GE Healthcare

Most fun healthcare IT vendor
athenahealth

Best leader of a vendor or consulting firm
Judy Faulkner, Epic

Best provider user of healthcare IT
Kaiser Permanente

Most promising technology development
Tablet (including iPad)

Most overrated technology
Cloud computing

Biggest HIT-related news story of the year
Meaningful Use

Most overused buzzword
Meaningful Use

”When ____ talks, people listen”
David Blumenthal, ONC

Most effective CIO in a healthcare provider organization
Ed Marx, Texas Health Resources

Most effective medical/clinical informatics professional
Martin Harris, Cleveland Clinic

HIS industry figure with whom you’d most like to have a few beers
Judy Faulkner, Epic

HIS industry figure in whose face you’d most like to throw a pie
Neal Patterson, Cerner

HIStalk Healthcare IT Lifetime Achievement Award
John Glaser, Siemens

HIStalk Healthcare IT Industry Figure of the Year
David Blumenthal, ONC

HIMSS Wrap-Up 2/24/11

From Just Saying: “Re: your Soarian demo. While pithy, this post would have been more honest if it had said, ‘I fell prey to the seductions of the attractive women and bright lights at the Siemens booth and I am so ashamed.’ Wouldn’t it have been just as valid to say ‘good to see Siemens playing offense again…Glaser seems to be making an impact already?’” Actually I wasn’t paying attention to the women or the lights – I was dragging along tired at the end of the day Wednesday and the rep stuck some 3D glasses out and promised the video would last only five minutes, just long enough for me to rest on what looked like comfortable benches (but weren’t). I didn’t find the video effective, but maybe some did. Actually, I already had an improving opinion of Soarian and the video didn’t really change it either way, but I was too tired and fidgety to want to sit through a demo, which was my real intention several times I passed the Siemens booth way down on the end (but somehow I never actually did it). I want Soarian to do well – we could use a respectably performing system that isn’t 30 years old. John Glaser did a little speech at the end of the video. He dropped by HIStalkapalooza, having warned me in advance that he wouldn’t be able to make it in time to accept his Lifetime Achievement Award in person before the band went on.

Just to show there’s no hard feelings, here’s a good consumer-oriented Soarian video from Yakima Valley Memorial Hospital that I found on YouTube. It’s more interesting than the 3D one if you ask me.

From LaVerne: “Re: Siemens. HHS lists Siemens as a certified vendor, but why do they list Enterprise Document Management as required additional software? How does that apply to Meaningful Use? MS4 is certified but does not require any document management product. Perceptive, Hyland, and other vendors don’t even modularly certify their DM products, so that might lead to the conclusion that Siemens has the only certified DM solution. Are they being intentionally mendacious or am I missing something?”

From Dolphins Fan: “Re: vendor attention. Once again, you guys did an awesome job of covering HIMSS — thanks! I can relate to your stories of being ignored by product vendors. I can think of several (Azzly and Phreesia immediately come to mind, but there were several others) where I felt if my nametag didn’t have ‘VC’ on it, I wasn’t worth talking to. As someone who provides significant guidance on many clients’ purchase decisions, it makes me wonder if these firms are actually driven by serving customers or just by scoring funding and being acquired.” I feel guilty going public with stories of unresponsive booth reps, but I’d want to know if I was the vendor. You get the feeling that nobody from management is overseeing, or if so, they aren’t very good managers (and in fact, some of the worst offenders were clearly the suits more interested in holding court with cronies than working prospects). Even Dr. Jayne’s CMIO badge couldn’t stir some of them. Let us read from the Book of Glengarry Glen Ross: “You got leads. Mitch and Murray paid good money. Get their names to sell them. You can’t close the leads you’re given, you can’t close %#*@, you ARE %#*@. Hit the bricks, pal, and beat it, ’cause you are going OUT … A guy don’t walk on the lot lest he wants to buy. They’re sitting out there waiting to give you their money. Are you gonna take it? Are you man enough to take it? What’s the problem, pal? … Always Be Closing.”

From Rodrigo Barnes: “Re: Certify Data Systems. Why don’t we hear more about them?” Never heard of them, sorry. I checked their management team and never heard of any of them, either. That doesn’t mean they aren’t good at whatever connectivity stuff they do, but maybe not so good at getting their story out.

From Northeastern CIO: “Re: HIStalkapalooza. Thanks to you, Inga, Dr. Jayne, and of course, Medicomp, for the wonderful HIStalkapalooza party. I enjoyed it, got to speak with several interesting folks, had fun watching the awards, and appreciated the food. You ordered great weather too, making it all the more difficult to return to the cold. As others continually state, you do great work and I appreciate being part of your expanding circle of colleagues.” Thanks! I bet lots of folks are missing the weather and the non-monochromatic Florida landscape.

From JL, MD: “Re: Microsoft. Go to silverlight.interknowlogy.com to view two videos that are part of the 2011 HIMSS Microsoft HSG presentations from today that demonstrate form-factor convergence for Surface, Windows 7, Windows 7 tablet, Windows Mobile for healthcare information display for patients and providers. A second video demonstrates the ability for a Windows 7 PC enabled with USB KINECT and custom healthcare gestures can display healthcare image data, and do 3D manipulation of coronary image data using gestures via KINECT without XBox 360.” I wish they hadn’t been so Microsofty in posting the videos in the annoying Silverlight format that takes a long time to load and requires a huge plug-in if you don’t already have it (I don’t mind it for apps, but it seems like overkill for a video). Had they done like every other vendor in the world and posted it on YouTube, I could have run it right here. Ever seen a Silverlight video go viral? Uh, no, and that’s why. So anyway, the videos are pretty cool. I saw a Surface at RelayHealth’s booth, but nobody seemed to be doing much with it. I have a feeling the other form factors are getting completely buried by the iPad with little hope of catching up, but I don’t claim to be an expert. Example: I saw dozens or hundreds of vendors raffling off iPads to hundreds of anxiously awaiting HIMSS attendees. I saw one giving away a KINECT and nobody offering the others.

Inga, Dr. Jayne, and I are home now. I won’t speak for the ladies, but I’m pretty beat since last night’s long post took me until midnight to finish and I was back up at 3:30 a.m. to get ready for the trip home. Maybe HIMSS is a fun week for some, but I’ve worked constantly since it started and slept little, including leaving HIStalkapalooza right after the band started so I could write that night’s recap. On the other hand, Mrs. HIStalk was waiting with open arms when I got home today and I’m calling it an early night tonight, so I expect conditions to improve steadily, at least until the pre-dawn commute to the hospital Friday morning. We’ll just clean up some loose ends tonight and I’ll be back in the usual swing Saturday for the Monday Morning Update.

And just to be clear, although nobody has complained: we write up what we think are the important, interesting, and amusing aspects of HIMSS. We don’t do it to make those who couldn’t attend feel left out – we do it so they’ll feel like they were there and didn’t really miss anything. I’m sensitive to reading about someone else’s good time, but it’s not that great a time when you’re taking notes all day and spending hours writing them up at night.

OK, was I the only one to do this (multiple times, in fact?) I was ambling along the exhibit hall aisle and rounded a corner a bit too sharply, stepping my inside foot into inches-deep swanky booth carpet and nearly falling over from the immediate, one-sided deceleration. Or this, a couple of times: I impulsively grabbed a freshly baked chocolate chip cookie from a booth and chomped down, but was horrified to get napalm-hot melted chocolate chips all over my teeth and fingers with no easy way to clean it off.

Since Medicomp was so gracious to sponsor HIStalkapalooza, I’ll give them a little more exposure with this video shot from the show floor as users went through brief Quippe training to earn their iPad (I’m in one snippet, I noticed). I think I recognize a couple of the docs who went on camera.

Here’s Vince Ciotti, debriefing after his industry history presentation Wednesday afternoon. I had joked that he should wear a Mike Brady costume to his presentation and sent him the link — darned if he didn’t do it. If he had some mascara, he’d look like Alice Cooper in his 70s heyday.

E-mail me.

HERtalk by Inga 

From Gossip Girl: “Re: Epic. A CIO to me explained Judy’s strategy. Epic is cutting the price on a lot of deals, especially the more prestigious health systems. If Epic has a couple of years that aren’t profitable, she can afford it and she doesn’t have investors to answer to. She realizes that these health systems make big HIT decisions only once every 10 or 15 years, so Epic needs to get in there now and hope that over time the health systems will keep buying more product. Meanwhile, the second-tier health systems see Epic getting all the wins and decide they need to get Epic, too. And those guys aren’t getting as sweet a deal as the top tier.”

From EMR vendor: “Re: HIStalk luncheon. Thank you for the great lunch today. I met some great people at my table and will have a follow up meeting with one of them.” Mr. H and I were thrilled to hear it provided a good networking opportunity. I mentioned in an earlier post that several competitors happened to sit at the same table and I and wondered how often folks like Girish Navani, Michael Sterns, and Evan Steele have lunched together. A reader suggested I’d be surprised how often it likely happens, since those folks collaborate as members of the EHR Association. For the record, two of these three told me they had never met the others before then.

From Greg Wilson: “Re: thanks. Just a quick note to convey my thanks. We had a lot of fun as a group and I had a lot of fun being a part of it. Very sincerely, thank you for the opportunity to be part of the ceremonies. It means a great deal to us.” Greg (regional sales VP for Salar) was the official HIStalk King and Queen judge and did an excellent job. I am not sure if we have complete video of his presentation, so you will have to trust me that it was wickedly funny. He gets bonus points for wearing his HIStalk Booth Babe sash in their booth for the rest of the show.

From Broke But Connected: “Re: exhibit hall Internet. Yes, it costs $1,500/day. We thought it was outrageous. I guess they figure whatever the traffic will bear! Do you think HIMSS gets a kickback on it???” Someone is clearly making serious money.

From Loyal Fan: “Re: HIStalkapalooza. It was great, but I think the music was a little too loud and it was too dark. The conference provides a great opportunity for people who haven’t seen each other in awhile to connect. They can listen to loud music at home.” That is great input. I’m sure that over the next few weeks Mr. H will continue to reflect on things and start thinking about next year.

Allscripts definitely had one of the most hopping booths. I liked its layout because it had a theater right in front and was quite open throughout. I hear Allscripts had over 1,000 people at their event at the Hard Rock Live (I had an invite, but missed it.) They also made a few product announcements, but they haven’t surfaced in my overflowing inbox yet.

I have concluded that I greatly favor the booths that are wide open with the product demo and people at the edges, as opposed to those that you have to enter in order to check out what they are offering. For example,the configuration of the booths for McKesson and Siemens (and to some extent NextGen) were a little intimidating. I almost felt I needed an invitation before walking in.

I thought Ingenix had a huge booth. Turns out it wasn’t quite as huge as I thought. They were right next to another vendor with the same red color scheme, so it appeared the two were one. Ingenix was featuring its various acquisitions and I just thought the vendor next to them was just another new division. Funny.

Orlando traffic, at least around the convention center, is insane. Fortunately my hotel was relatively close and I walked the 15-20 minutes most of the time. Wednesday I was weary and decided to ride the bus. Long story short, I got on the wrong bus and it took me 40 minutes to get back. After dropping off my things, I decided to take a cab back over to the Peabody. There was a limo in front and the guy said he had to drop a group off at the next hotel over and then would take me. So I shared the limo with artists who were performing for NextGen (they told me they practiced a lot). While it was fun chatting with them, that limo ride ended up taking at least 20 minutes because of the traffic. Sheesh.

JB walks the red carpet. Check out the gorgeous dress.

JB announcing the HISsies. Look at the size of the crowd.

I asked quite a few people what the “buzz” was. I think there is generally an agreement that we are past the Meaningful Use frenzy in terms of aligning with vendors. At this point, most people are either committed or at least pretty far down the line in the EHR selection process. Now people are looking a little more into the future and trying to figure out what tools they need for likely Stage 2 and 3 requirements (the HIE booths were busy) and for establishing ACOs. Meanwhile, everyone knows they must cut costs and improve care, and there are literally hundreds of niche vendors offering everything from tracking systems, infrastructure alternatives, and RCM add-on utilities. Obviously Meaningful Use and ICD-10 will remain the priorities for the next few years, but I think health systems are going to become increasingly interested in finding these more peripheral products, if they indeed offer a meaningful ROI or transform care. And likely the McKessons and Ingenixes will look to buy many of these smaller companies so they can sell more into their existing base. I wonder if over the next few years the number of individual HIMSS exhibitors actually declines.

I am now home and thanking my lucky stars that I don’t travel for a living. The Orlando airport was a zoo and it took me almost 30 minutes to go through security. While sitting at my gate, a couple guys (clearly vendors) were remarking that it looks like the economy has finally turned around, based on the heavy interest they saw this week. Maybe, maybe not, but that’s a pleasant thought to end the week.

 E-mail Inga.

Overheard HIStalkapalooza Comments
By Evan Frankel,  MD-IT (roving reporter wearing a memorable jacket)

Jonathan Bush:  “You can only interview me if you buy me a cigar. It is principled.”

DrLyle: “I can’t believe that people aren’t asking more questions. For smart people, they accept way too much.”

Dr. Gregg Alexander: “I have heard about college savings funds for children. I don’t have one.”

Dr. Christ Pavlatos: “The shiny and flashing buttons are lovely. As a trained medical doctor, a seizure episode could result from focusing too much on the flashing lights. I would think that the person that causes the seizure is required to resuscitate them — it’s only fair. The buttons are all conveniently located in the cardiopulmonary level, which is easy to focus too much eye attention on.”

Bill Fera, Ernst & Young: “Are you an HIStalker?”
Evan: “I am here, aren’t I?”
Bill: “Are you Mr H?”
Evan: “Nope, I am just a schmuck in a velvet jacket.”
Bill: “That you are. Baba Booey.”

Louann Whittenburg, Medicomp: “I love your coat. Is that velvet?”
Evan: “It is.”
Louann: “We are going to have fun tonight. I am very excited for people to get inside and start to drink, dance, and have a good time.”
Evan: "Me, too."
Louann: "I think your coat is awesome. It is perfect for this party."

Jonathan Bush: “I gotta be honest, I don’t actually read HIStalk. I have other people read it and I say, ‘What did it say?’ and then I am like, ‘Oh.’”

Jonathan Bush: “I did not know that Mr H takes the quotes verbatim from our conversations, and so I say all kinds of shit and I am expecting a lot of conversation back and forth between our PR guy and Mr H. on what he’ll actually  put up there. I mean, shame on me. It has happened more than once.”

Jonathan Bush: “We can’t predict anything. We don’t even know what Stage 2 Meaningful Use looks like. Do you think the ‘e’ at the end of Crowne makes it fancy?”

DrLyle: “I went to Washington and started asking them the tough questions. They don’t want to hear it. There is no easy answer to hard problems sometimes.”

Jonathan Bush: “I wouldn’t do anything that is resident on one device, iPad or otherwise. Make millions of little apps. The biggest growth prospect in healthcare is the little app. We want to drive business through our ecosystem where you do the R&D. You make hundreds of them and the one people all really like is the one that pays for all of the rest. Even if we grew our R&D department 30% each year we wouldn’t be able build all of the apps you can. Be agile, get them out there, get in front of the doctor. You just got the first interview on the athenahealth ecosystem. You kids take this stuff and go and make apps and make money. I don’t care. I can’t make it all and everyone else sucks. Figure out the APIs and then go build something cool.”

Dr. Amanda Heidemann: “It is great to see all these well-dressed people out for the night. I think it is hysterical how many people follow the blog and wanted to come to this party. Did you stop on the red carpet? I was so nervous. Can you go get me another glass of wine?”

Mrs. John (Denise) Glaser: “I think he (John) takes in all in stride. I mean, he is here. I actually believe John has a lot of respect for Jonathan Bush. It looks like you all are having a lot of fun. I like your jacket a lot.”

Jasmine Gee, athenahealth: “I am having a blast tonight. I think this is the most fun you can have at a conference. Why aren’t you dancing?”

Ash Gupta and Jonathan Baran of Healthfinch: “I am very happy to meet you, this is a real honor.” (they were talking about meeting Jonathan Bush and interrupting my private cigar and beer time with him. I wish they had said that about me.)

From HIMSS 2/23/11

From JJ Canuck: “Re: Oracle. I was visiting the Oracle booth (was trying to figure out their integration engine story … which is ‘coming out.’) The sales guy said they will announce a ‘big deal’ in the next week or so about a partnership with a ‘big vendor’ that will provide badly needed HIE capabilities and some other vague set of features. When I asked if it was Cerner, he just smiled, giving me the indication that I had made a good guess. Sore feet and off to Universal for the last wonkfest. Maybe I’ll throw-up that $9 bean burrito I had at lunch on the roller coaster with Neal Patterson sitting behind me. Daydreamin’.” You remind me that I forgot to complain about predatory convention center food pricing: a soda out of the machine was $3.25, a chicken salad sandwich was $9, and a banana was $3. That last one’s especially maddening since I buy a big bunch of them at Sam’s for half that amount.

From Jay: “Re: best marketing tee shirt ever. From backup vendor Mozy’s booth at HIMSS.” It’s a bit of a stretch, but almost funny. I tried their service a few months back and it was a pig on my PC, so I removed it and went with SugarSync.

From Andrea: “Re: HIStalk. LOVE LOVE HIStalk, you, and Inga. How would a small biz like us (VAR) compete with the big bad vendors unless we had inside dirt on them? Keep up the fantastic work and have fun at HIMSS!” Thanks — we love you right back.

From Fred: “Re: Meditech. Announced on Saturday that they would be getting modular or near modular certification for their HIS software. They reported that it just required some paperwork and would be completed soon.” I’ll mark this as Unverified since I was given related information off the record a couple of weeks ago.

From Leotards: “Re: Noteworthy. That’s a snarky comment made by an underperforming mid-level manager or sales rep no longer with CompuGroup Medical, I presume. Rick Mullins is gone; there’s been quite the shakeup of the existing C-suite amongst all the companies CompuGroup Medical US is merging into a single entity. Supernumerary chiefs of all stripes are being relieved of their individual fiefdoms as NoteWorthy,Healthport, Visionary HealthWare and Antek HealthWare are all subsumed by CompuGroup. Sweeping positive changes have been instituted, our flagship products are being strengthened and developed, and all this accomplished without sending out huge swaths of pink slips as sometimes happens with these acquisitions. I’m just a field rep in the trenches, but I’m quite pleased to now be part of CompuGroup Medical.” Unverified.

From J.B.: “Re: Meditech. The Meditech/LSS deal is finalized. They still haven’t straightened out any arrangements of staff, but LSS is still going to be called LSS.  It is now a ‘wholly owned subsidiary’ of Meditech.” Verified – Meditech has posted the news on their site.

From Dichotomy: “Re: HIStalkapalooza and sponsor lunch. You have to repeat these in Las Vegas! It was really great meeting together.” We’ll see how it goes, but I would definitely like to do both again. It was really nice (but nerve-wracking, especially for Inga) to briefly say hello to our sponsors and for me to be flanked by those lovely and whip-smart (but suddenly mute) ladies. Since I almost never see actual HIStalk readers in person, I asked for a show of hands of how many people felt they knew Inga, Dr. Jayne, and me personally even though we haven’t met. A surprising number of hands (a majority, I’d say, maybe more than that) went up. That was gratifying since we definitely feel connected to our readers and sponsors whether we’ve met them or not. I’m glad that comes across.

From Tech Doc: “Re: innovation. Saw Napochi at HIT X.0 Geeks Got Talent on Monday. Showed a 3D body module of their EMR used to map IVs and such which integrates with their flowsheet and physician note. Didn’t find a booth, but their website has a video of them demoing a touchscreen whiteboard replacement. Pretty neat stuff.”

From Kate the Sponsor: “Re: HIStalk. I just wanted to say thank you for the wonderful events at HIMSS! I really appreciate what you both do. HIStalkapalooza was a blast, loved the venue. I got there a little late, however, and missed the awards – are you going to post the full awards section on the site? I did see the highlights in the video Inga posted which were great. I’m sorry I missed the hilarious red carpet commentators — I felt like I was watching E! I also really enjoyed the sponsor lunch yesterday. It was great to break bread with fellow HIStalk fans and sponsors, but really the true highlight was having the three of you make an appearance. And, Inga, the handwritten thank you notes were so sweet. That must have really tired your hand out to write all those yourself, but the personal touch was really special. Thanks again for all you do for the industry, looking forward to next year!” Thanks for those nice words. I’ll get the HISsies list up when I get back to the comfort of a full-sized keyboard and dual monitors since there’s a lot of typing involved. I hope the lunch attendees whose notes were written by me (Inga and I split them) could read them since my handwriting is pretty bad. I said there that we are proud to be amateurish and my handwriting is a testimonial to sincerity backed by a total lack of polish.

From Suzanne: “Re: HIStalk. No doubt you are inundated with work, e-mails and miles and miles of walking this week, but I just wanted to send you a quick note to thank you for a great lunch today (and great party last night). We are thrilled to be new HIStalk sponsors – and not just because of free food and drinks! As a small, newcomer vendor in a tiny 10×10 booth at the far end of the hall and among the ocean of booths at HIMSS, it has quite literally been amazing how many people have come up to us, saying they have specifically sought us out.  When we ask how they have heard about us, many have said through HIStalk. I was a little skeptical of advertising on HIStalk at first, thinking that the majority of readers may be vendor types, but that is clearly not the case.” Thanks – you are too sweet. We won’t recommend a product we haven’t used ourselves, but we will get readers the information they need to allow them to qualify their own interest. I’m happy we can do that since it benefits both vendor and prospect. According to the survey I just finished, 83.4% of HIStalk readers say they have a higher level of interest in companies we’ve written about. That’s flat out amazing and we don’t take that responsibility lightly.

For me and many/most attendees, the HIMSS conference is over. Maybe you’ll see Michael J. Fox flying into MCO as you are flying out since he gets to speak to the few folks sticking around for Thursday sessions.

Tomorrow is traveling home day, and while I’ve really enjoyed being here, I’ll be even happier to get back to my familiar routine, PC, and wife. A ton of people were sitting in the grassy area outside the Lobby C area of the convention center this afternoon. It looked like a capitalist Woodstock as attendees in suits sprawled awkwardly in the grass (I saw one guy fully face down on the lawn, suit and all, reading a book). I bet most of the impromptu sunbathers were heading back to snow and gloom and figured they’d better get sun now or else wait a couple of months for it to find its way back to them. 

The weather was good today — it’s a perfect and breezy 78 as I write this close to sundown and kids are having a ball in the pool right outside my window. Walking back to my hotel, I could smell wood smoke from a steakhouse, blooming flowers, and a little tang of ocean salt in the air. For most folks going home, they’re going to be smelling smoke from the fireplace, flower-scented air fresheners in closed and airless rooms, and salt from the treated roadways. No wonder people like to vacation here, even though Orlando is culturally bankrupt, jammed with traffic, and filled with people who’ve lived her for decades and yet won’t quit calling New York and Ohio “home.” Those are issues that only the locals care about.

I’m behind on e-mails from the traveling, the conference, and our events, so bear with me as I try to catch up this weekend. I think people sometimes forget that it’s just me on the other end and I’m working a lot of hours.

Here’s the bad news for all you folks (including me) who are proudly taking new iPads home won as prizes this week: the iPad 2 comes out next week, so that new one you bagged this week is already obsolete even before you even get to strut it in front of your admiring families. Doh!

I got some e-mails from execs of some of the vendors I mentioned yesterday as ignoring my “I’d like a demo” booth body language to give them a second chance. I did so today, with mostly the same results. I should mention, however, that my title and hospital name on my badge wouldn’t necessarily make me a likely candidate, although the small font size makes it unlikely that they ignored me for that reason. Today was the last exhibit day and nobody was paying much attention to those of us still roaming the exhibits late into the afternoon. Mostly I saw reps talking on the phone or sitting together in their couch / table areas making dinner plans or cursing as they spoke animatedly among themselves (I’ve noted that young, male sales reps seem to curse a lot in each other’s company – it’s like using profane emoticons).

And speaking of that, I also do not identify myself to vendors, even those I exchange e-mails with or those who tell me to ask for the CEO or other executive personally. I’m a mystery shopper – I want to be treated exactly the same as anybody else (or as me in my day job role).

Our King and Queen judge Greg Wilson from Salar got this picture today with John Templin and his long string of badge ribbons. I’m not sure Greg knows the history – John does this every year, usually as he’s trying to raise money for the HIMSS Foundation. You saw him on stage this morning as the keynote started.

A CapSite survey finds that 23% of hospitals plan to use consulting help to get their clinical systems up and running.

Franciscan Alliance will roll out Epic at its 13 hospitals and 165 practices. The cost: more than $100 million over the next two years.

UK Healthcare will implement Allscripts EHR/PM and integrate it with a new version of its Sunrise inpatient EHR.

Jordan Hospital (MA) lays off four managers (IT, quality, pharmacy, and diagnostic services) and VP/CIO Dennis Fonseca.

New PatientKeeper CPOE customer: Madison Memorial Hospital (ID). Going live on the same product: Ashe Memorial Hospital (NC).

CollaborativeCARE Conference signs a deal to bring in HIMSS to run a one-day education program during its first conference this coming November.

Wednesday Keynotes – Kathleen Sebelius (HHS secretary) and David Blumenthal (national coordinator)

• I don’t know if I’ll ever get used to Steve Lieber’s spiked-up hair, which I noted as he read a suck-up HIMSS proclamation honoring Kathleen Sebelius for taking money away from taxpayers and giving it to much richer vendors and doctors.
• It’s a given: everyone in politics and government will always publicly praise their wise, hard-working, and selfless bosses (Sebelius-Obama, Blumenthal-Sebelius).
• Sebelius said that of 231 vendors of certified products, 2/3 of them have fewer than 50 employees, and “any one of them could be the next Google or Microsoft.” Really? With 230 competitors and few takers for most of them until the Cash for Clunkers EMR program came along? Maybe she meant the next Google Health or Microsoft HealthVault.
• She talked about the country’s health. I’d still argue that EMRs just make the treatment episodes arguably more efficient. It’s what people do when they’re not sitting in front of a provider that’s expensive. Someone should create a business model for wellness and population health. She didn’t mention any of those things.
• She said you can’t just advocate the technology – you must advocate an improved healthcare system.
• She lauded Blumenthal’s “doctor perspective” (he supposedly still sees the occasional patient, although he’s had muckety-muck Harvard jobs for so long it would be interesting to see how many and how well).
• Blumenthal was a pretty good speaker, just a bit quiet and monotonic and very careful with his words (I actually liked his style). He said he was naïve about what could be accomplished at last year’s HIMSS conference.
• He said 21,300 providers have signed up as Meaningful Users and $20 million has been paid out under Medicaid. The Medicare payments will start in May.
• He said the timetable for Stage 2 will be challenging, but reasonable and achievable.
• He cited 62 Regional Extension Centers enrolling 6,000 providers each week.
• He said that colleges have trained 3,400 people in HIT and the goal is 10,000 per year.
• “HIE is a team sport that requires local coaches.”
• He said the system was deficient in quality measures, population health, clinical decision support, and interoperability.

Exhibit Hall and Session Notes

• A reader asked me to check out Lawson. They were pitching ACO support, Cloverleaf, scheduling, HR management, and ERP. Their booth was pretty dead, but it was a bit early. They had coffee and popcorn. The booth looked nice (curvy yellow sofas and quiet demo areas) and the wall posters made it clear they have a lot of products. I can’t say I had a reaction either way.
• Another reader asked me to stop by Candelis Astra, which offers some kind of workflow cloud solution stuff for radiology and images. That’s all I know because of the five reps in the booth, two were on their phones and the other three were sitting around a table deep in their own conversation. One did pop around the corner and ask if I wanted a demo, but I was committed to walking away at that point. Still, they did ask, so I give them credit for that – I was just being stubborn.
• I dropped by Clairvia and still didn’t get much attention, but the over-the-shoulder demo I watched looked really strong and a big competitor admitted that when it comes to clinical scheduling and acuity, Clairvia is better. It’s a slick-looking product.
• I talked to one vendor’s rent-a-booth-babe. She says she likes HIMSS because it’s conservative. I asked what that meant and her answer was basically that this week’s vendor-employer didn’t make her come in nearly naked. Apparently vendors often do.
• The OnBase magic guy is the best ever. Not only is he funny and really good at riffing (“Step closer, the trolley is coming … I just saved  your life, dude”), he even knew a lot of product stuff, like when someone from HP was there and he knew details of OnBase’s partnership with them. I keep thinking maybe he’s an employee who just happens to know magic, but if so, he’s darned good.
• NCR had their HIStalk sign out. I played with their wayfinding kiosk and it was cool. The rep played me perfectly, letting me poke around while offering just enough conversation to make me feel engaged
• A reader asked me to find out what Epic’s Canto runs on. It’s iPad-only, the rep told me. I have to say those Epic kids are really pleasant and helpful.
• I like the big sign on Healthland’s booth: “We’re not for everyone – bringing a certified EHR to rural hospitals.” Bravo – how many companies would just leave it wide open in the hopes that Cleveland Clinic or someone like them might get fooled into buying it? I admire helping prospects qualify themselves. Well done.
• Orchestrate had their HIStalk sign out – thanks! I saw President Charlie Cook there.
• I looked over someone’s shoulder at Shareable Ink and it seemed pretty cool, but I didn’t really get to see any of the form-filling part, just the end result.
• A reader (or maybe it was the vendor – I forget) asked me to drop by Proxense, which does proximity-based security, I think. I’m guessing because the rep said hello and nothing else, so I did the same. I checked out their Web site and it’s not very well designed (note the hover text  over the Sales menu item that says “some sort of tagline about sales.”) and makes it hard to figure out what they do. They’re probably engineers from the looks of things.
• I stopped by HT Systems/PatientSecure several times and was anxious to see their palm biometrics in action, but that didn’t happen. There was some other company’s business development guy hogging their time (talking rather than listening). I think I would have saved that conversation for non-exhibit hours if I were him and if I were the company, I’d have some video or something since it’s a highly visual product and a conversation-starter (or so I assume, not having seen it). I’m pretty sure it’s cool.
• I watched a theatre presentation of Nuance’s new Healthcare Development Platform. It sounded interesting: products connect via HTTPS to Nuance to run speech recognition (support provided for iPad/iPhone/iPod Touch OS, Windows Mobile, and any browser). Five lines of code turns a text box into a speech recognition field that then runs its Clinical Language Understanding to extract structured data and map it. They’re offering a free 90-day developer’s license when it goes out of beta in March or April.
• The only good educational session I attended during the entire conference was today, a really good one on medication barcoding. It’s what you always hope for but rarely get at HIMSS – one guy describing in super-concentrated form all the problems his hospital solved when rolling out medication barcoding. I’ve never seen a session that was so meaty, full of real-life pearls, and pleasant to watch. The pocket guide says only Session 165, Still. Whoever Still is, kudos. No self-indulgent posturing, no fluff, no teasing in the hopes you’ll hire him or his company to finish the story – just really good experience shared. People actually clapped and meant it and the audience questions, instead of the usual droning pontificating, were insightful and on point. My faith in humanity was restored.
• A reader asked me to check out Success EHS, a Birmingham-based PM/EMR vendor. Like almost all Southern vendors, they were very nice and friendly. The product didn’t look all that much different than other EMRs, but it does run the MEDCIN engine and it had a cool Meaningful Use dashboard that shows real-time stats on how individual docs or groups are doing in hitting their numbers. Most impressive is that they charged nothing for that module or any of their Meaningful Use upgrades. I mentioned that I’d won an iPad and the young lady rushed off to give me a super-nice case for it, saying, “I bet you didn’t win one of these.”
• I dropped by former sponsor Apelon thinking I could find a few nuggets to mention just to be nice, but they didn’t have much to say.
• A pretty cool guy from Software AG skillfully pulled me from flowing exhibit traffic to chat. They’re the company giving away the electric guitar that Inga was bragging on playing. They have a rules-based SOA integration platform that can monitor streams of data and do trending and alerting. It’s a platform aimed at vendors and technically astute hospitals and I didn’t understand all of it, but they gave me a couple of cool books that I’m going to read: Process Intelligence for Dummies and SOA Adoption for Dummies.
• Siemens roped me into a five-minute 3D demo of Soarian that was a complete waste of time (and maybe not even a demo since I don’t recall seeing actual screens). The glasses were kind of cool, but the only 3D effects were some lists and video clips that looked like they were floating and the guy narrating live was a bit too over the top for me. It also seemed to be of the “we suck less than before” variety, proudly listing #2 in one category, “improving” in another, etc. I would have worked harder on the message and less on the medium.
• The best thing I saw all conference was Medicomp’s Quippe (pronounced “quip”, by the way), which I checked out only because Inga, Dr. Gregg, and Dr. Jayne were all raving about it and I figured I was the guy to neutralize the Kool-Aid (or IngaTinis) they’d obviously been given. Didn’t happen: it was way cooler than they said. It’s really iPad optimized, allowing dragging templates over to the work space, supporting insertion of pictures with a variety of annotation tools, and some proprietary gestures that are really cool. For example: drag on a vital signs table, write 101.5 with your fingertip on any blank part of the screen, draw a little L over the temperature field, and your 101.5 is instantly converted to text and dropped into the box (or you can use the on-screen keyboard if you’d rather). I don’t know much about ambulatory systems, but what impressed me most is that when you choose a given symptom, tabs open up unobtrusively that show previous encounters for that patient in which those same symptoms were reported. It’s just a very dynamic, fluid app that really wouldn’t work as well on a non-tablet platform. I’ll not call it a “game changer” since my cohorts have overused that phrase when referring to it, but I’ll call it as ingenious and as physician-friendly as anything I’ve ever seen. I saw another vendor’s implementation of the current MEDCIN engine and it was nice, but not in the same league (that vendor confided that they can’t wait to get their hands on Quippe to add it to their product).

E-mail me.

HERtalk by Inga

From The HIStalk Queen: “Re: HIStalk queen contest. My name is Janet Skinner from Skinner and Associates Executive Search and thank you! I won the HIStalk Queen contest and I wanted to thank you very much for the nice IPod Touch prize! Wanted to thank Dave Lareau and Medicomp for a fantastic party! Fun idea to include the shoe contest (what woman doesn’t love shoes?!) and the IngaTinis were fantastic, as you warned they would be. I must have had more than one if I pulled off winning the queen contest, but I think the group I was sitting with had a few too many IngaTinis of their own and their loud cheering tipped the scales in my favor. Would love to see the Histalkapolooza an annual event, great fun… and again, thanks so much for inviting us!” Hard to believe this was our fourth HIStalk party (though the first HIStalkapalooza).

Bill Fera, MD, of E and Y was our HIStalk King.

From Your Fan: “Re: Red Carpet Gals. The red carpet greeters are my CEO Jennifer Lyle and account manager Kara Heward of Software Testing Solutions. As a matter of fact, Jennifer won the Inga Loves My Shoes sash last year and still proudly displays it in her office. They had a fantastic time with the HIStalk readers who were great sports and the Medicomp men in the tuxes would have made Stacy & Clinton proud! We’re glad you had a great time and can’t wait to join you next year.”

The only way our shoe judge Lindsey of RelayHealth could have been more cute here was if she’d had more sleep Monday night and if you could have seen her gorgeous shoes.

Kronos: seriously, at least 100 people were in line trying to win one of the five iPads. I feel badly that I won one seeing how many people would have liked to win.

I shared a cab with the NextGen artist guys!

Assessments for the day:

• BlueCat: girls in cat woman suits. Really? I suppose they really looked fabulous and I am only jealous that I can’t pull it off like they could.
• David Blumenthal: watching paint dry probably could have been more exciting than listening to him as a keynote speaker.
• Meanwhile, Katherine Sebelius (who I swear was wearing the same suit as she does in all her head shots) was explaining to HIT professionals what healthcare reform and ARRA meant. Really? The place was packed and some folks had to watch on closed-circuit TV from the hallway.
• Thank you MEDecision for the Starbucks coffee. It was worth the 20-minute wait in line just to overhear Practice Fusion CMIO Robert brag that the company now has 70,000 users.
• The OnBase heckler was pretty good. He called out the “lady in pink” to come over and hear his deal. Very fun.
• IDS: good job and giving me the one-minute pitch you do.
• Pulse guy (who just started shaving last week): ask who your audience is before you start explaining why buying an EMR today is important. Most of us already are pretty familiar with Meaningful Use.
• From one very smart CEO: I figured out how much it cost us per hour to have people here and it is about $7,000. They better be standing on the corner of the booths trying to sell and not checking messages on their smart phones. Good advice that a lot of vendors should have heeded, including some that I kind of wanted to check out. Like CattailsMD, Azzly (the second time I came around), Wavelink, and a dozens of others.
• Thank you, Sage guy, for showing Health Unity. Yes, I noticed you looking at my shoes because you suspected I might be Inga. Integration is not all there yet (those blue screen errors are a dead giveaway) but the embedded integration will be cool.
• George at Sophos: I couldn’t pronounce your sexy Greek last name, but you were adorable.
• I loved the fondue at EDS. Wish more exhibitors (like Meaningful Use Monitor) had bottled water.
• Ingenious Medical: nothing like having a cute girl wearing high heeled blacked boots to bring in the crowd. Definitely not practical for a three-day show, but who the heck cares?

So much more to say, but Mr. H is ready to post. I will do my best to read my cryptic notes and share more tomorrow.

E-mail Inga.

EPtalk by Dr. Jayne

And now the end of HIMSS11 is upon us. I was surprised to see the exhibit hall as full as it was today. Usually by this point, folks are losing stamina, but at least around the noon hour there was still a veritable sea of navy blazers. I did see several ladies sporting running shoes with their suits, and although I stuck it out in the comfy yet stylish heels, I was a bit jealous.

I also saw quite a few people sporting the bright yellow clog slippers given out by ChipSoft. I stopped by to try to get a pair to mail to Inga as a gag gift, but was turned away empty-handed by the less-than-pleasant rep.

Several of you e-mailed over the past couple of days with thoughts on booths I should visit. I’m sorry I couldn’t get to them all. I gave preference to those that had a hook for why physicians would benefit from their products vs. those that just said, “Hey Jayne will you make an appointment with us?” It’s hard to make appointments when one is anonymous.

I ran into an old friend of mine, Vendor Boy, and asked him, as a veteran, what was the best thing he saw at the show. First place: the Epic booth. Second place: the kilt girls.

I agree with what Mr. H said yesterday. Many of the reps seemed tired and/or bored and some didn’t seem to care whether I was interested in talking about their products or not. I would have thought that with the badge scanners and RFID tracking there should have been some kind of “CMIO with purchasing and decision-making authority” alert like a Bat-Signal in the sky that could have shocked them back into action, but alas, several flat-lined. However, there were notable exceptions:

• OnBase, which does document management. With their sports bar theme, they were happy to tell me about their solutions. Our friendly bartender/rep was happy to show an iPad app that I didn’t see yesterday, which allowed quick on-screen approval of documents including annotation.
• Sage, which had a better showing today than when I tried to visit on Monday to see their new HIE solution.
• NCR, which was giving away autographed copies of the Newt Gingrich book Paper Kills 2.0 as a special HIStalk reader perk.
• Up to Date, which tried valiantly to entertain me while I waited to talk to a specific rep who I heard had a great story to tell, although I got pulled away and never did get to meet him.

I visited the 3M booth several times to try to find out about the new mobile app they told Mr. H they were launching. The people I talked to didn’t seem to know what I was talking about, but they did tell me about their coding support product that uses natural language processing to trigger patient care alerts from dictated text in EHR. Since I’ve seen a lot of care coordinators being let go recently (which seems short-sighted with Accountable Care breathing down our necks) that might be handy, but if that was supposed to be the mobile app, I’m not sure how mobile it was.

Personally I haven’t had good luck with the voice recognition software for mobile devices and most of our hospitals still use traditional dictation systems, so it’s not like the doctors are dictating daily notes directly into the system as they round.

TeraMedica had the guys in the colonial outfits with the tri-corner hats again today. Not sure how that plays with data migration, but they looked like they were having a better time than the ones who were in the booth on Monday.

I gave them a couple of days to spiff up, but Alcatel-Lucent still hadn’t ironed the white coats of the faux clinicians gracing their booth.

Emdeon awarded the iPad from their HIStalk reader-only drawing. The winner was very excited and even sent me a photo of the cute gift bag they packed it in. I’m always happy when someone goes beyond the expected, and delivering to the winner in style is much appreciated.

Props to the Hilton who accommodated my late check-out request and even smiled while doing it, allowing me to spend precious minutes poolside before I head back to the sleet and freezing rain that is surely covering my car. Maybe they could drive me home in this.

That’s a wrap for HIMSS11. See you next year in Vegas, baby!

E-mail Dr. Jayne.

Dr. Gregg Goes to HIMSS
By Gregg Alexander

“It’s late and I have a huge headache (no, I don’t drink, so it’s not a HIStalkapalooza leftover,) so I hope my observations come through better than they feel through the throbbing behind my eyeballs.”

OK, that’s how my post for Monday night would have started if I had not somehow hit “Minimize” instead of “Send.” I awoke Tuesday morning wondering why my post was absent and found that the headache cloud had somehow short-circuited me more than I knew.

So now it’s about 1:00 AM on Wednesday morning and I have just gotten back to snow-covered Ohio (I have a practice to run) and out of my HIMSS suit. I see Mr. H, Inga, and Doc Jayne have already posted for the night while I was traveling, so I’ve again missed out. (Sigh.)

So, this’ll be a mishmash of Monday/Tuesday and since I’m not, as I’ve said, a real reporter, I hope you’ll forgive my mark-missing tardiness.

MONDAY

HIStalkapalooza was a ball! Mr. H and Medicomp built upon the great groundwork laid last year by Ivo Nelson and Encore with the friendly venue, excellent food, free drinks, and a rockin’ venue. The red carpet entry, the HIStalk limo rolling up and down, and the Batman-sign-esque HIStalk light on the wall across from BB King’s set a superb tone for J. Bush, Dave Lareau, John Glaser, and the Insomniacs to rock the house all the way out. (Seriously, the red carpet entry and the gorgeous and funny red carpet interviewer ladies would have made even Billy Bush proud.)

The HIMSS opening session left me sort of … well, I actually left it, so I suppose that tells you how much I felt I was gaining. The typical HIMSS HIT rock show multimedia wasn’t enough to make the retread of “look how much we’re doing for the world of healthcare” seem worth enduring … again.

The 1,000-plus exhibitors made it appear that the economic downturn is over, at least in the HIMSS-associated halls. Exhibits stretched for what seems like a mile and from floor to ceiling. In fact, with so many vendors flying banners, signs, and rotating “come-see-mes” from the exhibit hall rafters, they all sort of drown each other out and it makes it seem like less of a good idea. I mean, if it doesn’t help people see where you are from across the vast exhibit hall stretches, is it still a helpful way finder device?

I got to enjoy many great conversations with tons of vendors and noticed one really impressive thing throughout: not once, not one single time did any one of them mention Meaningful Use during any of the conversations. It is possible my ears have started to become numb to it, but I’m pretty sure none brought it up. Not exactly sure what that implies, but I did enjoy the respite.

Loved the MED3000 demo of their incorporation of Medicomp’s Quippe tool. Providers – if you haven’t seen it, you should absolutely make the effort to check it out at either MED3000, Pulse, or especially the Medicomp booth where you might actually have a chance to walk away with a free version of it on a free iPad. I think it is perhaps the first, honest-to-goodness game changer (I see where Inga used this same term in her Tuesday night post) in the world of HIT to come down the pike since Larry Weed. Indeed, Dr. Jay Andres at MED3000 told me every single provider he’d shown it to had all made the exact same queries after seeing it: 1) How soon can I get it? and 2) Is it really as easy as it looks here?

RemitDATA has become a big HIMSS sponsor and has a pretty cool offering (at a GREAT price point) to help docs evaluate the financial side of their practices. Sort of athenaCollector-ish, but from multiple data capture sources.

Thomson Reuters is working on some great stuff for health education (and more) and also has some of the nicest people!

Soapware’s Randall Oates has a great new approach to the medical scribe concept: the Medical Coordinator. The MC sits in another room and listens in to a patient-provider visit, capturing the data and coordinating associated care management issues. No in-the-room intrusion and the provider can focus 100% of the patient. Now, that’s attractive … I am going to look deeper into this one.

athenahealth always has such a fun crew at their booth. Jonathan Bush was holding court (I got an short audience) in the central couch pit. It was just too much fun watching the procession of folks flowing in and out and the antics of the inimitable JB.

I’ve more, but my head has gone from throb to cannon fire…more HIMSS views tomorrow.

TUESDAY

Despite his humble protestations, Mr. H did a FANTASTIC job with the oratory when he, Inga, and Dr. Jayne made their first ever live-and-in-person show at the HIStalk sponsors’ lunch Tuesday and Maggiano’s. Inga’s boots were incredible and you could even see her just beaming, even through the surgical mask. They say they were Nervous Nellies, but they must cover well because it didn’t show. There was an absolutely incredible turnout with an amazing assortment of vendor bigwigs from all about the HIT world. A few glitches with food service aside, I think they did a knockout job. Mr. H and Inga even hand-wrote personal messages on thank you cards to each of the attendees and I overheard many comments on how nice or how funny the remarks were. All I can say is if you were invited and didn’t make it by, you missed out.

I had a sit-down with Dana Sellers of Encore. She is just as delightful to talk with as Ivo. I love their corporate philosophy and, especially, their slogan of “100% Referenceability.” Make your clients happy – all of them, all of the time. High standards, but their growth and abilities to attract and keep quality IT folks in the current market when those peeps are getting hard to find seems to add validity to their approach.

GE Centricity Advance is now shooting for docs in my neck of the woods (small practices). They seem to have learned some good stuff since I last looked at Centricity and their Mobile version, which is coming in Q2, appears to build even further upon those lessons. (Honestly, I never liked the look of Centricity, but the new Advance and Mobile stuff … much better.)

The trick shots on the pool table at the Iatric booth were very cool.

Ingenix says they’re now looking to thicken the relationships that have spread out so much in their recent buying frenzy. The buying may continue (as it will across the whole HIT market, eh?) but they want those thin ties to strengthen as they work to establish more “integrationability” (my word) across their many arms. Expect some rebranding soon. I like their stated open-to-sharing mindset.

Thomson Reuters has some really cool clinical decision support tools out or coming for physicians, pharmacies, infection control, pediatrics, and more which all benefit from the “same source of truth.” (I like that line.)

MEDHOST touchscreen tools and floor plans for EDs are not in my every day realm, but I really liked how they look and feel.

The Man & Machine waterproof keyboards and mice demo with waterfalls running over these tools was simple, slick, and effective. Contagion control is as, if not more, vital than data capture, I would wager to say.

Onyx and Stinger Medical had some really cool-looking carts and display tools for hospitals that just looked smart.

I felt like Maxwell Smart in the Unity Medical “cone of silence.” I want one.

Lastly, I noted how irritated I kept feeling as I tried to take in as much as I could in my limited window of time at HIMSS. Then, a quick calculation helped me realize it was a “setup for failure” kind of event. With somewhere around 1,000 vendors, if you only spent one minute with each, it’d still take over 16.6 hours to see all there was to see. And, that doesn’t even include the Interoperability Showcase, the education sessions, assorted keynotes, or bathroom breaks.

What a show.

E-mail Gregg.

From HIMSS 2/22/11

From Another CIO: “Re: VIP lines. My title is CIO, but it isn’t worth the ink to print it if all of our staff aren’t working together to accomplish everything that needs to get done.  To this end, I am literally embarrassed to hear about a ‘VIP Line’ at the HIMSS conference and wouldn’t be caught dead in one.” I’m sure HIMSS rationalizes its VIP treatment of CIOs by citing the vendor bucks chipped in to provide them with closed-session speakers, food, break rooms, and other perks. It also used to bug me that there was always an area where vendors could book time with HIMSS-pimped CIOs if they were willing to pay the CIOs cash for a ‘briefing’ (i.e., I’ll pay you to listen to my sales pitch). I suppose their other excuse is that it’s even worse than that at CHIME but  nobody’s complaining because non-CIOs aren’t invited there. Some hospitals have strict policies against executives accepting vendor gifts (“touch that vendor demo bagel and you’re fired”) but the rules doesn’t seem to extend off campus.

From All Hat No Cattle: “Re: Marc Overhage of Regenstrief. Resigning and going to Siemens. We received the announcement earlier this week and had an emergency medical informatics faculty meeting yesterday. Bill Tierney is taking much more of a leadership position initially and the search committee for the next leader of Regenstrief Medical Informatics has been formed.  He is fast tracking this search and we still hope that the next Chair of my department will also be a high level medical informatician.” Apparently verified, at least according to people who said they saw Marc wearing a Siemens badge at HIMSS.

From Florida Flash: “Re: Noteworthy Medical Systems. Continues cratering. Rick Mullins is now the former president and CEO. I guess the bright idea of getting rid of all the sales force, using a lead gen company, and then hiring salespeople back to work the leads didn’t work too well.” Unverified. Rick Mullins is still listed on the executive roster. I should have asked the folks in the CompuGROUP booth today when I was checking them out since they own the company.

From Digger: “Re: ONC. It was asked in the physician symposium what would happen if docs just sit on the EMR sideline until penalties kick in, and then either retire or stop seeing Medicare patients. ONC gave a politician’s non-answer.” It’s a fair question – there is a built-in assumption that doctors will voluntarily give up money rather than opting out of Medicare or hanging up their stethoscope. I overheard someone’s recommendation about shifting value of EMRs back toward the provider and away from the insurance companies: charge patients a $5 per visit surcharge and build a marketing plan around explaining to patients why that’s a good value. I also had another reaction: if doctors had any kind of pricing power, maybe the EMR burden would be lessened since they could charge more to cover their lost productivity. I still like the model of paying them to contribute their data for others to use, which would provide incentive for them to choose whatever product best meets their needs and implement it in a way that optimizes those contributions of patient information. If you were paid X dollars for a contributed H&P or other data set, Uncle wouldn’t need to be in the EMR bribes business.

From Zensocrates: “Re: Allscripts. Encouraging votes for Stephanie Reel is funny given JHM is negotiating with Epic to replace SunriseXA.” Unverified, but commonly known, I think.

From InfoNurse: “Re: HIMSS. Is that Elvis! No, that’s Neal Patterson! By golly, he’s coming to HIMSS11 on Wednesday. Just a walk-through after the lovers’ quarrel and breakup with HIMSS in San Diego. Must be coming to get the pie.” Cerner was a little shifty in mentioning a HIMSS booth number, but it was actually in the IHE section and not a real Cerner booth on the regular exhibit floor. Someone told me Cerner has a room in the convention center, though. I think I knew that vendors can book rooms out of the public eye to entertain right in the convention center. Speaking of The Pie, Neal did win again and I need to post the other HISsie winners, but I may do that when I get back home where I’ve got a more comfortable keyboard.

From Jay: “Re: AHDI/CDIA. CEO Peter Preziosi resigns.” They say they’ll miss him “sorely” and the announcement is gushy in general, so it sounds like it was his choice. The former Medical Transcription Industry Association just rechristened itself as the Clinical Documentation Industry Association.

From Mobile CMIO: “Re: Epic Canto. I have a working sample of the iPad app. Even though it is version 1.0, it is fast, great interface, and embedded dictation tool. I expect this to be quickly and enthusiastically adopted by our medical staff when we go live.” I mentioned Canto yesterday when I saw a poster for it on the outside wall of Epic’s booth.

The big acquisition announcement of the conference so far: Harris Corporation will buy identity management and integration vendor Carefx for $155 million. Obviously Harris wants more of the healthcare IT market than just its government and military business. The deal must have been struck awhile back since the Carefx booth had printed Harris information today that wasn’t an obvious last-minute add on.

Our other rumor was correct: TriZetto will acquire revenue cycle management vendor Gateway EDI.

One more acquisition: Scottish charge master vendor Craneware buys ClaimTrust for $20 million. The Tennessee company offers revenue cycle and auditing solutions, allowing Craneware to inflate its tagline to “automated revenue integrity solutions.” According to the ClaimTrust site, hospital revenue cycle consultant Joe Ferro and his programmer wife started the company in 1998. A nice exit for them.

HIMSS released its online survey results today. The Meaningful Use chase continues to draw a disproportionate share of hospital attention despite possibly more financially critical projects such as ICD-10 and preparing for healthcare reform.

We had a little lunch today for our sponsors, with Inga, Dr. Jayne, and me appearing in disguise for anonymity purposes (lab coats, surgical caps and masks, and reflector thingies). Thanks to Dr. Gregg for coordinating and Ed Marx for delivering a speech before we slipped in, did our thing, and headed out (I don’t know what he talked about, but I’m confident it was excellent). I can’t say we deliver an inspiring or polished performance for several reasons: (a) we have never appeared as ourselves in person and we were quite nervous about that, especially Inga, who Dr. Jayne and I thought sure was going to throw up on the sidewalk on the way in; (b) I had just met Dr. Jayne for the first time in the car (I like her – a little bit sassy and brash in a doctorly way); (c) we weren’t really sure what we should talk about; and (d) we’re writers, not talkers, so our oratorical skills are modest at best and Inga and Jayne declined to say anything at all once we got in the room (thanks a lot, gals). It was great to see everybody, though, and we really appreciate the support and the chance to say so in person. It would have been really cool to hang out for awhile, but we’re paranoid about anonymity since we’d rather not become unexpectedly unemployed. Inga wore the fab boots that I got her for Christmas and pics of those are going viral, she says. On the way in, some guy did a double take while checking our getup and asked if there was anything he should know. I told him we had the outbreak nearly under control.

Thanks to Dr. Gregg for choosing BB King’s for HIStalkapalooza way back in the fall and working up the menus and details. I liked the scale of the venue and the acoustics were good. Above is a red carpet picture from reader Rick. Below are some reader pictures – thanks for those.

If you’re at HIMSS, here’s my recommendation of a cheap, fun local place to eat that’s an easy walk up the street just past Pointe Orlando (one of my pals urged me to share it with you after I took him there even though he was paying and trying to steer me to high-end places). I’ve eaten at Miller’s Ale House probably 40 times over the years and it’s always good. The beer selection and prices are amazing, the waitresses are cute and fun, and you’d be hard pressed to find a better entrée than the $12.50 Bahamian dolphin baked in a foil pouch with garlic, wine, Tabasco, and vegetables. The blackened grouper sandwich is good, too. Start off with the excellent conch chowder and you’ll feel like a Florida native. I’d invite you to eat with me there except my doctor disguise wasn’t all that comfortable.

AT&T’s ForHealth division announces new products and pilots: a smart phone interface for its Healthcare Community Online portal, telepresence, and mHealth Manager.

Passport Health Communications announces a partnership with Bayfront Medical Center (FL) to beta test its precertification / prior authorization product, OrderRite.

I forgot to mention this the other day with all the HIMSS crush: athenahealth names former AMICAS CEO Stephen Kahane, MD, MS as president of the company’s Enterprise Services Group.

Merge Healthcare CEO Jeff Surges brings over some of his former Allscripts colleagues: Steve Brewer as EVP of solutions and Steve Martin as SVP of sales (please hold the arrow-through-the-head jokes since I’m sure he’s heard them many times).

McKesson announces its $1.5 million funding for six mobile health projects related to diabetes. The next grant cycle starts in April.

The folks behind the Extormity EHR and SEEDIE certification parodies come out of the closet: it’s NoMoreClipboard.com.

Allscripts announces its version of the Apps Store and demonstrates “native” integration between Sunrise and its Enterprise and Professional EHRs. I don’t know what “native” means when you have products developed by different companies whose only commonality is current ownership, but I’ll assume it just means you don’t need an integration engine or middleware. I heard a couple of times today that they’re doing a really good job, although whether it will be enough to fight the Epic juggernaut is anybody’s guess (actually, I’ll guess no since it’s late in the game, but kudos for going after them).

Cedars-Sinai picks Encore Health Resources to help with the next stages of  its EHR implementation.

Keane Healthcare Solutions Division announces a mobile client for its Optimum system.

Ross Martin provides this picture of the next challenge for IBM’s Watson, accompanying his funny writeup. “They also believe there is a place for synthetic vocals in pop music today. Andy Aaron, who lead’s Watson’s speech team, says, ‘We’ve hired will.i.am as a consultant to figure out how he makes his voice do that cool, computery voice thing and mimic that.’ Apparently, IBMers have not discovered Anteres Auto-Tune.”

GetWellNetwork announces GA of GetWell@Home, which allows discharged patients to use care plans, teaching tools, and personal health information created for them in the hospital.

From an athenahealth-Sermo survey of physicians about EMRs: three-fourths say they’re good for patient care and two-thirds say they’re worth the money, but 60% say EMRs slow them down. Still, 95% of those docs surveyed will seek Meaningful Use money. Other concerns involve the future of small practices, the impact on patient care of the Affordable Care Act, and the quality of medicine in general down the road.

Drummond Group announces its certification program for hospital EHRs that cover multiple or self-developed applications. The whole “complete EHR” Meaningful Use issue came up in the X.0 session I attended today, where vendors either don’t seek modular certification or decline to sell their offerings piecemeal, making it unclear whether a provider using or owning only specific modules can still claim to be using a certified EHR. ONC really needs to clarify this since it’s a mess and integrated systems vendors have little incentive to clean it up.

Palomar Pomerado Health announces Medical Information Anytime Anywhere (I’ll give them one-time dispensation for making Anytime one word when it should be two). Vendors already offer their own iPhone and iPad apps, but the hospital’s product works can assemble a single view of information from multiple systems (vendors don’t offer that, of course). Cisco covered half of the $250K cost of developing the prototype, but it will take lots more cash to turn it into a stable, off-the-shelf product (which is the hurdle that 95% of hospital-developed apps can’t clear).

Voalté hires former Ritz Carlton quality director Gigi Gray as user experience manager.

Exhibit Hall and Session Notes

• CCT, which offers training contracting services with emphasis on clinical systems, is holding mock training classes on the hour in booth # 5769.
• NCR announces new versions of its portal and kiosk products.
• The X.0 people seemed crestfallen that their beloved Twitter feed was down, forcing people to actually ask their questions instead of Tweeting them.
• Someone’s session talked about cost savings from IT, leading me to ask myself this: cost savings to whom? If you cut costs, you’ll just increase insurance company profits in most cases. They don’t often reduce rates even when their costs goes down. And second, hospitals are so inefficient that they never reduce rates when their costs go down, either. Even if technology allows cost savings, who gets the money?
• In a session on mHealth, one thing was clear: much of the variation in cost and outcomes is because patients are non-compliant. I was thinking that perhaps that’s why our outcomes and costs are so bad compared to those of other countries – our people are fatter, less motivated, more likely to be stressed in their quest for consumer bliss, and often unwilling to make even modest effort to improve their own health. That’s not something that providers can influence very much.
• I checked out a couple of products in the New/Emerging Technology part of the exhibit hall. Oddly enough, people from these startups seemed mostly uninterested in connecting with people looking at their offerings and neither of them offered me a demo despite not having much else to demand their attention. Expert-24 had Virtual Expert, a decision tree generator that looked a good deal like Visio and can supposedly be used by non-programmers to build simple applications that collect information or step through decision support steps. Canadian vendor MedConnex had a simple EMR. I would have had more to share if they had shown more interest.
• I said yesterday that ESD was the most creative vendor given their tiny space, and that’s not even counting the ultra-cool sign I saw in their booth today that I missed then. It said, “Big brother is not watching you,” explaining that you could visit them without being tracked because they opted out of the idiotic HIMSS vendor technology to track attendees with RFID like stray cattle in the exhibit hall. Kudos to them.
• Clairvia didn’t offer a demo of their scheduling and acuity apps despite broad hints from me that I was interested and a conversation of several minutes in which I asked about it, but I can say it looked very cool on the screen I saw.
• I will say that in general, booth people seemed out of energy today. Many of them were fiddling with their phones, talking to each other instead of paying attention to passers-by, or just sitting and staring at the floor. Maybe vendors should send in a fresh team on Tuesdays since many of them were letting prospects walk away without getting any recognition. I keep thinking about the cost of buying a booth just to give reps a place to sit, chat with each other, or talk on the telephone.
• I got a nice pitch from Healthcare Innovative Solutions, which provides consulting services specific to CPOE and EHR. They have a a good story.
• A company called ESET was giving out personal one-year licenses for the company’s antivirus product. I’ve never heard of them, but they say they’re replacing McAfee and the big boys pretty often because their product is more lightweight and doesn’t download huge updates, with their average update being only 18K in size. I’m going to install the license they gave me on my PC at home. I wish I could replace the one at work since when it cranks up once a day, it sucks the life out of my laptop for a couple of hours, not good news when there’s a technical or clinical emergency to deal with.
• Blue Cat Networks had a couple of girls in sequiny, skin-tight costumes that could have passed for spray paint. Just saying. Like many of the pretty females working booths, they were a bit cold, which I guess is the result of being leered at all day.
• Prognosis also didn’t offer a demo or pay much attention despite my broad hints of interest, but the product looked good on the screen shots.
• The folks at C3 Partners explained their Meaningful Use Monitor, a tracking tool to document MU status, ready to submit (after Stage 1, which does not require anything more than attestation, apparently).
• Google had a crappy little booth with – no lie – black and white photocopied sheets about Google Health that had been cut in half. They had a total of four PCs for demoing, which was three more than they needed at that point in time.
• Stoltenberg Consulting was offering free chair massages, which I could definitely have used if they had picked up on my obvious interest (clearly I get miffed when I’m ignored, but at least unlike the average attendee, I can call them out publicly on behalf of all of us).
• MediQuant had an excellent magician with some fun product pitch mixed into his patter. Definitely worth checking out. The guy will read your nametag clear across the aisle and call you by name to get you drawn into his tricks. You won’t mind.
• SSI was the company from Inga’s picture that had females wearing evening gowns.
• Someone asked me what I thought the big theme is this year. I don’t think there is one. iPads are cool, but not all that different, ICD-10 and tools to migrate to it are obviously on everybody’s radar. Other than that, nothing would distinguish this year’s conference from the last two or three. Everybody’s talking innovation, but I don’t see much if it out on the show floor. You tell me – what’s the coolest thing you’ve seen?

I have no further HIStalk responsibilities and I’m not leaving until Thursday morning, so let me know if you’ve seen something I should check out.

E-mail me.

HERtalk by Inga

Yes folks, that is my brand new iPad. I was one of Medicomp’s lucky winners. And yes, Medicomp was our amazing HIStalkapalooza sponsor and they also made me the proud owner of a cool toy. Regardless, their new Quippe is a serious game changer. I looked at the technology that is embedded into MED3OOO’s Integreat product and was amazed. Today I saw Medicomp demonstrate it further and I am convinced that every EMR vendor needs to check out this technology. I haven’t seen any product with anything similar and I am convinced that it’s the way of the future. I realize that I am such raving without giving details, but I will have to go back to that another time.

So this is going to be a totally rambling post, so hold on for the ride.

HIStalkapalooza: OMG I had an amazingly fun time. I must ask Mr. H who the red carpet gals were, but they were gorgeous and hysterically funny. Check out the YouTube video and see for yourself. Many folks came dressed to the nines, including our Inga Loves My Shoes winners and all the finalists for HIStalk King and Queen. If you were a winner, send me a note so I can mention your name. Our judges Lindsey and Greg were the most adorable and funny things. If Lindsey hadn’t been a judge, her pink stilettos would have surely won.

Ingatinis: I had one in the SIS booth yesterday as well as one at BB King’s. The original won over the newbie, though that didn’t stop me from drinking them at BB King’s.

Mr. H, Dr. Jayne, and I treated our sponsors to lunch today. We made a brief appearance and Mr. H said a few words. I rarely get anxious or nervous, but I was a wreck this morning. Thanks to the 100 or so that showed up and showed us the love. One of the sponsors told me that his table included someone from eClinicalWorks, Allscripts, Greenway, and e-MDs, and the NextGen guy came over to say howdy. How often do guys like that break bread together? I wish I could have heard what was being said.

HIMSS isn’t over yet, but already the conference has hit a record number. 30,947 so far, compared to an estimated 27,800 last year in Atlanta.

There are over 1,000 exhibitors, which means it is virtually impossible to check them all out. However, I asked my new BFF Dr. Jayne to join me for a peek at a few EMRs. For whatever reason, we had difficulty getting anyone to show us stuff, usually because people were too busy. We tried to look at Azzly, which I had seen in MGMA in October. It’s brand new and is having its first practice go-live in a couple months. It is cloud-based, so our demo was over the Internet. Apparently the Internet connection was horrible and thus it was impossible to get a feel for the product. Azzly does not offer a local version as a compliment to its hosted version. It’s a little scary to think of all the potential problems of having an Internet-based only product, though everyone is going that direction.

Another vendor said he had to pay $1,500 a day for high-speed Internet access in the booth. I think I heard him right. Could that number be correct?

Dr. Jayne and I also tried to check out Practice Fusion. Apparently they had similar Internet issues and were only providing demos on one small screen. The cute young guy working the booth told me that only about four of their clients go for the ad-free version of their product. When I interviewed Practice Fusion CEO Ryan Howard a couple of months ago, he wouldn’t share that number, by the way.

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Software AG is raffling a hot-looking Fender electric guitar. I gave it a test drive and totally impressed the booth staff.

I did a quick walk through the Interoperability section. There was apparently a speaker at the little theater in there and the crowd was  20 people deep. If you look really hard, you can see a speck that looks like David Blumenthal.

Speaking of Blumenthal, am I the only person who has noticed that SRSsoft’s Evan Steele could be Blumenthal’s better-looking brother?

Second best “trinket” after the iPad: a stainless steel coffee traveler cup from MedAssurant.

Cute fedora hats at FormFast, I think. They are apparently giving them away. I am not sure what it all means, but they also have a pseudo-juggle thing going on in their booth with lots of foliage adornment.

So much more to say, but I scored an invite to one of the big parties, and well, what’s a girl to do?

E-mail Inga.

EPtalk by Dr. Jayne

The highlight of today was stopping by the HIStalk sponsor lunch with Mr. H and Inga.  I felt like a rock star arriving in the HIStalk limo, but the looks on the faces of other patrons at Pointe Orlando at seeing the three of us in our white coats and surgical caps was priceless. We appreciate your sponsorship and thanks to all of you for welcoming me as the newest member of the HIStalk family.

The best thing I saw in the exhibit hall today was Medicomp’s Quippe offering, which they were demoing on the iPad.  Using the MEDCIN Engine as its backbone, it allows for creation of dynamic templates for documenting patient care, allowing physicians to customize while still mapping to recognized findings behind the scenes so that it all works for coding, compliance, and interoperability. You can see it at work also at the MED3000 booth as they have integrated it into their product.  As many vendors move to map to SNOMED and other standards, this approach is one that should be given serious thought.

And as more and more physicians express a desire to have templates that build the note on the screen, this type of functionality should be easier and easier to integrate into existing products.  Of course, some docs still aren’t going to like it, and there will be the ever-present debate over whether findings should be documented in clinical terms vs. patient terms.

I’d be interested to see what physician readers think about this idea – knowing that patients are going to have more and more direct access to their charts, are you changing the way you document? This is a fundamental issue that all of us are grappling with. How are you handling it?  Since Medicomp also gave iPads loaded with Quippe to the physicians attending HIStalkapalooza, let us know how you like it after you have a chance to try it. Drop me a note and I’ll write it up.

Thumbs down to the food court today, when the machines ran out of Diet Pepsi.  Sounds like quite a few of us are trying to avoid the extra sugar that comes with the caffeine that keeps us going.  Even for those who choose the full-sugar versions, at least we’re burning some calories with the trek through the convention center.

I’m still tuckered out from HIStalkapalooza. It was nice to see so many “real” physicians in attendance and I enjoyed talking with some of you. I also enjoyed talking with those of you who are suits – it was nice to share war stories and make some new connections. 

The awards ceremony was priceless and this being my first HIStalk party, I’m glad my expectations were exceeded. Looking forward to many more to come!

Tonight I swung by the Compuware bash at Cuba Libre with my wingman. Great atmosphere (a little heavy on the cigars, though) and reasonably good Mojitos. Enjoyed the heavy dance beat and the excellent people-watching as the night wore on.

Tomorrow’s my last day at HIMSS11, so if there’s something you think should be on my "must see" list, e-mail me.

E-mail Dr. Jayne.

From HIMSS 2/21/11

From KR: “Re: HIStalkapalooza. Let me be the first – this event has to be the highlight of the week! The awards, by Bush, were absolutely fantastic. Could not have hard a better MC. Thanks so much for a great event!” You knew it was going to be good if you watched JB waiting to go on – he was like a horse that couldn’t wait to run a race (if horses drank beer beforehand, that is). He was amazing, although he may cringe when he sees his words played back from the multi-camera video recording that was being made.

From Bobby Orr: “Re: HIStalkapalooza. Great time, big fan a good blues band, thank you. Largest  HIMSS ever over 30K attendees, but only about 9k providers is what I understood but I’ll leave that to the HIStalk  team to confirm the numbers.” They said 31K in the opening session, but I bet most weren’t providers. We’ll try to get specifics.

From West Coast Viewer: “Re: CHW. Ben Williams, CIO at CHW, has resigned, effective 4/15/2011.” Unverified.

From Rodgrigo Barnes: “Re: Pennsylvania Health Information Exchange. Medicity contract cancelled.” Unverified. I need to get clarification from Medicity, but the purported e-mail suggests that the state didn’t like PHIX’s strategic plan or its selection of Medicity, which the e-mail said AT&T protested. Also claimed is that the contract value was about was $31.7 million, only $17.1 million of which would be be covered by federal taxpayer dollars. I’ll get more information. It sounded like budget was the big problem.

From VIP CIO: “Re: VIPs. I had the same reaction as you to the article about ‘VIP Treatment.’ The first rule of being an executive is to appear to be getting less special treatment than you are actually getting. I am e-mailing you from the VIP lounge at HIMSS. It is pretty simple, but in the mad house that is HIMSS, it is a great perk. While the lines at the coffee vendor stands are 40 people long, I was able to come in and get a free cup of hot coffee in a china mug. There is soda on ice and water, too. There are nine tables and four workstations with Internet-connected computers and printers. It is kind of quiet, people are avoiding eye contact. One more thing — ribbons are for people that lack self-esteem. I agree CMIOs are major players, but they don’t need a ribbon to prove it. If they want recognition they can carry their medical degree. Nobody in the lounge is wearing a ribbon. Again, we know that it is not good to call attention to our special treatment. Gotta go, the massage therapist is here (just kidding).” I’m a little bit miffed – I pay the same dues and conference registration fees as CIOs, so why am I an inferior HIMSS member who doesn’t get the same perks?  

Thanks to everybody who came to HIStalkapalooza. Thanks, too, to Dave Lareau and Medicomp, their events and video people, BB King’s, the Insomniacs, our red carpet greeters, our shoe and King/Queen contestants, and Jonathan Bush.  I left early and will be up late, as usual, but everybody seemed to be having fun. Personally, I found JB’s beer-fueled riffs to be the funniest thing I’ve heard in a long time – better than MS3TK. Since I’m writing this after several beers, please forgive any slip-ups. I bet nobody else left the event to work several more hours — that’s my excuse.

The limo will run 9 a.m until noon or so Tuesday, cruising around I-Drive. Flag it down and get a luxury ride to the convention center. I’ve ridden in it a couple of times now and it was pretty cool. That’s the very sweet Jan above who was driving today, although I’m not sure we’ll have her again tomorrow.

Medicomp gave away iPads with its new Quippe product to physicians attending HIStalkapalooza. Drop by their booth Tuesday and take a 20-minute training session and you’re in drawing for several more (both physicians and non-physicians will be chosen). I didn’t explain it well, but just stop by and they’ll fill you in.

I’m going to save all the news and other items since it’s getting really late. Here are some random observations from the day, most of them about booths.

• I got nothing from the opening session. I didn’t thing the videos and a capella guys were all that interesting. Robert Reich was too basic and to general to hold my attention. I’m sure he’s really smart, but his talk seemed dumbed down for people who pay zero attention to economics and politics. Not much healthcare in it, either, although obviously Medicare expenses can’t keep rising and he said so.
• Actually, I did get one thing from the opening session: frostbite. My teeth were chattering afterward and every room I was in was just as cold. Floridians crank that AC down for sure.
• I went to two other sessions. Both were terrible. I didn’t learn anything after sitting in sessions all morning.
• The Onyx people had a pretty cool booth, with the ladies wearing red dresses and one wearing a Cinderella-looking outfit. I don’t get it, but it was cute.
• Ingenix had a huge booth with the logos of their acquisitions on the sign – Picis, Axolotl, Lynx Medical, A-Life Medical, HER, and Ingenix Consulting.
• MEDSEEK had a nice two-story model with a guy from The Apprentice doing something or other.
• iMDsoft had sleek version with lots of coffee urns.
• A couple of the Salar guys gave me a booth pitch not knowing who I was. They did a great job, which smaller companies often don’t – they had their story down pat, talked benefits instead of features, and referenced client sites.
• OnBase had its usual sports bar and that smarmy but funny card trick guy, neither changed in the last decade, it seems, but still cool.
• Walden University had a Kinect soccer game where you could try to kick goals over animated opponents.
• Nuvon had oranges as giveaways and a couple of other vendors had apples. Good idea for a health-oriented conference.
• Unity Medical had cool “cones of silence” that looked like old-fashioned hair dryers, which allowed people standing under them to hear the audio from their videos even with exhibit hall noise. They provide instructional and motivational health videos that seemed pretty cool.
• Sage used a red color as a theme quite effectively.
• Awarepoint did a good pitch when I dropped by anonymously. The guy qualified my interest and need very quickly, then gave some good examples of similar deployments. Nicely done for just a casual chat that I didn’t even ask for.
• EDIMS – had a nice setup and a big presence for a mid-sized booth.
• Allscripts had a massive spread using their new green color. Looked good.
• Emdeon had pretty cool orange shirts and a café table setup. They were talking health information exchange.
• Medicomp had their HIStalk sign front and center. They also had a two-sided theater, one playing a recorded demo and the other live.
• Elsevier had a water cooler, something simple that you don’t often see.
• InSite One had an incrementing counter of studies and images done.
• MEDecision had some cool light-up panels and a real Starbucks setup.
• ESD had the most unusual items – flip flops, fondue, and wheatgrass. Nice people, too. I think they may have been the most creative with the space they had.
• Epic put out signs covering their KLAS scores. The lovely Maggie noticed me checking them out, told me that was her job to publicize their scores, and ran back to get me a handout of every sign on their booth walls. Obviously their KLAS scores are shockingly good, lots of green in a sea of competitor yellow and red, but the fact she was so attentive and tasked with managing their score displays impressed me. They still had the fireplace, the wacky art, and Judy hanging out. They also had a sign for Canto, an iPad-based physician dashboard with dictation and messaging (new, I think).
• Nuance had a theater presentation about the new CAPD product built with 3M.
• Enovate had its usual carts, wall mounts, and articulated arms. Very sexy and smooth. Nice people, too.
• Somebody had mini Moon Pies, but my writing is too sloppy to decipher who (looks like Med Worth, but it could be anything).
• Rubbermaid had a cool water cascade right in the middle of their booth.
• Merge had a bunch of cool stuff – kiosks, the Tesla car that you could get your picture taken in, a wall of candy, and video games.
• Clairvia had coffee, a nice demo area, and their HIStalk sign on the table.
• Airwatch had cool management tools for mobile devices like IT shops use for PCs, allowing iPads, iPhones, and any devices to be secured, updated, and managed. They’re new to healthcare, but other clients include Walmart and Coke. This was one of the more interesting things I saw. I talked to the co-founder and he definitely had his pitch down pat.
• GetWellNetwork had their peds application running – very colorful and fun for education and applications.
• IBM had a ton of people visiting their booth. They were pushing the Watson connection.
• Microsoft also had a lot of people, demoing Vergence, HealthVault, and some other stuff. Their signs spelled HIMSS  as HIMMS, though.
• Vocera had our sign out. They also did a nice demo for me on the fly, under their own version of the cone of silence to allow you to hear the device talking.
• CattailsMD was giving away some kind of Buzz Lightyear action figure.
• AT&T had loads of people. I looked at Connect, a learning portal that also streams video. The coolest part is that the tool auto-indexes the audio track of a video, allowing it to be searched by any word without a transcription or manual keyword step. I didn’t know technology like that existed. You’d think YouTube would have it given that it’s owned by Google
• Perceptive had our sign out and was demoing their imaging application.
• Advisory Board had a big booth, ironically just two booths down from that of HIMSS Analytics where Dave Garets left to go there.
• PatientKeeper had a big rack of mobile devices and an effective slogan, “Reinventing CPOE.” Lots of people were checking it out.
• e-MDs had our sign out – thanks!
• Vitalz had a race car simulator.
• SIS used color extremely well, dressing their female booth people in light blue sweaters and the guys in blue Oxford shirts, both making the red and white SIS logo really stand out. They also had very cool theater chairs in the same red. Best use of color for sure.
• Wolters Kluwer had a golf simulator.
• Sunquest had a large booth with that green color that I really like. Thanks for the Chapstick – I needed some.
• McKesson’s spread was huge. It also had a giant electric billboard. There was nothing muted about the color or the design.
• Siemens had a booth that needed its own ZIP code. The wall of lights must have been 20 feet tall.
• Medicity had a nice crowd and an HIStalk sign right on their main podium.
• RelWare had the Back to the Future DeLorean, accepting donations for Team Fox.
• Cumberland Consulting Group had our sign out. They were way down on the end in the 6900 row.
• SourceCorp was giving away small wooden baseball bats.
• MobileMD had a foot massage machine. They also talked about their 100% “would recommend” HIE solution.
• Orchestrate Healthcare had some cool yellow colors, including fresh flowers and bags. They also had our sign front and center.
• Lockheed Martin had a huge liquid nitrogen tank that was pretty scary to behold. I think (and hope) they were doing something with ice cream.
• Billian’s had our sign out and was giving out flash drives, the only ones I saw.
• RelayHealth’s booth was lit up in pink and each demo station was surrounded by shimmering curtains. I might give them the Best Design award. They had a lot of people checking them out.
• Alert had a long booth that was kind of confusing, but they did have cute white outfits and were demoing in some language that wasn’t English. I thought it was interesting
• Pulse had a nice booth and a card guy.
• Pepid had the first guy I’ve ever seen doing a theater presentation who read directly from index cards and didn’t even try to hide that fact.
• Chipsoft had the cute yellow shoes again.
• HCA had a booth to recruit people in informatics, pharmacy, Meaningful Use, and Meditech.
• HT Systems (the palm reader people) was one of the companies in the New and Emerging Technologies section, with stand-up areas instead of full booths. Check that area out since those are the up-and-comers everyone says they want to support. Also there was My Health Direct. Both companies had their HIStalk signs out.
• ONC had a sizeable booth. They were giving away money (kidding).
• MED3OOO had a couple of really cool giveaways – little preloaded bubblegum machines and a nice computer cleaner with one gadget for the screen and another for the keyboard.
• Success EHR had the nicest people I ran across, two cute girls making fresh popcorn.
• MedAssurant was making fancy coffee like café con leche and café cubano.

That’s all I have time for tonight. Back at it tomorrow. Hopefully folks will send me pictures from HIStalkapalooza since I didn’t bring a camera. I believe Medicomp was planning to have video from tonight running in their booth Tuesday, so drop by.  

E-mail me.

HERtalk by Inga

Just a super quick post before I start my beauty regime for HIStalkapalooza!

,

A couple of pics of the nicely presented food at the reception last night. It’s hard to cook for 20,000, but I guess it was tasty enough.The best part of the evening: hanging out with Mr. H and critiquing the whole affair. I then joined some friends for one glass of wine (the glass never went empty, so I am assuming it was only one glass). Regardless, I made it to bed probably too late, but was up at 6:00 a.m. and in time for my painfully early 7:00 a.m. breakfast. Fortunately I arrived in style in the HIStalk limo, the interior of which is probably bigger than the bathroom in my budget hotel.

I’ll provide more details on my day tomorrow, but wanted to share some additional photos from the day.

He wins. ‘Nuff said.

I am guessing that she was concerned she wouldn’t have time to change clothes before the party tonight, so she wore her gown to the booth. Sorry I don’t remember the vendor, but the girls were good sports.

A little business meeting with the HIStalk sponsor sign prominently displayed. Thanks, iMDSoft.

Merge bought me lunch.

I thought the skirt was a wee short, but this guy thought it was worth looking at more than once.

I sat on the floor for awhile recharging my phone. What’s up with the official “recharging stations” having no power connected to them? I did find that by sitting on the floor I was nicely positioned to check out shoe fashions.

Much, much more later, including HIT X 2.0, commentary on exhibits and vendors, and some gossip. Look for big announcements probably tomorrow from Microsoft, Cisco, and perhaps Gateway EDI.

E-mail Inga.

EPtalk by Dr. Jayne

I was dying to post pictures today, but with my employer locking down my Facebook, it was difficult.  Inga beat me to the knight in shining armor, but be on the lookout for lots of other photos as she and I cruised the exhibit hall together.  Let me tell you, we saw some prime photo opportunities.

My goal today was to visit all of HIStalk’s sponsors.  I didn’t make it everywhere, but I did make it to quite a few.

A couple of shout outs:

• Iatric Systems (3601) is offering a special drawing for HIStalk readers, but also has a guy shooting trick pool shots.  Pretty entertaining!
• Enterprise Software Deployment (2777) not only has a special reader drawing, but also was giving away flip flops and sports sandals and had fondue in the booth.  Perfect for a mid-day pick-me-up!

Keep your eye out for the autographed (by Mr. H and Inga) signs alerting you to vendors who are HIStalk sponsors.  Be sure to tell them you read HIStalk.  Maybe next year I’ll get here early enough to put my physician-esque scrawl on some of them.

I said I’d be visiting Merge Healthcare to check out their kiosk solution, and was happy to find their Wall of Candy as well as a nice demo of their product.  I was a little concerned by the sales rep scanning her own drivers’ license and swiping a credit card, but I guess they can control where it goes.  I wonder, though, does the kiosk come in hot pink or zebra stripe?  They also have video games, including Big Buck Hunter.  Good for a break when you’re tired of walking the floor.

I visited Surgical Information Systems and was pleased to see that this year, not only were they serving the IngaTini but also the InterOpTini which is more my speed.  They also had chocolate covered everything, and I am the kind of girl that appreciates that.  Thanks again for the hospitality!

FormFast has a great Indiana Jones “Peril of the Untamed Workflow” theme and was throwing fedoras into the audience, but I wasn’t lucky enough to get one.

The “Best Badge” award goes to the attendee who replaced his first name with “Talk To Me” in bold letters.  I didn’t fully appreciate the value of that badge until I was given the brush off by a couple of vendors. 

News flash – you might want to find out a bit about the prospects that stop by so that you can make an educated pitch to them.  And if you can’t answer the questions, find someone in your booth who can, or schedule a follow up.  Trying to “fake it” is just really a bad idea and we can tell.

I enjoyed seeing so many members of the armed forces at HIMSS11 today and wanted to take the opportunity to thank all of you for your service to our country and around the world.  We appreciate each and every one of you and the excellent healthcare you provide to our troops and their families.  Seeing you puts everything in perspective and is an excellent reminder for those of us that tend to get focused on what in comparison are some fairly petty issues.  We’re not trying to keep systems up while caring for wounded on the battlefield or anything like that, and you deserve our utmost respect.

The big ticket of the day was of course HIStalkapalooza, and major thanks to Medicomp for their support.  It was a great bash and certainly one to remember. Thanks to my many new friends, especially Evan – your velvet jacket made my night.

E-mail Dr. Jayne.

From HIMSS 2/20/11

The weatherman calls for no snow today. Oh wait, HIMSS isn’t in Chicago this year – happily since it’s 35 degrees there but in the mid-70s in Orlando as I write this Sunday. I got out for a nice walk Sunday morning and it was perfect – green grass, swaying palms, colorful flowers, and egrets strutting around the fake water features and tacky tourist shops.

HIMSS is on the old side of the convention center again this year after being one of the first to use the new side when it opened a few years back. I think the old side is actually better, or at least I saw no drawbacks as I looked it over Sunday morning. it’s a pretty easy walk to the convention center form any of the I-Drive hotels between Sand Lake Road and Westwood Drive, as sidewalks are wide and crossings well laid out. 

Just a reminder: I hired a limo to cruise up and down I-Drive Monday and Tuesday mornings, so if you want a ride to the Convention Center, flag down the car with the HIStalk logo on the side and it will drop you off (sorry, the bar is not stocked – maybe next time when I book the one with the neon, massive sound system, and stripper pole). 

Badge pickup was easier than ever. HIMSS had e-mailed a barcode and you just waved it under the imager and out came your badge. I guess it was embarrassing for such a pro-automation organization like HIMSS to be running a conferenced on paper handouts, packaged symposia CDs, and forms.

I was happy to find that the convention center still has free WiFi, although it will probably be iffy once the whole world piles on it Monday morning. I saw plenty of food stand options and a good amount of seating in those areas (there’s never enough, but Orlando isn’t one of the convention centers that has almost none). The HIMSS people were zipping along at alarming speeds down the hallways on Segway-type standing tricycles for no apparent reason.

It’s worth making time to don casual attire (you can buy hideous tourist shorts and tee shirts if you didn’t bring warm weather clothes) and hit the street for a stroll. The mini-golf places are doing good business and all the restaurants have their patios open, so if it’s not summer where you came from, it is here. They were almost all totally booked Sunday evening, with big groups using large tables and in some cases buying the restaurant out (like we’re doing for BB King’s Monday night).

I checked out Pointe Orlando and it’s infinitely better than it was a few years ago.  BB King’s looks very nice, like all the other restaurants in the complex. It’s an easy walk or very short cab ride from the convention center and the surrounding hotels. There’s a parking garage attached if you’re planning to drive to HIStalkapalooza (easy on those IngaTinis if so, which is why I mentioned walking).

I dropped by CIO Forum area at W330, which always has free food and other goodies that the non-decision making peons don’t get (or as today’s Healthcare IT News headline surprisingly said, “Senior execs get VIP treatment.”) They already know that and the rest of us don’t like to feel less than special, so maybe that article should have been tossed. The CIO agenda didn’t look all that interesting, but the room seemed full and I saw quite a few familiar faces.

Speaking of Healthcare IT News, which was never afraid to tread the feel-good, self-congratulatory side of HIT, it’s just as cheerleaderly now that it’s owned by HIMSS. I think I made the day of the girl handing them out by actually taking a copy, instead of doing like everybody else and body-Englishing away from her thrust-out copy or mumbling, “already got one.” The “news” part of its title could be debated based on what’s in this issue, especially when some of the articles are about some vendor’s exhibit or product and contain nary a discouraging word

There’s a little picture of David Blumenthal on the front page – honestly, has the man never had another picture taken than the cocked-head, slightly-smirky one that runs ever single time he’s mentioned? It actually appears at least three times in the same issue.

Two different people reacted separately to me about a well-known industry figure who I won’t name: “Man, that guy is weird.” I can’t say I’m shocked.

I saw Judy Faulkner walking around wearing a purple cast on her left arm. I felt sorry for her, not because of the cast, but she was like Brad Pitt trying to see a movie or get on a plane – people kept stopping her to introduce themselves or to pester her in some way.  

I saw some small vendor women dragging huge cases bigger than themselves. It must be a pain to set up the booths and then work the show. Somehow I don’t think HIMSS is a place where vendor people have a lot of fun.

This year’s sappy conference tagline: Linking People, Potential and Progress (I abhor the ever-so-trendy omission of the second comma – it makes it harder to read). They should have included the fourth, most-important P in the HIMSS vocabulary: politics. Once again all things Meaningful Use and taxpayer handouts dominate the conference. Do medical conferences obsess on Medicare payments?

The opening reception was no different than those from past years, other than drinks were unlimited (!!) and no tickets were required (thus squelching an entire secondary market for unused tickets). The drinks were cheap wine and horrible beer (Bud and two others that I’d rather not remember). There was the usual soulless cover band playing away in decoration-free room with an acoustics-killing concrete floor (insert my usual airplane hangar reference here) and allegedly ethnic foods that, while probably better than usual for the opening reception, were mostly harmless filler with no real distinguishing characteristics. Mostly it was a staging area for dinner.

HERtalk by Inga

It’s Sunday afternoon and my first half day of HIMSS is behind me. I sat in a few different sessions today, even though I wasn’t technically eligible to listen in on all of them. Fortunately HIMSS has cute college students assigned as doorkeepers. I just smiled at them, walked into room, and acted like I owned HIMSS.

Today’s highlight: Aneesh Chopra. OMG he is hot! He’s got a great face, but is also tall and lean. And as a speaker, he is dynamic and charismatic. I was ready to say “Hallelujah, I love technology!” just to see if he’d notice me. But I refrained myself. I also observed outside of the session and he is clearly the funnest- guy-in-the-room-type guy. Aneesh, if you would like an invite to HIStalkapalooza, drop me an e-mail. Better yet, just drop by the party and just tell them “Inga’s new heartthrob is here.”

I did actually listen to Aneesh, by the way. He and Farzad Mostashari (ONC Deputy) shot on how HITECH is driving innovation for the market. The soft-spoken Mostashari, poor thing, seems plenty smart and all, but Aneesh is a hard speaker to follow. Their presentation was geared to individuals that perhaps didn’t have a deep understanding of the current state of the HIT market and all the implications of HITECH. It was interesting enough, but I didn’t learn much new.

I had a Judy Faulkner sighting. She seems to be sporting a purple cast on her left wrist. Fell out of the tree house, perhaps?

I feel quite nerdy saying this, but I got all tickled each time I saw an HIT celebrity like Martin Harris, John Glaser, Ed Marx, Lynn Vogel, and Marc Probst.

Overheard: lots of ACO discussions. Based on the number of times ACOs were mentioned today (and I was not in an ACO-specific session) I think we’re going to hear a lot about accountable care organizations this week.

I am having serious iPad envy. Quite a number of people seem to have them in sessions and the units seem so small and easy to tote. I must go sign up for every single exhibit booth contest.

Also overheard: plenty of concerns about healthcare going bankrupt. Healthcare reform won’t be repealed because no one has anything better. Meanwhile, we are going to be in for some kind of serious hurt if we can’t figure out a way to control costs and improve quality. The musings aren’t necessarily original but are definitely prolific.

I am thrilled to be meeting up with Mr. H to go to the cocktail reception. Surprisingly I don’t think he and have even spoken on the phone, much less seen each other, since last HIMSS. So it is quite a treat to get to spend some time together critiquing the HIMSS experience. Then I must go to bed early tonight because tomorrow is going to be a long day before one long and exciting evening!

E-mail Inga.

EPtalk by Dr. Jayne

After another delightful trip on my favorite on-time airline, I have arrived at HIMSS11.  I daresay these flights are always a bit more entertaining and less annoying with a vodka/cranberry cocktail.  Although most airlines don’t have in-flight entertainment unless you’re flying cross country, we did have a bit of drama with two passengers being escorted off the plane before we even left the gate.

It seems like every year these events get busier and more over the top.  I can’t tell whether no one has noticed we’re in a recession or whether they’re just trying to stimulate the economy.  Although it’s been great comparing notes with Inga to make sure the fun parties are equitably distributed between the ladies of HIStalk, frankly putting my agenda together for the week has been a bit like preparing for an amphibious assault.

I’m traveling with my work BFF who commented, “I’m not sure we’re going to survive this trip.  I have visions of ‘The Hangover’…”  So if you see a sassy CMIO passed out in the convention hall, please find the nearest AED and follow the instructions when you open the cover.

I’m most interested in the physician-focused sessions, of course, but also those around interoperability and HIE.  I have an aggressive list of booths to visit – if you have a gadget that promises to make my physician world easier, more connected, or more fun, I will be stopping by –  so make sure you show the physician attendees some love, because you never know when you might actually be visited by Dr. Jayne or her crew.

Registration was smooth but I was disappointed by the lack of CMIO ribbons for my lanyard.  The opening reception seemed low key — reasonably good band and well-behaved attendees — but then again the week is early.  No dessert, though – and I am a chocolate girl – so we were forced out to the traffic of International Drive to hunt our prey.

The downside of the day was discovering that my hospital IT department figured out I had the Facebook app on my BlackBerry and blocked it, so there will be no updates from the convention floor unless an intrepid reader has ideas. I’d have a hard time calling and asking them to open it up.

I’m off to get my beauty rest so I can be at my best to walk the HIStalkapalooza red carpet Monday night.  I’m excited at the number of actual physicians on the list and can’t wait to see you all on the other side of the velvet rope!

Have a question about medical informatics, electronic medical records, or whether the paper on the exam table is really changed with each new patient? E-mail Dr. Jayne.

Dr. Gregg Goes to HIMSS
By Gregg Alexander

From back in my days as a rock-n-roll sound engineer, I have always loved the set up/tear down times better than the actual show. Same goes for when we put on the “Pediatric Office of the Future” in the exhibit hall for the American Academy of Pediatrics’ annual conference; the behind-the-scenes stuff is so much more fun. At least, for me it is.

That’s why I finagled my way into the HIMSS exhibit hall floor today as all the vendors were still in their pre-show frenzy. The HIStalk press pass wasn’t powerful enough to open the exhibit hall doors until actual show time begins on Monday, so I had to do a little smooth-talking. (I’ve learned a thing or two about shows and how to … well, maybe I’ll get in less trouble if I just stop there.)

I sent Mr. H a few of the almost obligatory shots of the convention center and the gigundo HIMSS logo and signage now adorning the Orange County Convention Center (West Concourse.) I couldn’t help also including a few shots from the exhibit hall, like the one below:

It’s just a random shot down the main corridor, but if you’ve never seen the exhibit hall pre-show controlled chaos, well, your bucket list just isn’t complete.

You can’t see the madness here because they’re pretty far along in the set up process, but the frenzy of union crews and forklifts, rolling travel cases and hydraulic lifts, show folks and vendor reps all makes for one truly entertaining phenomenon. (Actually, tear-down is even more impressive because stuff just flies apart, into its assigned shipping containers, and then out the loading dock doors faster than you can say “accountable care organization.”)

Anyway, the show is huge as always, celebrating HIMSS 50th year (really?) and, so far, seems much better organized and technologically adept than any I’ve seen before. (The tech abilities of some conventions are weak, to say the least; HIMSS seems to be getting a good grip on the concept.) Yes, I may change my opinion of that once the busloads of people hit and the masses overwhelm the walkways and meeting rooms, but on this pre-show day, it all looks very well put together here in Orlando.

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Got to go to dinner last night with the good folks from Medicomp who are sponsoring this year’s already infamous HIStalkapalooza. I can say with 100% assuredness that if even a tenth of the event goes as they and Mr. H/Inga have planned, it’s going to go down in the annals of HIMSS history as one of the all-time great events ever. The team they’ve assembled is off-the-hook fun. The plans I’ve heard that Mr. H and Inga have set in motion are “memory book” material. I can’t wait. (I even brought my tux for Inga’s red carpet entrée!)

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There is just so much to see and to hear and to take in here. All the pre-HIMSS marketing almost dulled my sense of anticipation. (It’s just tooooo much.) But, here on the eve of show time, the news and the people and the techno-geekiness are starting to re-enliven my senses. I’m looking forward to the hoopla.

But, I have one last question for the pre-HIMSS Marketeers before I head off to the opening reception: just what the h*** is an “embargoed” press release? Really? Do marketing people actually think that labeling some PR shout out as “secret” will make press people think they’re getting in on some super special sneak preview?

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