Hitsphere Feeds

New Assay on AcuStar Hemostasis Testing System Receives CE Mark | Medgadget

Wed, 22 Feb 2012 13:00:16 -0500

Instrumentation Laboratory (IL), Bedford, MA, announced the release of their new HemosIL AcuStar HIT Panel assay that is also now a European CE IVD Marked product.The ACL AcuStar is a fully automated device for chemiluminescent testing in the hemostasis laboratory. Ready to use cartridges with reagents can be kept stable up to six weeks refrigerated at 4°C onboard. One test takes around 30 minutes and one rack accommodates 30 samples, so 60 results can be produced per hour.

The system comes with an easy to use touchscreen and runs on a Windows interface. Several hemostasis assays are already available on the ACL AcuStar like D-Dimer testing and an Anti-phospholipids panel for diagnosis of Antiphospohlipid syndrome (APS).

New Assay on AcuStar Hemostasis Testing System Receives CE Mark | Medgadget

Wed, 22 Feb 2012 13:00:16 -0500

AAPC Introduces Online Exam Review for Medical Auditors | ADVANCE Perspective: HIM

Wed, 22 Feb 2012 12:09:00 -0500

AAPC, the nation's largest training and credentialing association for the business side of medicine, announced the CPMA® (Certified Professional Medical Auditor) Online Exam Review for experienced auditors. The online exam review is approved for six continuing...(read more)

Children’s Hospital Boston’s Innovation Day Showcases Local MedTech | Medgadget

Wed, 22 Feb 2012 11:37:59 -0500

Last week, the researchers and clinicians in residence at Children’s Hospital Boston gathered under the auspices of the Innovation Acceleration Program at CHB for an afternoon of “TED-like” talks and demos. Since we mentioned it here, it was only appropriate that we go to check it out. If you want to watch the whole afternoon of talks, the recording has been posted online. (For a really good discussion of what it takes for a clinician to bring an innovation from idea to practice, watch Dr. Pedro del Nido’s talk at the 2 hr mark).

The point of the sessions was to promote collaboration between the relatively autonomous clinical and research departments at CHB, and pitch the innovation grants available to clinicians and researchers at the institution. Dr. Joseph Madsen MD, one of the recipients of the grants, explained that small innovation grants, which don’t require a lot of preliminary data or extensive applications, are helpful in exploring ideas that otherwise would not have been pursued. Another theme of the talks was that, from an institutional perspective, a great way to support innovation from within is to have a place where innovators can bring napkin-drawing level ideas to establish time of invention and the institutional know how to connect the napkin artist to people who can bring the idea to the world. Two ideas that followed that path were a head wrap for re-warming babies during cardiac surgery thought up by nurse Karen Sakakeeny and an implantable kidney dialysis unit that will be undergoing clinical trials soon originated by Hiep T. Nguyen, MD.

Children’s Hospital Boston’s Innovation Day Showcases Local MedTech | Medgadget

Wed, 22 Feb 2012 11:37:59 -0500

Possibility of Future Mergers of Hospital Pathology Groups? | Lab Soft News

Wed, 22 Feb 2012 08:45:59 -0500

A recent post focused on the possibility of mergers of smaller hospital-based pathology groups into larger multi-speciality practices, precipitated by a comment from Barry Portugal (see: Big Pathology, Multi-Specialty Groups Versus Small; Which Way in the Future?) Here is his comment in which he predicts an increasing tempo of such mergers:

I believe that there will be a significant number of pathology group mergers over the next few years. According to industry information, the majority of pathologists working in hospitals practice in groups of five or less. Smaller pathology groups are unable to negotiate effectively with managed care plans, and are often excluded from performing outreach work from plans offered by large insurance companies. Larger pathology groups with substantive sub-specialization and with more geographical diversity will be able to leverage multiple hospital contracts to be included in those networks and compete with national reference laboratories. Additionally, larger pathology groups can compete more strategically relative to the outsourcing of outpatient histology and pathology services to office-based practices.

Joe Plandowski sent me an email in which he disagrees with Barry's prediction. Here is the full text of his email:

I just had an opportunity to read this posting and do not concur with the assertion that there will be an upsurge in pathology group mergers in the next few years. It would take a monumental turnaround in the thinking of pathologists for mergers to happen. Pathologists have heard that drumcall for at least the past 20 years that I have been involved in the business of pathology. All to no avail, even though as pathologists look around at other medical specialists at their hospitals they see larger and larger specialty groups forming.

One big stumbling block, the agreements hospital-based pathology groups have with their hospitals will prevent them for working at another hospital. Most of those agreements are very restrictive. Merging, in most cases, will mean fewer pathologists in the larger entity. Two merged groups of five pathologists each will probably need a total of nine pathologists. Consider the senior pathologist in a group is usually the individual who manages the practice. A merged group only needs one of these "managers." At that larger merged size, the group ought to hire an experienced practice manager and drop another pathologist from the group.

Today, even the commercial pathology companies, such as AmeriPath and Aurora Diagnostics, have little interest in hospital-based practices because they have no real growth. Specialists, such as urologists and gastroenterologists, have abandoned hospitals wherever possible taking their anatomic pathology specimens along with them to off-site facilities and putting hospital-based pathologists in a further squeeze (see: Corrected Definition for a Pod Lab and a Look at In-Office Labs). Even larger hospital-based pathology groups are going to have a tough time competing against the specialty pathology commercial laboratories with their sales forces, courier networks, sophisticated computer systems for data entry and results reporting, flexible billing systems, and most importantly, restrictive contracts with third-party payers.

There obviously are exceptions, especially where hospital administration decided to move into the outreach testing market and pathologists went along for the ride. There are also the few groups that got the message big-is-good early and merged aggressively to build mass. Examples are PathGroup (TN), ProPath (TX) and Pathology Inc. (CA), among others. However, the majority of pathologists will wind up as employees of the healthcare systems, particulary if ACOs become a reality. Otherwise, they will plod along in groups of 3 to 4 pathologists inwardly focused on "their' hospital.

I tend to agree with Joe on this topic. The majority of most hospital-based pathology groups are highly constrained by their hospital contracts. If such mergers would take place, there would also be a potential loss of positions which tends to act as a brake. I also think that the majority of pathologists are relatively satisfied with the status quo. To quote Joe, they have been resistant in the past to following the pattern other clinical specialty groups such as urology to build mega-groups (see: Many Big Urology Practices Now Utilize an In-Office Histology Lab and Their Own Pathologist). A point worth noting is that some of these clinical groups are now returning to the hospital fold (see: The Increasing Tempo of Physician Practice Purchases by Hospitals).

In a previous note, I raised the possibility of the development of closed lab networks that would connect the various hospitals comprising a health system (see: The Development of Health-System-Owned Lab Network). With such networks, one or two of the larger hospitals could be designated as "lab centers of excellence" and esoteric testing for the whole health system could be performed in such centers. Using such lab networks, the smaller pathologist groups in the individual hospitals could function as "virtual" multispecialty groups while remaining in-situ in their home hospitals.

HIMSS 2012 Official Day One | EMR and HIPAA

Wed, 22 Feb 2012 05:03:56 -0500

As you can probably imagine, things have been extraordinarily crazy with HIMSS happening this week. My first HIMSS event actually was on Saturday and Monday I enjoyed a number of interviews and spent some time at the venture forum. As some of you know, my goal at HIMSS is mostly to spend time around really smart people having really interesting discussions. These discussions form the basis for a multitude of posts to come post-HIMSS. Unfortunately, that means much of the best things I learn and talk about at HIMSS won’t come until the weeks and sometimes months after HIMSS.

If you want to get a bit of an idea of the insane activity that’s happening at HIMSS, you should browse through the various press releases on EMR and Health IT News. David has done an amazing job posting all the various press release announcements that are sent out before and during HIMSS. You’ll need to go through a few pages of press releases, but even browsing through the titles offers an interesting perspective on the industry and what it’s trying to communicate.

Also, this year I decided to do some more videos at HIMSS. I wanted to do something that was simple, but interesting. Plus, I wanted it to be a series of videos that when watched video after video provided something more. Thus, I decided to do what I’m calling 5 Questions with EHR Vendor Executives at HIMSS12. I posted the first video with Dr. Andre Vovan, Founder of Mitochon. I think I’ve already done 4 more that I’ll be posting on EMR and EHR over the next little while. I hope you find the videos as interesting as I do.

I also would be remiss if I didn’t post one of the most incredibly things I learned at HIMSS. It has almost nothing to do with Healthcare IT, except for the fact that Inga at HIStalk LOVES shoes and so shoes are relevant at HIStalkapalooza. I guess some other people take shoes very seriously as well. I learned that Timur Tugberk from DrFirst was wearing an $1250 pair of shoes. When he said this, Brittanie from ESD said you know that’s twelve hundred and fifty dollars, not twelve dollars and fifty cents. Of course, with that background, I of course took a picture for others to see:

Funny thing is. I bet I haven’t spent $1250 in my entire life on shoes. I guess different strokes for different folks.

The essential list of guidances for software medical devices | Software in Medical Devices

Wed, 22 Feb 2012 03:21:00 -0500

Too many documents in too many places, that’s what I felt the first time I looked for guidances and other similar stuff about software medical devices.
Where do I find relevant documents?
Which one do I begin with?
My answer:
I created a page where I gather my own list of guidances. It’s a selection of guidances and recommendations for CE mark.

Click here to see the list.

Hope you enjoy it

Agilent Unveils DNA Methylation Target Enrichment System | Medgadget

Wed, 22 Feb 2012 02:13:17 -0500

The SureSelect XT Human Methyl-Seq System was presented by Agilent Technologies last week at the Advances in Genome Biology and Technology meeting in Florida. The Agilent SureSelect XT Methyl-Seq is the first comprehensive DNA methylation discovery system that uses target enrichment.

It enables researchers to analyze more than 3.7 million individual CpG (Cytosine-phosphate-Guanine) sites for their methylation state. Agilent states that the SureSelect XT Human Methyl-Seq System delivers higher throughput and lower costs than whole genome bisulfate sequencing.

Agilent Unveils DNA Methylation Target Enrichment System | Medgadget

Wed, 22 Feb 2012 02:13:17 -0500

Making a Difference | Galen Healthcare Solutions: Allscripts Consultants Enterprise EHR

Wed, 22 Feb 2012 02:00:55 -0500

I love working go-lives. I prepare for them like I’m heading out to “The Big Game”. I uniform myself with my knowledge, my game face, and the desire to really help people be successful. It’s normal to be anxious when going out on go-live. However, users are always more anxious than we could ever be. [...]

ReCor PARADISE Percutaneous Renal Denervation System Receives CE Mark | Medgadget

Wed, 22 Feb 2012 01:32:15 -0500

ReCor Medical has received CE mark for its PARADISE (Percutaneous Renal Denervation System) ultrasound platform for renal denervation. The PARADISE is designed to treat patients with resistant hypertension. It does this by reducing sympathetic nervous system hyperactivity by denervating sympathetic nerves in the renal artery walls, which may be the primary mechanism by which the kidneys contribute to systemic hypertension.

PARADISE includes a 6 French-compatible catheter with a cylindrical transducer that emits ultrasound energy circumferentially, allowing for a rapid and highly efficient renal denervation procedure. The advantage of PARADISE is its ability to uniformly denervate all the way around the arterial wall while simultaneously cooling the endothelium, to help enable a safe, consistent, and fast renal denervation procedure.

ReCor PARADISE Percutaneous Renal Denervation System Receives CE Mark | Medgadget

Wed, 22 Feb 2012 01:32:15 -0500

Closed Hospitals in the Los Angeles Area Get a Second Life for Television and Movie Filming as Turn Key Sets | The Medical Quack

Wed, 22 Feb 2012 00:52:00 -0500

Some facilities are better than others but when you stop and think of the shows we see on television, hospitals are all over the place as someone is always getting shot, or something along that line. The location though formerly used for Scrubs though was not as nice as some of the other locations used.

Scrubs Television Show Hospital Filming Site Filled with Rats

The one I remember though was the Bucket List which I believe used the closed Century City hospital for it’s set. BD

Bucket List

The scene, for an upcoming episode of the CBS crime drama “Criminal Minds,” actually unfolded last week on the former Sherman Way campus of Northridge Hospital Medical Center, which solely serves as a location backdrop for shows that have included such dramas such as TNT’s “Rizzoli & Isles” and "Hawthorne."
The Northridge facility is among a dozen current and onetime medical centers and hospitals represented by Real to Reel Inc., a 30-year-old Van Nuys location agency that has built a successful niche supplying location managers with something they frequently seek: film-ready hospital settings.
“Hospitals are a staple of crime dramas. Someone’s always getting shot, so we’re always going to the hospitals,” said Jeffrey Spellman, location manager for “Criminal Minds,” which plans to shoot its next episode at another closed hospital, St. Luke Medical Center in Pasadena. “To have a facility like this makes our job much easier.”

Reel to Reel’s clients include St. Luke Medical Center in Pasadena, used in Clint Eastwood’s Oscar-winning boxing drama “Million Dollar Baby” and HBO’s vampire series “True Blood,” and St. Vincent Medical Center, the working hospital in downtown Los Angeles often used by crime dramas such as “CSI,” “The Closer” and “Southland.”

The former Northridge medical center, for example, has gimbal windows that can swing open to make it easier to shoot inside rooms. The nurse’s station table was lowered to improve camera angles.
"These properties are affordable, they’re turn-key and they’re ready to go and directors love them because they offer a variety of looks," Onyshko said.

http://latimesblogs.latimes.com/entertainmentnewsbuzz/2012/02/criminal-minds-other-shows-turn-to-hospitals-for-filming.html

Technorati Tags: Scrubs,television,filming,Los Angeles,movies,hospitals,income,TurnKey

Senate Estimates Hearing - NEHTA - Wednesday 15 February 2012. Transcript and Comments. | Australian Health Information Technology

Wed, 22 Feb 2012 00:30:00 -0500

Here is the relevant part of the transcript with some comments in italics. Community Affairs Legislation Committee - 15/02/2012 - Estimates - HEALTH AND AGEING PORTFOLIO - National E-Health Transition Authority National E-Health Transition Authority CHAIR: I suggest that we move to e-health, outcome 2, and then we will go from there. Senator BOYCE: Is Mr Fleming here? CHAIR: I hope he is, because I have a statement to make for Mr Fleming. I will put a statement on the record first with Mr Fleming. During a recent hearing that we had on the e-health legislation I actually made comments on record which stated that Mr Fleming and NEHTA had not returned questions on notice in time. Mr Fleming, I received your letter, I was incorrect and I want to put it on public record that my statements were incorrect and that your responses were on time. They may not have been to the satisfaction of everybody who was receiving them, but absolutely they were on time and I was wrong. I want to...

This is the initial part of the post - read more by clicking on the title of the article. David.

Foundation Medicine - Personalized Medicine for Biopsy DNA Studies - Will Cost $5000 for the “Pan-Cancer” Test - Any Oncologist Will Be Able To Use The Center For Testing | The Medical Quack

Tue, 21 Feb 2012 23:50:51 -0500

This is very interesting article and goes in depth to discuss how running the DNA on a biopsy can help doctors with prescribing cancer drugs and many of which are still in early testing stages. It could also lead to more patients in that respect being referred to a clinical trial.

The big problem here cited with this article is the same old same old with insurance reimbursement and the fact that some of the genes have patents like the HER2 gene which has really been scrutinized by insurance carriers with Myriad. This however is going to be the way treating cancer will be in a few years as it makes sense rather than guessing. Of course with reimbursements we have the generic versus the name brand costs to look at too. Right now the clients are mostly drug companies and of course they want to know where their products would line up as far as treatments as well and really that part of the entire scenario too. The company also is getting some investments and mentoring from Google.

Foundation Medicine too has been rushing to file their patents as well and again we have this same question as to whether or not a gene should be patented.

“The company also scours the medical literature to provide doctors with the latest information on how genetic changes influence the efficacy of specific drugs.”

“Molecular testing by Foundation Medicine provides precise genomic information about your cancer in a way never before available.”

The commercial end is due to be launched soon and the website has a page of “patient stories” available to read. BD

Michael Pellini fires up his computer and opens a report on a patient with a tumor of the salivary gland. The patient had surgery, but the cancer recurred. That's when a biopsy was sent to Foundation Medicine, the company that Pellini runs, for a detailed DNA study. Foundation deciphered some 200 genes with a known link to cancer and found what he calls "actionable" mutations in three of them. That is, each genetic defect is the target of anticancer drugs undergoing testing—though not for salivary tumors. Should the patient take one of them? "Without the DNA, no one would have thought to try these drugs," says Pellini.

Starting this spring, for about $5,000, any oncologist will be able to ship a sliver of tumor in a bar-coded package to Foundation's lab. Foundation will extract the DNA, sequence scores of cancer genes, and prepare a report to steer doctors and patients toward drugs, most still in early testing, that are known to target the cellular defects caused by the DNA errors the analysis turns up. Pellini says that about 70 percent of cases studied to date have yielded information that a doctor could act on—whether by prescribing a particular drug, stopping treatment with another, or enrolling the patient in a clinical trial.

So far, most of Foundation's business is coming from five drug companies seeking genetic explanations for why their cancer drugs work spectacularly in some patients but not at all in others. The industry has recognized that drugs targeted to subsets of patients cost less to develop, can get FDA approval faster, and can be sold for higher prices than traditional medications. "Our portfolio is full of targets where we're developing tests based on the biology of disease," says Nicholas Dracopoli, vice president for oncology biomarkers at Janssen R&D, which is among the companies that send samples to Foundation. "If a pathway isn't activated, you get no clinical benefit by inhibiting it. We have to know which pathway is driving the dissemination of the disease."

So why pay $5,000 to know the status of only about 200 genes? Foundation has several answers. First, each gene is decoded not once but hundreds of times, to yield more accurate results. The company also scours the medical literature to provide doctors with the latest information on how genetic changes influence the efficacy of specific drugs. As Krenitsky puts it, data analysis, not data generation, is now the rate-limiting factor in cancer genomics.

Although most of Foundation's customers to date are drug companies, Borisy says the company intends to build its business around serving oncologists and patients. In the United States, 1.5 million cancer cases are diagnosed annually. Borisy estimates that Foundation will process 20,000 samples this year. At $5,000 per sample, it's easy to see how such a business could reward investors. "That's ... a $100-million-a-year business," says Borisy. "But that volume is still low if this truly fulfills its potential."

Insurance companies may also be unwilling to pay $5,000 for the pan-cancer test itself, at least initially. Some already balk at paying for well-established tests, says Christopher-Paul Milne, associate director of the Tufts Center for the Study of Drug Development, who calls reimbursement "one of the biggest impediments to personalized medicine."

http://www.technologyreview.com/biomedicine/39707/?mod=chfeatured

Technorati Tags: Tumors,cancer,DNA,healthcare,Foundation Medicine,genomics,biopsy,oncology,test,targets,genes,personalized medicine

Oracle updates healthcare analytics platform | Pulse+IT Magazine

Tue, 21 Feb 2012 23:00:00 -0500

Oracle has released an updated version of Oracle Enterprise Healthcare Analytics (http://www.oracle.com/us/industries/healthcare/058441.html), a business intelligence and performance management solution aimed at helping healthcare organisations make informed decisions that improve financial performance, care quality and outcomes. The new version has added modules to support the mobile workforce through functionality for the

Panel to discuss eHealth and broadband at ITAC | Pulse+IT Magazine

Tue, 21 Feb 2012 22:00:00 -0500

A panel of experts will discuss how the National Broadband Network and initiatives such as the PCEHR can assist in delivering better aged care at the 5th annual Information Technology in Aged Care (ITAC) (http://www.itac2012.com.au) conference, being held in Melbourne on April 19 and 20. Smart technology for modern aged

MD and PracSoft training sessions for Melbourne | Pulse+IT Magazine

Tue, 21 Feb 2012 21:00:00 -0500

Health Communication Network (HCN) (http://www.hcn.com.au) is hold training sessions for Medical Director 3 (http://www.hcn.com.au/Products/Medical+Director) and PracSoft (http://www.hcn.com.au/Products/Pracsoft) in Melbourne next month. The training sessions – on Wednesday, 21 March for MD3 and Thursday, 22 March for PracSoft – are aimed at nurses, receptionists, allied health professionals and doctors. The

From HIMSS 2/21/12 | HISTalk

Tue, 21 Feb 2012 20:19:46 -0500

From Mr. H

You know you had good day when you thought it was about 10 at night, and you check your watch and find that it’s well after 1:00. I’ve never stayed until the end of HIStalkapalooza in years past and yet this time, I found new old friends that I just didn’t want to leave. I’ll probably forget all kinds of stuff since it’s late, but I’ll try to put some thoughts down.

Inga, Dr. Jayne, and I had our HIStalk sponsor lunch today, with a brief in-costume appearance. Our sponsors are magnificent, taking time from their very busy first day of HIMSS to spend time with us. Thanks to Dr. Travis of HIStalk Mobile for managing the event; Duke Hospital CIO Art Glasgow for speaking to our guests; Tom Visotsky for helping out; and Micky Tripathi for dropping by as one of our favorite people. We appreciate the support of our sponsors and hope the event conveyed that fact to the folks who make all this possible.

HIStalkapalooza was just perfect. ESD did everything right and had a great group of ambassadors on site to welcome our guests. Ross Martin MD did an amazing opening number dressed as Elvis with lyrics customized for HIStalk – Ross comes through for us every time and he was excellent in every way, from his rhinestone-studded Elvis costume to his great singing and dance moves. We had an Elvis impersonator, something I wasn’t sure I’d like, but he was definitely working the crowd and doing some great Elvis work up there. It was fun having e-Patient Dave there as the subject of one of Ross’s songs, and the duet featuring Ross and Elvis was really good.

The contests were great fun. I’ll let Inga fill in the details later, but the show was skillfully handled by the polished Greg Wilson of Salar and the beautiful Jennifer Lyle of Software Testing Solutions. Our new BFF Timur Tugberk helped out with the activities along with our judges (photos and details to follow). And of course, Jonathan Bush was endlessly entertaining with the HISsies awards – he’s been doing it for us for years and this was his best performance in my mind. I don’t think any description could do it justice.

The IngaTinis were seriously too good – those First bartenders concocted a mixture that was a little sweeter than I like, but prone to disappearing in seconds leaving an empty glass and an inner voice saying, “Don’t have another … these things are liquid crack.” I had two other folks try them and they just moaned their approval.

I didn’t have much to eat, but the prime rib was outstanding, the beer was cold, and the service from the First crew was really good even when it got slightly rowdy.

Thanks to everyone who came, with special recognition to the ladies who were wearing some amazing outfits and shoes and definitely working it. And thanks to ESD, especially Brittanie Begeman, who put unbelievable effort over many months into making this evening special for those present.

Here’s Inga’s footwear in a pic taken by me in the limo going to the sponsor lunch. She repeatedly emphasized that she had painted her toenails to match her jaunty scarf, while Dr. Jayne and I tried to seem moved by that knowledge.

The Palazzo shops area, near First.

One of the lovely ladies of ESD welcoming our guests.

Prime rib, nut brown ale, and a view overlooking the Strip and the Treasure Island fireworks and pirate show. Nice.

Dueling Elvi, with Ross Martin on the left. They were both good.

Jennifer and Timur with some of our contestants.

Judges on the left, Greg Wilson on the right, contestants in the middle.

The incomparable JB doing the HISsies.

The ESD folks taking a much-deserved bow.

Epic won a lot of the “good” HISsies awards. Thanks to Judy Faulkner for dropping by.

I’m sure we’ll have more, but it’s now 2:00 in the morning and I’m tired, so here’s a quick rundown of the exhibit hall.

I was exhausted trying to swing by all the booths, only to find that there’s a downstairs. Seriously. So-called Hall G (the only place your free food coupon was good for) is downstairs off the main level, filled with mostly small or oddball booths and other non-exhibit items. I’m thinking that anyone who bought a big space down there got a bad deal.
Iatric Systems had the coolest crowd draw – a trick pool guy with a full-sized table.
Omnicell had cappucino.
Versus had the perfect sized, done in a really nice green.
The HipLink folks were wearing cool racing shirts.
Several booths had every rep screwing around with their smart phones and never looking up even when someone stopped right in front of them (Vital was one I noticed only three minutes after the doors opened.) I’d confiscate their gadgetry if it were me.
DrFirst was doing their superhero photos and caricatures.
Covisint had bean bag chairs in their theater.
Enovate had the same effect on me as in every other year – their cool ergonomic computer carts and arms compelled me to caress their wares.
I’ll award two companies my “best booth performance of the day.” Optum had a huge space and had one rep whose name I should have got come out to masterfully strike up a conversation. One of the best demos ever was by Bonny of Aventura, who showed me their quick clinician logon/logoff. I highly recommend taking a look – it’s really cool, fast, and easy.
Medicity’s booth was packed. Nice.
AT&T had a charging station for personal devices and was demonstrating their Managed Telehealth system that can be leased with a monthly fee.
Cisco’s theater was packed.
T-System was set up like an ED, with employees in scrubs.
Passport Health had their booth crawl sign out.
Quest /Care360 had their booth crawl sign out and a guy doing lasso tricks.
Emdeon had cool purple shirts and a nice green color scheme.
Allscripts had the biggest booth and sign that I’ve ever seen.
Siemens had a mammoth booth as well.
Epic had the usual fireplace, wacky sculptures, and throngs of people.
GE Healthcare had a stations set up for Caradigm.
NextGen had a nice open booth with real grass growing.
Lawson had a cool coffee bar.
Microsoft’s booth was packed.
MEDecision had cool blue martinis and an sculpture. I saw Dr. Jayne later and she had visited it, of course.
Merge had a honeycomb design that was fun.
Vitalz had a full-sized race car.
Medicomp was running their Quipstar game, which was amazing considering they programmed the game system themselves and had really cool player stations. We were early fans of Quippe last year and if you haven’t seen it, check it out on an iPad.
I overheard good things about Intelligent Medical Objects from a customer who said they are rock solid in getting their ICD-9 releases out early and in being prepared for ICD-10 well ahead of time, which of course penalizes them with the delay.
Alert, the Portugal-based vendor that seems to exhibit every year with few customers to show for it, had a graphic saying they had 2,926 sites live in Portugal, over 8,000 in Brazil, and 24 in the US.
MyMedicalRecords was pouring champagne.
Airwatch had a candy and apple display that was quite attractive. It’s nice to see healthy food in the hall.
NTT DATA had a cool booth and a coffee bar.
Tibro had a bicycle challenge, where you can ride a stationary bike.
The State of Georgia had a booth and was giving away Georgia peanuts, sharing space with Georgia Tech and Greenway.
Check out Modernsolid of Taiwan – cool carts.
Salar had a very cool booth and lots of candies.
Firehost was giving away decks of cards.
JEMS Technology was demonstrating their mobile video solution in the Enovate booth.
SCC Soft Computing had a jet ski.
Agfa Healthcare had the coolest coffee machine ever.
Identity Finder told me about their product that uses patterns to locate PHI on publicly accessible servers.
The guys from Perceptive Software showed me their iPhone that Steve Wozniak autographed in his recent visit there.
The Advisory Board booth had some folks I know on hand.
Billian’s had our sign out and was offering extra badge holders.
PilotFish had a nice crowd for their interface engine despite a terrible location. They were giving away colorful fish stuffed animals.
OnBase had the sports bar, but I was crushed to see that their outstanding magician has been replaced.
Beacon Partners had our sign out and is conducting an ICD-10 survey.
Dr. Nick was doing a demo in the Nuance booth.
Epic touted its Lucy thumb drive PHR.
McKesson had the usual dark blue/orange booth and, surprisingly, had about the same number of attendees talking to the Horizon people as with those from Paragon.
SIS had our sign out.
Access had our signs out. They promise they’re going to figure out a way to bring their Texas barbeque to New Orleans next year since I’ve been bugging them to do that for three years now (they have a competition barbeque team.)
Cerner and Meditech were in Siberia after losing HIMSS points for dropping out for a few years
Most brilliant marketing idea: Laserfiche offered chair massages, but had monitors mounted beneath the face cushion so you could watch a video while getting massaged. The massage was amazing. This is my #1 tip to check out, which Dr. Jayne didn’t need since when I told her about it, she said she’d already had one.

From Inga

I’m meeting my BFF Dr. Jayne for a pre-HIStalkapalooza cocktail, so I don’t have much time to do more than highlight the last day in pictures.

Dr. Jayne and Mr. H let me take their picture with HIIMSS President Steve Lieber (he’s the one in the middle.)

Elvis was alive and kicking last night at the opening session.

The only missing from this dancing Elvis was a pole.

This gentleman was calling home to tell his kids about the amazing giant dice decorations.

Opening keynote this morning was Twitter founder Biz Stone. But, not until 35 minutes of music, dancing and a rather dry welcome from a HIMSS board member (I missed her name.) Stone was smart and funny. I only Tweeted a couple times during his talk.

I was one of the ones crushing my way to the front of the line to get in the exhibit hall the moment the doors opened.

Merge brought another car.

I think she was a professional booth babe but wow – really tall and in really high heeled shoes.

I will be playing Quipstar at Medicomp’s booth tomorrow at 4:00 pm. Come see me.

Bloggers meet-up. Dr. Travis is participating in one of these sessions at some point but Mr. H, Dr. Jayne, and I weren’t asked to participate.

Orchestrate was just one of the HIStalk sponsors promoting the HIStalk Booth Crawl with a sign. Thank you!

Hall G is downstairs and easy to miss but that is where you will find the Interoperability Showcase and a number of other special booths. The ceilings are definitely lower than in the upstairs hall and it feels a bit dungeon-like. However, there were still plenty of people.

The longest line: Cafe Presse, where the caffeine-addicted stood in line for 15 minutes to get their fix.

HIStalkapalooza time!

From Dr. Jayne

HIMSS opening day – we wait for it each year, and it dawns pretty much the same as any other day, except this year it’s a day later. I was pleased to see the turnout at the opening reception Monday night – it seemed like a lot more people than last year and most of them were having a good time. Mr. H and Inga and I had a nice visit – after all, we only see each other once a year, so there’s a lot of catching up to do. I did feel a bit conspicuous standing there with the three of us just hanging out, but that’s the magic of being anonymous.

HIMSS always seems like a whirlwind, and it’s no different this year. What’s been different this year (so far) is meeting actual family physicians out in the wild – yes, they do exist at HIMSS. And I’m happy to report they were pretty fun, even introducing me to some kicky Belgian ale. You do have to love a beverage that has pink elephants on the label (and that was also served in accompanying pink elephant glasses.) Don’t get me wrong, they also ordered milk and Cookies, revealing their Midwestern roots.

What do informaticians do when they get together? Make fun of ICD-10. In honor of my collision with Judy Faulkner on Monday, one whipped out his homegrown iPhone app and coded my visit: W51: Striking against or bumped into by another person – unintentional. It was actually a pretty cool app, with twirling dials (think slot machine) that allows you to shake your phone and select codes a la Urbanspoon’s mobile app. Based on the wackiness of ICD-10, I may be better off using the app than actually trying to select codes rationally.

Your HIStalk crew got together again (this time, craftily disguised in our white coats) today for the HIStalk vendor. appreciation lunch. Since almost anything goes in Las Vegas, we didn’t get many odd looks as we swept into Fashion Show Mall. It’s great to see everyone together and we do really appreciate the support that makes it possible for us to do our HIStalk thing.

Tonight was HIStalkapalooza of course and a good time was had by all with Jonathan Bush delivering a stellar performance and many hot shoes to be seen. One winner was asked in the hotel elevator if she was Miss America, what with the beauty queen sash and all. A little disappointed that I did not see my secret crush Farzad, although several other Dr. Jayne crushes were in the house, including Evan in his polka-dot jacket.

More to come tomorrow after I get my beauty rest. These Louboutins are killing me.

Minute Clinics Moving to Allscripts Medical Records System So I Guess E-Clinical Works Who Started With CVS Clinics Is Out the Door? How Do Medium/Small Companies Compete with Huge Corporate Conglomerates | The Medical Quack

Tue, 21 Feb 2012 19:26:33 -0500

Back in January of 2010 this article was out with the two companies collaborating on e-prescribing so what did Allscripts do, edge out eClincalWorks with a corporate package deal? I don’t know that’s what occurred but it’s pretty accurate about 85% of the time today with mergers and acquisitions in healthcare. eClinical Works is an excellent EHR that is both web and client based and is used all over the US is connects with most hospital medical record systems and they have a big base of business but they are not a “corporate conglomerate” looking to feed hungry shareholders either.

CVS and AllScripts Collaborating on E-Prescribing – Minute Clinics Get Joint Commission Accreditation Award

We also have Humana in here hawking some software services too for consumers so they can get some data. I do wonder what CVS makes on selling data as the Walgreens SEC statement for 2010 said they made just under $800 million on selling data, that’s a lot of money.

Humana and CVS Minute Clinics Partner To Add More Services for Members such as Life Synch and InnoPsych

You can see that eClinical Works is even sold in Sam’s Club for a simple pre-configured system.

HealthVault Connects with eClinicalWorks EHR, NextGen EHR/EMR Systems and more…Shop Wal-Mart (Sam’s Club) in the Spring

It just kind of looks like 2 big conglomerates that have shareholders here jumping in together and again the medium and smaller companies have no shot here. Allscripts of course has been a merger and acquisition game too over the years and almost at it during 2008 with the crash. This merger action took place in June of 2010. BD

Misys Sells Allscripts Shares to Enable Eclipsys Merger – Medical Records

CHICAGO and WOONSOCKET, R.I., Feb. 21, 2012 /PRNewswire/ -- CVS Caremark's MinuteClinic, the leading retail health clinic in the United States, will transition from its existing, proprietary Electronic Medical Record system to the AllscriptsMyWay Electronic Health Record. This transition will assist MinuteClinic in its mission of delivering high quality accessible medical care in hundreds of retail clinics across the United States.

"MinuteClinic is partnering with Allscripts to assure that we are utilizing the most advanced electronic health record platform in the market," said Andrew Sussman, M.D., president, MinuteClinic and senior vice president/associate chief medical officer, CVS Caremark. "This will help support our nurse practitioners and physician assistants in continuing to meet and exceed the high standards we have set for quality and adherence to practice guidelines."

http://www.embedded.com/electronics-products/electronic-product-releases/medical-design/4236629/CVS-Caremark-s-MinuteClinic-to-Deploy-Allscripts-EHR-Nationally

Technorati Tags: CVS retail clinics,Allscripts,iScribe,e-Prescribing,heatlhcare,Heatlh IT,technology,PHR,personal health records,software,EHR

Argus achieves CCA for secure messaging | Pulse+IT Magazine

Tue, 21 Feb 2012 18:43:31 -0500

Database Consultants Australia's (DCA) (http://www.data.com.au) Argus (http://www.argusconnect.com.au/) version 6.0 secure messaging product has passed the Conformance, Compliance and Accreditation (CCA) (http://www.nehta.gov.au/connecting-australia/cca) assessment process for the National E-Health Transition Authority's (NEHTA) secure messaging delivery (SMD) implementation. It was evaluated by two independent assessors in January and received its formal

IT Security for Less than 1 Cent | eHealthNews.EU Portal / All News

Tue, 21 Feb 2012 17:00:01 -0500

An increasing number of everyday devices such as car keys, smart phones and even medical implants need protection from hackers. The encryption method PRESENT is the smallest cipher for such cost and energy constrained applications.

IT Security for Less than 1 Cent | eHealthNews.EU Portal / All News

Tue, 21 Feb 2012 17:00:01 -0500

Siemens Healthcare Asserts its Leading Worldwide Position in Medical Technology | eHealthNews.EU Portal / All News

Tue, 21 Feb 2012 17:00:00 -0500

The Siemens Healthcare Sector has maintained its leading position in the field of medical technology despite a tough business environment. "In past years, we've expanded our product portfolio and even more consistently aligned it to customer needs," said Hermann Requardt, CEO of the Healthcare Sector, at the Siemens Healthcare Capital Market Day in London.

Siemens Healthcare Asserts its Leading Worldwide Position in Medical Technology | eHealthNews.EU Portal / All News

Tue, 21 Feb 2012 17:00:00 -0500

“The Future of Platforms in Healthcare” — PowerPoint from eCollaboration Forum at HIMSS12 | e-CareManagement Blog

Tue, 21 Feb 2012 16:47:07 -0500

My colleague Shahid Shah and I are glad to make available to you a copy of the slides from our upcoming presentation “The Future of Platforms in Healthcare.” This presentation takes place at the eCollaboration Forum as part of HIMSS12 on Thursday, February 23.

You can access the slides here.

While the eCollaboration Forum in Las Vegas is sold out, you can still sign up for the live webinar all day Thursday, February 23: http://eCollab12.eventbrite.com

Here’s a brief summary of our presentation “The Future of Platforms in Healthcare”.

I. NECESSARY: Platforms are a “Must Have”, Not Just A “Nice to Have”

Today’s EMR (electronic medical record) products cannot enable accountable care. Here’s what you would have to believe to think that closed, proprietary products can get us to accountable care:

That one company can develop all needed functionality, and
That health IT will become a winner-take-all market (either through single-payer or all care providers in a market voluntarily choosing to buy the identical “product”), or
That optimal collaboration across products can be achieved by phone, paper, fax

Our conclusion is: interoperable is platforms are a “Must Have”.

II. COMPLEX: Many Key Characteristics of Platforms (more…)

No tag for this post.

Lego Prosthethic Arm Takes Custom Prostheses to a Whole New (Fun) Level | Medgadget

Tue, 21 Feb 2012 16:44:59 -0500

Lego is an attractive tool for biomedical engineers and scientists looking to create low cost custom mounts for their imaging equipment or looking to prototype novel prosthetic devices. We have covered a number of useful Lego medgadgets over the years, however few have been as complex as a new Lego prosthetic arm developed by engineering student Max Shepherd.

Max developed and built the 12 degree of freedom prosthetic arm from Lego components as a means to accurately mimic the full range of motion of a normal human arm and hand. The hand movements are powered using Lego pneumatics while the wrist pronation/supination, wrist flexion/extension, and elbow flexion/extension are powered by Lego motors.

Lego Prosthethic Arm Takes Custom Prostheses to a Whole New (Fun) Level | Medgadget

Tue, 21 Feb 2012 16:44:59 -0500

5 Questions with EHR Vendor Executives at #HIMSS12 – Founder of Mitochon Dr. Andre Vovan | EMR and EHR

Tue, 21 Feb 2012 16:43:58 -0500

As mentioned previously, I’m planning to do 5 questions with as many EHR vendor executives as possible at HIMSS12. I plan on posting at least one of these videos each day of HIMSS on EMR and EHR. Plus, each day I’ll plan on doing a HIMSS12 overview post each day on EMR and HIPAA.

First up in our 5 questions with EHR vendor executives is the Dr. Andre Vovan, founder of Free EHR software vendor Mitochon.

See more of Mitochon’s HIMSS12 Announcements on EMR News.

Full Disclosure: Mitochon is an advertiser on EMR and EHR.

Keeping Up With the Progress of Progressive Lenses | Medgadget

Tue, 21 Feb 2012 16:14:05 -0500

Progressive lenses made their commercial debut in the middle of the last century. Also known as progressive addition lenses (PAL), the lenses enable eyeglass wearers to transition from distance to near vision without the image jumping when the eyes shift from one distance zone to another. They also have a cosmetic benefit: there is no line as there is with bifocals.

In the past, producing these lenses was no easy feat. The traditional process required a semi-finished lens with a standard front. The prescription would be ground onto the back surface with a generator. Calculating the geometry to impart on the lens involves complicated mathematics. “You can imagine doing this without Excel spreadsheets to do all of your calculations,” says Dennis Fong, OD, clinical instructor at the UC Berkeley School of Optometery. “Everything was originally done by hand and then you see pictures of these old generators that made forms and then you use the forms to create the complex curvature.”

Keeping Up With the Progress of Progressive Lenses | Medgadget

Tue, 21 Feb 2012 16:14:05 -0500

USB-Powered DNA Nanopore Sequencing for $900 | Medgadget

Tue, 21 Feb 2012 15:56:45 -0500

Nanopore sequencing has been promised as a technique that will revolutionize genomics for quite a few years, and it looks like we will finally see some real-world results soon. Oxford Nanopore Technologies from Oxford in the U.K. has just announced two systems for DNA sequencing, a high throughput system called GridION and a smaller USB-powered miniature sequencer called the MinION. Both devices take advantage of proprietary nanopore sensing techniques as explained in the video below.

The GridION system consists of scalable nodes which use consumable cartridges to perform multi-nanopore sensing. Each node is capable of delivering tens of gigabytes of sequence data per day. The MinION system is a miniaturized version of the GridION node and cartridge. It is a disposable, portable DNA sequencing device the size of a large USB memory stick which is expected to retail for less than $900.

USB-Powered DNA Nanopore Sequencing for $900 | Medgadget

Tue, 21 Feb 2012 15:56:45 -0500

FutureMed: Taking Electronics Out of the Proverbial Box | Medgadget

Tue, 21 Feb 2012 14:26:00 -0500

“We are trying to reshape electronics to advance the quality of life,” said David Icke, CEO of MC10 at a special FutureMed-organized event on the evening of February 10. Icke explained that his company was working to free “electronics from the tyranny of rigid wafers,” enabling them to interface with soft tissue.

While the exponential pace of development has enabled phenomenal gains in computing power, modern electronics are typically rigid and packaged into boxy devices. It is certainly true that the mobile paradigm has changed how (and how often) we interact with electronic devices, but Icke predicts that further changes are on the horizon and that the next big trend will be conformable electronics.

FutureMed: Taking Electronics Out of the Proverbial Box | Medgadget

Tue, 21 Feb 2012 14:26:00 -0500

AMA Selling Online Physician Portal to AT&T–The Amagine Project, There’s Money in Selling And Aggregating Those Algorithms | The Medical Quack

Tue, 21 Feb 2012 14:15:56 -0500

I guess if you are attending HIMSS this year you can find out more about it at their booth. Writing code or in this case having an outsourced company do you development turns into money, right? The AMA appears to have been just as busy in developing their software house as many vendors have. Back in July they made the Allscripts e-Prescribing tool available and enhancements and other offerings have proceeded from here.

Allscripts ePrescribing Tool Will be Offered by AMA

Not too long after the above announcement it was followed with working with HealthVault personal health records for access.

American Medical Association and HealthVault to Provide Physician’s Portal – Physicians Will be able to access “Patient Shared” Information

Further along in 2010 the AMA announced their own consulting group to help doctors with choosing medical record systems, so they have been busy in the software department with branding their installations and support as well and here’s a little more history on the Amagine project so this kind of gives you an idea as to some of the partnerships that were developed along the way with the Amagine project with large Health IT vendors, one owned by an insurance company,Care Tracker, owned by United.

“In addition to agreements with Ingenix for its CareTracker product and with NextGen, the Amagine project has inked deals with DrFirst for e-prescribing; Quest Diagnostics' Care360, a suite that includes lab ordering, e-prescribing and other tools; WellCentive's patient registry; and Dell, which will offer e-mail and data-storage services, as well as discounts for Amagine customers who want to upgrade their hardware.”

AMA and Other Medical Groups Joining Forces with EHR and Health IT Businesses–More Software House/Consulting Choices

Here’s a quick screenshot from the AMAGINE page with some examples of a couple partners in Revenue Cycling and I see NaviNet who was just in the news as being bought by a group of Blue Cross Groups so they all are seeming to mesh together in some fashion or another and no wonder mergers and acquisitions in Healthcare today are so confusing at times. BD

The American Medical Association will combine the platform of its online physician portal, Amagine, with that of AT&T Healthcare Community Online in a deal that would have AT&T owning and operating the combined product. No financial terms were disclosed.

AT&T will lead further development of the platform, though the AMA “will remain actively engaged” in collaborating on business strategies and expanding availability of health IT for physicians, according to a joint AMA-AT&T news release.
Both Amagine and Healthcare Community Online operate on platforms powered by Covisint, a Detroit-based subsidiary of Compuware Corp.

http://www.modernhealthcare.com/article/20120221/NEWS/302219983/

Technorati Tags: AMA,AT&T,software,algorithms,coding,HealthIT,doctors,patients,Compuware,business intelligence,AMAGINE

Watson as an innovative approach to business intelligence #HIMSS12 | Medicine and Technology [part of HCPLive]

Tue, 21 Feb 2012 14:10:00 -0500

The session on Watson was completely full as health IT professionals crowded to learn about the IBM Watson technology in the evolution of health care data analytics.

In the session Watson: The Innovative Approach to Business Intelligence, attendees will hear how "Watson" processes natural language and complex meanings to support clinical decision support.

Watson is a computing platform that understands natural language, not just words. Watson can process a tremendous amount of data to outline a differential diagnosis and also calculate the probability around each dx. Plus, it determines clinical decisions based on individual patient factors.

Earlier this month we saw the following appear in Forbes: IBM's Watson, Cedars-Sinai and WellPoint Take On Cancer

Watson was originally designed to play a game show in TV, but now its use is being actively applied in health care. Because it is a platform that learns and understands, Watson will improve over time.

Watson looks at data, evaluates the evidence source, determines a list of answers, then continues to evaluate the evidence. It quantifies degrees of confidence in potential answers. In health care, Watson will generate a list of suggestions to help physicians make better evidence-based clinical decisions.

Evidence must be evaluated for different forms:
Temporal reasoning
Geospatial reasoning
Statistical paraphrasing

In the clinical decision making process, we go through the process of data gathering to decision. We work within the realms of knowledge, context, and experience. Watson does not have bias, so there is no risk of cognitive error based on presumptive thoughts.

Watson also prioritizes information and makes suggestions that are all linked with references and sources of information. Health care is inherently uncertain. It identifies missing information. It provides evidence-based information to assist the clinician making decisions. Watson does not make clinical decisions, but if offers suggestions that can significantly improve patient care.

I think the future of medicine will dramatically evolve as physicians gain access to clinical decision support tools that are powered by super computer artificial intelligence platforms like Watson.

Session:
Watson: The Innovative Approach to Business Intelligence

Speaker
Dr. Martin Kohn (also an MIT alum!)

HIMSS12 coverage is sponsored by HP. HP’s extensive portfolio of products, solutions, services and relationships can help your healthcare organization achieve quality business practices and provide quality patient care.

Spider Silk-Inspired Biomedical Thread | Medgadget

Tue, 21 Feb 2012 13:47:52 -0500

Spider webs are commonly known as a frustration when cleaning the house, or as a source of anger when walking into one while hiking or camping. However, thanks to researchers at University of Akron they may now be associated with a more positive, biomedical application: sutures with embeddable drugs for wound healing.

Writing in a recent issue of Langmuir, the researchers describe employing…

Spider Silk-Inspired Biomedical Thread | Medgadget

Tue, 21 Feb 2012 13:47:52 -0500

Writing in a recent issue of Langmuir, the researchers describe employing…

Bill Seay of Lifepoint Interviewed by HIStalk; IT Support for Lab Outreach | Lab Soft News

Tue, 21 Feb 2012 12:57:56 -0500

Mr. HIStalk recently posted an excellent, comprehensive interview of Bill Seay, CEO and founder of Lifepoint Informatics (see: HIStalk Interviews William Seay, CEO, Lifepoint Informatics). Read the whole thing if you have the time. I can only post scattered excerpts from it -- they are listed below:

Obviously we have other [lab outreach] connectivity vendors that we compete with that have very similar business models to ours, but the fact of that matter is Quest really drives the demand nationally for products like ours, because what our customers are looking for is a way to compete and level the playing field, particularly with Quest these days....
[Hospital outreach programs] move a little slower [than Quest] because of their non-profit status and mission. They have a longer sales cycle. I think they don’t have the profit-driven mindset and the aggressive commercial nature that the commercial labs have.....
I see EMR companies and other people in the health IT field underestimating the complexity of lab order entry, asking order entry questions, the ABN printing, and the medical necessity checking. At Lifepoint, we have solutions that can plug in and connectors that can easily adapt to multiple EMRs, either from a single sign-on or through web services.
Hospitals want to get into the reference lab business, but it’s driven...by scale. The more business you have, the more you can automate, so that the national labs supposedly have their tests down to a cost of pennies or less per test. Can hospitals compete with that volume and the polished corporate performance?
One of the reasons that the outreach lab market has been so successful [in hospitals is that] they have untapped capacity. Normally they’re testing during the day. With the average business, they’re turning around specimens in the evening. In that respect, they’re filling up their capacity and utilizing their instruments at a higher rate....
I think the [lab outreach] portal will continue to be necessary going forward because it gives the labs a way to control their brand and their functionality, which they lose out on if the results are streamed into an EMR....
I think there are some people in health IT that have a misunderstanding of how dominant Quest and LabCorp are. In fact, together they represent less than 9% of the laboratory test market by test volume. They only comprise 26% of the independent laboratory market volume.
What we’re passionate about here at Lifepoint is enabling hospital-based outreach labs and smaller commercial regional labs to level the playing field and compete against the larger national labs with IT and connectivity solutions.

Most of the quotes that I have selected from Bill refer to the ability of hospital outreach programs to compete with the major national references labs like Quest for business. Such hospital programs have certain disadvantages in the market such as a longer sales cycle for new physician office customers and sometimes a less aggressive attitude toward sales opportunities. On the positive side, hospital labs tend to have untapped reserve capacity on the afternoon and night shifts when most of the outreach lab work is performed. As Bill emphasizes, the hospital labs loose brand recognition if their test results are "streamed into the EMR." The key take-home point for me from this interview is encapsulated in the last bullet: lab portal software such as that offered by Lifepoint levels the playing field and enables hospital lab outreach programs to compete with aggressive competitors like Quest.

Dental CR Reader Featuring Tablet Support | Medgadget

Tue, 21 Feb 2012 12:43:56 -0500

3DISC Imaging inc., Dulles, VA, a manufacturer of digital imaging products, has developed a compact imaging device that provides reading of reusable dental imaging plates. The FireCR Dental Reader features a tablet computer to immediately view and share imaging results at the chair side and features touch screen software that provides dentists with immediate access to the history of the patient’s dental images.

The reader is DICOM 3.0 compatible with existing systems and uses low-cost, reusable imaging plates in a variety of sizes, including bite-wing and intraoral dental imaging plates.

Dental CR Reader Featuring Tablet Support | Medgadget

Tue, 21 Feb 2012 12:43:56 -0500

The reader is DICOM 3.0 compatible with existing systems and uses low-cost, reusable imaging plates in a variety of sizes, including bite-wing and intraoral dental imaging plates.

Study Finds EHR Adoption Growing, But Meaningful Use Remains a Challenge | ADVANCE Perspective: HIM

Tue, 21 Feb 2012 11:39:00 -0500

Editor's Note: For an executive summary of IVANS 2012 Healthcare Provider Survey, contact Cecile Locurto at Cecile.Locurto@ivans.com or (203) 905-7330. IVANS Inc. a national health information exchange, announced in a Feb. 20 press release that while...(read more)

Opening Keynote at #HIMSS12 by Twitter Co-founder | Medicine and Technology [part of HCPLive]

Tue, 21 Feb 2012 10:52:00 -0500

HIMSS 2012 opened this morning with a keynote by Biz Stone, co-founder of Twitter. He spoke about how social media can change the health care landscape.

These are some of the key questions that may be on people'a minds:

How can social media improve the delivery of health care? How can social media improve disease management? How can social media improve wellness and promote disease prevention? How do health care professionals use social media and protect patient privacy? How do you use social media in a HIPAA-compliant way?

Social media is another extension of health information technology. Health IT is not simply about HIE, EHR, CPOE, or e-prescribing.

Biz shared several stories and assumptions about human nature and applied these to health care.

The first story was the Twitter story. He left Google, did some work at Odeo on podcasts, then started Twitter. Would a person share a short status message? As they built Twitter, they found that people enjoyed sharing short updates, even if it was not useful. They were having fun and they saw the potential to move masses of people using a simple social communication tool. They saw how a single person could send a Tweet and fuel behavior change. Lesson learned: more information is not necessarily more knowledge.

He also shared a story about being in a program called "boy rangers" when he was a child. He was motivated to play sports and he started a lacrosse team. Lesson learned: opportunity can be manufactured.

Then, he shared a story about college where he got a part-time job moving boxes. He designed a graphic cover at the age of 19 and got promoted from a box mover to a graphic artist. He learned that creativity is a renewable resource. You will never run out of it.

The next story was about a German movie where an immortal angel falls in love with a mortal. He thinks about becoming a mortal because he wishes to experience life as a mortal. The lesson is this: to succeed, you have to be willing to fail completely. You have to make the plunge.

His last story was about helping other people. Growing up, he thought that helping was something that was expected. The problems were unsolvable. He then learned how inexpensive HIV medications can significantly improve health and allow people to and communities to experience renewal. Lesson learned: there is compound interest in altruism.

Biz wrapped up by sharing some key assumptions that organizations need to keep in mind when they do business.

When it came to Q&A, Biz shared how different companies are using social media to help patients connect with providers. Examples may include telemedicine. More empathy for patients. The more connected we are, the smaller the world becomes. People can improve general awareness about their personal health by leveraging social tools.

There are so many ways that social media can facilitate patient education, health care professional communication, and even the continuing education of physicians, pharmacists, and nurses. However, most people who work in the health care community do not know how to effectively leverage social media in a safe, appropriate way to accomplish these types of things.

IT of The Tiger: TIGER Initiative supports nurses using technology | HL7 Standards » HL7 Blog

Tue, 21 Feb 2012 09:41:57 -0500

Those of you attending HIMSS12 this week – beware! There are TIGERs on the loose. Not to be confused with the fercious felines or cereal mascot, these TIGERS support the Technology Informatics Guiding Education Reform Initative aka TIGER. The mission of this collaborative is to prepare nurses and healthcare professionals to use technology and informatics to improve patient care. [...]

Healthcare Blogger Gets Spammed by Hedge Fund Using Internet “Reputation Restore” With Some Really Bad Algos–Attack of the Killer Algorithms Chapter 20 | The Medical Quack

Tue, 21 Feb 2012 08:30:02 -0500

First of all who was the blogger, it was me of course and this is my story on how this all took place. If you are not familiar with “Reputation Restore” you can search it on the internet and find many companies who will provide this service for you if you feel you have been slammed with bad publicity on the internet or just want to hide what is out there. You will find quite a few pages with companies that advertise on the web and run a business to fix your reputation. Here’s a screenshot of what a simple search turns up. As you can see there are a lot of folks out there offering to fix your reputation on the internet.

I won’t get into the specifics of it here yet but if you watched 60 Minutes a couple weeks ago and heard the story about the Duke Cancer Clinical Trial, at the very end of the story they mention the doctor who created the false information was found on the internet, practicing in another state and they mentioned “Reputation Restore” was used. New information about the doctor was created on new websites to show a more favorable side of the doctor. In case you missed it you can watch the video at the link below where I covered the story and added it to my series on the Attack of the Killer Algorithms as Chapter 15.

Story of Duke University - The Sad Case of Flawed Data Published in Medical Journals That Was Declared Inaccurate 60 Minutes –Attack of the Killer Algorithms Chapter 15

I’m a Healthcare blogger that has been around for about 5 years now on the internet and the name of the blog, Medical Quack sometimes attracts attention by tags and keywords that may or may not be relative. This seems to be happening quite frequently today as free text is being mined and searched for words that can bring relative information of value to various posts I have. Everybody gets this today with search engines and aggregation of data.

Sometimes using such methodologies can create some very surprising results too and in my case with Reputation Restore, it created a ton load of spam. Anyone who blogs today pretty much uses their “spam” filters, and I do too so spamming comments are not allowed to “auto populate” on my blog posts; however the spammers are still alive and well out there and keep trying. I get an email notification on every comment so this way I can approve the comments and this is done to keep the spamming commenters out. When you see such comments you can easily recognize them as they are comments not relative to the topic at all and usually contain a link that advertises something or is a link to promote their own site.

I have other healthcare bloggers who post and have a link back to related material they have, it’s not a problem for me to allow those as it is good sharing of information and I do encourage that; however, when the unrelated and easily recognized spammers hit, again I don’t want those and neither do my readers want to see such clutter either.

The commenting is also done to create links back for SEO purposes as well and if you read the news last year both JC Penney and Overstock were a couple of the companies busted by Google for using text links to move their ranks up higher in the search engines. They were both put in the penalty box by Google for a while and then once fixed they were back out again. What was also interesting about this though was a few months later Google was challenged on their own policy with such links. The whole idea here is too keep things fair and not allow certain companies and websites to monopolize search engine results and rank at the top unfairly as I see it.

Now back to the story line here and as a disclosure I don’t’ own any stocks and thus have no ties one way or another to anything in this story other than the fact that I do a website that helps give small cap companies exposure. I am a 1099 webmaster here and they are a publishing website so I wanted to put this out front so there’s no confusion there with the sponsor of my blog.

Ok so here goes…about a year ago my spam filters and email notifications one day started going crazy. When you do a blog you have few comments that come in every day and depending on the size and circulation of your blog it varies but when you get about 20-30 from the same source in a matter of 15 minutes coming in, you go look. My first thoughts were that someone was trying to game the search engines and was placing a number of links on my blog posts.

Again these are all non related topic “generic and canned” comments that an algorithm created. I have had these before but not quite this heavy as they continued on for a number of days. 20-30 blog comments each time were being sent to my blog. It would stop for a couple days and then about 2-3 days later, the next rush of spam comments would fill up the spam filter and my inbox notification system. Well after a few days of this I decided to check into this as I had not seen anything as persistent as this and the fact that every few days more loaded up got my curiosity going.

In looking at the spam comments I noticed that all of them contained links and they went back to the same 10 to 20 websites and decided to do some looking around. They were comments all made by Lindsay Rosenwald that had links back to other websites. Well needless to say I got an education in this process and found some very interesting websites and some that are very quirky, which are known as “splogs”. If you have not heard that term before this is a new word that was created to be a merge of the words spam and blogs which means these are not in fact “real” blogs but rather aggregated material from various sources. Lindsay Rosenwald is a Biotech related Hedge Fund manager and all of these comment links lead me back to the splogs.

Now upon finding these “splogs” I decided to do a search to see if they came up in general searches, and guess what, they did. They are easily recognized as the “splogs” all have very similar names so if you spend time searching the web enough you see patterns. Here’s an example of one of my notifications I had in my inbox. You can read the comment and clearly see that it was created by a “bot” just by the content. I had a bunch of these.

It looks like the “splogs” were updated since the comments in April. By following the link I find out that he has a hedge fund called OpusPoint Partners. How does one know this is a “splog”…one look at the blogroll tells all as all the past articles have the same title…his name…

Ok so in searching this link from April of 2011 and finding a link to a September 2011 updates, this tells me the “splogs” and Reputation Restore seems to be alive and well and occasional updates have been made. The good thing though is that I didn’t get “spammed” again with 20-30 comments this time as back in March and April of 2011 I had over 200 spam comments, all just like the screenshot above.

Ok so looking at this splog a little closer I see several categories here and decided to poke around a bit and see what’s there as we have Mystery, Romance and Adventure posts here to see. At the bottom of the page is an advertisement stating the page was done by SRS Solutions a marketing firm. The romance column is hysterical as you can see this is “filler text” and I wonder if anyone else besides me was curious and read this? Here’s a small preview of the filler text, again all arranged and put in place by some algorithm bots…kind of funny…and I don’t know what novel or book this came from but random text as filler (enjoy) …and see how the algorithms put his name in place in selected tag areas with links back to other “splogs”. In reading this I am thinking if perhaps his wife saw this? If she didn’t know a lot of questions could come about <grin>, but we all know this is filler text created by an algorithm.

“No matter how much she hung around him, she couldn’t help but stare – not at his well toned physique, not at his startlingly blue eyes, not at his near transparent blonde hair – but at his perfectly straight teeth, as bright as polished white marble. Normally she had to stop herself from watching him quite this intently, but “the guys” (Michael, Ryan, and Wes) were all occupied. Michael was in the kitchen, where he meticulously topped off three shot glasses with smooth, amber-colored tequila. Meanwhile, Ryan and Wes in the other room.

Stacey pried her eyes away from Lindsay Rosenwald, the man she kept staring at, and looked at the blank white ceiling for a moment, startled to realize that it now seemed off-white compared to Lindsay’s teeth. The white was a strange contrast to the eight-decade old wood paneling that covered all the walls. Stacey slouched back into the couch – which was mostly a khaki color, though marked artistically with various chocolate, rum, and soda stains. The couch was easy to sag back into; Stacey gave in to the sensation of being devoured by the plush micro-fiber fabric.

Lindsay Rosenwald took a gulp of his beer then lifted it into the air in a mock salute and said “I’m lame.” Stacey laughed, and Ryan jokingly flipped Lindsay off.

As the guys started doing shots (yelling inappropriate words before each one) Stacey stood and silently went into the bathroom, turning on the light and closing the door behind her, leaning against the counter. She started looking herself over in the mirror.

In the back of her mind, she knew she was checking how she looked. Checking to make sure she looked like the cute girl-next-door that she had always been labeled as. She knew she was making sure because of the unspoken temptation in the back of her mind. A temptation she had completely resisted during the two years that Becky Fullmer and Lindsay Rosenwald were together, but that was getting harder and harder to ignore.”

Going back to the home page on this particular “splog” we see that Mr. Rosenwald has his hedge fund discussed and also has some other pretty high credentials to his name as well, such as his involvement with Cougar Biotech and selling the company to Johnson and Johnson last year and this bit of information below.

“Rosenwald has had an extensive career in managing investment funds, most notably for the Aries Fund (1994 – 2007) and the Orion Fund (2002 – 2006.) Both of which are highly regarded. In the year 2000 under the overseeing of Dr. Rosenwald the Aries Fund invested a substantial one billion dollars into healthcare.”

Dr. Lindsay Rosenwald partakes in many other activities outside of his professional career at OpusPoint Partners, most notably he sits as a member of the Board of Directors in the Republican Jewish Coalition. Though maintaining his thriving business is his main goal, he foresees its continued growth and works diligently to expand and preserve his solid contacts in the biotech and life science financing industry.”

When you follow some of the links, you are lead to even more “splogs” and again you can see where the algorithms mess up with formatting text…like here…you find the same text over and over and again in some areas the algorithm really messed up <grin>. Utah SEO is another company listed at the bottom of the sites for producing some of these. I would call this a rogue algorithm here that got a little out of control and we read this happening to in the stock markets and a company called Nanex is very good at reporting these incidents with great images, but this is one little algo who couldn’t spell or follow formatting rules.

Here’s another “splog” page and again all the past articles have all the same titles..wild stuff!

Coming back around here I would have probably cared less and never would have seen any of this if it were not for the big spam attack on my blog. When the company did the “Reputation Restore” process it was probably not a good idea to hit a rather well read healthcare blog like mine, you think? Did they check that out, obviously not. Here’s yet another spam comment, again one of a few hundred that infiltrated my blog, so I went to go check out this link that goes way back to the New York Times in 1988 and talks about his Director of Finance appointment at D.H. Blair. Well before I read this link I didn’t know who or what D.H. Blair was but after reading several of these links I thought this was some of the content that was maybe meant to be hidden or buried? Keep on reading…

Ok so now my curiosity is aroused to find out what is D H Blair since this article was so old and was obviously put in there for folks to read, right? So let’s go see what a search turns up here. This is what shows up with a search…OMG Bernie Madoff? We all know who that is, so I decided to do some reading as I do a lot of that but now I’m curious and boy what a reading file Google pulled up for me. I also looked at Google images via a search and he was the first picture that came up. Actually it was a good thing that my spam filter caught a lot of the comments as more of my Medical Quack readers may have done some additional reading.

Ok so now it’s starting to set in as to why this Reputation Restore campaign might exist as I begin reading? From what is published on the web, there’s a lot of players here and again I don’t know any of these folks here and didn’t know any of this, but I do now after being spammed. Shoot this was more reading than I bargained for in just my small pursuit of finding out who spammed me! Let’s dig around and check out another spammed comment shall we.

So I followed this link and found yet another so called “splog” and checked it out. I found out he was a Republican and part of the Republican Jewish Coalition as a member of the Board of Directors and there’s a video at the splog that references the other “splogs”..and it was done in March of 2010 but it looks like they have his age wrong in the comments at stating 76? It was created by this firm it states under the comments. Looks like a bunch of bad algorithms to me.

Paramount BioCapital

If you look around under similar videos that appear we seem to have the same video created by SEORouters here and another one here and yet one more here that dates back to the same time when I was being spammed.

The only half way decent page linked in all of this is Wikipedia but guess what, I found different links and some other artifacts such as the New York Times paper article from 2008 stating he had been offered $85 million for his penthouse in New York and again the sale of Cougar Biotech to Johnson and Johnson. What I also found interesting on this page were the “dead” social network links, in other words they don’t work and take you back to the home page.

Needless to say this is the work a a ton of “bots” to say the least. Anyway getting back to the search I did above now I’m reading Deep Capture, Market Rap and a ton of other archived articles which I probably would not have known existed otherwise:)

So the question here is what purpose has the Reputation Restore accomplished? Did this Hedge Fund manager get taken for a ride on his money spent? I am guessing he did spend some money on this project as these folks would not work for free with creating and running these algorithms.

With all the wealth and money I wonder what he was sold on the job this company did and why the bots used were so “not good” as they connect to “splogs” and when you look at the examples you can see what is out there. Let’s go one more step and see what Google has for searches that are related…and here it is…

We come right back around to D H Blair again for one and Madoff, along with a few others added in there. Guess what, I get a lot of the same “splogs” again and a few other tidbits and this time the Market Rap and Deep Capture results are at the top, (which I am guessing is the portions meant to be buried in searches) so what is this campaign doing besides making a mess out there? The You Tube videos in the splogs have little play so hardly anyone is looking at those either.

This even gets better as when you do a search for reputation restoration there’s even a link on the Deep Capture page where a company wrote a story about this and is probably looking for new business. What I did learn by reading is that Deep Capture did not profile Mr. Rosenwald very favorably and again Deep Capture has their own naked short selling tale to tell and who knows what the whole story is once it all comes together. Now in my travels around searching Google I ran across a few other blogs with the same “spammed-canned” comments, like this one. My spam catcher caught mine but no back links from the Quack to the splogs which doesn’t do anything for “splog search engine optimization” <grin>.

Also this came up in a search, a comment that is exactly the same as the posts on the “splogs”…at a reverse merger page back in 2009…

http://www.reversemergerblog.com/2009/08/08/cougar-biotech-wow/

Here’s yet another one by a blogger called “Noel Vega” and yup it’s all about Mr. Rosenwald and is yet one more splog it appears. Actually I was not the first site to notice this activity as a site in Germany (which I don’t know if they were spammed or not) figured it all out too. Below is what that site had to say as he linked right over to the Deep Capture site, which by the way is published by the CEO of Overstock.com. He did a pretty good job as describing the whole lot of web sites.

Real-Life Reputation Management Example

“These are all simple WordPress installs with a few articles. It’s pretty obvious they’re only here to occupy the first page on Google.
As soon as you dig deeper into the SERPs (search engine results pages) you’ll find tons – and I mean TONS – of web 2.0 properties linking and pushing his WordPress sites and the EDU profile among others”

“Lindsay Rosenwald may be the son-in-law of “the king of stock fraud.” And he was once the vice chairman of D.H. Blair, a firm affiliated with the Mafia – a firm that was run by two former top lieutenants of Michael Milken before it found itself at the center of one of the biggest Mafia investigations in the history of the FBI and on the business end of a 173-count federal indictment.”

In some cases the splogs even spam themselves with comments such as here…

And there’s some links back to some cached pages of Cougar Biotech floating around out there which we know now was purchased by Johnson and Johnson mainly for their prostate drug which is now on the market.

It sure looks like he got soaked on this deal on repairing his reputation as with browser and search changes made by Google and others, all it appears to be doing now is stuffing the web full of spam and again I would not even be aware of this if who ever they hired knew what they were doing and wouldn’t have spammed my blog so badly. You know we hear in the news all the time about money not matching up or they can’t find it, like Corzine and no wonder if the big guys at the the top get sucked in by folks like this who did this some what make shift reputation restore effort which only serves to bring all of the stuff I feel they want to hide out into the forefront.

How do they make business decisions today one might ask? Obviously nobody can be an expert in every area but gee to use one of these services that does a job like this? I would hope they could hire staff that could at least get a quality job done if pursing such a project.

These are a bunch of programmed algorithms that go out and mine the web and relate articles and such on tags, keywords and so on. I still laugh at the romance section that was just jammed in there as filler.

Mr. Rosenwald got attacked by the very algorithms he hired to help hide him it seems to me.

I am now much better educated on the past of the financial markets and biotech having been spammed and have passed along some of the articles I found interesting to others to read. His bot did try to comment on my Happy Doctor’s Day post though to let us know he went to school at Penn State and this was yet another comment that the algorithm was responsible for.

I had pages of these comments stacking up and of course when you read them the English is not that good and of course never would been written from a man in his position and education, so maybe “splogs” have a side benefit of not making one look to smart? Anyway, I wouldn’t want my name attached to such <grin>.

This page at Google Knol which will end on May of this year even has a Creative Commons License listed, pretty funny as splogs can have those too. SEO Services of course is one of the commenters here so those are his fans the SEO folks it seems:) Again I have just never seen anything so extensive and they must be working hard to justify their contract with Mr. Rosenwald. I have to say the algorithms that created these sure did use and re-use the same text to the maximum! It’s over here at the Knol site too, so blog platforms were not issue for the algorithms to cross with speed running bots at work.

There was actually one “real” press release from PRWeb buried in the splogs and I wonder why he doesn’t use avenues as such to promote himself instead of splogs? If you publish enough legitimate information out there the other stuff with age will go down the ranks. Link at the title below from March of 2011.

Lindsay Rosenwald: Biotechnologies Financial da Vinci

Once more it is amazing that a well known hedge fund manager would not know the difference here and is more comfortable with the Splog efforts.

One thing too about the web is that what may have been an effective tool yesterday, may not be so today and some Killer Algorithms here appear to be biting the Hedge Fund Manager. I happen to have a series on the Attacks of the Killer Algorithms that you may want to check out. I certainly was attacked by the Killer Algorithms here with spamming my blog and Mr. Rosenwald has them biting at his back too as they are getting to be just in the way and not really serving a purpose any longer.

Attack of the Killer Algorithms–Digest & Links for All Chapters–See How the Math and Crafty Formulas Today Running on Servers 24/7 Make Life Impacting Decisions About You

Perhaps to his good news or maybe not so good news, this post will now be circulating and searched in Google and other browsers as well and perhaps it may even give Mr. Rosenwald ’s “splogs” some real competition for that top spot:)

So why did I do this story, that algorithm woke up and snuck in another spam comment! I was attached by the Killer Spamming Algorithms hired by a Hedge Fund who maybe didn’t have a clue on what he thought he was paying for. BD

Technorati Tags: algoirthms,mathmatics,12 step addictions,healthcare,desired results,rogue algorithm,Charles Seife,books,numbers,analytics,journalism,Google,Rosenwald

Meaningful Use: 2011 and Beyond | Galen Healthcare Solutions: Allscripts Consultants Enterprise EHR

Tue, 21 Feb 2012 08:00:44 -0500

It’s official: year one is in the books for Meaningful Use. 2011 was the first year that Stage 1 attestation was possible for eligible professionals, hospitals and critical access hospitals. There were a number of organizations that partnered with us last year to get the ball rolling on the attestation process. Let’s take a closer [...]

From HIMSS 2/20/12 | HISTalk

Tue, 21 Feb 2012 03:11:47 -0500

We’ll have posts tonight from me (Mr. H) and Dr. Jayne. Inga always sends hers late because she’s out socializing, so expect her recap sometime Tuesday. Our big events Tuesday are the sponsor lunch and HIStalkapalooza, so I’m sure we will have stuff to share.

We’ll be covering fewer routine vendor announcements for the next few days since we don’t really have time to chase them down. If we miss one that really is big news, let us know. Otherwise, I may do a summary this weekend after the conference is over.

Mr. H

From Jimbo: “Re: LAS taxi line. It was a 45-minute wait Monday afternoon.” It was a wait for me Sunday night as well. They have a lot of taxis, but they still can’t handle the passenger load. Not to mention that you can easily see your hotel from the airport, but you’ll spend around $20 to get there by the time the cabs add on the mandatory charge for picking you up at the airport and the $3.30 for the first 1/13th mile.

From I Know Nothing: “Re: Amagine. AMA spins it off to AT&T.” According to the draft announcement apparently set for a Tuesday release, AMA and AT&T will put the Amagine community portal on AT&T’s Healthcare Community Online, with AT&T owning the result.

From @Cascadia: “Re: HCA. Noticed that HCA is recruiting for an EHR director and it includes both Epic and Meditech.”

From Rebecca: “Re: ICD-10. In response to your reader’s comments regarding ICD-10, I also took away that the delay may only pertain to certain segments of the healthcare community, based on the following from HHS. The statement said that HHS would ‘initiate a process to postpone the date by which certain health care entities have to comply with [ICD-10].’ As HHS and CMS have yet to provide further clarification, I would recommend that the hospital and provider community stay the course in preparation of ICD-10. (On a side note, shame on the government for making such a vague, open-ended and potentially financially-impactful statement without concrete direction to the healthcare community, seemingly just to kowtow to the AMA.)”

Here’s a shot I took this morning of the Venetian – Palazzo – convention center complex. HIMSS hung large banners out, but of equally massive size are those pitching David Spade and Blue Man Group.

Here’s a shot taken from the Venetian looking out to Las Vegas Boulevard. Inside, it’s a fake canal under a fake sky, women with fake breasts, and men with fake tans. Finally the exhibit hall isn’t the only place where things aren’t as they seem.

I took this picture for Inga in the Palazzo shops. I figure this guy’s a genius if he can get women to pay $1,200 for $10 worth of material turned into red-soled shoes. I admit that as a non-profit hospital guy, I felt creepy being surrounded by all this excess. We’re supposed to be following a selfless calling of taking care of patients, or at least that’s what they used to say before the government became such a big payer and made it attractive for big corporations to use healthcare as a profit center.

The exhibit hall will look perfect on Tuesday, but here’s how it looked Monday morning.

I hung out with Inga and Dr. Jayne at the opening reception. While it wasn’t anything to get excited about (bad beer choices, passable but cute Elvis impersonators, mostly a staging area to execute dinner plans) it wasn’t as bad as those in Chicago and Orlando, which were held in rooms that resembled airplane hangars without the charm. The band was better this year, which isn’t saying much given the usual bad lamestream cover bands HIMSS hires to get the straight-laced IT types gyrating slightly to the tired oldies. HIMSS ditched the drink ticket concept – it was open bar, so that’s a plus. We didn’t try any food so I can’t vouch for it, but I didn’t see or smell anything that called to me.

Remember that under this year’s odd Las Vegas HIMSS calendar, Monday this year was Sunday from years past – pre-conference workshops and the opening reception. The mainstream part of the conference starts Tuesday with the keynote speaker (Biz Stone, founder of Twitter, who doesn’t seem all that interesting on the surface.) Since Inga, Dr. Jayne, and I didn’t sign up for any of the extra-cost workshops Monday, we have nothing to report from those.

I confess that I usually get a little bit discouraged at the conferences since I’m reminded that we’re just tooling around anonymously and not accomplishing a whole lot compared to the folks actually moving and shaking. We may feel slightly good about what we do the other 51 weeks of the year, but this week, we’re bit players and sideliners. Still, we’ll do what we can.

The funniest moment: Inga and Dr. Jayne were talking about Epic’s Judy Faulkner on the way to the opening reception when Dr. Jayne ran into someone and swapped the usual apologies. Inga had to tell her it was Judy she had just collided with. What they were discussing is that Inga had seen Judy outside a session room and I said I was surprised she wasn’t surrounded by hangers-on. Last conference, Judy couldn’t hit the coffee urn or restroom without people from vendors you’ve never heard of trying to sweet-talk her into dealing with them. She was more polite than she could have been.

It looks as though the particulars about Meaningful Use Stage 2 will be released in the ONC meetings scheduled for Wednesday morning. That is damned annoying: you know they’ve been finished for some time, so holding them back just to crow about them at HIMSS is unfortunate. Why couldn’t ONC have released them last week to give people time to study the proposed rules so they could discuss them intelligently this week? ONC is going to hijack all of the topics and issues being discussed at the conference by people who have spent a lot of time and money to be here and turn it into a test of who can make an Excel worksheet the fastest. That’s a shame. It’s not like the government doesn’t already hog more than its share of the healthcare IT spotlight.

Someone brought up a very good point to me about why it’s so weird about having HIMSS in Las Vegas. In every other city, HIMSS takes the place over. You see the same comforting faces that you see every year. In Las Vegas, we’re still outnumbered by the regular tourists, many of whom are bizarre, annoying, and indifferent to the conference as is typical in Las Vegas. Part of the conference draw is that attendees get to feel very special, insular, and collegial. I’m not sure we’re getting that here. On the other hand, the skirts are shorter than you can possibly imagine.

I finally figured out what I really dislike about Las Vegas. It’s the restaurants. I keep hearing locals bragging on the great restaurants here, but they are the antithesis of great restaurants. The are upscale mall food courts owned by faceless corporations, run by faceless corporate chefs determined to orchestrate the cookie cutter experience to the maximum wallet-extracting extent possible and to kill off any independent restaurants that might cook from the heart rather than the pocketbook. The big-name chefs set foot on the premises only long enough for a quick photo op and to load up their pockets with culinary hush money to pretend that they’re really involved and proud of the end result (surely you didn’t think Bobby Flay or Wolfgang Puck would lower themselves to actually cook in restaurants bearing their names.) The food is the kind of stuff that unsophisticated bus-tripping Midwesterners crave and brag about to those left at home – mammoth and overpriced hamburgers, expensive hunks of steak with little more creativity applied than to put them on the fire, and dumbed-down ethnic food that isn’t too challenging for the casino crowd. There is minimal farm-to-table or local cuisine because, after all, we’re smack dab in the middle of a desert where the only key food source is what comes in from more hospitable climes via the airport. If there are great Las Vegas restaurants – and I’m thinking there aren’t — I’d wager that they aren’t found in Strip hotels. Las Vegas may have slightly better chains than Cheesecake Factory and Applebee’s, but they are still soulless corporate outposts that resemble a real, creative, chef-owned restaurant only superficially.

Speaking of restaurants, HIMSS included a $10 certificate for food Tuesday, good in the exhibit hall. A nice gesture, even if $10 doesn’t get you much from union-run food service concession stands.

The Madison, WI couple competing in The Amazing Race, the female half of which works for Epic, placed first in Sunday night’s episode.

Dr. Jayne

As I was on my way to the airport to catch my flight to HIMSS, I made one last pass by the mailbox to see if there were any cool marketing materials and I’m glad I did. The first one was a kicky orange band-aid cutout (I probably should call it an adhesive bandage so the trademark police don’t come calling) from Aventura. Even better was the tagline when I flipped it over:

Needless to say, it made my day and I was grateful for a good chuckle.

I’m glad I found the other mailing from ICA because it offers a chance to win $2,000 for your local community food bank. I’ll definitely be stopping by for that contest, right after I drop off my shoes at one of the Soles4Soles collection points at ESD (booth 4616), HealthPort (252), DrFirst (5456), or Gnax Health (2875).

I spent most of the flight out planning my activities for the next few days – I’m still trying to sort out the best way to fit in all the sessions I want to catch with all the exhibitors I want to see. Plus, I need to make sure to leave some time to try to catch up with my bow tie-clad crush, Farzad Mostashari. I’m grateful for HIStalk’s Guide to HIMSS12 which gave me a starting place from which to plot my escapades.

Like many of you, my favorite part of HIMSS is networking. I’m looking forward to attending a couple of vendor events and some physician gatherings as well as catching up with old friends. I’ll be stalking the exhibit hall with a couple of my CMIO buddies and will be reporting on their reactions throughout the week. One of them is a first timer, so I can’t wait to see what he thinks.

Networking is particularly fun when you’re an anonymous semi-celebrity. I recently shared a drink with my trusty sidekick Bianca Biller and another long-time colleague who was lamenting how hard it is to keep up with all the industry gossip. The conversation turned to HIStalk, of course, and it was all I could do to not giggle. I’ll be non-competitively participating in the HIStalk Booth Crawl so I’m sure I’ll have to suppress more than one giggle over the next few days. Good luck to all our readers competing for the chance to win one of 55 iPads. And remember – if you can’t find the answer, make up something funny to keep Mr. H entertained as he stays up ‘till the wee hours of the night handling your entries.

We’ll be on e-mail, Facebook, and Twitter this week and looking forward to hearing from our readers. Got a picture of the best giveaways, coolest booths, or craziest outfits? E-mail me.

Contacts

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

More news: HIStalk Practice, HIStalk Mobile.

Read Closely - This is Really A Rather Odd Position To Be Adopting On The PCEHR. | Australian Health Information Technology

Tue, 21 Feb 2012 00:30:02 -0500

The following appeared today. Liberal MPs to vote for e-health records by: Karen Dearne From: The Australian February 21, 2012 12:00AM LIBERAL MPs will vote to pass the Gillard government's legislation on personally controlled e-health records in the lower house, but warn they may move changes when the findings of a Senate inquiry are released. Opposition e-health spokesman Andrew Southcott said the Coalition supported the concept of shared e-health records, but had concerns about the way the system was being implemented. "Labor's implementation of the PCEHR since taking government in 2007 has received enormous criticism from industry for the poor management of the program's development and progress," he told the house last week. "This legislation was introduced in the final sitting week of 2011; the opposition referred the bills to a Senate inquiry, which is due to report on February 29. "Submissions to that inquiry have just closed. In its public hearing (on...

This is the initial part of the post - read more by clicking on the title of the article. David.

PCEHR legislation likely to pass: report | Pulse+IT Magazine

Mon, 20 Feb 2012 21:32:16 -0500

Opposition MPs are likely to vote for the PCEHR legislation in the lower house, The Australian (http://www.theaustralian.com.au/australian-it/government/liberal-mps-to-vote-for-e-health-records/story-fn4htb9o-1226276320032) newspaper is reporting. The Australian quoted Andrew Southcott, shadow parliamentary secretary for primary healthcare, as saying his party's MPs will probably vote for the passage of the legislation, but may recommended changes after

Primary care conference investigates eHealth | Pulse+IT Magazine

Mon, 20 Feb 2012 19:13:31 -0500

Renowned British healthcare researcher Trisha Greenhalgh and the National E-Health Transition Authority's (NEHTA) (http://www.nehta.gov.au) head of clinical leadership, safety and engagement Mukesh Haikerwal are headlining the eHealth stream at the upcoming International Primary Health Care Reform Conference (http://ihcrc.yrd.com.au), being held in Brisbane from March 6 to 7. Sponsored by

Medway is First to Implement Advanced Health & Care's Advanced Community System | eHealthNews.EU Portal / All News

Mon, 20 Feb 2012 17:00:00 -0500

Medway Community Healthcare, a community interest company, is the first to implement the newly launched community healthcare system, Advanced Community, from Advanced Health & Care (Advanced).

Medway is First to Implement Advanced Health & Care's Advanced Community System | eHealthNews.EU Portal / All News

Mon, 20 Feb 2012 17:00:00 -0500

Medway Community Healthcare, a community interest company, is the first to implement the newly launched community healthcare system, Advanced Community, from Advanced Health & Care (Advanced).

5 Questions with EHR Executives at HIMSS12 | EMR and EHR

Mon, 20 Feb 2012 14:51:36 -0500

As some of you know, I’ve toyed with videos on my site for a while now. HIMSS is definitely the place where I’ve done the most video and that will be true again this year. I decided to take a pretty simple approach to video at HIMSS12. Since a large portion of my meetings at HIMSS will be with EHR vendor executives, I thought it would be fun to ask all the EHR vendors the same 5 (I don’t mind doing more or less if they’re good questions) questions.

Since I love the idea of involving the community and kind of crowdsourcing the questions, I’m going to put a few questions out there and listen to feedback from the community on other questions I should ask or modifications to the questions which will get EHR executives to provide some useful information.

1. What differentiates your EHR today?
2. In what ways has the EHR stimulus money and meaningful use had an impact for good or bad on the EHR industry?
3. What are the top reasons why doctors are adopting EHR software?
4. What are the main reasons doctors aren’t adopting EHR software?
5. What will differentiate your EHR 5 years from now?

I’m looking forward to hearing any suggestions you have on how to improve or modify the questions. I suspect I’ll do quite a bit of editing of the questions before I start asking the questions tomorrow. Watch for the videos to be posted on this site, EMR and HIPAA, and EMR and EHR Videos.

AMA Announces Doctors And Patients Can Expect To See the UnitedHealthCare/Ingenix Class Action Settlement Checks In the Mail Soon - Out of Network Short Payments–Attack of the Killer Algorithms Chapter 19 | The Medical Quack

Mon, 20 Feb 2012 14:43:56 -0500

This falls under the series as it was a group of formulas and algorithms that allowed the short payments to continue on. When the claims were submitted, doctors had the choice of either substantiating their actual shortages or could accept their portion of the settlement by letting United (Ingenix which is now Optum) calculate it for them. We all might remember when Cuomo from New York questioned and found the data base was out of whack with normal and customary fees charged and most of the other insurers licensed and subscribed to the same data base so United collected from their use of the data base as well it appears.

I did one story here a while back to where HealthNet agreed to pay claims at 14% higher than the data base called for until the actual settlement was reached and the data base was disbanded. This goes back to June of 2009.

Health Net Agrees to Stop Using Ingenix Database for Calculating Reasonable and Customary Fees

That was an interesting time as with the Tri-Care bidding going on United ended up buying a big chunk of HeatlhNet in the New England area.

United HealthCare Purchase of HealthNet in the Northeast Did Not Include Transfer of Employees

The Tri-Care battle over contracts is still going on with a lawsuit filed by United as that was and probably still is an administrative mess. This goes back to June of 2011 and I have not seen the outcome of this one yet.

Update: UnitedHealthcare Sues Department of Defense Over Tri-Care Contracts–They Said They Would Do This – Is This A Case Of My Algorithms Are Better Than Yours?

Long and short of this outside of the checks being sent out is a reminder of the fact that United has been in the analytics business a long time and the settling of this lawsuit reminds us all to at times ask questions and see how the analytics are being used and make sure you are not under the Attack of the Killer Algorithms unknowingly. Last week I commented about the new “cloud” services that is due out soon to market hospitals and doctors and over at Seeking Alpha a writer was very kind to link back to this post and he mentioned how United was winning the war with Health IT, and again from someone outside the industry a very good look at what has been done, but in reality their analytics and algorithms produced have been around for a long time, just behind the scenes where most either don’t look or see.

UnitedHealthCare Launching Cloud Platform Via Optum Subsidiary Will Sell Apps Like the Apple Store But They Won’t Be As Much Fun And Solicit Hospitals for Record Storage

About a year ago was the last time I covered the Fair Data base which is now run by a non profit who hopefully has some analytics of their own to make sure insurance companies keep their algorithms in check.

New FAIR Data Base Slated to Be Available Later this Year To Replace the Corrupted Data Base Used by Ingenix to Calculate Out of Network Insurance Charges

“FAIR Health is a national independent, not-for-profit corporation whose mission is to bring transparency to healthcare costs and health insurance information through comprehensive data products and consumer resources. FAIR Health uses its database of billions of billed medical and dental services to power a free website that enables consumers to estimate and plan their medical and dental expenditures. The website also offers clear, unbiased educational articles and videos about the healthcare insurance reimbursement system. In addition to its consumer offerings, FAIR Health licenses data products to businesses, governmental agencies, healthcare providers and researchers. With its professional staff of experts in healthcare, statistics, technology and communications, FAIR Health strives to offer accurate, consistent and timely information to all stakeholders in the healthcare system.”

There are still a few more lawsuits that are smaller out there floating around related to this data base and who knows when they will all be solved. This one also just sprung up last yea.

Outpatient Surgery Centers File Class Action Lawsuit Against UnitedHealth and Ingenix for Underpayments

In this case just due to the settlements here with with math and formulas, this makes a good case to stop and think about the algorithms in use and perhaps as yourself if you think they are designed for “accuracy” or “desired” results.

The 2 should be the same but as the outcome of this lawsuit shows they are not always and that goes for any area of healthcare but especially the payables end of the equation as that’s where all the ruckus and lawsuits always take place.

I have a summary post of how the Killer Algorithm Attacks occur in other businesses and other areas of healthcare too that has a great video that explains how “context is everything” so ask question today by all means as the amount of flawed data out there used for analytics is certainly on the rise with data mined from the internet combined with steroid marketing for a sometimes “big spin” and it’s hard to tell the difference . BD

Attack of the Killer Algorithms–Digest & Links for All Chapters–See How the Math and Crafty Formulas Today Running on Servers 24/7 Make Life Impacting Decisions About You

Twelve years after the original AMA v. UnitedHealth Group litigation was filed, and three years after the class-action settlement was announced, physicians and patients can expect to see checks in the mail soon, representing their part of the $350 million settlement.

U.S. District Court Judge Lawrence McKenna signed an order Feb. 2 allowing for the settlement disbursement. The money is meant to compensate millions of doctors and patients for payments lost as part of a system under which United and other insurers underestimated the "usual, customary and reasonable" charges for certain services.

Some insurers base what they pay out-of-network physicians on UCR. Physicians had argued for years that the UCR payments bore little relation to typical charges, and that the methodology behind them was hidden in what they called a "black box."

"While the monetary settlement is important, far more important is the fact that under the settlement agreement, United and other health insurers will no longer be able to use the flawed Ingenix database to determine out-of-network payment rates," Rick Abrams, executive vice president of the Medical Society of State of New York, said in a statement.

Now that the litigation has been wrapped up, the $350 million -- plus interest, and minus attorneys' fees and the cost of sending the settlement notices and checks -- is on its way to doctors and patients. Checks were expected to be in the mail beginning in February.

The new medical charge database, known as FAIR Health, is up and running, and offers not only a new database for insurers and physicians, but also a new online tool for consumers to see typical charges for medical services in their area.

http://www.ama-assn.org/amednews/2012/02/13/bisf0216.htm

Technorati Tags: UnitedHealthcare,Optum,Ingenix,Algorithms,medical billing,software,attorneys,black box,New York Cuomo,Fair Data Base,healthcare,data base

ePatient HIMSS 2012 Badge | Fred Trotter

Mon, 20 Feb 2012 14:42:39 -0500

Hi, I am happy to announce with psuedo-permission from the Society for Participatory Medicine (by which I mean that they have not asked me not to do this) a Twitter badge for HIMSS 2012. There are a handful of the epatients who are attending this years HIMSS (alas, I am not among them) and they [...]

ePatient HIMSS 2012 Badge | Fred Trotter

Mon, 20 Feb 2012 14:42:39 -0500

Lessons from Las Vegas - HIMSS 12 and Healthcare | HealthBlog

Mon, 20 Feb 2012 13:11:53 -0500

As almost anyone even remotely connected to the world of health ICT knows, this week is the HIMSS Conference in Las Vegas. I arrived early to provide a keynote Sunday morning for a large contingent of our customers and partners visiting HIMSS from...(read more)

MTBC Healthcare IT Company Buys United Physicians Management Services, Revenue Cycling and Practice Management Company–Subsidiary Watch | The Medical Quack

Mon, 20 Feb 2012 12:48:52 -0500

Here’s yet one more merging of software technologies to aggregate more functionalities into one software kit. We certainly do not have a shortage of medical record vendors today. There are many companies that already provide this integrated service to so stay in the game here’s one more out there. BD

SOMERSET, N.J., Feb 13, 2012 (GlobeNewswire via COMTEX) -- MTBC, a leading healthcare IT company serving providers throughout the United States, announced today that it has acquired United Physicians Management Services, Inc. (UPMS), a revenue cycle and practice management company based in Winston-Salem, North Carolina.

"We are privileged to have the opportunity to work with the many healthcare providers who have relied upon the UPMS team for more than a decade," according to Stephen Snyder, President of MTBC. He continued, "We're confident that our proprietary, technology-driven solutions will reduce the administrative expenses, increase practice revenues and enhance the workflows of our new clients in North Carolina."

About MTBC

Founded in 1999 and based in Somerset, New Jersey, MTBC provides practice and revenue cycle management services and proprietary software solutions to private physician offices and hospitals throughout the United States. Its integrated and competitively priced premium plan, MTBC PracticePro(TM), presents a service suite unmatched in the industry for its scope and value. Features include an ONC-ATCB certified EHR provided and supported at no charge, a practice website with patient scheduling, automated appointment reminders, e-prescribing, lab connectivity, real-time insurance eligibility verification and much more. MTBC has been consistently recognized by Deloitte LLP - 2009, 2010, 2011 - as one of the fastest growing companies in North America and has also been recognized in each of the last two years as an Inc. 500¦5000 company.

http://www.marketwatch.com/story/mtbc-acquires-united-physicians-management-services-inc-a-winston-salem-nc-based-medical-billing-company-2012-02-13

Technorati Tags: Health IT,MTBC,software,algorithms,EHR,medical records,healthcare,mergers and acquistions,medical billing,practice management,doctors,revenue cycling

Day 1 of the 2012 HIMSS Conference #HIMSS12 | Medicine and Technology [part of HCPLive]

Mon, 20 Feb 2012 12:40:00 -0500

There are over 35,000 people here in Las Vegas for the 2012 HIMSS conference. I always enjoy reconnecting with my Twitter connections and find that conferences like HIMSS is really a great place to meet new and interesting people who share similar passions.

On day 1, I spent some of my time at the Physicians' IT Symposium in the morning. Then, I went downstairs to spend the rest of my morning at the Health IT Venture Fair. I heard some interesting presentations around the innovative use of artificial intelligence to reduce adverse events associated with medication use, companies attempting to leverage power of the PHR to improve disease management and improve medication adherence in patients, and others looking for innovative ways to improve health information exchange across various platforms. So many companies are starting in the health IT space and I often wonder when this bubble will burst. After all, there is a really strong push for health IT implementation right now, but eventually the market will be saturated with companies looking to connect and leverage health data to improve care management.

During lunch, I had the opportunity to reconnect with a few CMIOs who are active in the social media space, particularly Twitter. This evening, I am going to a Tweetup hosted by Search Health IT. Looking forward to more tweets!

I have been walking quite a bit today. I already passed 10,000 steps in my Fitbit today. Does this mean I get to eat some extra dessert?

This year, you can follow Tweets from HIMSS by searching for #HIMSS12

Bat Infestation Closes Hospital in North Carolina- Bats in the Belfry? | The Medical Quack

Mon, 20 Feb 2012 12:32:23 -0500

I would say these are not your normal patients needing care:) It appears they have found a home in the duct work and other areas in the ceilings.

Imagine being a patient and having a visit from a bat when you might be expecting the night nurse instead, hope these are not vampire bats. For now until they are removed, no new patients will be admitted and current patients get your bat swatters out. BD

ROCKINGHAM, N.C. A Rockingham hospital has temporarily closed its doors until a colony of bats can be removed.

Officials with FirstHealth Richmond Memorial Hospital said Saturday that no new patients would be accepted and existing patients had been moved out for the time being.

The hospital has been working with a professional bat removal service to expel the bats, which have been living in the walls. Hospital employees called county officials about the problem on Friday, and teams inspected air handling units, patient rooms, common areas and ceiling tiles, among other areas.

http://www.charlotteobserver.com/2012/02/19/3027932/nc-hospital-shuttered-while-bat.html

Technorati Tags: North Carolina,hospital,bats,walls,patients,bat removal,infestation

A New Breed of RCM Business Models to Assist Independent Physicians | Healthcare IT Insider

Mon, 20 Feb 2012 11:28:54 -0500

As many independent physicians’ groups in the US, face the threat of reimbursement cuts, high costs of software solutions, and dwindling referrals. A new generation of billing service providers is offering creative packages and solutions to help these private organizations sustain profitability through creative offerings.

For years now we have seen many IDNs and hospital systems joining forces with private physician’s practices. But for some independent docs, this is raising concerns as it is affecting their referrals and revenues. There are also concerns that they may not have the ability to compete with the marketing dollars, negotiating powers and technology budgets of these health systems and their member practices.

For some revenue cycle management service providers, this was the best opportunity to assist some of the concerned private physician. The services that are being offered are tailored to help eliminate some of the typical challenges that small to mid size physicians face.

Hosted Practice management and Electronic Health Records: Some of the companies have eliminated the high up front capital costs associated with a purchase of EHR and PM. By offering a full platform with services, a physician’s group can pay a monthly fee or part of their reimbursement and receive fully operational PM/EHR system.

Revenue Cycle Management: Many of the RCM firms offer as part of their services some of the following:

Fully out sourced billing and collections.
Improved coding to increase reimbursement
Higher cash flow
Lower overhead
Improved collections

Best practices:

Technology: Technology has been a new territory for many of the billing service providers. By included hardware or infrastructure as a service (IaaS), many of their clients have the advantage of receiving support and services form one single group. This also provide a much more predictable cost and fee structure for the organization.

Consulting: For healthcare-billing groups, they financial revenues are directly associated with the client’s reimbursements. This means that they are incentivized to get the highest reimbursements. They are continuously working with physician’s to assist them with coding challenges, as well as helping identify efficiencies and added value solutions. This helps them continue to reinforce the value that the firm provides the physicians group with.

Portals: Payment and referral portals have been a new addition that many of the billing firms have started to adds to their offerings. This significantly improves cash flow as well as allows for all their clients in a community to interact with each other and share patient information electronically.

Compliance: With all many of the P4P programs available as well as MU and other federal programs, billing firms are helping physicians receive some of the offered incentives made available.

It seems that in the past most of what has been written about revenue cycle sector has focused on the outsourced collections and billing aspect of services. There are many new RCM providers that are bundling additional services that bring tremendous value to the independent physicians. Despite the currently complexity and changing landscape of healthcare, many physicians are able to focus on patient care and have some assistance on the back office processes and administration.

HIMSS 2012 and a Week of Education and Discovery! | Healthcare IT Insider

Mon, 20 Feb 2012 11:25:06 -0500

Every year the HIMSS attendees get to take advantage of many educational activities and sessions offered during the yearly conference event. In addition, many can spend time visit the exhibit halls and learn about some of the latest products available out there.

This year, there are many events that I will be attending and looking forward to. For starters, I am very interested in seeing some of the sessions presented by the ONC, and HHS. These would be the presentations in which we are expecting some additional details on the Meaningful Use Stage 2 dates. I will also be spending sometime on some of the sessions about HIE, EHR best practices, business intelligence, and mhealth.

There are several vendors that I am interested in visiting and discussing some of the products being offered.Some of these range from EHR, RFID, cloud computing, robotics, medical equipment and others vendors.

During this week-long conference, I will also spend sometime meeting and networking with health professionals, fellow bloggers, technology enthusiasts and old friends.

What’s Needed From Tomorrow’s HIT Talent? | Healthcare IT Insider

Mon, 20 Feb 2012 11:18:44 -0500

As the health care landscape continues to change, hosptials, health systems and other provider organizations are faced with a growing number of increasingly complex projects – ICD-10 conversion, HIPAA 5010, EHR implementations, meaningful use complaince and and IT system merges, just to name a few. Because of the new demand on IT innovations, several health IT leaders are finding it difficult to recruit and maintain staff with the appropriate skills to help lead and manage these challenging projects.

Over the past 12 years that I have spent working in health care technology, I have had the opportunity to work with many talented health care IT individuals, coming from varied backgrounds — some clinical, some technical and others from engineering. This goes to show, once again, that sometimes the ideal candidates and health IT superstars do not necessarily come from IT backgrounds.

There are several traits that a top HIT pick would have, and out of many I will discuss the top six that I feel are most significant:

Personal skills: Most IT folks in health care recognize that there are continuously being challenged. In this complex environment, many of the rising stars are empowered through self-motivation and drive. These candidates tend to be the ones taking on projects and experimenting with new solutions that may be out of their comfort zone.

Clinical workflows knowledge: For IT directors, having a candidate with a clinical background provides an incredible value. In many cases, analysts and support specialists who have been in the front lines working with physicians and nurses during the implementation of an EHR and other projects have learned about the processes and clinical workflows. And with the ability to understand how technology can help streamline and facilitate the care of patients, super stars are empowered. They bring the best of both worlds and become one of the organization’s strongest supporters.

Strong communication skills: An important aspect of working in health care IT is the requirement to implement new products and support clinical and administrative staff on those endeavors. In those roles, strong communication skills becomes even more critical to ensure buy in from the group. Not only does it becomes critical for the IT candidate to have effective soft skills, but they also must have a positive attitude.

Technical skills: While having the technical background on specific products (EHR vendor products and other clinical tools) may not exist in many of the new candidates, it is very important for the top performers to be exposed to many of today’s technologies. Whether it is some sort of programming, mobility, or even other ERP systems, having that diversity in experience will help when dealing with different health care applications.

Leadership skills: Many times, there are opportunities to grow and expand your role within an organization.Having strong leadership skills will help advance the strong HIT candidate quickly.

Everyday is training day: Hospitals and other health organizations continue to face software upgrades, staff turnover and regulatory changes. The only constant for healthIT is, in fact, change. A superstar not only needs to maintain a finger on what changes are coming down the pike, but must also continue to attend trainings, conferences and educate themselves on the latest and greatest technologies and collaborative projects going on in the industry.

One of the best sources for raw talent is the candidate pool of graduating students from the new health IT specific certifications. Whether it’s a post graduate degree or college level certification, these individuals may be the superstars that will help a hospital accomplish its goals and stay ahead of the curve in the coming years.

AMA continues to oppose the implementation of ICD-10 | Healthcare IT Insider

Mon, 20 Feb 2012 11:16:39 -0500

On Feb. 2, the American Medical Association (AMA)’s CEO has urged HHS and congress once again, to halt the ICD-10 conversion. In a letter to secretary Kathleen Sebelius, James Madara, MD stated “On behalf of the physician and medical student members of the AMA, I am writing to urge you to immediately halt the Health Insurance Portability and Accountability Act (HIPAA) required implementation of ICD-10, and re-evaluate the penalty program timelines associated with the number of Medicare health IT programs underway today”.

In the letter address to congress in January, Dr. Madara also urged House Speaker John Boehner (R, Ohio) to block the mandate to ICD-10 scheduled for Oct. 1, 2013.

“Stopping the implementation of ICD-10, and calling on appropriate stakeholders including physicians, hospitals, payers, national and state medical and informatics associations, to assess an appropriate replacement for ICD-9 will help to keep adoption of EMRs and physician participation in quality and health IT programs on track and reduce costly burdens on physician practices,” Dr. Madara stated.

While the AMA has voiced clear opposition to the switch to ICD-10, highlighting the complexity and burden it puts on physicians, there are several groups who are proponents for the transition. For example, the American Health Information Management Association (AHIMA) has voiced strong support for the new code set as well as many of the areas it will benefit long term.

As the deadline for the switch gets closer, it is critical to ensure full organizational readiness for the switch. Since there are many areas affected by the transition – including EHRs, clinical support tools, and administrative and billing function – all areas of the organization must come together and ensure that they are prepared, and that preparation must be underway now.

Forecast and Ramifications of Payers in the HIE Market: Part Two | Chilmark Research

Mon, 20 Feb 2012 10:59:42 -0500

(Note: This is the second of a two-part post.)

Keeping it Local

This is most representative of the status quo and the most realistic path forward for the vast majority of payers who typically operate at the local level. In this scenario, one or more health plans in a regional market partner with other community stakeholders to co-fund and sustain a regional HIE. These stakeholders typically include large corporations with a large local employee base and/or provider organizations. Successful examples of such multi-stakeholder HIEs include the Louisville HIE (Humana, Anthem, Ford, Yum! and Kroger), and the Rochester RHIO, where payers (Aetna, BCBS, MVP) and hospitals share a 2/1 split of all operating expenses on a transaction model.

The benefit to payers in participating and most often funding the majority of such an HIE is three-fold. First, partnering with other organizations in the region contributes to a greater “fabric of trust” between the HIE and physicians within the region leading to greater physician participation. Secondly, by partnering with others, the payer is able to share HIE operating costs with other stakeholders. Third, physicians actively exchanging patient data can prevent some hospital readmissions and decrease duplicative lab and imaging tests, thereby lowering a payer’s total coverage cost in the region.

Conclusion: As HIE’s unfold at the community scale, local and regional stakeholders will share the operating costs and governance. As far as payer support for HIE’s goes, Chilmark predicts continued growth of these types of HIEs, particularly in less urban communities. We also predict that there will be significant growth in enterprise HIEs that are partially funded by payers, ultimately in support of a payer-provider partnership to establish an ACO. (Again, look to the recently announced NaviNet-Lumeris deal wherein three regional payers also played a role. For those payers, it’s all about making the provider transition to ACO/PCMH models as frictionless as possible.)

Real Challenges Remain

Despite a seemingly straightforward path for payers to get involved with HIE’s, there remain a number of challenges. These are two-fold in nature: Regulatory and Marketplace. On the regulatory front, the list of challenges is long and familiar: ICD-10 (while it seems like there will be another delay, much to the chagrin of the AMA this isn’t just going to go away) and HIPAA 5010, health insurance exchanges and other health reform mandates. (On the plus side, health information exchange-related spending counts favorably towards new medical loss ratio (MLR) rules).

However, the marketplace is where the true challenges lie, as there is hardly a guarantee that payers and provider groups will play nice with each other. Nowhere is this more evident than in the Western PA market, where a sort of fisticuffs have been going on between Highmark BCBS and UPMC. Without going into the sordid details, Highmark (who just bought Pittsburgh’s second largest hospital network, West Penn Allegheny) and UPMC are now building competing HIEs in the same region because of a longstanding spat over contract negotiations. To hospitals who are now faced with participating in two separate HIE’s, this does not make much sense.

For the payers however, it does make sense when cast against the backdrop of rising competition. (Chilmark noted this challenge after attending the AHIP confab last summer.) Insurers are fighting with each other to keep their networks competitive. Providers are fighting with each other to secure preferred referral status, i.e. patient volume. Introducing an HIE in the middle of this environment has wide reaching implications for where patients are sent as well as who accrues and shares the savings. Throw in the variable of different reimbursement rates for commercial, Medicare and Medicare Advantage patients and you can see why partnering up to set up an information network is more than simply writing a check.

2012 and Beyond

So what does this all mean for a huge guest who’s seemingly unwanted at the party? Ultimately, payers’ involvement boils down into a few categories:

In the light of the tighter margins imposed by health reform, insurers who can afford it will diversify their business. The national health plans will be looking to acquire their own platform ala Aetna and UHG, with the additional hopes of squeezing cost savings out provider users and building a more favorable MLR. The main considerations in predicting this shift include vendor consolidation and the readiness of existing provider networks to collaborate.
Regional Insurers, such as the Blues and other statewide or multistate networks, have the wherewithal to setup and license their own platform for exchange either through payer-payer partnerships or on their own. The recent NaviNet deal seems to be more of an ACO play, but indicative of the business strategy of this class of payers who are willing and able to be flexible in how they approach their role as stakeholder in information networks.
Local Insurers who have fewer resources and who operate directly in the tides of market competition will opt for a ‘safer,’ multi-stakeholder approach in their communities. Partnerships will be heavily influenced by network dynamics, reimbursement channels and existing arrangements, such as burgeoning accountable care communities.

So, as rosy as information exchange seems on paper, it is permanently changing the way that provider and payer groups do business. From where Chilmark stands as an observer of the market’s evolution, it is all too clear that payers and providers ultimately have little choice but to work together. Payment reform and millions in IT incentives have already begun to influence the way that the delivery and payment markets work; the future of accountable care, proactive population health management and ‘smart’ health care delivery all depend on willing and trusting partnerships.

Unfortunately, as is too often the case, patients and other stakeholders get left out of the decision calculus. Pittsburgh residents will hardly benefit from the competitive business posturing there. We hope the folks deploying HIE’s over the coming years will put as much of an emphasis on leadership and governance as they do on technology and of course, the health of their business.

Are Retiring Physicians Eligible for Incentives? – Meaningful Use Monday | EMR and HIPAA

Mon, 20 Feb 2012 10:34:31 -0500

Lynn Scheps is Vice President, Government Affairs at EHR vendor SRSsoft. In this role, Lynn has been a Voice of Physicians and SRSsoft users in Washington during the formulation of the meaningful use criteria. Lynn is currently working to assist SRSsoft users interested in showing meaningful use and receiving the EHR incentive money. Check out Lynn’s previous Meaningful Use Monday posts.

As the industry anxiously anticipates the Proposed Rule for Stage 2 meaningful use—likely expected during HIMSS this week—many providers are still struggling to understand meaningful use Stage 1. So while we wait for the impending news story to break, let me address another question that was recently posed by a reader.

Q: Can a physician attest and earn a Medicare EHR incentive for his second reporting year if he will be retiring in the middle of the year?

A: To my surprise, this situation is not explicitly addressed in the regulations. One would think that a physician who works full time for part of the year would be just as eligible as one who works part time for the full year. The retiring physician, however, faces two obstacles: 1) The regulations require that an EP report for an entire calendar year after receiving a first meaningful use payment. 2) The EP must have an active enrollment record in PECOS (Medicare) to be eligible to attest—if he retires and withdraws from Medicare, he would no longer have active status. These factors suggest that a retiring physician is not eligible for an incentive (unless, of course, he times his retirement for the end of the year!)

In lieu of a definitive answer to the question, however, I offer the following food for thought: 1) Couldn’t the retiring physician simply wait until December 31 to attest and then report on the full calendar year? 2) What if he simply postpones surrendering his PECOS enrollment until the end of the year? (According to a local Medicare contractor, nothing prohibits him from doing that even though he would no longer be submitting claims.) If there are countervailing reasons not to do this that readers are aware of—and there may well be—please share your insights by commenting below.

(Note: This is not an issue for retiring physicians in their first incentive year since they attest immediately upon the conclusion of their 90-day reporting period.)

Identifying Therapeutically Relevant Genetic Abnormalities in Cancer Patients | Lab Soft News

Mon, 20 Feb 2012 10:06:43 -0500

I just came across an example of a new type of cancer genomic test. Foundation Medicine has developed a test that utilizes tumor biopsies to detect the presence of therapeutically relevant gene abnormalities (see: High-Speed DNA Scans Help Most Lung Cancer Patients, Study Finds). Below is an excerpt from the article:

More than half of lung and colon cancer patients may benefit from high-speed tests that detect DNA flaws doctors can target with existing medicines, a study found. Researchers used a gene test made by closely held Foundation Medicine...to sequence 145 cancer-associated genes in 40 colon tumor samples and 24 lung tumors. They found that 53 percent of colon tumors and 71 percent of lung tumors had mutations that may be attacked with cancer medicines on the market or in human trials....In some cases, the results revealed what drugs wouldn’t work against the tumors. The study from researchers at Foundation Medicine and the Dana-Farber Cancer Institute in Boston, shows the value of using DNA sequencing machines to optimize treatment by matching drugs against specific gene abnormalities inside a patient’s tumor....The researchers also spotted a previously unknown genetic flaw in 2 percent of 561 lung tumors tested. The flaw activates a growth-boosting protein targeted by [the] Pfizer...kidney- cancer drug Sutent, hinting that the treatment from the New York-based drugmaker may also work in these lung patients....

Here's more information about the test from the web page of Foundation Medicine (see: For Physicians, Our Approach):

Foundation Medicine has developed a molecular diagnostics test that analyzes routine clinical [tumor] specimens for somatic alterations in relevant cancer-related genes. It provides valuable information needed to inform treatment decisions based on an individual patient’s molecular cancer subtype....Our test is designed to capture molecular information for all solid tumor types, therefore alleviating the uncertainty associated with appropriate selection of genomic tests for patients, and subsequent interpretation of multiple sets of information. Using DNA extracted from cancer biopsy tissue, our test examines a wide range of specifically targeted cancer-related genes for all potential somatic alterations....Our broad approach, which captures any relevant alterations in one test, is made possible by using massively parallel sequencing. Although many alterations may be identified, our proprietary analytics specify the small number (average 2-3) of somatic alterations that are reportable and actionable for each patient....Test performance requires a very small amount of cancer tissue such as that typically obtained from surgical resection, core needle biopsy, or fine needle aspirate (FNA). [The test] uses routine clinical pathological specimens, typically formalin-fixed paraffin embedded (FFPE) tumor tissue....Foundation Medicine’s comprehensive cancer genomics test will be launched nationally mid-2012.

Very quickly, a few points jump out at me from the description of this new test:

I have stated in previous notes that I prefer the term targeted therapy over personalized medicine (see: Genetic Testing to Cull Out the "Un-Right Patient" as a Candidate for a Particular Drug Therapy; A "New" Twist on Personalized Medicine: Genetically Targeted Therapy). This more specific term is used frequently in the Foundation Medicine web site. The discovery of "actionable and reportable" genetic tumor flaws is clearly the goal of this new approach.
As noted above, the test, in a research study, has detected a "previously unknown genetic flaw in 2 percent of 561 lung tumors tested." We are thus now seeing the emergence of a type of test will become routine for hospitalized cancer patients and that will also generate a list of new targets for biotech drugs. In other words, new information will now be moving "bed to bench."
Finally, we are witnessing a genomic test that will change over time as new drugs come to market and as the the list of actionable cancer genes expands. In other words, such a test done today will be different than the "same" test a few months ago. A patient's tumor will also need to be genomically tested periodically to confirm that the patient is being treated optimally.

You’re Invited: HIMSS12 to Host Live #HITsm Chat, Wed., Feb. 22 at 11 AM, PT | HL7 Standards » HL7 Blog

Mon, 20 Feb 2012 09:27:13 -0500

Please join us for a very special #HITsm TweetChat, on a new day, time and location. I am happy to announce that Jon Mertz (@jonmertz) and Erica Olenski (@thegr8chalupa) will be hosting a #HITsm TweetChat “In Real Life” at 11 a.m., PST, this Wednesday in the HIMSS Social Media Center. If you will be in [...]

HIMSS So Cal Healthcare IT Conference | Christina's Considerations

Mon, 20 Feb 2012 08:53:00 -0500

Just as I'm getting ready to experience the big HIMSS Conference, the Southern California Chapter has released its agenda for their upcoming Healthcare IT Conference in Los Angeles.

The conference is a great opportunity to hear from National and California leaders on HIEs, EHRs and Meaningful Use, wireless health IT applications, development of the HIT workforce and job search strategies, and accountable care organizations. It is also a perfect networking event.

I'm excited for the opportunity to return to my roots in Health IT and participate on the HIE panel. Register here to join us at the Center for Healthy Communities at the California Endowment near downtown Los Angeles on April 4, 2012 from 8am to 4pm. I hope to see you there!

Creating a Service Oriented Culture in Healthcare IT | Galen Healthcare Solutions: Allscripts Consultants Enterprise EHR

Mon, 20 Feb 2012 08:00:42 -0500

I just finished reading a blog by Scott Ruehle on the Healthcare IT News website entitled “Six Keys to Creating a Service-Oriented Culture in Healthcare IT”. The post originally appeared in the blog@SunViewSoftware.com on January 18, 2012. Ruehle describes himself as an “IT Process Manager for a healthcare IT organization” and he shares his views [...]

Build a business that is good for you | Wellington Digital

Mon, 20 Feb 2012 06:31:56 -0500

You’re no doubt aware that marketing is about creating something that people want and convincing them to buy it from you. But in small business, do we take too narrow a view of it?

Consider the ‘official’ definition of marketing as presented by the American Marketing Association: “Marketing is the activity, set of institutions, and processes for creating, communicating, delivering, and exchanging offerings that have value for customers, clients, partners, and society at large.”

It’s easy to understand the first part about creating and delivering value to customers. But take a look at the last part of the definition: it also includes doing things in a way that creates value for our partners and society in general.

This is a part of the equation that big businesses forgot over the years, as they selected suppliers based on the lowest possible price, regardless of how those suppliers had to slash their own margins or screw their own employees to do that.

They also closed local factories and went offshore to source ever-cheaper goods, and tried not to think about conditions in those factories. In terms of affordability, this was great for the customer: think about what you pay for clothes and electronic goods compared to 10 or even 20 years ago. But it was not so good for local suppliers, or workers in those factories.

When businesses realized the damage this approach caused to their reputation, they went down the path of corporate social responsibility, investing in ‘good works’ to restore their reputation.

Read the rest of this article on NETT

Real-time access to controlled drugs data from July | Pulse+IT Magazine

Mon, 20 Feb 2012 01:25:18 -0500

The components of the electronic recording and reporting of controlled drugs system (http://www.health.gov.au/internet/ministers/publishing.nsf/Content/mr-yr12-tp-tp014.htm) announced by the federal government last week are still being worked out but will be based on an existing system designed by Hobart-based XVT Solutions (http://www.xvt.com.au/) under contract to the Tasmanian Department of

Weekly Australian Health IT Links – 20th February, 2012. | Australian Health Information Technology

Mon, 20 Feb 2012 00:30:02 -0500

Here are a few I have come across the last week or so. Note: Each link is followed by a title and a few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment. General Comment Really a quiet sort of week with a couple of highlights. The first is the first statement I have seen from the opposition on the PCEHR as reported by e-Healthspace.org. The comparison with ‘pink bats’ does not seem to bode all that well. The other big issue is the re-emergence of the incentive issue for GPs to assist patients with their PCEHR. This story certainly has some way to run! Enjoy a quiet week as we are meant to hear from the PCEHR Senate Enquiry next week! ----- http://ehealthspace.org/news/opposition-votes-ehealth-slams-pcehr Opposition votes for ehealth, slams PCEHR Posted Wed, 15/02/2012 - 12:42 by Josh Gliddon The federal opposition has weighed into debate about the...

This is the initial part of the post - read more by clicking on the title of the article. David.

Weekend EHR and Meaningful Use Roundup – Justin Barnes #HIMSS12 Edition | EMR and HIPAA

Mon, 20 Feb 2012 00:12:44 -0500

It’s Sunday and the excitement to see old friends and hear interesting things at HIMSS 2012 is just around the corner. The #HIMSS12 hashtag is off the charts with people flying into Las Vegas and others talking about what they’re doing, seeing, hearing and expecting from HIMSS Las Vegas.

Most people on Twitter are quite excited for HIMSS (as am I), but a few have said that people won’t be missing much. I thought about it for a minute and realized that the thing I love most about HIMSS is meeting really smart people. With 37,000 people likely to attend HIMSS 2012, there are plenty of smart people to meet and connect with at HIMSS.

Justin Barnes, VP at Greenway Medical, is one of the smart people I like to talk with at HIMSS. Turns out that tonight he was sharing some of that wisdom, information and perspective on Twitter tonight. So, this EMR and Health IT Twitter roundup is the Justin Barnes edition.

Strong #MeaningfulUse progress ~ $3.1+ billion paid to 43,000+ care providers. #CMS #EHR #EMR @ONC_HealthIT @CMSGov #HealthIT #HIMSS12

— Justin Barnes (@HITAdvisor) February 20, 2012

I wish he would have broken this out into ambulatory doctors versus hospitals. $3 billion of ~$36 billion projected. I guess they’re expecting a windfall next year?

That is the billion-dollar question @theEHRGuy. There are good reasons to stay the #ICD10 course & good reasons to delay…. #HIMSS12

— Justin Barnes (@HITAdvisor) February 20, 2012

Is a billion dollars at stake in the ICD-10 delay decision? Regardless of the exact amount, it shows you the magnitude of the ICD-10 delay announcement.

Tuesday looks to be the day now when we should see the #MeaningfulUse Stage 2 proposed rule. #CMS did try to get it out on Friday. #HIMSS12

— Justin Barnes (@HITAdvisor) February 20, 2012

Someone on Twitter asked if it could be delayed past Tuesday. Neil Versel from Meaningful Healthcare IT News answered well: “Never underestimated bureaucracy.”

Good #MeaningfulUse update ~ $71M+ paid to 3,379 Nurses & Physicians Assistants under #Medicaid #EHR Program. #CMS #HIMSS12

— Justin Barnes (@HITAdvisor) February 20, 2012

That’s a little surprising to me that so many Nurses and PA’s got paid so much since they only qualify under Medicaid. I’m glad to hear it.

$412,866,000 in #EHR #MeaningfulUse incentives paid to 22,937 #Medicare Eligible Professionals. #HIMSS12 #EHRAssociation @CMSGov #EMR

— Justin Barnes (@HITAdvisor) February 20, 2012

When the number is totally written out, that’s a lot of 000′s and that’s only millions.

Looking forward to seeing many old friends and making many new friends at HIMSS this week.

AusHealthIT Poll Number 109 – Results – 20th January, 2012. | Australian Health Information Technology

Sun, 19 Feb 2012 22:57:25 -0500

The question was: Would Requesting Detailed Reports From The AGIMO And ANAO Assist The Senate Enquiry Into The PCEHR and NEHTA? Not At All - 19 (51%) Possibly - 8 (21%) Probably - 1 (2%) You Bet! - 9 (24%) Votes: 37 Very interesting result - I would love to know why there is so little confidence in the oversight agencies. Feel free to post a comment PLEASE on why the scepticism. Again, many thanks to those that voted! David.

This is the initial part of the post - read more by clicking on the title of the article. David.

Doctor Dalai's Ultimate PACS Fix | Dalai's PACS Blog

Sun, 19 Feb 2012 22:29:00 -0500

Confusion regarding admission | Forum Discussions - Health Informatics Forum

Sun, 19 Feb 2012 22:05:12 -0500

Hello,

I am Doctor from India.

I have got admission both in University of Leeds as well as in City University.

I am confused which to choose?

also I want to know about the future scopes in the field.

The Placebo Drug Effects–Clinical Studies, Trials and Research With Anti-Depressant Drugs and the Degree of Effectiveness | The Medical Quack

Sun, 19 Feb 2012 22:02:59 -0500

Women running through daisy fields as the commercials indicate with advertising. This is perplexing to see where the placebo effect lies. Severely depression doesn’t seem to be of question but more so moderate depression is questioned. It’s interesting the way the comments are made on how the FDA approves the anti-depressant pills. Are the negatives being thrown out with studies?

The degree of effectiveness is a big area of discussion, so if there’s only a very small improvement there may be no need for the durg to be prescribed. None of the drug companies wanted to go on camera to talk about it. Lily said that patients on placebos are more likely to relapse (huh), that is an odd statement.

If you want to hear someone in the US who’s looks at the math with clinical trials, use the link below as he discusses he same issues with the numbers without all the data being included when looking at the data.

Context is Everything–More About the Dark Arts of Mathematical Deception–Professor Siefe Lecture Given at Google’s New York Office–Big Healthcare Focus

Maybe there is more Asymptomatic Depression, in other words depression that is better treated with human intervention, exercise and other methodologies? Shoot even if you are not diagnosed depressed none of this can hurt you anyway.

Asymptomatic Depression: Hidden Epidemic and Huge Untapped Market (Reality Check)

Back in 2008 a study showed that half of US doctors often prescribe placebos too. BD

Half of U.S. doctors often prescribe placebos

http://www.cbsnews.com/video/watch/?id=7399362n&tag=contentBody;storyMediaBox

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