Healthcare Informatics

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What’s Next On Capitol Hill?

Mostashari’s Plea On Meaningful Use

Insurance Exchange Deadlines Loom

December 2012

Volume 29, Number 10

Bridging the EHR Divide

A Vendome Publication

RE 20 SO 13 GU U ID RCE E

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CONTENTS December

COVER STORY 8

26

Ronald N. Riner, M.D., CMO of Health Management Associates, a hospital management firm, shares his perspective on integrated PM and EHR solutions in a smaller-hospital/medical group integrated system

BRIDGING THE EHR DIVIDE Genuine interoperability across the inpatient-outpatient divide is the key to moving forward on the many fronts of healthcare reform. Yet establishing automated connectivity between hospitals and physicians, including doctors in private practices, is proving to be particularly challenging. What are healthcare IT leaders doing to build bridges between the various groups as they guide their organizations forward?

BY MARK HAGLAND

30

HEALTHCARE’S NEW CONNECTOR: THE CHIEF INTEGRATION OFFICER The chief integration officer is emerging as the pointperson that ties together physicians and hospitals as health systems move toward a future of value-based population-health initiatives. It’s a demanding role that brings together long tenure at the organization, familiarity with the provider and payer sides, care management experience, familiarity with IT, and clinical credentials

BY MARK HAGLAND

32

BY TERRI GOCSIK

34

BY MARK HAGLAND

38

BY MARK HAGLAND

DEPARTMENTS INSIDE

6

EDITOR’S PAGE

22

POLICY UPDATE WHAT’S NEXT FOR HEALTHCARE ON CAPITOL HILL? Blair Childs, vice president for public affairs at the Premier health alliance, shares his views on the implications for healthcare policy and, in particular, healthcare IT policy, in the wake of the November federal elections

BY MARK HAGLAND

24

MEANINGFUL USE PERSPECTIVE MAKING THE CASE FOR EMPOWERMENT Why Farzad Mostashari, M.D. made a passionate case at the CHIME Fall Forum for his vision of the healthcare system of the future

BY MARK HAGLAND

FINANCIAL UPDATE AN UNCERTAIN PATH AHEAD Is Medicare reimbursement uncertainty inhibiting the willingness of medical groups to develop new care delivery and reimbursement models and make investments?

BY JENNIFER PRESTIGIACOMO

4

INSURANCE EXCHANGE UPDATE MEETING INSURANCE EXCHANGE DEADLINES CSC’S Jordan Battani shares her views on how—and whether—states will be able to meet the fast approaching deadline for implementing health insurance exchanges

MOBILE DOCUMENTATION: DOING MORE WITH LESS How the University of Missouri Health System adapted its barcode scanning system for mobile patient-bedside medication documentation administration—a budget neutral innovation that led to better patient care

ANESTHESIOLOGY UPDATE LAST MAN STANDING? Advice for implementing an electronic medical record in anesthesiology services, which is often the last department to make the transition from paper to the electronic world

BY JENNIFER PRESTIGIACOMO

20

DOCUMENTATON UPDATE BALANCING CLINICAL AND ADMINISTRATIVE USES IN PHYSICIAN DOCUMENTATION The tension between supporting a rich patient narrative and structured documentation was a central theme at the AMIA 2012 Symposium as a panel of clinical informaticists discussed the implications for physician workflow, efficiency, clinical effectiveness, and care quality

BY RICHARD R. ROGOSKI 14

CMO PERSPECTIVE MEETING THE NEEDS OF SMALLER PROVIDERS

39

POPULATION HEALTH UPDATE THE CASE FOR PAYER-PROVIDER TEAMWORK Why payers and providers should collaborate by sharing and integrating clinical data when it comes to achieving better outcomes in population health

BY GABRIEL PERNA

64

CAREER PATHS MAINTAINING HIRING STANDARDS FOR TEMPORARY WORKERS

Why hiring managers need to be vigilant in the screening process of temporary workers, even as this group is proving their value in the new economy

BY TIM TOLAN

★ 2013 RESOURCE GUIDE ★ 41 HEALTHCARE INFORMATICS’ ANNUAL COMPREHENSIVE GUIDE TO ALL ESSENTIAL VENDORS IN THE INDUSTRY

Healthcare Informatics (ISSN 1050-9135) is published 9 times per year by Vendome Group, LLC, 6 East 32nd Street, 8th Floor, New York, NY 10016. Periodicals postage paid at New York, NY and additional mailing offices. POSTMASTER: send address changes to HEALTHCARE INFORMATICS, P.O Box 2178, Skokie, IL 60076-7878. Subscriptions: For questions or correspondence about a subscription, phone 847-763-9291 or write to HEALTHCARE INFORMATICS, PO Box 2178, Skokie, IL 60076-7878. If you are changing your address, please enclose entire mailing label and allow 6 to 8 weeks for change. Subscription rate per year (U.S. Funds): U.S. $58.00; Canada/Mexico $82.00; all other countries $109.95 (includes air delivery). Single copy rate (U.S. Funds) except September and January: U.S. $8.00; Canada/Mexico $12.00; all other countries $15.00. September 100 and January Resource Guide: $50.00 (U.S. Funds) includes shipping/handling to all countries. Add state and local taxes as applicable. 2 December 2012 • www.healthcare-informatics.com

Healthcare

Informatics

INSIDE

Healthcare IT Leadership, Vision & Strategy

EDITORIAL

Building Bridges for Providers, Mobile Documentation, Next Policy Moves

A

s healthcare moves toward a model of value-based care, the need to build bridges to facilitate the collaboration among caregivers has never been greater. This month’s cover story package takes a deep dive into what this means for both IT infrastructure as well as the human side of the equation. On page 8, Richard R. Rogoski looks at what CIOs and other healthcare IT leaders are doing to establish automated connectivity between hospitals and physicians, including doctors in private practices. In the companion article on page 14, Senior Editor Jennifer Prestigiacomo examines the emerging role of the chief integration officer, which combines the necessary clinical, IT and organizational credentials to tie together physicians and hospitals across the care continuum as they move toward a future of value-based population health initiatives. Beginning on page 20, Prestigiacomo presents an intriguing example of a healthcare provider organization that is using its existing technology to do more with less. In an effort to optimize its bedside documentation workflows, the University of Missouri Health System has adapted its barcode-scanning system for mobile patient-bedside medication administration documentation, which advanced the speed of documentation of patient data and improved patient care. On page 24 Editor-in-Chief Mark Hagland reports on one of the highlights of the CHIME Fall Forum: an impassioned plea by Farzad Mostashari, M.D., the National Coordinator for Health Information Technology, on his vision for the future of healthcare. Also in this issue on page 34, Hagland writes about his revealing conversation with CSC’s Jordan Battani on deadlines for health insurance exchanges, and how prepared states are to move ahead on that front. Will payers and providers be able to move beyond their often adversarial relationship to a more collaborative one? In the article on page 39 Associate Editor Gabriel Perna examines a report, recently released by PricewaterhouseCoopers, that suggests that population health is an opportunity for both parties to work together to share and integrate data that will produce better results for patients. MORE ONLINE

Make sure to visit www.healthcare-informatics.com for the latest healthcare IT coverage: ACOs and patient care; personalized medicine; top healthcare IT trends in 2013; UPMC’s healthcare analytics initiative; and an outside-the-box approach to patient satisfaction.

2012 EDITORIAL BOARD Marion J. Ball, Ed.D. Professor, Johns Hopkins School of Nursing Fellow; IBM Center for Healthcare Management; Business Consulting Services, Baltimore, MD Lyle L. Berkowitz, M.D., FHIMSS Medical Director, Clinical Information Systems Northwestern Memorial Physicians Group, Chicago, IL William F. Bria II, M.D. CMIO, Shriners Hospital for Children, Tampa, Fla. Adjunct Associate Professor, University of Michigan Tina Buop CTO, La Clinica de La Raza, Oakland, CA Bobbie Byrne, M.D. VP for HIT, Edward Hospital, Naperville, IL W. Reece Hirsch Partner, Morgan, Lewis & Bockius LLP, San Francisco, CA Christopher Longhurst, M.D. CMIO, Lucile Packard Children’s Hospital, Clinical Assistant Professor of Pediatrics, Stanford University School of Medicine, Palo Alto, CA

4 December 2012 • www.healthcare-informatics.com

Brian D. Patty, M.D. Vice President and CMIO, HealthEast Care System, St. Paul, MN Chuck Podesta SVP and CIO, Fletcher Allen Health Care, Burlington, VT Wes Rishel VP and Research Area Director, Gartner Healthcare, Industry Research and Advisory Services, Alameda, CA Benjamin M.W. Rooks Principal, ST Advisors, LLC, Evanston, IL Rick Schooler Vice President and CIO, Orlando Health, Orlando, FL Patricia Skarulis Vice President and CIO, Memorial Sloan Kettering Cancer Center, NY, NY Fran Turisco Director, Aspen Advisors, Denver,, CO Ferdinand Velasco, M.D. Chief Health Information Officer, Texas Health Resources, Arlington, TX

EXECUTIVE DIRECTOR OF EDITORIAL INITIATIVES Charlene Marietti [email protected] EDITOR-IN-CHIEF Mark Hagland [email protected] MANAGING EDITOR John DeGaspari [email protected] SENIOR EDITOR Jennifer Prestigiacomo [email protected] ASSOCIATE EDITOR Gabriel Perna [email protected] SENIOR CONTRIBUTING EDITOR David Raths [email protected]

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EDITOR’S PAGE

Got Velcro? HEADING INTO 2013, THE HEALTHCARE INDUSTRY COULD USE THE INGENUITY OF INVENTORS LIKE GEORGE DE MESTRAL

H

eading into 2013, I thoroughly enjoyed a short article in the Nov. 11 New York Times Magazine entitled “Who Made That?” In the article, Pagan Kennedy writes, “In 1941, a Swiss engineer named George de Mestral returned from a hunting trip with burs clinging to his pants and tangled in his dog’s coat. When de Mestral examined the seedpods under a microscope,” Kennedy notes, Mark Hagland “he marveled at how they bristled with hooks ingeniously shaped to grasp at animal fur. Most people stop at the ‘Oh, that’s cool, that’s what nature does,’” says Janine Benyus, a pioneer in the field of biomimicry, the science of studying natural models— anthills and lizard feet, say—to solve human problems. But de Mestral went much farther; and of course, because of his curiosity, we have Velcro. I remember, myself, personally discovering Velcro as a child, and finding it quite fascinating. But what I want to focus on here is not the inherently interesting quality of Velcro, as delightful as that is; rather, it is the human ingenuity that looks, observes, and applies observations to problems, and comes up with novel solutions. That’s exactly the kind of spirit that is being brought to bear in innumerable situations these days in the healthcare and healthcare IT world, and honestly, such spirit is needed now more than ever before. With healthcare costs inevitably increasing because of the aging of the U.S. population and a continuing climb in the prevalence of chronic illnesses, our nation’s healthcare cost trajectory is unsustainable. But many of the innovations being pioneered across the U.S. healthcare system—accountable care, bundled-payment contracts, the patient-centered medical home, alternatives to hospitalization, evidence-based care strategies— are already reaping rewards, both under federal and state auspices, and across the private healthcare sector, and with very impressive results. This month’s cover story package contains two articles that look at the challenges facing those who would truly 6 December 2012 • www.healthcare-informatics.com

integrate inpatient and outpatient clinical care and other information systems, and the emerging role of the chief integration officer in healthcare IT. Building workable bridges across the inpatient-outpatient IT divide remains exceptionally complex and difficult, but offers tremendous potential to improve care delivery community-wide and even healthcare system-wide. More broadly, the shift towards a new population healthbased focus, and towards authentic care management, is requiring not only bridges across the divide between care locations, but also intensive work to develop care delivery and management models healthcare system-wide. It goes without saying that this is difficult work; yet the leaders at many pioneering organizations are powering ahead, forging new paths without waiting for anyone to direct them to the new healthcare. And of course, they’re building new information systems and IT capabilities to support their innovations. In that regard, we’ll be hosting a very exciting event this spring: our third annual Healthcare Informatics Executive Summit, to be held May 15-17, 2013 in San Francisco. We’ll have both lecture-style presentations and panel discussions on a very broad range of topics, from population health and analytics, to the implementation of system-wide dashboards to support readmissions reduction, to privatesector ACO development. Here’s the link to our microsite: http://www.healthcare-informatics.com/summit/ healthcare-informatics-executive-summit-2013. So as we close our calendars on 2012 and open them to 2013, there has never been a time when ingenuity and invention were more needed than now. Fortunately, our healthcare system is blessed with countless George de Mestrals. So while there are challenges galore, there are also opportunities aplenty. Here’s to 2013—and to the as-yet inventions that will be the new versions of Velcro.

Mark Hagland Editor-in-Chief

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COVER STORY

BRIDGING THE EHR HOSPITALS, PHYSICIAN PRACTICES WORK TOWARD TRUE INTEROPERABILITY BY RICHARD R. ROGOSKI

EXECUTIVE SUMMARY: Moving forward in so many areas, including under meaningful use, will require the establishment of genuine interoperability across the inpatient-outpatient divide, and in particular, far more automated connectivity between hospitals and physicians, including those doctors in private practice. But building bridges in this area is far more complex than it first appears, say healthcare IT leaders who are guiding their organizations forward say the healthcare IT leaders who are guiding their organizations forward nationwide.

W

ith the policy landscape emerging out of healthcare reform having been clarified by a Supreme Court ruling and the November federal elec-

8 December 2012 • www.healthcare-informatics.com

tions, and with the meaningful use process under the federal American Reinvestment and Recovery Act/Health Information Technology for Economic and Clinical Health (ARRA/ HITECH) Act proceeding apace, there has never been a more urgent need for clinicians and others to share information across the inpatient-outpatient divide. But the basic reality of disparate, multiple electronic health record (EHR) systems involved in most hospital-physician communications remains a stumbling block to easily facilitated sharing of key clinical information at the point of care or use. That reality is proving to be thorny on multiple levels, as healthcare IT leaders try to help lead their organizations forward towards such important goals as accountable care, health information exchange (HIE), analytics for value-based

purchasing, and other efforts. A report published last year by IDC Digital Marketplace predicted that am-

COVER STORY

DIVIDE

Getting to that point means having those of its affiliated practices are the to overcome some basic challenges, ac- historically slow adoption rate of EHRs cording to a survey conducted by the by physicians, and the variety of availWashington, D.C.-based Biable best-of-breed syspartisan Policy Center and tems, says Cervenak. Doctors Helping Doctors. “Many decisions were Results of the survey, pubmade before vendors lished in October, showed had a solution for that 71 percent of clinicians both sides,” she says. cite lack of EHR interop“Hospitals also may erability and information have acquired physiexchange infrastructure as cians and gotten their major barriers to the exsystems.” Additionally, change of health informaorganizations may not tion. In addition, 69 percent be inclined, because of say the cost of creating and time or cost, to replace Jody Cervenak maintaining interfaces is a these older systems major problem. with a single, integratAlso, more than half of ed system, she notes. the respondents say they Traditionally, getwant critical data pushed ting disparate systems to them electronically, to communicate with but prefer to selectively each other has only retrieve other, less critirequired an interface cal information. The deengine based on an insire to cherry-pick data dustry standard such comes as no surprise to as HL7 ( from the stanJody Cervenak, a principal dards organization at the Pittsburgh-based Health Level Seven consulting firm Aspen International, Ann ArAdvisors. “Each physician bor, Mich.). But that Donald Cope, Jr. has a need for very spemay not be enough cific data,” she says. “Each when all kinds of data wants a different slice of the electronic need to travel from multiple departhealth record.” The kind of data being ments in a hospital to the hospital’s core accessed will largely depend upon that EHR and then to numerous physician physician’s specialty, she adds. practices. Likewise, physicians need to Donald Cope, Jr., director of infor- send orders and data from their EHR mation systems and security officer at back to the hospital, so a bidirectional Newman Regional Health in Emporia, solution is needed. Kan., notes that mobile technology has In order to achieve that kind of highstreamlined data capture and compli- level interoperability, a separate intecated issues of interoperability as well. gration system needs to be installed, “Clinicians want data sent to their cell Cervenak says. Essentially “middlephones, but they don’t want all the re- ware,” that system is able to collect and “harmonize” data—converting it into an understandable, cross-platform format while maintaining the original meaning of the data.

EACH PHYSICIAN HAS A NEED FOR VERY SPECIFIC DATA. EACH WANTS A DIFFERENT SLICE OF THE ELECTRONIC HEALTH RECORD. —JODY CERVENAK bulatory EHR use will increase from less than 25 percent adoption in 2009 to over 80 percent by 2016. With adoption on the rise, hospitals and medical groups are making a concerted effort to achieve total interoperability between their systems.

sults,” he says. “They want the system to think for them—to alert them.”

GETTING CONNECTED Among the reasons for the lack of integration between a hospital’s EHR and

ESTABLISHING THE LINK While the meaningful use program offers financial incentives for physicians to purchase and use EHRs—and will eventually penalize those who don’t—a number of large hospitals have found it

www.healthcare-informatics.com • Healthcare Informatics 9

COVER STORY

advantageous for themselves and their physician practices to offer their own form of monetary assistance. Jim Venturella, CIO for physician and hospital services at the University of Pittsburgh Medical Center (UPMC)

Since all of UPMC’s employed physicians use Epic’s EHR, true interoperability between Epic and Cerner was achieved by installing a semantic interoperability solution provided by Pittsburgh-based dbMotion Inc., Ven-

CLINICIANS WANT DATA SENT TO THEIR CELL PHONES, BUT THEY DON’T WANT ALL THE RESULTS. THEY WANT THE SYSTEM TO THINK FOR THEM— TO ALERT THEM. —DONALD COPE, JR. turella says. This allows in Pittsburgh, Pa., has all data captured and been working with his stored in each system colleagues to provide to be harmonized and connectivity to the orreadily retrievable by ganization’s more than any clinician, he notes. 3,200 employed physiThe interoperability socians and 2,000 non-emlution also allows UPMC ployed, affiliated physito participate in a ninecians. hospital HIE which UPMC’s inpatient started pushing data last EHR is from the Kansas summer, he says. City, Mo.-based Cerner Karen Thomas, vice Jim Venturella Corporation, and was president and CIO of implemented in the late Main Line Health in 1990s. On the outpatient Bryn Mawr, Pa., is workside, Venturella notes ing toward total interopthat affiliated practices erability as well, but are offered several opis not quite there yet. tions when it comes to With a medical staff of outpatient EHR adop2,200 and non-employed tion. The health system’s physicians numbering choice for its employed about 1,900, Main Line physicians is the EHR is currently working on solution from the Veroa bidirectional interface na, Wis.-based Epic Sysso that physician practems Corporation; nontices can send orders employed, affiliated Karen Thomas electronically to any one physicians may choose of Main Line’s six hospieither Epic or the Chicago-based Allscripts; high admitters, he tals. To facilitate that process, Thomas notes, tend to pick Epic. For those practices that already have their own EHR, says her organization also plans to

and Health Level Seven International. It allows for the exchange of reports and clinical data in the original format. Main Line’s core inpatient EHR is Soarian Clinicals, supplied by Siemens Healthcare, Malvern, Pa. It was chosen because it is scalable and has an integrated database between EHR and practice management functions, she says. The ambulatory EHR for employed physicians is supplied by NextGen Healthcare, Horsham, Pa. Community physicians who are not employed by Main Line use an EHR supplied by eClinicalWorks, Westborough, Mass. To increase the EHR adoption rate among community physician practices, Thomas says Main Line offers a loan program that covers eClinicalWorks. “We bought the licenses and if they get meaningful use dollars, they pay us back,” she says. Main Line has partnered with Siemens to provide its MobileMD solution to establish an operational link between these varied EHRs, Thomas says, adding that this allows harmonized data to be sent to a physician practice’s EHR so that the physician can select the data he or she wants. Thomas also notes that Main Line is planning to become part of a regional HIE; and she says she’s confident that the MobileMD platform will be able to handle the interoperability demands of multiple links.

THE HIE CONNECTIVITY FACTOR Hoag Memorial Hospital Presbyterian, located in Newport Beach, Calif., has been part of a private, three-hospital HIE for two years, according to Tim Moore, senior vice president and CIO. To achieve the necessary connectivity to the HIE, Hoag chose Salt Lake City, Utah-based Medicity. Although the hospital’s core EHR is Allscripts Sunrise Clinical Manager, the EHRs being used by physician practices run the gamut from Allscripts to NextGen to eClinicalWorks, he says. Moore says that until three years ago, Hoag had in place a program through which it helped subsidize a practice’s purchase of an EHR from one of those three vendors. But when

TO BE MEANINGFUL USE-CERTIFIED, THEY MUST INCORPORATE STANDARDS. BIG INDUSTRY PLAYERS COULD COME TOGETHER AND BREAK DOWN COMPETITIVE BARRIERS. —JODY CERVENAK UPMC offers a connection back to the hospital’s core EHR via a customized platform provided by MedLink, a selfdeveloped solution at UPMC. 10 December 2012 • www.healthcare-informatics.com

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COVER STORY

the health system began to seriously can be sent from one system to the consider joining an HIE, that program other. was discontinued. Kieran Murphy, Hoag’s director of BREAKING DOWN BARRIERS health information exchange, notes Cope says that achieving interoperthat Hoag has approximately 1,500 ability between systems is the biggest affiliated physicians, challenge he has ennot all of whom have countered. Even though an EHR. Some are still the interface engine using paper charts and uses HL7, “There is a fax machines, he says. big difference between Still, the emphasis on interfacing and intean HIE, which was prigration. The challenge marily physician-driven was in the translation of because the hospital’s data,” he says. CEO is a physician, has Venturella agrees that paved the way for inachieving true interopcreased EHR interoperability can be proberability, resulting in lematic, especially since Kieran Murphy the connection of 825 vendors are slow in dephysicians. “Medicity is veloping cross-platform our HIE platform. Now standards that would it’s our intercommunity make it easier to intecommunication,” he grate disparate EHRs. notes. As a result, systems Not yet part of an need to be reconfigHIE, Newman Regional ured and a middleware Health adhered to a solution needs to be best-of-breed strategy employed. The problem until a few years ago, of harmonizing data says the health system’s is magnified when a director of information healthcare delivery sysservices, Donald Cope, tem becomes part of an Tim Moore Jr. In 2010, there were HIE, he says. three separate systems There are now a numand no interfaces, he recalls. “The old ber of integration platforms that essystems weren’t robust, but each sys- sentially act as middleware, accordtem suited the specialists,” he says. In- ing to Aspen Advisors’ Cervenak. But

START VERY EARLY WITH PHYSICIANS AND GET THEM INVOLVED. THEN PICK ONE GOOD BUSINESS PARTNER. —TIM MOORE stead of updating the modules, Newman Regional decided to look for one system that offers seamless integration. A hosted Magic Health Care Information System, supplied by MEDITECH, Westwood, Mass., was chosen for the 53-bed hospital. Each of the five clinics owned by Newman Regional rolled out NextGen Healthcare’s EHR. An interface engine resides in the hospital, Cope notes, and acts as a translator so that harmonized data 12 December 2012 • www.healthcare-informatics.com

getting all types of data into a form that meets the criteria for semantic interoperability is still a major hurdle. For example, there is no one code for allergies, she says, and lab values vary widely from test to test. There are many governing bodies working on standards, she notes, but vendors need to do their part. “To be meaningful use certified, they must incorporate standards,” she says, adding that “big industry players could

come together and break down competitive barriers.”

LESSONS LEARNED In advising others who are attempting to achieve interoperability between their hospital’s core EHR and those of affiliated practices, Venturella says, “Make sure people understand the difference between interfacing and interoperability.” And even if you’re relying on a sophisticated interface engine, Cope says, “Find a good interface engine for traffic control and one that is easy to use.” But even before choosing a software solution, the needs of all stakeholders must be considered, says Moore of Hoag Hospital. “Start very early with physicians and get them involved. Then pick one good business partner.” Thomas of Main Line suggests looking at the impact such interoperability efforts will have on physicians’ practices. That hospital started with a small pilot program and invited input from its physicians. “Start with small wins,” she says. Given the rapidly changing landscape of healthcare delivery, it is obvious that the old ways of exchanging patient information are no longer viable. Whether through federal mandates or decisions made by hospitals to streamline processes and stay competitive in the marketplace, physicians are now beginning to see the importance of EHRs and the sharing of data, not just with their hospital, but with other physicians as well. While there are still those who rely on paper charts and fax machines for the transmission of data, that number is declining. As private or state-run HIEs take hold, the electronic transfer of patient information will become even more relevant. For those who have an integrated platform from a single vendor spanning their entire enterprise, there is no problem in achieving interoperability. For those who don’t—and there are many—a middleware solution residing between disparate EHRs is at least, for now, a way to bridge the EHR divide. ◆

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COVER STORY

Healthcare’s New Connector:

The Chief Integration Officer WITH VALUE-BASED POPULATION HEALTH INITIATIVES ON THE RISE, A NEW ROLE IS EMERGING TO LINK PROVIDERS AND HOSPITALS IN THE CARE CONTINUUM BY JENNIFER PRESTIGIACOMO EXECUTIVE SUMMARY:

health, VP of integration, chief accountable care officer, and As healthcare moves toward a future in which providers will VP of the continuum of care, is beginning to formulate the handle more population level risk, the chief integration officer organizational design for population health management. will play a central role in helping hospitals integrate and align They’re juggling an overwhelming number of projects in a short time frame without many dedicated team with physicians to build a broad-based care members, says Amanda Berra, practice manmanagement platform. ager, research and insights, at the Washington, D.C.-based The Advisory Board Company, who rganizations are working on a mulidentified this role in a recent research brief. titude of initiatives to prepare for “I think the thing that is driving it is the growgreater contractual risk for populaing industry commitment to a future in which tion management, while also moving toward providers are going to handle a lot more populavalue-based care initiatives. In this new era tion-level risk,” says Berra. “Between the passage of accountable healthcare, a  new role, the of the ACA [Accountable Care Act], the emerchief integration officer, is beginning to take gence of a lot of commercial ACO contracts, the shape to link hospitals and providers in the number of new Medicare programs for ACO and care continuum. ACO-related demonstration projects, you defiThe chief integration officer, which is going Amanda Berra nitely sense a momentum in the industry.” by many titles, such as the VP of population

O

14 December 2012 • www.healthcare-informatics.com

COVER STORY Knight’s clinical integration responsibilities fall into several buckets, which include overseeing the affiliation of the 1,100-member hospital medical staff; creating mechanisms for physician alignment; facilitating the creation of an accountable care organization (ACO); and negotiating for group contracting with payers. “It’s very important that at each step along the way we facilitate integration and wire and connect these physicians together, both with each other and with the hospiEllis Knight, M.D. tal system,” says Knight. “Part of our strategy with the employed physician network is that we have everyone up on the same EHR.” The health system currently has an inpatient EHR provided NEW ROLE, NEW RESPONSIBILITIES by the Kansas City, Mo.-based Cerner Corporation, and is curEllis “Mac” Knight, M.D., senior vice president of physician and clinical integration at Palmetto Health (Columbia, S.C.), rently implementing Cerner on the ambulatory side to provide and executive medical director of  Palmetto Health Quality connectivity. Through the PHQC, Palmetto Health’s physicianCollaborative  (PHQC), has been in his integrator role for a led, patient centered, independent medical ACO, a discounted year now. He is an internist by training, and 10 years ago tran- Cerner EHR will be offered to non-employed physicians. Knight says that the ACO will be focusing on effectively managing certain populations like its own employee population of more than 10,000 and patients within its own zip code, which has one of the highest percentages of diabetic amputations in the country. At Baptist Health System in Birmingham, Ala., Scott Fenn is the first sitioned to the administrative side of medicine, after getting person in the chief integration officer role (he also holds the tia business degree. He’s worked in a variety of roles: vice presi- tle of vice president). He is responsible for inpatient and ambudent of medical affairs at Palmetto Health Richland, senior latory clinical strategies and for creating the Baptist Physician vice president of ambulatory services for the health system, Alliance Organization, which is a clinically integrated network of 400 affiliated physicians that will provide the opportunity to and now the head of the PHQC. Berra says she started seeing this position emerge a year ago, and it now is beginning to proliferate as  hospitals are integrating and aligning with physicians to build care management platforms that allow for risk segmentation, the ability to reach out proactively to high-risk patients, avoid preventable readmissions, and focus on chronic care management. Berra says she has been finding the chief integration officer in organizations that are committed to change. “The more clear-cut the ambition is to become a capable population manager at a health system, the more those health systems have taken early steps,” she says.

IT’S VERY IMPORTANT THAT AT EACH STEP ALONG THE WAY, WE FACILITATE INTEGRATION AND WIRE AND CONNECT THESE PHYSICIANS TOGETHER, BOTH WITH EACH OTHER AND WITH THE HOSPITAL SYSTEM. —ELLIS KNIGHT, M.D.

www.healthcare-informatics.com • Healthcare Informatics 15

COVER STORY share data across many Baptist Health ambulatory clinics located throughout north and central Alabama, four hospitals, and aligned post-acute providers. “[We’re] really working on collaboration with our doctors through our IT infrastructure committee, which includes the key hospital IT leadership [who envision] how the data should flow, what that looks like with the master patient index, so we can effectively know and manage those we’re going to be covering in the future,” says Fenn. Fenn previously worked at Memorial Hermann Healthcare System in Houston for 17 years, serving in numerous leadership positions in hospital operations, physician practice management, and managed care contracting. Currently, Fenn is working on many projects: creating order sets for Baptist Health’s system-wide inpatient EHR (Epic Systems Corp., Verona, Wis.), creating a master patient index, imple16 December 2012 • www.healthcare-informatics.com

menting ACO infrastructure, and implementing a business intelligence platform ( from the Waltham, Mass. -based MedVentive) that will produce physician scorecards to show performance based on quality measures. “We’re building the patient-centered medical home network with both our employed and aligned doctors,” says Fenn. “There are 78 physicians in over 40 practices that are working to achieve the  NCQA  [National Committee for Quality Assurance] patient-centered medical home status by 2013, so we will have geographic points of access for all of those patients that we are going to be held responsible for in the future, whether that be for readmissions, or chronic condition management, or ACO.”

REPORTING STRUCTURE AND STAFF In many cases the chief of integration reports to the health system CEO, says

Berra, as Fenn does at Baptist Health. Knight, on the other hand, reports to Palmetto Health’s CMO, who reports to the CEO. As executive director of PQHC, he also reports to the board, which reports to the system board of Palmetto Health. Berra says that many times this role is staffed with a “skeleton crew” of a few direct reports, and many dotted line or indirect reports, which requires the chief integration officer to have good persuasion skills to address concerns on various organizational levels. “[One of my] goals would be to further develop the culture of these organizations,” says Knight. “I’ve always said you can talk about economic integration, you can talk about clinical integration, but cultural integration trumps all of those things. Like minded physicians develop in a culture that fosters behaviors and vision that we’re looking at together, otherwise we’re not going to be success-

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COVER STORY

tion-related job titles, ful. It’s a big change for a many had a relatively lot of physicians.” long tenure at the orKnight has three direct ganization, worked on reports that include the both the provider and vice president of clinithe payer side of healthcal integration, the vice care, had clinical crepresident business operadentials (oftentimes as tions, and the vice presia nurse leader), and had dent of clinical affairs for experience with care the employed physician management and clininetwork. cal IT roll-outs. Fenn agrees that the Scott Fenn “You’re definitely lookintegration officer must ing for someone who earn and build trust within the organization to align various has a lot of experience working on adphysician groups across the healthcare ministrative teams and administrative system. “Our employed doctors should initiatives,” says Berra. “There are a lot of be our largest supporters when it comes nursing positions that have a significant to why the independent medical staff administrative and leadership compowould want to work collaboratively nent to them, so potentially that is why with the hospital system team,” he says. this person is getting pulled. I think it

is not sure a formal business degree is needed, but rather an understanding of the economics of healthcare and a strong management skill set to get physicians “to march in the same direction.”

FINANCIAL AND CULTURE CHALLENGES Executives with direct responsibility for transitioning health systems into a risk-based world face some significant challenges, notes Berra. She adds that these leaders are faced with an overwhelming number of projects to complete in a short time frame, and therefore, have to prioritize. “The setting up of this care management platform so that it does the basics of care management, which would [create] some sort of risk segmentation capability and ability to reach out proactively to higher-risk patients and get them into care coordination [programs],” she adds. Additionally, Berra says that because the chief integration officer and its team is so new, budgetary input, or even having a dedicated budget, is not always clear. Fenn agrees saying that most health systems in the country don’t have the financial wherewithal to pay for the tremendous cost of clinical alignment that necessitates EHRs, health information exchange technology, patient kiosks, and more. “It’s going to take some ingenuity in the way we construct these contracts with payers and employers that they step up and pay for the infrastructure that could save healthcare dollars and provide a better healthcare product for the patient,” adds Fenn. Knight says his biggest challenge is to help create that cultural shift for providers in today’s mixed reimbursement environment. “Hospitals and physicians are both providers of healthcare, and I don’t think we need to be in an antagonistic relationship,” says Knight. “I think we should work together, and it will not only help quality of care, but bring down some of the costs [as well].” ◆

THERE ARE A LOT OF NURSING POSITIONS THAT HAVE A SIGNIFICANT ADMINISTRATIVE AND LEADERSHIP COMPONENT TO THEM, SO POTENTIALLY THAT IS WHY THIS PERSON IS GETTING PULLED. I THINK IT DEPENDS ON THE ORGANIZATION AND WHERE THIS POSITION IS LIVING. —AMANDA BERRA “If the employed doctors weren’t able to effectively communicate that they thought it was a good idea, then no one else in the medical staff would do it. We spent a good year and a half repositioning and refortifying the relationship with our employed doctors before we started in on the alliance.” Fenn has 10 direct reports that include the CMO, CIO, the president of

depends on the organization and where this position is living.” The person in the chief integration role must understand the clinical and business side of healthcare, and Fenn believes that a physician with an MBA would be a good fit. “Some experience in working closely with physicians and organizing the delivery systems of care that achieve real clinical results, but in

WE SPENT A GOOD YEAR AND A HALF REPOSITIONING AND REFORTIFYING THE RELATIONSHIP WITH OUR EMPLOYED DOCTORS BEFORE WE STARTED IN ON THE ALLIANCE. —SCOTT FENN medical group; and leaders in managed care contracting, graduate medical education, outpatient services, and quality/ case management.

PROFESSIONAL BACKGROUND Berra says that in interviews she did with about 30 executives with integra18 December 2012 • www.healthcare-informatics.com

a way that’s collaborative with the hospital and physician staff,” says Fenn. “I spend a lot of time building consensus with hospital teams and physician teams, and helping lead them to come up with the right answer.” Knight agrees that the position requires solid clinical background. He

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FEATURE

Mobile Documentation: Optimizing Technology to do More with Less HOW THE UNIVERSITY OF MISSOURI HEALTH SYSTEM ADAPTED ITS BARCODE-SCANNING SYSTEM FOR MOBILE BEDSIDE DOCUMENTATION TO ENHANCE THE QUALITY AND SAFETY OF PATIENT CARE BY JENNIFER PRESTIGIACOMO

EXECUTIVE SUMMARY: When the University of Missouri Health System sought to optimize its bedside documentation workflows, it chose to enhance its current medication administration devices to allow mobile point-ofcare documentation, an innovation that has led to a dramatic advance in speed to documentation of patient data, ultimately improving patient care.

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n an era of tight healthcare budgets, it’s become extremely important for healthcare IT leaders to figure out how to stretch their dollars—and their technology—to better achieve the goals of meaningful use and accountable care. That’s just what the five-hospital University of Missouri Health System (UMHS), based in Columbia, Mo., did when it adapted its barcode scanning system for mobile patient-bedside medication-admin- University of Missouri Health System nursing student, Tetyana Pytel, records patient data via istration documentation. the CareMobile device. Photo: University of Missouri Health System

20 December 2012 • www.healthcare-informatics.com

the bedside. In addition, this automation allowed for positive patient and staff identification through barcode scanning. The project planning started in May 2011, and documentation was implemented by that July. Initially, the project was rolled out to one floor for issue resolution; then in a span of three weeks, the team rolled out the technology to all 12 units. For the first two weeks, the device was used 7,429 times, which was a high usage rate.

QUICK ADOPTION, BUDGET NEUTRAL A key for this IT project was the coordination with the nursing staff, says Dow, which allowed her team to show results in a short amount of time, allowed for quick user adoption, and was budgetneutral. Essentially, the current medication administration devices were enhanced to allow for mobile point-of-care documentation, which has shown to be a successful method of capturing patient data and ultimately improving patient care. “A factor of why this [project] got done instead of something else is because of the fact that it was budget neutral; we didn’t have to go ask anyone for money,” says Dow. “It was a fairly simple build within the EHR, and nurse educators on the units agreed to do the training, so we really didn’t have to involve a lot of people to get this in place.” Another reason this approach was taken was the fact that this would be an interim solution. UMHS is planning to build a new patient care tower adjacent to University Hospital (its main campus location in Columbia) that will have vital sign machines (provided by the Skaneateles Falls, N.Y. -based Welch Allen) in all patient rooms that wirelessly feed the data into the EHR. “Instead of taking two to three years to [implement this project], we actually got to that point in two to three months knowing that two to three years down the line this technology would be replaced by something that was actually better,” says

THERE’S ALWAYS A VENDOR OUT THERE THAT OFFERS A SPECIFIC SOLUTION TO ADDRESS A SPECIFIC NEED, BUT THAT BECOMES EXPENSIVE AND ENDS UP BEING A LOT MORE MAINTENANCE TO SUPPORT THAT SEPARATE APPLICATION OR VENDOR. —DEBRA DOW go beyond current best practices and create new solutions that enhanced the quality and safety of patient care. The University of Missouri Health System’s IT department is run by Cerner, and all five hospitals and 52 ambulatory sites have the Cerner electronic health record (EHR) as their core clinical information system. Dow, who has a team of 28 associates, manages incoming project requests and the resourcing of them. Within two years, the University of Missouri Health System has seen rapid adoption of clinical best practices and moved from a HIMSS Level 2 to 6, as well as being recognized as a “Most Wired” hospital, and receiving the Missouri Quality Award.

GENESIS OF A MOBILE SOLUTION To solve the problem of transferring patient vital signs to the EHR, the

the EHR was 32 minutes, which potentially impacted patient safety due to the time delay. For example, the delay in entry reduced the effectiveness of assessing the risk of conditions like sepsis or monitoring the increase of temperature after surgery. Since not all patient rooms had PC workstations, the only mobile device that nurses and nurse techs had access to at that time was the barcode medication administration device (the Honeywell Dolphin 9900). This device also supported the Cerner CareMobile product, which made the implementation and adoption of bedside documentation much easier. The workflow design for the mobile documentation included electronic EHR rules that triggered tasks upon patient admission, such as collecting vital signs, intake and output, activities of daily living, and pain scores at

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FEATURE

“Looking at what technology you al- University of Missouri Health System ready have and how you can use it in sought to implement an efficient and new ways [is important],” says Debra timely method for mobile patient bedDow, senior project manager, Tiger In- side documentation. Vital signs and stitute, University of Missouri Health pain scores are critical, and if they are not input in a timely matSystem. “There’s always ter a nurse might not be a vendor out there that aware of critical informaoffers a specific solution like a patient’s pain tion to address a spemedication needs or pocific need, but that betential infection risks. comes expensive and Historically, nurse techends up being a lot nicians at UMHS would more maintenance to round on the units and support that separate collect vital signs of all application or vendor,” the patients consecutiveshe says. ly, write the information Dow works in the Tidown on paper, and then ger Institute for Health Debra Dow enter the results into the Innovation, which the EHR in a batch process. University of Missouri A timed study found the Health System, in partnership with the Cerner Corporation length of time on average from point of (Kansas City, Mo.), formed in 2009 to collection to results being entered into

POLICY UPDATE

What’s Next for Healthcare on Capitol Hill? A POST-NOVEMBER ELECTION CONVERSATION WITH PREMIER’S BLAIR CHILDS BY MARK HAGLAND

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HCI: So you believe that a grand deal will be achieved? n the wake of the Nov. 6 federal elections, Blair Childs, Childs: I think so. Now, the question is how big it will be. senior vice president for public affairs at the Charlottebased Premier health alliance, spoke with HCI Editor- I think it will be on the order of $3-4 trillion. With regard to in-Chief Mark Hagland on Nov. 7, the day after the elections, healthcare, I think it will involve combination of payment reductions, and benefit changes when it comes regarding the elections’ implications for healthto entitlement programs, because everyone care policy and healthcare IT policy. Since knows that something will have to be done then, numerous legislative developments have about healthcare spending. I’ve been sharing a already occurred, and at press time, the fate of chart that contains all the different proposals the so-called “fiscal cliff ” negotiations was as of by all sides. And when I look at that chart and yet unresolved. Below are excerpts from Childs' think about what the things are that are likely Nov. 7 interview with Hagland. to happen, I think that among the Medicare Healthcare Informatics: What are your predicpayment changes might be a shift to what’s betions regarding the prospect of budget sequesing called “site-neutral payment.” Right now, tration and the so-called “fiscal cliff ” facing the one type of patient care site leads to a different U.S. Congress, in the wake of the elections? payment rate for physicians than another; so Blair Childs: The fiscal cliff and sequestration that’s one area that might be explored. Another are the levers that are going to force action. The Blair Childs is a closer look at physician payment for evalukey thing here is a major budget deal, and that’s ation and management, or E&M. what’s going to have to happen. There will be Those elements will be among the things on the table for some kind of budget deal next year, and something’s got to be done. I should send you our election report, with all the differ- discussion; and I think [when it comes to making budget or payment cuts], that it will be your classic Washington, D.C. ent recommendations from the different committees. 22 December 2012 • www.healthcare-informatics.com

POLICY UPDATE slugfest; or what I call the circular firing squad, where everybody’s shooting at everybody else. The doctors say it should come out of the hospitals, the hospitals say it should come out of the doctors, and so on. HCI: What about the “SGR problem” [the complicated issue around physician payment cuts based on requirements of the sustainable growth rate formula under Medicare]? Childs: I think they’re going to do something on SGR within the context of the larger budget deal. Some of the ideas circulated on the Hill have been that, for example, the first year there would be a pay freeze; the second year, a pay reduction to specialists with primary care physicians kept whole; and then they shift it over to CMS [the federal Centers for Medicare & Medicaid Services] to come up with different payment ideas to bend the cost curve, which will essentially be providing incentives for physicians to participate in accountable care organizations or bundled payments. They can’t keep doing this every year, where they’ve got to come up with savings to balance out the [SGR] patches. HCI: With regard to the threats to shut down HITECH payments [letters sent this autumn to Health and Human Services Secretary Kathleen Sebelius by Republican House Ways & Means Committee and Republican Senate Finance Committee and Health, Education, Labor, and Pensions Committee mem-

bers]—will those threats now go away? Childs: I don’t think the threats will go away, because there will continue to be congressional oversight of that program, and you’ll see letters like that from time to time, though I don’t think they’ll say “shut it down”; they’ll be more along the lines of, “what can we do to tweak it?” And you’ll see more letters like those in the House, overseeing implementation. If you think about the magnitude of things now that are in healthcare reform that impact the budget, it’s just so huge that you almost can’t do anything in Congress every year, without touching healthcare. So everything’s going to be looked at all the time. HCI: Will there still be maneuvering to reduce some funding for ACA [Affordable Care Act] implementation? Childs: I think that’s still very possible. If you look at the environment today and the lack of preparation on the part of the states to expand Medicaid and to establish the health insurance exchanges, and the fiscal pressures on state governments, I think there’s some money there that could be sliced away without fundamentally affecting the program. So I think every year there will be challenges. I think Republicans are going to be very focused on policing the implementation of the ACA, and on advancing ideas that would potentially tweak the ACA, but it obviously won’t be anything like the discussion in the past around wholesale “repeal-and-replace.” ◆

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MEANINGFUL USE PERSPECTIVE

Making the Case for Empowerment FARZAD MOSTASHARI, M.D. MAKES IMPASSIONED PLEA TO CHIME FALL FORUM ATTENDEES TO SHARE IN HIS DREAM BY MARK HAGLAND

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n a 40-minute address on Oct. 17 to several hundred of most important thing we can do. And we’re going to do it the 730-some attendees at the CHIME Fall Forum, held through technology.” Intensifying his broad remarks, Mostashari moved at the Renaissance Esmeralda Resort and Spa in Palm Springs, Calif., Farzad Mostashari, M.D., the National Co- on to describe in some detail a situation involving his ordinator for Health Information Technology, spoke with own mother that unfolded just before he joined the Ofintense passion about his vision for the healthcare system fice of the National Coordinator for Health Information Technology (ONC) in the middle of 2009 as of the future, placing the meaningful use prodeputy to then-National Coordinator David cess in the context of a broader drive towards Blumenthal, M.D. Speaking with intensity, a system with greater patient safety, care Mostashari described a systemic failure of quality, efficiency, and cost-effectiveness. information, communication, and care Executives and leaders from the College management that had put his mother into of Healthcare Information Management Exmortal danger, and that made him feel nearly ecutives (CHIME) had given Dr. Mostashari a helpless, even though he is a physician, a special platform, crafting a “Special Plenary public health expert, and an expert in mediSession” for healthcare IT’s top federal ofcal informatics. “We can do better,” he urged ficial, and giving him free rein to speak on the his audience, and repeatedly emphasized the subjects of his choice, followed by a 20-minpower audience members had and have to ute question and answer session. Randy create the fundamental changes necessary to McCleese, vice president-IS and CIO, St. bring about internal revolution in healthcare. Claire Regional Medical Center (Morehead, Farzad Mostashari, M.D. Mostashari, speaking for 40 minutes Ky.) read questions from the audience immediately after Mostashari’s speech. McCleese is a member without any notes, circled back several times to three key of the board of CHIME and is chair of CHIME StateNet, the themes: population health, health information exchange, and patient engagement, citing those as meta-level goals association’s state-level advocacy collaborative. As he had in past appearances before CHIME and other that should encourage healthcare leaders forward as they healthcare IT audiences, Mostashari used the opportu- work to rework the healthcare system to better serve panity to urge CHIME’s CIO and other healthcare IT executive tients, families, communities, and the broader society. members forward, exhorting them to move meaningful use out of a dedication to a vision of a new healthcare, rather USING MEANINGFUL USE AS A TOOL FOR CHANGE than “checking off boxes in order to get the check” that the Acknowledging the widespread anxiety felt by many healthHealth Information Technology for Economic and Clinical care and healthcare IT leaders in the rapidly changing operHealth (HITECH) Act offers successful providers. ating environment, Mostashari told his audience, “Someone Mostashari called CIOs and other healthcare IT ex- said to me recently that it feels like we’re all going down the ecutives “heroes,” and spoke of the internal reform of the rapids now, and there are lots of rocks, and it’s very scary. healthcare system as “this incredible journey we’re on, this But,” he added immediately, “if you dip your oar in and you incredible challenge as a society.” Reducing costs while push, then you’re in control; you’re not a passenger. You’re improving patient safety and care quality, he said, “is the leaning into it, you’re guiding it. So if there’s one thing I ask of 24 December 2012 • www.healthcare-informatics.com

MEANINGFUL USE PERSPECTIVE you, it’s to use meaningful use, use certification, as your tool. And help us improve every part of it.” And he then turned back once again to the theme of patient engagement, saying that “When I was in the hospital with my mom, the one place where all the information was was in the chart; that’s where care was being coordinated. And,” he said, returning to his personal story of watching while clinicians struggled to save his mother’s life in the summer of 2009, “it didn’t feel to me—from a pretty empowered guy, I’m a doc-

yet, a person who loves the patient. And we’re making ourselves vulnerable. But we’re not going to make things better without being open to the government, open to the patient,” in terms of creating transparency in care delivery and communication processes. Mostashari then responded to several questions conveyed to him by Randy McCleese, clarifying the intention behind the requirements around the continuity-of-care (CCD) document, or, as he gently urged it be better termed, the “consolidated CDA (clinical document architecture).” He deftly sidestepped political issues, including a question around what might happen to healthcare reform had former Gov. Mitt Romney been elected president in November, though he endorsed the CHIME advocacy team’s response to the letter sent recently by Republican members of the House of Representatives to Health and Human Services Secretary Kathleen Sebelius urging that the meaningful use process be shut down over interoperability concerns. ◆

IF YOU DIP YOUR OAR IN AND YOU PUSH, THEN YOU’RE IN CONTROL; YOU’RE NOT A PASSENGER. YOU’RE LEANING INTO IT, YOU’RE GUIDING IT. SO IF THERE’S ONE THING I ASK OF YOU, IT’S TO USE MEANINGFUL USE, USE CERTIFICATION, AS YOUR TOOL. AND HELP US IMPROVE EVERY PART OF IT. —FARZAD MOSTASHARI, M.D. tor, I have a sister-in-law who was the chief resident of the hospital—but  I didn’t feel like I could ask to see the chart. There was something rude about the idea of asking to see the chart to save my mom’s life. That’s messed up. That’s messed up,” he repeated. “We’ve got to empower the patient—better

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CMO PERSPECTIVE

Meeting the Needs of Smaller Providers MOVING AHEAD ON INTEGRATED PRACTICE MANAGEMENT AND EHR SOLUTIONS IN A SMALLER-HOSPITAL/MEDICAL-GROUP INTEGRATED SYSTEM BY MARK HAGLAND

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onald N. Riner, M.D. is chief medical officer of Health Management Associates, a Naples, Fla.-based hospital management company that manages 70 hospitals in 15 states, for a total of 10,500 licensed beds. The company operates primarily in the Southeast U.S., along with a smaller presence in Pennsylvania, the Midwest, and the Pacific Northwest. Health Management Associates manages smaller community hospitals in rural and semi-urban markets; the average size of a Health Management-managed facility is 125 beds. Health Management recently signed a contract with the Watertown, Mass.-based athenahealth  for an ensemble of practice management, electronic health record (EHR) and patient communication solutions. 26 December 2012 • www.healthcare-informatics.com

From Dr. Riner’s standpoint, moving forward across the entirety of the Health Management health system was of paramount importance, with ease of use for end-user physicians a key consideration. Riner spoke recently with HCI Editor-inChief Mark Hagland regarding his organization’s automation strategies, and his perspectives on the strategic IT challenges of smaller hospitals and physician groups. Below are excerpts from that interview.

PHYSICIANS INVOLVED IN THE EHR SELECTION PROCESS Healthcare Informatics: Your organization is now live on athenahealth?

CMO PERSPECTIVE Ronald N. Riner, M.D.: Yes, we are. We have about 10,000 physicians using health management facilities, and of those 10,000, about 1,200 are in an employed position. In terms of selecting an EHR, we wanted to go through a process in which the physicians would feel comfortable. As you know, many hospitals and health systems go through a selection process and then hand it to the physicians. We elected to involve about 250 physicians and subject experts, and those 250 people were actively involved in the selection process. We went from about 10 products down to about three. And then through a series of teleconferences, webinars, and site visits, we ended up choosing athenahealth for the employed physicians. HCI: How many physicians are using the solution right now? Riner: It’s a small number at this point in time. We’ve made presentations in about 25 communities. I’m the CMO, but I’ve had the privilege of working with Patrick Easterling, the president of Health Management Physician Network, which encompasses all the employed physicians. That’s headquartered in Naples as well; it’s a division of the company. And Mr. Easterling and his team have been actively engaging our physicians in this technology deployment throughout the company. HCI: What were the key qualities you were looking for?

Riner: As you can imagine, one of the most important qualities was that it meet the needs of the physician users in terms of ease of use and clinical relevance. The vast majority of these physicians are primary care physicians. Interoperability was another quality, and service and assistance in implementing the system and maintaining it were other areas that people had interest in. HCI: The solution is totally Web-based? Riner: Yes, we refer to it as cloud-based; and that turned out to be a feature that many of the physicians felt was advantageous. The ability to implement the system without having to upgrade hardware over time was seen as an advantage. In fact, there were a good number of folks who felt that that was without question the focus of the future. HCI: When did you go live? Riner: We started going live on December 1, 2012, though we’ve been having folks use electronic health records antedating the selection of athena. But candidly, our mission is to enable America’s best local healthcare; and in fact, there were challenges with previous systems, as you can imagine. It was felt that this was an opportune time to re-look at things, and that was what led to this process, and to athena being selected. HCI: What have the physicians’ reactions been so far? Riner: It is just going live, but the physicians who visited with

www.healthcare-informatics.com • Healthcare Informatics 27

CMO PERSPECTIVE during site visits had very positive reactions. The company has been delightful to work with, so much so that we’re now offering this solution to all the physicians who are not only employed by but who are also affiliated with Health Management Associates. HCI: What have the lessons learned been around the selection process? Riner: The number-one lesson is that it’s tremendously helpful to include as part of the process the people who are going to be using the system. It was tremendously gratifying to see how many physicians were involved, and their input was great. HCI: How quickly will all 1,200 physicians be going live? Riner: I’d have to defer that answer to Mr. Easterling, but within 18 to 24 months, I think we’ll see not only all 1,200 employed physicians, and a good percentage of affiliated physicians also live on this.

DIFFERENCES BETWEEN INPATIENT AND OUTPATIENT SETTINGS HCI: Do you think that hospital-based people tend to underestimate the differences in the inpatient and outpatient environments in terms of automation and EHR implementation? Riner: Yes, absolutely. The business metrics are different,

and the processes are different between the two environments. The vast bulk of care takes place in the office-based setting. The people who function in the context of the hospital environment do underestimate the differences; the needs of a hospital-based electronic record are different from those in the hospital, and those needs need to be understood in order to be useful. One of the most common complaints we see are around a solution not being useful. And as you know, most of this technology is disruptive at first; and that in my mind, is not fully appreciated by people working in the hospital environment. There are many dire consequences of that. A lot of the interoperability issues are also absolutely critical. HCI: Do you have any explicit advice for CIOs and CMIOs based on your early experiences so far? Riner: My advice would be, do your homework, look carefully at the products you’re assessing; make sure they’re applicable to the environment in which your people will be working; and plan heavily for the disruptions that will inevitably occur. Make sure that you communicate with a capital ‘C’ all along the process. It’s my own personal feeling that it also helps that individuals such as CMIOs have credibility from having worked in practice, so that they understand the nuances of this technology. ◆

FEATURE

(Continued from p. 21)

they could look on it and see which of their staff was using [mobile documentation] and getting the information in a timely manner,” says Nickell. “And if someone’s name was not on that report, they could go talk to them. Educators and managers were adamant that this would be used for patient safety and workflow.” To measure success, a pre- and post-implementation time study was conducted, and significant improvements were found. The average length of time from point of collection to results documentation in the EHR decreased from 32 minutes to 2.2 minutes. This project has resulted in improved patient care and safety, efficient nursing workflow, and care team satisfaction, say Dow and Nickell. Documentation errors have been reduced, electronic health advisor rules now trigger in a timely manner and the care team workflow and satisfaction is improved. ◆

I ACTUALLY RAN WEEKLY REPORTS AND SENT IT TO THE MANAGEMENT OF THE UNITS SO THEY COULD LOOK ON IT AND SEE WHICH OF THEIR STAFF WAS USING [MOBILE DOCUMENTATION] AND GETTING THE INFORMATION IN A TIMELY MANNER. AND IF SOMEONE’S NAME WAS NOT ON THAT REPORT, THEY COULD GO TALK TO THEM. —KAREN NICKELL, R.N. Karen Nickell, R.N., nursing architect, of 30 to 60 minutes per person was proTiger Institute, University vided to the nurses and of Missouri Health System. nurse technicians on Nickell, a 14-year IT the units. veteran, designed the Compliance was build and worked with continually measured the device professional to post-implementation, build the workflows and says Dow. Tiger leaderdevelop special server ship followed up with configurations. The implenurse coordinators mentation team included on floors where nurse IT services, nursing leadtechs were still using ership, 12 unit nurse edupaper, and worked with cators, and six staff memthem to ensure comKaren Nickell, R.N. bers from the education pliance. “I actually ran and training department. weekly reports and sent “Just-in-time” training for an average it to the management of the units so 28 December 2012 • www.healthcare-informatics.com

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DOCUMENTATION UPDATE

Physician Documentation: Balancing Clinical and Administrative Uses AMIA PANEL PARSES THE TENSION BETWEEN PATIENT NARRATIVE AND STRUCTURED DOCUMENTATION BY MARK HAGLAND

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s self-created electronic physician documentation replaces transcribed clinical documentation, what are the implications of that shift for physician workflow, efficiency, and clinical effectiveness, and ultimately, for care quality? Those questions were explored by a panel of clinical informaticists, all of whom have engaged in recent research of some of these issues. That discussion took place during a Nov. 6 session at the AMIA 2012 Symposium, held at the Chicago Hilton & Towers in downtown Chicago, and sponsored by the American Medical Informatics Association (AMIA). Not surprisingly, one of the big topics of discussion was the oft-discussed tension between supporting a rich narrative within the patient record, and facilitating EHR-focused efficiency. Peter J. Embi, M.D., M.S., associate professor in the Division of Rheumatology & Immunology and in Biomedical Informatics at The Ohio State University in Columbus, led off a discussion with three other experts: Charlene Weir, Ph.D., R.N., associate research professor in the Hartford Center of Geriatric Nursing Excellence at the University of Utah in Salt Lake City; Kenric Hammond, M.D., clinical associate professor at the VA Puget Sound Health Center in Tacoma, Wash.; and S. Trent Rosenbloom, M.D., M.P.H., associate professor of biomedical informatics, associate professor of internal medicine and pediatrics, and associate professor of nursing, at Vanderbilt University in Nashville. Making use of the term “computerized provider documentation,” or CPD, Hammond underscored the fundamental tension between the administrative, analytical, and performance improvement uses of physician documentation, and its direct patient care uses. “The strength of CPD is that it improves communication,” Hammond said. “The vulnerability is that CPD takes over. I’ve heard estimates of up to 25 percent of physicians’ time going to documentation. But a balance needs to be struck between the administrative uses, which are essential—otherwise, the organization dies—and the clinical uses—otherwise the patient dies. 30 December 2012 • www.healthcare-informatics.com

So my plea,” he said, “is, ecosystem members unite! Clinicians, administrators, and information scientists need to work together to characterize and understand the ecosystem and understand everyone’s needs.” Meanwhile, Rosenbloom briefly described several studies at Vanderbilt in the past few years that have examined documentation issues. In one small study, he said, Vanderbilt researchers uncovered five core factors that were linked with physician satisfaction with electronic documentation systems. These were efficiency; accessibility to notes within the physician workflow; a balance between the structure needed to ensure accuracy and completeness while at the same time supporting descriptive expressivity; document quality; and physicians’ desire for the note to support improved patient care quality. In that study, “We found that some of these factors were in tension with each other, particularly accuracy versus efficiency, and completeness versus efficiency,” Rosenbloom noted. In a different study of physicians at Vanderbilt, Rosenbloom reported, he and his colleagues found a considerable divergence between physician adoption of narrative text-based documentation systems, which were far more widely adopted, and structured documentation systems, which were “very poorly adopted.” Significantly, he noted, “We learned that champions really influenced which modes were used” in different settings. “And different tools found different niches. A simple Web form might be widely used for intake in the ED’s intake triage, for example. The discussion that ensued among the four presenters, and in a subsequent question-and-answer session that became both substantive and highly granular, served to underscore the complexities involved in moving forward to optimize physician documentation processes. And though no issues were “resolved,” the session allowed for the airing of many nuanced questions and arguments in an area of intense interest and concern to all healthcare informaticists. ◆

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ANESTHESIOLOGY UPDATE

Last Man Standing? ADVICE FOR ENGAGING ANESTHESIA CLINICIANS WHEN IMPLEMENTING AN EMR IN ANESTHESIOLOGY SERVICES BY TERRI GOCSIK, CRNA

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lectronic medical record (EMR) implementations are becoming more commonplace as hospitals and health systems race to meet governmental deadlines for achieving meaningful use. Yet implementation of an EMR in anesthesia services (referred to as an anesthesia information management system or AIMS) remains low, and it’s not unusual that this practice area is one of the last departments to transition from paper to the electronic world. Implementing an AIMS solution must be on the organization’s IT roadmap, since it enhances care coordination and contributes a financial benefit to both the institution and the group practice. Integrating documentation and workflow for anesthesia services improves efficiency and data accuracy with upstream and downstream systems such as the perioperative OR information system (ORIS) and inpatient and ambulatory EMRs. Just as important is the expectation that anesthesia data will be available in standardized and discrete formats, which will be mandatory as meaningful use Stages 2

and 3 requirements are “operationalized.” Given the importance of automation of this area, anesthesia services’ stakeholders should play an important role in the AIMS system selection and implementation processes. Without their involvement, you may be faced with inefficiencies and challenges for providing high quality care. Of course, involving them in the process does not come without a challenge. Anesthesia services have many competing priorities, such as employment/contracting arrangements, scheduling commitments at multiple sites, and concerns and resistance over how an EMR may change their daily practice. Here are 10 tips for engaging your anesthesia clinicians: • Convey clearly the need for change and why remaining at “status quo” will not meet the quality and financial strategic goals of the institution. Choose effective leaders at the executive and operational level. Don’t be afraid to coach them if necessary. • Demonstrate an understanding of the financial implications of participation on both sides—the financial burden assumed (Continued on p. 37)

32 December 2012 • www.healthcare-informatics.com

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INSURANCE EXCHANGE UPDATE

Meeting Insurance Exchange Deadlines NOVEMBER ELECTION IMPACT: STATES NOW FACE A TIGHT DEADLINE FOR IMPLEMENTING HEALTH INSURANCE EXCHANGES—WILL THE I.T. BE READY? BY MARK HAGLAND

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he Nov. 6 elections yielded numerous implications for healthcare, none of them more momentous than the cementing of some policy certainty around federal healthcare reform. Following the June 28 affirmation of the constitutionality of the Affordable Care Act (ACA) by the Supreme Court, the only practical remaining question for the healthcare industry was the outcome of the November federal elections—both in the U.S. Senate and House of Representatives, and in the presidential election. With the reelection of President Barack Obama and the results in the Senate and House (where Democrats retained control of the Senate and Republicans kept control of the 34 December 2012 • www.healthcare-informatics.com

House), it appears clear now that no fundamental changes will be made to the ACA (though there remains the potential for small legislative tinkering around the margins). With the November elections completed, state governments now face stringent deadlines going forward for implementing the statewide health insurance exchanges, or for letting the federal government establish exchanges in their stead. Not surprisingly, laying the IT foundation for such exchanges is expected to be a major challenge for the states, says Jordan Battani. Battani, the managing director of the Waltham, Mass.-based Global Institute for Emerging Health Care Services at the Falls Church, Va.-based CSC, has been

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INSURANCE EXCHANGE UPDATE the states, all those different agencies, and send information back as well; and it’s not well-defined yet. The effective date of coverage is January 1, 2014; and just as in the private marketplace, they really have to be ready in the fall of 2013 to be prepared for open enrollment. They really have just a year, and these deadlines were really aggressive when they were LONGSTANDING AND NEW POST-ELECTION passed in 2010; and they’re terrifying now. CHALLENGES There’s another whole element to this. If you think of the Healthcare Informatics: Following the November 6 elections, what’s the latest with regard to the establishment of the health insurance exchange as a diagram, on the one side, you have individual consumers and employer groups; and then health insurance exchanges? Jordan Battani: From a big-picture perspective, there are a this information flows back and forth to and from different couple of things that have been challenging all along for the state and federal agencies on the eligibility verification; and states in this process. Kind of like for a drowning person go- then you have a whole bunch of feeds going back and forth ing down for the third time, some state government people with commercial health plans. We’re seeing health plans said, maybe after the election, we won’t have to do this; and looking around now and are saying, yeow! How are we going to do this? Because they don’t have functionality that’s easy to plug into a portal. There are a lot of data flows involved, and it will have to be a continuous series of flows. HCI: Are any states close yet in terms of their creating the exchanges? Battani: The challenge for the early adopters is that they’ve now they do. The whole point here is to create an online marketplace for consumers to shop for health insurance; but been dependent on all the definitions for the interface the other element is to create a one-stop shop for eligibility standards coming out of the agencies, and the definitions determination for any of the government programs, includ- have not yet been finalized; so even the early adopters are challenged. Is anybody ready to go? No. The ing both federal and state programs. Eligibility best-positioned is probably Massachusetts, is fairly straightforward for Medicare, but it’s because their existing exchange was the not at all straightforward for Medicaid; every model for the national system; but even they state has different eligibility requirements, and don’t have this built yet. And the option for in some states, those even differ by counties. states is to default to the system developed That’s the eligibility verification landscape right by the federal government; but even that one now, and it’s the elephant in the room. hasn’t been built yet—they’re on the same Once the healthcare reform-related deadline timeline. passes, there are a bunch of new kinds of eligiHCI: So what will happen? bility verification that have to be determined, Battani: What will happen officially right with the full implementation of the ACA. There now is that everyone will be ready for open are all kinds of new eligibility verification rules enrollment in the fall of 2013, and be ready that come into play in 2014; and they’re really Jordan Battani for the opening of the exchanges on Jan. 1, around eligibility for all the health insurance 2014. subsidies. Medicare eligibility is pretty much at CMS [the federal Centers for Medicare & Medicaid Services]. But with Medicaid eligibility, some of it will be at CMS, and IMPLICATIONS OF MEDICAID EXPANSION FOR some will be at the state level. The subsidy verification level PROVIDERS will be really complicated, but there’s an additional player HCI: Will any of this directly affect providers? that comes online—actually, two of them—the Department Battani: Yes, because the other thing that happens in 2014 of Labor, and the Internal Revenue Service, per the income is that there’s a massive expansion of Medicaid eligibility that requirements. Now the challenge for the states is not just to goes into effect; and there’s the new and very significant recreate an online, portal-based marketplace; they also have quirement for everyone to have health insurance. That really to be able to catch all those data feeds from the feds and is good news for providers, because your uncompensated closely following developments in this area. The Californiabased Battani spoke recently with HCI Editor-in-Chief Mark Hagland about the latest in this sphere. Below are excerpts from that interview.

THE CHALLENGE FOR THE EARLY ADOPTERS IS THAT THEY’VE BEEN DEPENDENT ON ALL THE DEFINITIONS FOR THE INTERFACE STANDARDS COMING OUT OF THE AGENCIES, AND THE DEFINITIONS HAVE NOT YET BEEN FINALIZED. —JORDAN BATTANI

36 December 2012 • www.healthcare-informatics.com

INSURANCE EXCHANGE UPDATE care should decline precipitously; but the patients who show up will often have longstanding health problems, and they will also be people who have not interacted much with the health insurance world. Don’t expect right out of the gate that these people will be able to use self-service mechanisms. You’ll see lots of pent-up demand and not very sophisticated users. In terms specifically of the exchanges, if there’s a delay,

relevant comparison. We were able to bring up the Medicare program in 12 to 15 months, but the world was a lot simpler then. Back then, we knew who everyone was; they were already effectively enrolled. That’s not true of this population. There are some implications for providers here. First, the reality is that payment rates are going down for hospitals; and anything that expands eligibility for some program is probably good for hospitals, especially because the uncompensated care problem was becoming unsustainable. On another level, there’s a question here for hospitals as purchasers of care for their own employees, because there’s a movement among employers to do what they did with pensions, to get out of defined benefit programs and get into defined contribution programs; and that will now happen in healthcare. A lot of hospitals may release their employees into these exchanges, or move to a defined a contribution plan, and having exchanges where their employees can shop for insurance options, will be a huge benefit. I don’t see hospitals doing this wholesale, and here in the west where I am, the labor organizations won’t let them do it; but health employers will have a harder time in the new environment coping with their benefit costs. ◆

IN TERMS SPECIFICALLY OF THE EXCHANGES, IF THERE’S A DELAY, IT WILL HAVE TO BE A FULL-YEAR DELAY, BECAUSE OF THE WAY THESE PROGRAMS WORK. MEDICARE AND MEDICAID, LIKE PRIVATE HEALTH INSURERS, WORK ON CALENDAR YEAR SCHEDULES. —JORDAN BATTANI it will have to be a full-year delay, because of the way these programs work. Medicare and Medicaid, like private health insurers, work on calendar year schedules. Whenever you have an initiative that takes more than one cycle to complete, it’s code for “never.” And this is magnificent and national in scope: if you think about it, Medicare came up in one year, in 1965, and they knew who the beneficiaries were, because they were in the Social Security system. It’s a comparison that people don’t make very often, but it’s a (Continued from p. 32)

by the parent hospital and the resource burden contribution by the anesthesia teams to participate in selection, planning, design, and implementation processes. • Make the EMR the path of least resistance. • Use decision-support tools to improve compliance with quality and reporting metrics, standardizing care processes whenever possible. • Create a highly interoperable system that includes integra-

ANESTHESIOLOGY UPDATE health information management (HIM) when creating your legal health record policies. • Focus on system reliability. The operating room is a critical care area, and the team often has limited resources to provide assistance when any system fails. Consider service level agreements with the department to provide 24-hour coverage via online, on call support for the application and interfaces. Anesthesia implementation as part of a total EMR will be challenging, but it is essential to providing accurate real-time data to increase efficiency and care delivery, throughout the perioperative process and, when applicable, the inpatient stay. By following these tips, you’ll be well prepared to implement an EMR in a department that is typically the last area remaining on the EMR roadmap. Ultimately, your anesthesia clinicians will be better engaged to support the implementation process and realize the many benefits of a well-constructed and implemented anesthesia information management system. ◆

GIVEN THE IMPORTANCE OF AUTOMATION OF THIS AREA, ANESTHESIA SERVICES’ STAKEHOLDERS SHOULD PLAY AN IMPORTANT ROLE IN THE AIMS SYSTEM SELECTION AND IMPLEMENTATION PROCESSES. —TERRY GOCSIK tion of biomedical device data. • Ensure participation by considering all competing priorities when timing project activities. • Set expectations early and create a governance structure that is empowered to drive the necessary change. • Make training and system use mandatory once implemented. • Include subject matter experts from both clinical and

Terri Gocsik, CRNA, nurse anesthetist, CPHIMS, is a manager at Aspen Advisors, LLC, Pittsburgh, Pa. www.healthcare-informatics.com • Healthcare Informatics 37

FINANCIAL UPDATE

An Uncertain Path Ahead IS MEDICARE REIMBURSEMENT UNCERTAINTY INHIBITING ADVANCES AMONG MEDICAL GROUPS? BY MARK HAGLAND

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ven with greater policy certainty created by the Supreme Court’s affirmation of the constitutionality of the Affordable Care Act (ACA) this summer, physician group leaders say that the financial instability created by the reliance on a decade of temporary, last-minute congressional reprieves from Medicare sustainable growth rate (SGR) payment cuts is inhibiting their willingness to develop new care delivery and reimbursement models and to invest in staffing, clinical equipment and facilities. Such was the overwhelming sentiment expressed by 1,000 physician group executives in response to questions in a survey executed by the Englewood, Colo.-based Medical Group Management Association (MGMA). The results of that survey were announced during a press briefing on Oct. 22, during the MGMA Annual Conference, held at the Henry B. Gonzalez Convention Center in downtown San Antonio, Texas.

FACTORS STANDING IN THE WAY OF INNOVATION Following opening remarks by Susan Turney, M.D., MGMA’s president and CEO, and by Todd Evanson, the association’s director of data solutions, Anders Gilberg, senior vice president of government affairs at MGMA, cited “instability and uncertainty over potential future cuts, plus the Budget Control Act cuts, and potential sequestration” (the result of a deal reached in Congress several months ago during a budget impasse) and, above all, physician payment cuts resulting from the potential inability of leaders in the U.S. Congress to reach a long-term solution to the SGR problem, as major inhibitors for medical group leaders to innovate on care delivery and reimbursement models, or even maintaining the status quo. Indeed, many respondents cited reimbursement uncertainty as having already forced them to reduce clinical staff, delay purchases of equipment or facilities, and cut back on charity care. Though the survey did not ask group practice executives specifically about investment in electronic health records, the responses of medical group executives clearly 38 December 2012 • www.healthcare-informatics.com

implied a difficult environment, financially speaking, for investment in clinical and other information systems. Most importantly, 82 percent of those surveyed by MGMA said that they would be interested in pursuing such innovative arrangements as accountable care organizations and patient-centered medical homes, if only they could see greater policy and reimbursement certainty. Not surprisingly, given their feelings about the current payment environment, only 18 percent are currently involved in such innovative efforts. The current reality, though, is that many are hanging back; indeed, the three top barriers survey respondents cited with regard to their not participating in such initiatives were, in order, the lack of payment predictability due to the looming 27-percent physician payment cut under Medicare if another SGR patch is not enacted by Congress; the programs offered aren’t “relevant or accessible” to particular medical groups; and program regulations are too onerous (presumably particularly with regard to accountable care organization requirements). Instead, 60 percent of those surveyed by MGMA have delayed the purchase of new clinical equipment and/or facilities in the past year; 36 percent have reduced clinical staff; and only 18 percent are participating in one or more of Medicare’s new payment models and/or demonstration projects at present. In short, Gilberg told members of the media on Oct. 22, “You have the specter of SGR hanging over everybody’s head.” ◆

POPULATION HEALTH UPDATE

The Case for Payer-Provider Teamwork WITH POPULATION HEALTH, PAYERS AND PROVIDERS HAVE TO PLAY NICE BY GABRIEL PERNA

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s the healthcare industry embraces an outcomes-based approach from a population health standpoint, a recent report from PricewaterhouseCoopers (PwC) Health has looked at the power of the payer-provider collaboration in terms of sharing and integrating clinical data. The authors of the report conclude that it is payers that hold the treasure trove of useful data, and when combined with providers’ clinical systems and expertise, that data can produce better results for patients. “When working with payers, providers, and pharmaceutical companies, we’ve noted that the one with the most information that could typically help support population health and allow the sharing of information to begin to occur, is not the provider—it’s the payer,” says John  Edwards, director of healthcare strategy and healthcare business intelligence practice at PwC and one of the report’s authors, in an interview with  Healthcare Informatics. “Most payers have made significant investments in data on their consumers about their healthcare.” While much of the data coming from the payer side is administrative and lacks a clinical richness, the bills come with

the report had begun to see examples where payers were sharing that information and using it to empower the physicians. This information has allowed payers and providers to form partnerships, which are tied into incentives, bonuses, and how the payment structure would occur. “More importantly, it started to forge the possibility of thinking about quality of care for the population and learning from studying the practice of care across the population,” Edwards says. “When you think about it, a given doctor may see two to four thousand patients in a year, while a payer has one million, five million, maybe 10 million patients in its system. They have more complete information on clinical care

WHEN WORKING WITH PAYERS, PROVIDERS, AND PHARMACEUTICAL COMPANIES, WE’VE NOTED THAT THE ONE WITH THE MOST INFORMATION THAT COULD TYPICALLY HELP SUPPORT POPULATION HEALTH AND ALLOW THE SHARING OF INFORMATION TO BEGIN TO OCCUR, IS NOT THE PROVIDER—IT’S THE PAYER. —JOHN EDWARDS procedure codes and provide a longitudinal record that has been in place for multiple years. Edwards says the authors of

www.healthcare-informatics.com • Healthcare Informatics 39

POPULATION HEALTH UPDATE than any one doctor. So what might be rare case for a doctor in their portfolio, the payer probably has multiple examples of people with that condition, and they’re able to see how different doctors ordered different procedures. From that, they can create a new dialogue with those providers.” For years, the report says, insurers have been using data to squeeze excess cost out of the system. With changing reimbursement models, including the rise of accountable care organizations (ACOs), the payers’ role is expanding. Not only does data integration lead to cost-savings for all parties, Edwards says; payers can provide information that becomes actionable for the providers. The winners of this collaboration, he says, will be the patients.

EXAMPLES OF PAYER-PROVIDER TEAMWORK The report’s authors looked at several pilot programs already integrating this kind of data, which Edwards says he and his colleagues have seen popping up across the country. He mentions Hartford, Conn.-based insurer, Aetna, which is using clinical and payer data, forming partnerships with hospitals and providers, and making it available for employers and consumers. He says this effort not only empowers the provider, but it increases consumer engagement. Another initiative looking to increase consumer engagement through data and other technology integration comes from Oakland, Calif.-based integrated provider and payer, Kaiser Permanente. Edwards says Kaiser is using filmed interactions between providers and payers, along with data analytics from the payer side, to improve communications at the point of care. Kaiser developed this initiative because

removed in an integrated system. However, that’s not always the case, he says. “I have seen some companies where the hospital system owns a payer, and those traditional barriers of trust are as solid as they ever were. The purchase [of a payer by a hospital system] doesn’t automatically remove those barriers of trust,” Edwards says. Along with the Aetna example, the report includes other pilot triumphs from non-integrated entities collaborating together. In fact, one such instance, Edwards says, is the perfect example of a successful payer-provider partnership. The initiative, between the Indianapolis, Ind.-based payer Wellpoint, the Armonk, N.Y.-based tech giant IBM and its Watson technology, and a large academic medical center, the West Hollywood, Calif.-based Cedars-Sinai Samuel Oschin Comprehensive Cancer Institute, is “the most far reaching example we’ve seen,” according to Edwards. The initiative uses Watson, which became famous for winning on the television game show Jeopardy!, and its ability to process an abundance of clinical information to help better guide the clinicians when they are treating patients. “The level of investment [ for this initiative] is not something all payers and providers can make, which really is leading edge. But it’s a great example of where the future practices of medicine can go through aligned partnerships,” he says.

EVOLUTION OF INCENTIVES Edwards is confident about the future potential of the payerprovider collaboration and how this can expand beyond those that are leading edge. Thanks to incentives from the Centers for Medicare and Medicaid Services (CMS), Edwards says, there are now more reasons than ever for payers and providers to collaborate. He cites the measures for the CMS star ratings for Medicare Advantage plans and how medication adherence is highly weighted. When this went down, Edwards says, it made the payers realize they had to partner with health systems to hit those measures. “It caused new conversations to occur by taking the traditional incentives of the right drugs are being prescribed to the [new incentives] of the right drugs are being taken. As that continues to evolve, it could be the right diseases under control because we’re seeing right value,” says Edwards, who doesn’t see the train stopping any time soon. “This evolution is occurring rapidly and it’s taking us beyond more traditional incentive programs into more shared risk around the reward programs and towards more value-based measures.” ◆

THIS EVOLUTION IS OCCURRING RAPIDLY AND IT’S TAKING US BEYOND MORE TRADITIONAL INCENTIVE PROGRAMS INTO MORE SHARED RISK AROUND THE REWARD PROGRAMS AND TOWARD MORE VALUE-BASED MEASURES. —JOHN EDWARDS it recognized that a lack of communication was a huge reason for high readmission rates. Using the data analytics and video component, Kaiser’s 30-day readmission rates at one medical center fell from 13.6 percent to 9 percent in six months. Edwards says integrated systems, such as those at Kaiser and Danville-Pa.-based Geisinger, which is also mentioned in the report having created a data analytics tool that is used to track medication compliance in certain conditions, typically have an advantage that others attempting to form these partnerships do not. For one thing, an integrated payer-provider system will have easier access to the right set of data expertise on both sides. Also, the familiar barrier that providers and payers face when attempting to trust each other is usually 40 December 2012 • www.healthcare-informatics.com

2013 RESOURCE GUIDE

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nterested in information on a particular product or service? The 2013 Resource Guide will help you research key vendors quickly and easily. You can also access the Resource Guide online at http://directory.healthcare-informatics.com, where you may contact vendors directly through e-mail and social media, and view additional detailed product information. We hope you will find this to be a valuable resource.

RESOURCE GUIDE INDEX ACO/HIE Data Analysis/Predictive Modeling Software ........................ 42 Acute .............................................. 42 Ambulatory ...................................... 42 Asset Tracking—Bar Coding/RFID ...... 42 Billing .............................................. 42 Business Continuity/Disaster Recovery ...................................... 42 Care Management ............................ 42 Clinical Decision Support/ Evidence-Based Medicine .............. 43 Clinical Documentation ..................... 43 Clinical Information System/Hospital Information System ....................... 43 Cloud Computing Providers ............... 44 Coding............................................. 44 Computer-Based Provider Order Entry ................................... 44 Computer Carts/Mobile Computing .................................... 45 Computer Server Hosting .................. 45 Consulting—Clinical Informatics ........ 45 Consulting—Meaningful Use Strategy................................. 45 Consulting—Outsourcing................... 46 Consulting—System Implementation............................. 46 Consulting—User Adoption/ Workflow ...................................... 47 Dashboards—Census/Labor/ Financials..................................... 47 Dashboards—Project Management/ Staff Utilization ............................. 47 Dashboards—Revenue Cycle Management ................................ 47 Data Encryption................................ 47 Data Solutions ................................. 47 www.healthcare-informatics.com

Dictation/Transcription ..................... 47 Dietary and Nutritional Management ................................ 48 Disease Management ....................... 48 Document Imaging/Management ....... 48 E-Commerce .................................... 49 Education/Compliance/Legal ............ 49 EMR/EHR ........................................ 49 EMR/EHR Training and Certification .................................. 50 Enterprise Imaging ........................... 50 Enterprise Resource Planning/ Business Intelligence/Business Process Management.................... 50 Enterprise Revenue Management ...... 51 Environmental/Building ..................... 51 E-Prescribing .................................... 51 Executive Search .............................. 51 Financial Management ...................... 51 Fraud and Abuse Detection and Analytics ...................................... 52 Healthcare Facility Data .................... 52 HIE/RHIOs/NHIN.............................. 52 HIM ................................................. 53 Human Resources Management ........ 53 ICD-10 Compliance ........................... 53 Imaging/PACS .................................. 53 IS Management and Consulting ......... 54 Kiosk Solutions ................................ 54 Lenders/Financial Institutions ........... 54 LIS .................................................. 54 Long-Term Care ................................ 55 Managed Care ................................. 55 Market Research .............................. 55 Master Patient and Provider Index ............................... 55

Medication Carts.............................. 55 Messaging ....................................... 56 Middleware ...................................... 56 Mobile App for iPad .......................... 56 Nurse Call Systems .......................... 56 Nursing/Patient Information Systems ....................................... 56 Pathology Information System ........... 56 Patient Monitoring and Connectivity .................................. 56 Payroll ............................................. 58 Practice Management ....................... 58 Quality Reporting.............................. 58 RAC Management............................. 58 Radiology Information System ........... 59 RCM—Claims Management .............. 59 RCM—Payer Contract Management ................................ 60 RCM—Self Pay ................................. 60 Revenue Management ...................... 60 Scheduling—Procedures ................... 60 Scheduling—Staff ............................ 60 Secure File Transfer .......................... 60 Security ........................................... 60 Software Development ...................... 60 Speech Recognition .......................... 61 Storage ........................................... 61 Supply Chain Management................ 61 Systems Integration ......................... 61 Telehealth/Telemedicine ................... 61 Wireless Devices .............................. 61 Wireless Networking ......................... 61 Workflow Solutions ........................... 61 Workforce Solutions ......................... 61 Workstations, Wall-Mounted .............. 62

Healthcare Informatics

December 2012

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SPECIAL ADVERTISING SECTION

ACO/HIE DATA ANALYSIS/ PREDICTIVE MODELING SOFTWARE

AMBULATORY

ASSET TRACKING— BAR CODING/RFID CognitiveTPG

InfoMC, Inc.

Ithaca, NY Contact: Angela Mansfield-Swanson (607) 274-2500 E-mail: [email protected] Web: www.cognitivetpg.com

Conshohocken, PA Contact: JJ Farook (484) 530-0100 E-mail: [email protected] Web: www.infomc.com

Stanley Healthcare Solutions MedeAnalytics

(877) 494-2528 E-mail: [email protected] Web: www.StanleyHealthcare.com

Emeryville, CA Contact: Doug Hart (510) 379-3300 E-mail: [email protected] Web: www.medeanalytics.com

BILLING

NextGate Optum

Pasadena, CA Contact: Richard Garcia (626) 376-4100 E-mail: [email protected] Web: www.nextgate.com

Connected Technology Solutions

Vantage Point Healthcare Information Systems New Milford, CT Contact: Lawrence Borok (860) 210-9049 E-mail: [email protected] Web: www.vantagepointinc.com

ACUTE

Mequon, WI Contact: Gila Katz (262) 242-7203 E-mail: [email protected] Web: www.connectedts.com The CTS patient check-in kiosks are becoming the industry standard. With more than 5 years of proven success, these units have deployed in more than 50 healthcare systems. Adjustable, floor standing, desktop, and wall-mount offerings are available.

Eden Prairie, MN Contact: Sales Info (800) 765-6793 E-mail: [email protected] Web: www.optuminsight.com

BUSINESS CONTINUITY/ DISASTER RECOVERY GNAX Health Atlanta, GA Contact: Matt Mong (855) 280-4629 E-mail: [email protected] Web: www.gnaxhealth.com

CARE MANAGEMENT

DSS, Inc. NTT DATA Healthcare Technologies (formerly Keane) Los Angeles, CA Contact: Larry Kaiser (800) 699-5329 E-mail: [email protected] Web: www.nttdata.com/americas

Stanley Healthcare Solutions (877) 494-2528 E-mail: [email protected] Web: www.StanleyHealthcare.com

Juno Beach, FL Contact: Kelly Kavooras (561) 284-7155 E-mail: [email protected] Web: www.dssinc.com To meet the needs of each unique medical facility, DSS offers a comprehensive EHR system including customizable behavioral health, clinical decision support, dental, and document imaging extension modules, all integrated into a single database.

Alere Wellogic Waltham, MA Contact: Natalie Pietrzak (855) 935-5644 E-mail: [email protected] Web: www.wellogic.com

InfoMC, Inc. Conshohocken, PA Contact: JJ Farook (484) 530-0100 E-mail: [email protected] Web: www.infomc.com

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Healthcare Informatics

www.healthcare-informatics.com

SPECIAL ADVERTISING SECTION

CLINICAL DECISION SUPPORT/ EVIDENCE-BASED MEDICINE

UpToDate

DSS, Inc. Juno Beach, FL Contact: Kelly Kavooras (561) 284-7155 E-mail: [email protected] Web: www.dssinc.com

Waltham, MA Contact: Shellie Rapson James (800) 998-6374 E-mail: [email protected] Web: www.uptodate.com More than 600,000 clinicians in 149 countries rely on UpToDate, the premier evidence-based clinical decision support resource authored by physicians to help healthcare practitioners make the best decisions at the point of care. More than 5,100 world-renowned physician authors, editors, and peer reviewers use a rigorous editorial process to synthesize the most recent medical information into trusted, evidence-based recommendations that are proven to improve patient care and quality. UpToDate is part of Wolters Kluwer Health.

3M Health Information Systems Murray, UT (800) 367-2447 E-mail: [email protected] Web: www.3mhis.com 3M Health Information Systems delivers software and consulting services to help organizations improve clinical documentation, quality, and financial performance. We offer expertise in coding, ICD-10, dictation, transcription, speech recognition, medical terminologies, and data exchange to support electronic health records. With more than 25 years of healthcare experience, we work as a trusted and stable business partner to provide reliable implementation, training, and support to our clients.

CLINICAL DOCUMENTATION Elsevier Clinical Decision Support Philadelphia, PA Contact: Che Dildy (866) 416-6697 E-mail: [email protected] Web: www.ClinicalDecisionSupport.com Elsevier Clinical Decision Support is a marketleading provider of world-class, point-of-need HIT solutions that help healthcare organizations to provide meaningful care for a patient-centered approach to achieving the triple aim.

InfoMC, Inc. Conshohocken, PA Contact: JJ Farook (484) 530-0100 E-mail: [email protected] Web: www.infomc.com

Nuance Communications, Inc. Burlington, MA (888) 350-4836 Web: www.nuance.com/healthcare Nuance Healthcare’s clinical understanding solutions improve the clinical documentation process—from capture of the complete patient record to clinical documentation improvement, coding, compliance, and reimbursement. More than 450,000 physicians and 10,000 healthcare facilities worldwide leverage Nuance’s solutions. See our ad in this issue

www.healthcare-informatics.com

DSS, Inc.

Nuance Communications, Inc. Burlington, MA (888) 350-4836 Web: www.nuance.com/healthcare Nuance Healthcare’s clinical understanding solutions improve the clinical documentation process—from capture of the complete patient record to clinical documentation improvement, coding, compliance, and reimbursement. More than 450,000 physicians and 10,000 healthcare facilities worldwide leverage Nuance’s solutions. See our ad in this issue

CLINICAL INFORMATION SYSTEM/HOSPITAL INFORMATION SYSTEM Arbor Solution

Juno Beach, FL Contact: Kelly Kavooras (561) 284-7155 E-mail: [email protected] Web: www.dssinc.com To meet the needs of each unique medical facility, DSS offers a comprehensive EHR system including customizable behavioral health, clinical decision support, dental, and document imaging extension modules, all integrated into a single database.

McKesson Alpharetta, GA (404) 338-6000 E-mail: [email protected] Web: www.mckesson.com

San Jose, CA Contact: Kate Garrison (408) 452-8900 E-mail: [email protected] Web: www.arborsolution.com

Healthcare Informatics

December 2012

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SPECIAL ADVERTISING SECTION

NTT DATA Healthcare Technologies (formerly Keane) Los Angeles, CA Contact: Larry Kaiser (800) 699-5329 E-mail: [email protected] Web: www.nttdata.com/americas

Prime Care Technologies Inc.

Optum

Duluth, GA Contact: Keith Farley (877) 644-2306 E-mail: [email protected] Web: www.primecaretech.com PCT’s powerful cloud-based IT infrastructure and services help providers save money, increase revenues, and insure compliance through managed hosting; digital dashboard reporting; T&A, HR, and payroll solutions; procurement services; claims management; and more.

Eden Prairie, MN Contact: Sales Info (800) 765-6793 E-mail: [email protected] Web: www.optuminsight.com Optum™, a leading health services business, has been providing coding solutions for 25 years. We offer a range of solutions—from innovative print and electronic resources to sophisticated technology, including computer-assisted coding, a powerful web-based encoder, and ICD-10 mapping software.

CODING OBIX by Clinical Computer Systems, Inc. Elgin, IL Contact: Heather Ruchalski (888) 871-0963 E-mail: [email protected] Web: www.obix.com Care providers ranked the OBIX system number one among perinatal information systems in the May 2012 KLAS® report, “Labor and Delivery 2012: Pursuing Interoperable Functionality.” Visit www.KLASresearch.com for more information. The OBIX System combines enterprise-wide surveillance and alerting with comprehensive, point-of-care patient charting, data archiving, and Internet-based physician access. It is ideally designed for interfacing to other hospital systems. Exclusive E-Tools provide decision support and promote safety. Superior education and service assures user satisfaction and success.

Psyche Systems Corporation Milford, MA Contact: Lisa-Jean Clifford (508) 473-1500 E-mail: [email protected] Web: www.psychesystems.com See our ad in this issue

Practice Management Information Corporation (PMIC) 3M Health Information Systems Murray, UT (800) 367-2447 E-mail: [email protected] Web: www.3mhis.com 3M Health Information Systems delivers software and consulting services to help organizations improve clinical documentation, quality, and financial performance. We offer expertise in coding, ICD-10, dictation, transcription, speech recognition, medical terminologies, and data exchange to support electronic health records. With more than 25 years of healthcare experience, we work as a trusted and stable business partner to provide reliable implementation, training, and support to our clients.

Los Angeles, CA Contact: Meta Rias (800) 633-7467 E-mail: [email protected] Web: www.pmiconline.com PMIC, the nation’s leading independent publisher of medical coding and compliance solutions since 1989, offers a variety of comprehensive IT solutions including data files, e-books, and software. Our e-books can be delivered at low cost to thousands of users from your document servers. Our #1-rated Flash Code software can be accessed via the Internet by an unlimited number of users. We have ICD-10 ready solutions for your IT staff.

COMPUTER-BASED PROVIDER ORDER ENTRY

CLOUD COMPUTING PROVIDERS GNAX Health

Health Language

Atlanta, GA Contact: Matt Mong (855) 280-4629 E-mail: [email protected] Web: www.gnaxhealth.com

Denver, CO Contact: Marc Horowitz (720) 940-2900 E-mail: [email protected] Web: www.healthlanguage.com Health Language provides software for managing and updating standard and localized medical terminology. Health Language also offers medical content and professional services to enable interoperability, ICD-10 conversion, web-based terminology mapping, and Meaningful Use compliance.

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Healthcare Informatics

DSS, Inc. Juno Beach, FL Contact: Kelly Kavooras (561) 284-7155 E-mail: [email protected] Web: www.dssinc.com To meet the needs of each unique medical facility, DSS offers a comprehensive EHR system including customizable behavioral health, clinical decision support, dental, and document imaging extension modules, all integrated into a single database.

www.healthcare-informatics.com

SPECIAL ADVERTISING SECTION Stanley Healthcare Solutions (877) 494-2528 E-mail: [email protected] Web: www.StanleyHealthcare.com

Ignis Systems

Carstens

Portland, OR Contact: Katy Isaksen (888) 806-0309, ext. 507 E-mail: [email protected] Web: www.ignissystems.com EMR-Link CPOE Toolkit helps EMR vendors put the usability in Meaningful Use by plugging in to virtually any EMR to deliver orders and results functionality with the tightest possible integration to clinical workflows. Vendors can speed time to market and reduce risk by leveraging Ignis’ expertise and proven success—and gaining instant integration to more than 100 of the top labs in the U.S.

Chicago, IL Contact: Gail Zell (800) 782-1524 E-mail: [email protected] Web: www.carstens.com See our ad in this issue

Stinger Medical Murfreesboro, TN Contact: Todd Jackson (888) 909-8906 E-mail: [email protected] Web: www.stingermedical.com

COMPUTER SERVER HOSTING

GCX Corporation Petaluma, CA Contact: Kevin Merritt (800) 228-2555 E-mail: [email protected] Web: www.gcx.com See our ad in this issue

GNAX Health Atlanta, GA Contact: Matt Mong (855) 280-4629 E-mail: [email protected] Web: www.gnaxhealth.com

NTT DATA Healthcare Technologies (formerly Keane)

CONSULTING—CLINICAL INFORMATICS

Los Angeles, CA Contact: Larry Kaiser (800) 699-5329 E-mail: [email protected] Web: www.nttdata.com/americas

PHICON Corporations Institute for Health Informatics Atlanta, GA Contact: Anthony O Oloni, MD, MPH (800) 713-9925 E-mail: [email protected] Web: www.phiconcorp.com/hi

COMPUTER CARTS/MOBILE COMPUTING

CONSULTING—MEANINGFUL USE STRATEGY Stanley Healthcare Solutions Rubbermaid Healthcare ALTUS Walker, MI Contact: Eric Kahkonen (888) 537-1311 E-mail: [email protected] Web: www.altus-inc.com ALTUS designs and manufactures mobile and wall-mounted technology workstations at our state-of-the art facility in Grand Rapids, Michigan. ALTUS Functionology is successfully optimizing EMR/CPOE initiatives and efficiency in thousands of healthcare facilities around the country.

www.healthcare-informatics.com

Huntersville, NC (888) 859-8294 E-mail: customer.service@ rubbermaidhealthcare.com Web: www.rubbermaidhealthcare.com Rubbermaid Healthcare is the premier provider of medication carts, wall-mounted workstations, mobile computing solutions, and telemedicine carts for healthcare facilities striving to enhance patient care, safety, and staff productivity. The company’s product portfolio is designed to reduce user fatigue and improve workflow while adapting to multiple clinical environments. Product development focuses on providing caregiver workflow advantages and improving the integration and acceptance of technology into the patient care process.

(877) 494-2528 E-mail: [email protected] Web: www.StanleyHealthcare.com

Healthcare Informatics

December 2012

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SPECIAL ADVERTISING SECTION

CONSULTING—OUTSOURCING

Stanley Healthcare Solutions (877) 494-2528 E-mail: [email protected] Web: www.StanleyHealthcare.com

VCPI Milwaukee, WI Contact: Andrea Harman (414) 908-8590 E-mail: [email protected] Web: www.vcpi.com

3M Health Information Systems Murray, UT (800) 367-2447 E-mail: [email protected] Web: www.3mhis.com 3M Health Information Systems delivers software and consulting services to help organizations improve clinical documentation, quality, and financial performance. We offer expertise in coding, ICD-10, dictation, transcription, speech recognition, medical terminologies, and data exchange to support electronic health records. With more than 25 years of healthcare experience, we work as a trusted and stable business partner to provide reliable implementation, training, and support to our clients.

Nuance Communications, Inc. Burlington, MA (888) 350-4836 Web: www.nuance.com/healthcare Nuance Healthcare’s clinical understanding solutions improve the clinical documentation process—from capture of the complete patient record to clinical documentation improvement, coding, compliance, and reimbursement. More than 450,000 physicians and 10,000 healthcare facilities worldwide leverage Nuance’s solutions. See our ad in this issue

CONSULTING—SYSTEM IMPLEMENTATION

Cumberland Consulting Group Franklin, TN Contact: Jim Lewis (615) 373-4470 E-mail: [email protected] Web: www.cumberlandcg.com Cumberland Consulting Group, LLC is a national technology implementation and project management firm serving ambulatory, acute, and post-acute healthcare providers. Cumberland provides strategic information technology planning, systems selection, implementation, and optimization services. Through the implementation of new technologies, Cumberland helps providers nationwide advance the quality of patient care they deliver and improve overall business performance.

3M Health Information Systems Murray, UT (800) 367-2447 E-mail: [email protected] Web: www.3mhis.com 3M Health Information Systems delivers software and consulting services to help organizations improve clinical documentation, quality, and financial performance. We offer expertise in coding, ICD-10, dictation, transcription, speech recognition, medical terminologies, and data exchange to support electronic health records. With more than 25 years of healthcare experience, we work as a trusted and stable business partner to provide reliable implementation, training, and support to our clients.

Optimizing the business of healthcare

Hayes Management Consulting Newton Center, MA Contact: Wendy Loveland (617) 559-0404 E-mail: [email protected] Web: www.hayesmanagement.com

CharlesRiver Advisors, LLC Framingham, MA Contact: Fred Zodda (508) 370-3549 E-mail: [email protected] Web: www.charlesriveradvisors.com

Claricode Waltham, MA Contact: Andrew Needleman (800) 635-5284 E-mail: [email protected] Web: www.claricode.com

Sedona Learning Solutions

InfoPartners Inc.—A Santa Rosa Consulting Company Nashville, TN Contact: James Baxter (615) 297-4215 E-mail: [email protected] Web: www.infopart.com

Phoenix, AZ Contact: Kerry Kuehn (602) 840-1000 E-mail: [email protected] Web: www.sedonalearning.com Sedona Learning Solutions offers EMR educational services. Sedona’s project managers, instructional designers, and instructors work with you to design and deliver customized training and support for your EMR. Sedona delivers instruction on site or online. See our ad in this issue

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Healthcare Informatics

www.healthcare-informatics.com

SPECIAL ADVERTISING SECTION

CONSULTING—USER ADOPTION/ WORKFLOW

DASHBOARDS—PROJECT MANAGEMENT/STAFF UTILIZATION

MedWorth, LLC Mobile, AL Contact: Tom Myers (251) 345-0100 E-mail: [email protected] Web: www.ssimedworth.com

DATA ENCRYPTION Linoma Software - GoAnywhere Managed File Transfer Solution

3M Health Information Systems Murray, UT (800) 367-2447 E-mail: [email protected] Web: www.3mhis.com 3M Health Information Systems delivers software and consulting services to help organizations improve clinical documentation, quality, and financial performance. We offer expertise in coding, ICD-10, dictation, transcription, speech recognition, medical terminologies, and data exchange to support electronic health records. With more than 25 years of healthcare experience, we work as a trusted and stable business partner to provide reliable implementation, training, and support to our clients.

DASHBOARDS—CENSUS/ LABOR/FINANCIALS

iDashboards Troy, MI Contact: Jonathan Kucharski (888) 359-0500 E-mail: [email protected] Web: www.idashboards.com/healthcare iDashboards enterprise-class software application helps hospitals and healthcare organizations leverage information in real-time through visually rich, interactive and personalized dashboards. Learn more and download a 30 day trial at www. iDashboards.com/healthcare.

Ashland, NE Contact: Brian Pick (800) 949-4696 E-mail: [email protected] Web: www.GoAnywhere.com

DATA SOLUTIONS

DASHBOARDS—REVENUE CYCLE MANAGEMENT Health Care Software Inc. (HCS) Farmingdale, NJ Contact: Sue Trajkoski (800) 524-1038 E-mail: [email protected] Web: www.hcsinteractant.com

DEA Lookup.com, Inc. Wilmington, DE Contact: Gregory Merritt (877) 482-5400 Web: www.dealookup.com

DICTATION/TRANSCRIPTION iDashboards Troy, MI Contact: Jonathan Kucharski (888) 359-0500 E-mail: [email protected] Web: www.idashboards.com/healthcare iDashboards enterprise-class software application helps hospitals and healthcare organizations leverage information in real-time through visually rich, interactive and personalized dashboards. Learn more and download a 30 day trial at www. iDashboards.com/healthcare.

Prime Care Technologies Inc. Duluth, GA Contact: Keith Farley (877) 644-2306 E-mail: [email protected] Web: www.primecaretech.com

VCPI Milwaukee, WI Contact: Andrea Harman (414) 908-8590 E-mail: [email protected] Web: www.vcpi.com

www.healthcare-informatics.com

iDashboards Troy, MI Contact: Jonathan Kucharski (888) 359-0500 E-mail: [email protected] Web: www.idashboards.com/healthcare iDashboards enterprise-class software application helps hospitals and healthcare organizations leverage information in real-time through visually rich, interactive and personalized dashboards. Learn more and download a 30 day trial at www. iDashboards.com/healthcare.

MedeAnalytics Emeryville, CA Contact: Doug Hart (510) 379-3300 E-mail: [email protected] Web: www.medeanalytics.com

3M Health Information Systems Murray, UT (800) 367-2447 E-mail: [email protected] Web: www.3mhis.com 3M Health Information Systems delivers software and consulting services to help organizations improve clinical documentation, quality, and financial performance. We offer expertise in coding, ICD-10, dictation, transcription, speech recognition, medical terminologies, and data exchange to support electronic health records. With more than 25 years of healthcare experience, we work as a trusted and stable business partner to provide reliable implementation, training, and support to our clients.

Healthcare Informatics

December 2012

47

SPECIAL ADVERTISING SECTION

Nuance Communications, Inc. Burlington, MA (888) 350-4836 Web: www.nuance.com/healthcare Nuance Healthcare’s clinical understanding solutions improve the clinical documentation process—from capture of the complete patient record to clinical documentation improvement, coding, compliance, and reimbursement. More than 450,000 physicians and 10,000 healthcare facilities worldwide leverage Nuance’s solutions. See our ad in this issue

MEALTRACKER Dietary Software

Alpha Systems

Hornell, NY Contact: Cole Racho (800) 755-3284 E-mail: [email protected] Web: www.mealtracker.com

Huntingdon Valley, PA Contact: Cyndi Rauch (800) 732-9644 E-mail: [email protected] Web: www.alpha-sys.com Alpha Systems provides comprehensive data and document management solutions that address every stage of the healthcare information life cycle. By eliminating bottlenecks caused by paper processes and disparate IT systems, our electronic solutions deliver greater efficiency and improved cash flow. Alpha Systems capabilities include document scanning, Electronic Document Management (EDM) software, Computer Assisted Coding (CAC), and electronic discovery services. For nearly 40 years, Alpha Systems has delivered high quality solutions to America’s leading healthcare organizations.

DISEASE MANAGEMENT Claricode Waltham, MA Contact: Andrew Needleman (800) 635-5284 E-mail: [email protected] Web: www.claricode.com

InfoMC, Inc. Speech Processing Solutions USA Inc. Alpharetta, GA Contact: Michaela Kraft (877) 773-3242 E-mail: [email protected] Web: www.philips.com/dictation Philips voice technology solutions are indispensable daily tools for healthcare users. Our digital dictation solutions, including the new SpeechMike Premium and smartphone apps, are equipped with state-of-the-art technology for use in a medical setting.

Conshohocken, PA Contact: JJ Farook (484) 530-0100 E-mail: [email protected] Web: www.infomc.com

DOCUMENT IMAGING/ MANAGEMENT

DIETARY AND NUTRITIONAL MANAGEMENT Dietary Management Software by Brimstone Allon Enterprises, LLC Finksburg, MD Contact: Bill Valway (800) 752-5121 E-mail: [email protected] Web: www.dietarymanagementsoftware.com

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3M Health Information Systems Murray, UT (800) 367-2447 E-mail: [email protected] Web: www.3mhis.com 3M Health Information Systems delivers software and consulting services to help organizations improve clinical documentation, quality, and financial performance. We offer expertise in coding, ICD-10, dictation, transcription, speech recognition, medical terminologies, and data exchange to support electronic health records. With more than 25 years of healthcare experience, we work as a trusted and stable business partner to provide reliable implementation, training, and support to our clients.

Healthcare Informatics

Care360, Healthcare IT Solutions from Quest Diagnostics Mason, OH Contact: Jeff Lusby (800) 444-6235 E-mail: [email protected] Web: www.care360.com ChartMaxx, the eight-time ‘Best in KLAS’ Document Management and Imaging (DMI) and Enterprise Content Management (ECM) solution, enables healthcare organizations to see immediate improvements through electronic documents, eForms, and automated workflow. To learn more, visit www.Care360.com and click on the Hospital tab.

DSS, Inc. Juno Beach, FL Contact: Kelly Kavooras (561) 284-7155 E-mail: [email protected] Web: www.dssinc.com

www.healthcare-informatics.com

SPECIAL ADVERTISING SECTION Cerner Corporation

E-COMMERCE

Kansas City, MO Contact: Stephanie Reid (800) 927-1024 E-mail: [email protected] Web: www.cerner.com/physicianpractice

University College

ZirMed Louisville, KY Contact: Kent Rowe (877) 494-1032 E-mail: [email protected] Web: www.zirmed.com ZirMed, one of Healthcare Informatics magazine’s Top 100 companies, is a nationally recognized leader in delivering revenue cycle management solutions to healthcare providers, serving more than 115,000 healthcare providers. ZirMed leverages the power of technology to cure administrative burdens and increase cash flow, enabling providers to not just survive but thrive. ZirMed solutions include eligibility verification, credit/debit/ check processing, claims management, coding compliancy, electronic remittance advice, patient statements, e-commerce, and lock box. See our ad in this issue

Denver, CO Contact: Irene Frederick, MD (800) 347-2042 E-mail: [email protected] Web: universitycollege.du.edu The Medical and Healthcare Information Technologies master’s degree is offered online or on campus at the University of Denver in the evenings, or in a combination of both, to meet the needs of busy adults.

EMR/EHR Accumedic, Inc. Great Neck, NY Contact: John Teubner (516) 466-6800 E-mail: [email protected] Web: www.accumedic.com

DSS, Inc. Juno Beach, FL Contact: Kelly Kavooras (561) 284-7155 E-mail: [email protected] Web: www.dssinc.com To meet the needs of each unique medical facility, DSS offers a comprehensive EHR system including customizable behavioral health, clinical decision support, dental, and document imaging extension modules, all integrated into a single database.

EDUCATION/COMPLIANCE/LEGAL Linoma Software - GoAnywhere Managed File Transfer Solution Ashland, NE Contact: Brian Pick (800) 949-4696 E-mail: [email protected] Web: www.GoAnywhere.com

Foothold Technology Alere Wellogic Waltham, MA Contact: Natalie Pietrzak (855) 935-5644 E-mail: [email protected] Web: www.wellogic.com

New York, NY Contact: Nick Scharlatt (212) 780-1450 E-mail: [email protected] Web: www.footholdtechnology.com

Health Care Software Inc. (HCS) Farmingdale, NJ Contact: Sue Trajkoski (800) 524-1038 E-mail: [email protected] Web: www.hcsinteractant.com

Sedona Learning Solutions Phoenix, AZ Contact: Kerry Kuehn (602) 840-1000 E-mail: [email protected] Web: www.sedonalearning.com Sedona Learning Solutions offers EMR educational services. Sedona’s project managers, instructional designers, and instructors work with you to design and deliver customized training and support for your EMR. Sedona delivers instruction on site or online. See our ad in this issue

www.healthcare-informatics.com

Care360, Healthcare IT Solutions from Quest Diagnostics Mason, OH Contact: Susan Curts (888) 835-3409 E-mail: [email protected] Web: www.care360.com Care360® EHR is a certified solution that transitions workflow from paper to electronic in a step-wise approach. Practices implement features at their own pace including electronic lab order management, prescription management, and practice management integration. Care360 EHR provides anywhere access through mobile devices like the iPhone® and iPad®.

Henry Schein MicroMD Boardman, OH Contact: Dawn Domitrovich (800) 624-8832 E-mail: [email protected] Web: www.micromd.com

Healthcare Informatics

December 2012

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SPECIAL ADVERTISING SECTION Interaction Information Technology-Pace+

ENTERPRISE RESOURCE PLANNING/ BUSINESS INTELLIGENCE/ BUSINESS PROCESS MANAGEMENT

Mesa, AZ Contact: John Hopkins (866) 359-3829 E-mail: [email protected] Web: www.pace-plus.com

InterSystems Corporation Cambridge, MA Contact: Jackie Gentile (617) 621-0600 E-mail: [email protected] Web: www.intersystems.com InterSystems Corporation is a global leader in software for connected care. InterSystems HealthShare® is a strategic healthcare informatics platform for information exchange and analytics within a hospital network, and across a community, region, or nation. See our ad in this issue

simplifyMD

Dimensional Insight, Inc.

Alpharetta, GA Contact: Michael Brozino (877) GO-SIMPL E-mail: [email protected] Web: www.simplifymd.com SimplifyMD understands the amount of stress and complexity added to the life of physicians and their staff when buying and deploying EHR software. We are dedicated to simplifying the life of physicians and administrators by providing a simple experience to Electronic Health Records management. simplifyMD EHR software mirrors your chart, uses your forms, and preserves your workflow. Our EHR software streamlines operational workflow, lowers operating costs, and increases revenue without disruption to your medical practice.

Burlington, MA Contact: Ed O’Brien (781) 229-9111 E-mail: [email protected] Web: www.dimins.com

EMR/EHR TRAINING AND CERTIFICATION PHICON Corporations Institute for Health Informatics

iDashboards Troy, MI Contact: Jonathan Kucharski (888) 359-0500 E-mail: [email protected] Web: www.idashboards.com/healthcare iDashboards enterprise-class software application helps hospitals and healthcare organizations leverage information in real-time through visually rich, interactive and personalized dashboards. Learn more and download a 30 day trial at www. iDashboards.com/healthcare.

Atlanta, GA Contact: Anthony O. Oloni, MD, MPH (800) 713-9925, ext. 8 E-mail: [email protected] Web: www.phiconcorp.com/hi

NTT DATA Healthcare Technologies (formerly Keane) Los Angeles, CA Contact: Larry Kaiser (800) 699-5329 E-mail: [email protected] Web: www.nttdata.com/americas

ENTERPRISE IMAGING

Kronos Incorporated Chelmsford, MA Contact: Mitch Moffett (800) 225-1561 E-mail: [email protected] Web: www.kronos.com/healthcare

Agfa HealthCare Sigmund Software Brewster, NY Contact: Cory Valentine (800) 448-6975 E-mail: [email protected] Web: www.sigmundsoftware.com

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December 2012

Greenville, SC Contact: Jim Banghart (877) 777-2432 E-mail: [email protected] Web: www.agfahealthcare.com Agfa HealthCare delivers informatics solutions to healthcare providers to advance their improved efficiency and the safety of care they deliver to patients. With our PACS-neutral, vendor-neutral archive ICIS (Imaging Clinical Information System) workflow-centric services platform, imaging data consolidation is lifted to the enterprise, to drive both clinical advances and IT efficiencies. ICIS makes patient-centric imaging data, from radiology and multi-disciplinary imaging, readily available across the enterprise.

Healthcare Informatics

McKesson Alpharetta, GA (404) 338-6000 E-mail: [email protected] Web: www.mckesson.com

MedeAnalytics Emeryville, CA Contact: Doug Hart (510) 379-3300 E-mail: [email protected] Web: www.medeanalytics.com

www.healthcare-informatics.com

SPECIAL ADVERTISING SECTION MediClick

EXECUTIVE SEARCH

Raleigh, NC Contact: Christine Struckmeyer (919) 861-4400 E-mail: [email protected] Web: www.mediclick.com

Optum Eden Prairie, MN Contact: Sales Info (800) 765-6793 E-mail: [email protected] Web: www.optuminsight.com

ENTERPRISE REVENUE MANAGEMENT

ZirMed Louisville, KY Contact: Kent Rowe (877) 494-1032 E-mail: [email protected] Web: www.zirmed.com ZirMed, one of Healthcare Informatics magazine’s Top 100 companies, is a nationally recognized leader in delivering revenue cycle management solutions to healthcare providers, serving more than 115,000 healthcare providers. ZirMed leverages the power of technology to cure administrative burdens and increase cash flow, enabling providers to not just survive but thrive. ZirMed solutions include eligibility verification, credit/debit/check processing, claims management, coding compliancy, electronic remittance advice, patient statements, e-commerce, and lock box.

Belle Oaks of America Inc. Vero Beach, FL Contact: Ed Simmons (772) 492-1844 E-mail: [email protected] Web: www.belleoaks.com See our ad in this issue

See our ad in this issue

Experian Healthcare Maple Grove, MN Contact: Merideth Wilson (800) 930-9095 E-mail: [email protected] Web: www.experian.com/healthcare Experian Healthcare provides revenue cycle products and consultative services powered by data and advanced analytics that allow health systems, hospitals, medical groups, and specialty healthcare organizations to more effectively manage critical financial decisions.

Health Care Software Inc. (HCS) Farmingdale, NJ Contact: Sue Trajkoski (800) 524-1038 E-mail: [email protected] Web: www.hcsinteractant.com

Witt/Kieffer

ENVIRONMENTAL/BUILDING

Rees Scientific Corp.

Oak Brook, IL Contact: Linda Hodges (630) 990-1370 Web: www.wittkieffer.com Witt/Kieffer is the nation’s leading executive search firm dedicated to finding IT leaders who can translate healthcare business and leadership needs into successful IT solutions. For more information, visit www.wittkieffer.com.

FINANCIAL MANAGEMENT

Trenton, NJ Contact: Sales (609) 530-1055 E-mail: [email protected] Web: www.reesscientific.com

E-PRESCRIBING McKesson Alpharetta, GA (404) 338-6000 E-mail: [email protected] Web: www.mckesson.com

DSS, Inc. Juno Beach, FL Contact: Kelly Kavooras (561) 284-7155 E-mail: [email protected] Web: www.dssinc.com

www.healthcare-informatics.com

Healthcare Informatics

December 2012

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SPECIAL ADVERTISING SECTION

HIE/RHIOs/NHIN

ZirMed Louisville, KY Contact: Kent Rowe (877) 494-1032 E-mail: [email protected] Web: www.zirmed.com ZirMed, one of Healthcare Informatics magazine’s Top 100 companies, is a nationally recognized leader in delivering revenue cycle management solutions to healthcare providers, serving more than 115,000 healthcare providers. ZirMed leverages the power of technology to cure administrative burdens and increase cash flow, enabling providers to not just survive but thrive. ZirMed solutions include eligibility verification, credit/debit/check processing, claims management, coding compliancy, electronic remittance advice, patient statements, e-commerce, and lock box. See our ad in this issue

ICA 3M Health Information Systems Murray, UT (800) 367-2447 E-mail: [email protected] Web: www.3mhis.com 3M Health Information Systems delivers software and consulting services to help organizations improve clinical documentation, quality, and financial performance. We offer expertise in coding, ICD-10, dictation, transcription, speech recognition, medical terminologies, and data exchange to support electronic health records. With more than 25 years of healthcare experience, we work as a trusted and stable business partner to provide reliable implementation, training, and support to our clients.

Nashville, TN Contact: Sandra Lillie (615) 866-1487 E-mail: [email protected] Web: www.icainformatics.com ICA was established to take innovative solutions developed at Vanderbilt Medical Center to the broader healthcare market, and now delivers a comprehensive interoperability platform to hospitals, IDNs, IPAs, HIEs, payers, and others. CareAlign® unites a wide range of information supporting analytics associated with transitions of care communication, re-admissions reduction, meaningful use requirements, and PCMH/ACO operations.

FRAUD AND ABUSE DETECTION AND ANALYTICS Ignis Systems Alere Wellogic Waltham, MA Contact: Natalie Pietrzak (855) 935-5644 E-mail: [email protected] Web: www.wellogic.com

Experian Healthcare Maple Grove, MN Contact: Merideth Wilson (800) 930-9095 E-mail: [email protected] Web: www.experian.com/healthcare Experian Healthcare provides revenue cycle products and consultative services powered by data and advanced analytics that allow health systems, hospitals, medical groups, and specialty healthcare organizations to more effectively manage critical financial decisions.

HEALTHCARE FACILITY DATA Linoma Software - GoAnywhere Managed File Transfer Solution Ashland, NE Contact: Brian Pick (800) 949-4696 E-mail: [email protected] Web: www.GoAnywhere.com

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December 2012

Certify Data Systems Inc. San Jose, CA Contact: David Caldwell (408) 236-7494 E-mail: [email protected] Web: www.certifydatasystems.com Certify Data Systems is a pioneer in HIE technology. Certify’s HealthLogix™ Enterprise HIE platform has been adopted by the nation’s leading hospitals, physicians and laboratories. HealthLogix provides bi-directional semantic interoperability between disparate EHR systems, enabling all healthcare providers to exchange essential health information in real-time. In addition to processing electronic orders and results, HealthLogix delivers CCD/CDA seamlessly across a healthcare ecosystem. Certify’s industry leading “last mile” solution is easy to deploy, scale, manage, and support.

Healthcare Informatics

Portland, OR Contact: Katy Isaksen (888) 806-0309, ext. 507 E-mail: [email protected] Web: www.ignissystems.com EMR-Link’s provider-centric workflow is readily adopted by providers, which is critical to the success of any HIE solution. Ignis’ simple, proven technology framework complements any HIE solution by providing integration with over 100 lab facilities. Cost savings for labs and clinics alike deliver ROI to support a sustainable business model for ongoing HIE participation. EMR-Link helps your healthcare organization be more competitive by offering an order and result workflow that reduces operational costs for labs and clinics alike by generating clean, complete orders from clinics that use any EMR—or none yet.

InfoMC, Inc. Conshohocken, PA Contact: JJ Farook (484) 530-0100 E-mail: [email protected] Web: www.infomc.com

www.healthcare-informatics.com

SPECIAL ADVERTISING SECTION

HUMAN RESOURCES MANAGEMENT

InterSystems Corporation

Nuance Communications, Inc.

Cambridge, MA Contact: Jackie Gentile (617) 621-0600 E-mail: [email protected] Web: www.intersystems.com InterSystems Corporation is a global leader in software for connected care. InterSystems HealthShare® is a strategic healthcare informatics platform for information exchange and analytics within a hospital network, and across a community, region, or nation. See our ad in this issue

Burlington, MA (888) 350-4836 Web: www.nuance.com/healthcare Nuance Healthcare’s clinical understanding solutions improve the clinical documentation process—from capture of the complete patient record to clinical documentation improvement, coding, compliance, and reimbursement. More than 450,000 physicians and 10,000 healthcare facilities worldwide leverage Nuance’s solutions. See our ad in this issue

HIM

Kronos Incorporated Chelmsford, MA Contact: Mitch Moffett (800) 225-1561 E-mail: [email protected] Web: www.kronos.com/healthcare

ICD-10 COMPLIANCE

IMAGING/PACS

MedeAnalytics Emeryville, CA Contact: Doug Hart (510) 379-3300 E-mail: [email protected] Web: www.medeanalytics.com

3M Health Information Systems

Agfa HealthCare

Murray, UT (800) 367-2447 E-mail: [email protected] Web: www.3mhis.com 3M Health Information Systems delivers software and consulting services to help organizations improve clinical documentation, quality, and financial performance. We offer expertise in coding, ICD-10, dictation, transcription, speech recognition, medical terminologies, and data exchange to support electronic health records. With more than 25 years of healthcare experience, we work as a trusted and stable business partner to provide reliable implementation, training, and support to our clients.

Greenville, SC Contact: Jim Banghart (877) 777-2432 E-mail: [email protected] Web: www.agfahealthcare.com

HealthPort Alpharetta, GA Contact: Catherine Valyi (800) 737-2585 E-mail: [email protected] Web: www.healthport.com HealthPort ensures the compliant exchange of PHI through flexible release of information services and technology. You can outsource the entire function or just a few tasks. Choose from on-site, shared services, remote, or business office solutions.

www.healthcare-informatics.com

Medical Coding & Compliance Solutions, LLC (MCCS) Turlock, CA Contact: Karlen Bailie, M.D. (800) 711-7873 E-mail: [email protected] Web: www.flashcode.com Flash Code™, the #1-rated medical coding software, is used daily by thousands of physicians, medical groups, hospitals, and third party payers for comprehensive coding and compliance tasks. Flash Code users will find the transition to ICD10 easy with our ICD-10-CM coding module, ICD-9-CM to ICD-10-CM code mapping (GEM), ICD-9-CM to ICD-10-CM Side-by-Side™ display, and our ICD-10-PCS Code Builder™ module.

Aperio Vista, CA Contact: Valerie Hofstetter (760) 539-1100 E-mail: [email protected] Web: www.aperio.com Aperio has advanced the technology that enables glass slides to be digitized and securely shared with others. Aperio ePathology Solutions are transforming the practice of pathology in hospitals and reference labs around the world. Aperio products are FDA cleared for specific clinical applications, and are intended for research and educational use for other applications. They are not approved by the FDA for primary diagnosis. For clearance updates, specific product indications, and more information, please visit www.aperio.com.

Healthcare Informatics

December 2012

53

SPECIAL ADVERTISING SECTION GNAX Health

LENDERS/FINANCIAL INSTITUTIONS

Atlanta, GA Contact: Matt Mong (855) 280-4629 E-mail: [email protected] Web: www.gnaxhealth.com

InfoPartners Inc.

McKesson Alpharetta, GA (404) 338-6000 E-mail: [email protected] Web: www.mckesson.com

NovaRad Corporation American Fork, UT Contact: Paul Shumway (801) 642-1001 E-mail: [email protected] Web: www.novarad.net

IS MANAGEMENT AND CONSULTING Ashvins Group Inc. Miami, FL Contact: James Berlin (877) 274-8467 E-mail: [email protected] Web: www.ashvinsgroup.com

Nashville, TN Contact: James Baxter (615) 297-4215 E-mail: [email protected] Web: www.infopart.com Founded in 1986, InfoPartners, a wholly owned subsidiary of Santa Rosa Consulting, provides information systems management and consulting services to hospitals. Through our IS Management Partnership, we provide a collaborative, advocate-driven service focused on supporting IS department leadership, and adopting best practices and operational improvements. We currently serve more than 40 hospitals. Benefits include: IS Leadership Support, Operational Assessments, Strategic Planning, Budget Process, Vendor Relationship, Departmental/Project Readiness, Disaster Planning, Technology Assessments, Security Monitoring, Staffing Analysis and Departmental Organization, Service Desk Process and Organization, Systems Selections, and Implementation/ Project Management services.

LIS

Milwaukee, WI Contact: Andrea Harman (414) 908-8590 E-mail: [email protected] Web: www.vcpi.com

KIOSK SOLUTIONS

Framingham, MA Contact: Fred Zodda (508) 370-3549 E-mail: [email protected] Web: www.charlesriveradvisors.com

Connected Technology Solutions Mequon, WI Contact: Gila Katz (262) 242-7203 E-mail: [email protected] Web: www.connectedts.com The CTS patient check-in kiosks are becoming the industry standard. With more than 5 years of proven success, these units have deployed in more than 50 healthcare systems. Adjustable, floor standing, desktop, and wall-mount offerings are available.

December 2012

Minnetonka, MN Contact: Brad Swenson (952) 656-7689 E-mail: [email protected] Web: www.winthropresources.com Technology changes rapidly, post-warranty maintenance is expensive, and interdepartmental connectivity causes ripple effects through your organization that drive unplanned change. Winthrop provides custom technology leasing solutions to hundreds of leading healthcare organizations across the U.S.

VCPI

CharlesRiver Advisors, LLC

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Winthrop Resources Corporation

Healthcare Informatics

Ignis Systems Portland, OR Contact: Katy Isaksen (888) 806-0309, ext. 507 E-mail: [email protected] Web: www.ignissystems.com In a world where physicians increasingly see the EMR as their “clinical cockpit,” EMR-Link helps labs be more competitive by offering a provider-centric order and result workflow that reduces operational costs for labs and clinics alike by generating clean, complete orders from clinics that use any EMR—or none yet. EMR-Link’s proven technology and ease of implementation helps labs simplify EMR outreach and respond proactively to the rising tide of EMR adoption, making it easy to comply with requirements for patient-friendly results and HIE participation.

www.healthcare-informatics.com

SPECIAL ADVERTISING SECTION

MARKET RESEARCH

Lifepoint Informatics Glen Rock, NJ Contact: Jay Alicea (201) 447-9991 E-mail: [email protected] Web: www.lifepoint.com Lifepoint Informatics, a healthcare IT leader, serves data connectivity, integration, and communication needs of clinical laboratories, hospitals, and health networks, helping healthcare providers reduce costs and improve patient care through advanced information technology solutions. Since 1999, Lifepoint Informatics has enabled more than 200 hospitals, clinical labs, and anatomic pathology groups to grow market share and extend their outreach programs by deploying our ONC-ATCB Certified Web Provider Portal, ready-to-go EMR/ EHR interfaces, and additional technologies supporting clinical lab outreach.

Sunquest Information Systems, Inc. Tucson, AZ (800) 748-0692 E-mail: [email protected] Web: www.sunquestinfo.com See our ad in this issue

LONG-TERM CARE

NextGate Pasadena, CA Contact: Richard Garcia (626) 376-4100 E-mail: [email protected] Web: www.nextgate.com

Chelmsford, MA Contact: Mitch Moffett (800) 225-1561 E-mail: [email protected] Web: www.kronos.com/healthcare

Anna, TX Contact: Michael Mihalik (800) 798-3540 E-mail: [email protected] Web: www.pathview.com From specimen tracking to web/EHR reporting, Progeny by PathView Systems is a comprehensive LIS solution for today’s Anatomic Pathology, Cytology, and Molecular laboratories. Realize LEAN efficiencies and empower your business to compete in a dynamic marketplace.

Psyche Systems Corporation Milford, MA Contact: Lisa-Jean Clifford (508) 473-1500 E-mail: [email protected] Web: www.psychesystems.com See our ad in this issue

MEDICATION CARTS

Stanley Healthcare Solutions (877) 494-2528 E-mail: [email protected] Web: www.StanleyHealthcare.com

VCPI Milwaukee, WI Contact: Andrea Harman (414) 908-8590 E-mail: [email protected] Web: www.vcpi.com

MANAGED CARE InfoMC, Inc.

Rubbermaid Healthcare

Conshohocken, PA Contact: JJ Farook (484) 530-0100 E-mail: [email protected] Web: www.infomc.com

RAM Technologies Inc. Fort Washington, PA Contact: Mark Wullert (215) 654-8810 E-mail: [email protected] Web: www.ramtechnologiesinc.com

www.healthcare-informatics.com

Atlanta, GA Contact: Jennifer Dennard (678) 569-4872 E-mail: [email protected] Web: www.porterresearch.com

MASTER PATIENT AND PROVIDER INDEX

Kronos Incorporated

PathView Systems

Porter Research

Huntersville, NC (888) 859-8294 E-mail: customer.service@ rubbermaidhealthcare.com Web: www.rubbermaidhealthcare.com Rubbermaid Healthcare is the premier provider of medication carts, wall-mounted workstations, mobile computing solutions, and telemedicine carts for healthcare facilities striving to enhance patient care, safety, and staff productivity. The company’s product portfolio is designed to reduce user fatigue and improve workflow while adapting to multiple clinical environments. Product development focuses on providing caregiver workflow advantages and improving the integration and acceptance of technology into the patient care process.

Healthcare Informatics

December 2012

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SPECIAL ADVERTISING SECTION

MESSAGING

MOBILE APP FOR IPAD

Amcom Software Eden Prairie, MN Contact: Cory Rablin (952) 230-5342 Web: www.amcomsoftware.com See our ad in this issue

ClientTell Inc. Valdosta, GA Contact: Chad Greer (877) 244-9178 E-mail: [email protected] Web: www.clienttell.net

Spacelabs Healthcare Issaquah, WA Contact: Dorothy Marshall (978) 552-7080 E-mail: [email protected] Web: www.spacelabshealthcare.com ICS XPREZZ provides the power of ICS G2 Clinical applications in the palm of your hand. From near-live waveforms to graphical trends, your patient info can be with you–all the time.

NURSE CALL SYSTEMS Rauland-Borg Corp. Mount Prospect, IL Contact: Denny McReynolds (847) 590-7100 E-mail: [email protected] Web: www.rauland.com

HipLink Software Los Gatos, CA Contact: Vaughn Marie Gouff (408) 399-6120 E-mail: [email protected] Web: www.hiplink.com HipLink paging software enables instant, encrypted communication manually via any browser or automatically from any software. Messages can go via voice or SMS text to smartphones (Android or iPhone), iPads, BlackBerry, land phone, or pager.

PATHOLOGY INFORMATION SYSTEM

Stanley Healthcare Solutions (877) 494-2528 E-mail: [email protected] Web: www.StanleyHealthcare.com

NURSING/PATIENT INFORMATION SYSTEMS

Aperio Vista, CA Contact: Valerie Hoffstetter (760) 539-1100 E-mail: [email protected] Web: www.aperio.com Aperio has advanced the technology that enables glass slides to be digitized and securely shared with others. Aperio ePathology Solutions are transforming the practice of pathology in hospitals and reference labs around the world. Aperio products are FDA cleared for specific clinical applications, and are intended for research and educational use for other applications. They are not approved by the FDA for primary diagnosis. For clearance updates, specific product indications, and more information, please visit www.aperio.com.

Psyche Systems Corporation Milford, MA Contact: Lisa-Jean Clifford (508) 473-1500 E-mail: [email protected] Web: www.psychesystems.com See our ad in this issue

PATIENT MONITORING AND CONNECTIVITY

MIDDLEWARE Dawning Technologies, Inc. Fort Myers, FL Contact: Jay Sax (239) 931-6004 E-mail: [email protected] Web: www.dawning.com

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December 2012

Accent on Integration® DSS, Inc. Juno Beach, FL Contact: Kelly Kavooras (561) 284-7155 E-mail: [email protected] Web: www.dssinc.com

Healthcare Informatics

Murphy, TX Contact: Marc Andiel (888) 788-8264 E-mail: [email protected] Web: www.accentonintegration.com Accent on Integration® delivers extensive integration solutions—from HL7 interfaces to proprietary data extraction. Its vendor-agnostic software, Accelero Connect®, is an FDA-registered Medical Device Data System that integrates patient care devices with EMRs/other clinical systems.

www.healthcare-informatics.com

SPECIAL ADVERTISING SECTION

PRACTICE MANAGEMENT

Ignis Systems Portland, OR Contact: Katy Isaksen (888) 806-0309, ext. 507 E-mail: [email protected] Web: www.ignissystems.com EMR-Link’s Enhanced Results makes it easy for providers to keep patients and other members of the care team informed about lab results and to highlight important actions. These patient-friendly lab results also help labs meet new federal requirements for patient connectivity.

QUALITY REPORTING

Accumedic, Inc.

Insight Health Solutions, Inc.

Great Neck, NY Contact: John Teubner (516) 466-6800 E-mail: [email protected] Web: www.accumedic.com

East Providence, RI Contact: Gita Afshar (866) 743-9481 E-mail: [email protected] Web: www.insighthealthsolutions.com

Cerner Corporation Kansas City, MO Contact: Stephanie Reid (800) 927-1024 E-mail: [email protected] Web: www.cerner.com/physicianpractice

Nuance Communications, Inc.

Henry Schein Dentrix Enterprise

Spacelabs Healthcare Issaquah, WA Contact: Dorothy Marshall (978) 552-7080 E-mail: [email protected] Web: www.spacelabshealthcare.com Spacelabs patient monitoring and connectivity systems can uniquely utilize your existing infrastructure and network resources (run on your core). One, single, HL7 interface to your EMR. One, single, enterprise-wide database–for anytime/anywhere access.

Stanley Healthcare Solutions (877) 494-2528 E-mail: [email protected] Web: www.StanleyHealthcare.com

American Fork, UT Contact: Bill Nixon (770) 715-5345 E-mail: [email protected] Web: www.dentrixenterprise.com See our ad in this issue

Burlington, MA (888) 350-4836 Web: www.nuance.com/healthcare Nuance Healthcare’s clinical understanding solutions improve the clinical documentation process—from capture of the complete patient record to clinical documentation improvement, coding, compliance, and reimbursement. More than 450,000 physicians and 10,000 healthcare facilities worldwide leverage Nuance’s solutions. See our ad in this issue

ReportingMD Georges Mills, NH Contact: Molly Minehan (888) 783-5280 E-mail: [email protected] Web: www.reportingmd.com

Henry Schein MicroMD Boardman, OH Contact: Dawn Domitrovich (800) 624-8832 E-mail: [email protected] Web: www.micromd.com

RAC MANAGEMENT

PAYROLL HealthPort

Optum

Kronos Incorporated Chelmsford, MA Contact: Mitch Moffett (800) 225-1561 E-mail: [email protected] Web: www.kronos.com/healthcare

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December 2012

Eden Prairie, MN Contact: Sales Info (800) 765-6793 E-mail: [email protected] Web: www.optuminsight.com Optum™, a leading health services business, has been providing coding solutions for 25 years. We offer a range of solutions—from innovative print and electronic resources to sophisticated technology, including computer-assisted coding, a powerful web-based encoder, and ICD-10 mapping software.

Healthcare Informatics

Alpharetta, GA Contact: Catherine Valyi (800) 737-2585 E-mail: [email protected] Web: www.healthport.com HealthPort ensures the compliant exchange of PHI through flexible release of information services and technology. You can outsource the entire function or just a few tasks. Choose from on-site, shared services, remote, or business office solutions.

www.healthcare-informatics.com

SPECIAL ADVERTISING SECTION RAM Technologies Inc. Fort Washington, PA Contact: Mark Wullert (215) 654-8810 E-mail: [email protected] Web: www.ramtechnologiesinc.com

Rycan Marshall, MN Contact: Jody Heard (800) 201-3324 E-mail: [email protected] Web: www.rycan.com

RADIOLOGY INFORMATION SYSTEM

Experian Healthcare Maple Grove, MN Contact: Merideth Wilson (800) 930-9095 E-mail: [email protected] Web: www.experian.com/healthcare Experian Healthcare provides revenue cycle products and consultative services powered by data and advanced analytics that allow health systems, hospitals, medical groups, and specialty healthcare organizations to more effectively manage critical financial decisions.

NovaRad Corporation

Health Care Software Inc. (HCS)

American Fork, UT Contact: Paul Shumway (801) 642-1001 E-mail: [email protected] Web: www.novarad.net

Farmingdale, NJ Contact: Sue Trajkoski (800) 524-1038 E-mail: [email protected] Web: www.hcsinteractant.com

Rycan Marshall, MN Contact: Jody Heard (800) 201-3324 E-mail: [email protected] Web: www.rycan.com

InfoMC, Inc.

RCM—CLAIMS MANAGEMENT

Conshohocken, PA Contact: JJ Farook (484) 530-0100 E-mail: [email protected] Web: www.infomc.com

The SSI Group, Inc. (SSI) Mobile, AL Contact: Doug Bilbrey (800) 881-2739 E-mail: [email protected] Web: www.thessigroup.com See our ad in this issue

Capario Santa Ana, CA Contact: Patrick Malecky (800) 586-6870 E-mail: [email protected] Web: www.capario.com Capario simplifies the reimbursement process, helping providers get paid faster and more accurately. Our easy-to-use portal streamlines the entire revenue cycle, including patient check-in, claims management, denials management, patient billing and payments, and business intelligence. With 25% of a practice’s revenue coming from patients, it’s more important than ever to collect payments before patients leave the office. Capario’s patient pay solution offers multiple options—at patient check-in, online, through the mail, or over the phone.

NTT DATA Healthcare Technologies (formerly Keane) Los Angeles, CA Contact: Larry Kaiser (800) 699-5329 E-mail: [email protected] Web: www.nttdata.com/americas

Optum Eden Prairie, MN Contact: Sales Info (800) 765-6793 E-mail: [email protected] Web: www.optuminsight.com Optum™, a leading health services business, has been providing coding solutions for 25 years. We offer a range of solutions—from innovative print and electronic resources to sophisticated technology, including computer-assisted coding, a powerful web-based encoder, and ICD-10 mapping software.

www.healthcare-informatics.com

ZirMed Louisville, KY Contact: Chandler Jenkins (877) 494-1032 E-mail: [email protected] Web: www.zirmed.com ZirMed, one of Healthcare Informatics magazine’s Top 100 companies, is a nationally recognized leader in delivering revenue cycle management solutions to healthcare providers, serving more than 115,000 healthcare providers. ZirMed leverages the power of technology to cure administrative burdens and increase cash flow, enabling providers to not just survive but thrive. ZirMed solutions include eligibility verification, credit/debit/check processing, claims management, coding compliancy, electronic remittance advice, patient statements, e-commerce, and lock box. See our ad in this issue

Healthcare Informatics

December 2012

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SPECIAL ADVERTISING SECTION

RCM—SELF PAY

RCM—PAYER CONTRACT MANAGEMENT

Kronos Incorporated Experian Healthcare Experian Healthcare Maple Grove, MN Contact: Merideth Wilson (800) 930-9095 E-mail: [email protected] Web: www.experian.com/healthcare Experian Healthcare provides revenue cycle products and consultative services powered by data and advanced analytics that allow health systems, hospitals, medical groups, and specialty healthcare organizations to more effectively manage critical financial decisions.

Maple Grove, MN Contact: Merideth Wilson (800) 930-9095 E-mail: [email protected] Web: www.experian.com/healthcare Experian Healthcare provides revenue cycle products and consultative services powered by data and advanced analytics that allow health systems, hospitals, medical groups, and specialty healthcare organizations to more effectively manage critical financial decisions.

Chelmsford, MA Contact: Mitch Moffett (800) 225-1561 E-mail: [email protected] Web: www.kronos.com/healthcare

SECURE FILE TRANSFER

MedCore, Inc. Health Care Software Inc. (HCS) Farmingdale, NJ Contact: Sue Trajkoski (800) 524-1038 E-mail: [email protected] Web: www.hcsinteractant.com

Mobile, AL Contact: Mike Ruggles (251) 345-0123 E-mail: [email protected] Web: www.medcoreinc.com

REVENUE MANAGEMENT Optum

NTT DATA Healthcare Technologies (formerly Keane) Los Angeles, CA Contact: Larry Kaiser (800) 699-5329 E-mail: [email protected] Web: www.nttdata.com/americas

Optum Eden Prairie, MN Contact: Sales Info (800) 765-6793 E-mail: [email protected] Web: www.optuminsight.com

Eden Prairie, MN Contact: Sales Info (800) 765-6793 E-mail: [email protected] Web: www.optuminsight.com

SCHEDULING—PROCEDURES Unibased Systems Architecture Inc. St. Louis, MO Contact: Stephanie Speth (800) 489-6069 E-mail: [email protected] Web: www.unibased.com

Avantas Omaha, NE Contact: Larry Punteney (888) 338-6148 E-mail: [email protected] Web: www.avantas.com

Marshall, MN Contact: Jody Heard (800) 201-3324 E-mail: [email protected] Web: www.rycan.com

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December 2012

Ashland, NE Contact: Brian Pick (800) 949-4696 E-mail: [email protected] Web: www.GoAnywhere.com GoAnywhere is a managed file transfer solution that runs on multiple platforms and supports popular protocols (SFTP, FTPS, HTTPS, etc.) and encryption standards (Open PGP, GPG, AES, etc.) to automate and secure file transfers.

SECURITY

SCHEDULING—STAFF

Rycan

Linoma Software - GoAnywhere Managed File Transfer Solution

Healthcare Informatics

CynergisTek, Inc. Austin, TX Contact: Mac McMillan (512) 402-8550 E-mail: [email protected] Web: www.cynergistek.com

Stanley Healthcare Solutions (877) 494-2528 E-mail: [email protected] Web: www.StanleyHealthcare.com

SOFTWARE DEVELOPMENT Ashvins Group Inc. Miami, FL Contact: James Berlin (877) 274-8467 E-mail: [email protected] Web: www.ashvinsgroup.com

www.healthcare-informatics.com

SPECIAL ADVERTISING SECTION Claricode Waltham, MA Contact: Andrew Needleman (800) 635-5284 E-mail: [email protected] Web: www.claricode.com

SYSTEMS INTEGRATION

Rees Scientific Corp. Trenton, NJ Contact: Sales (609) 530-1055 E-mail: [email protected] Web: www.reesscientific.com

SPEECH RECOGNITION

Stanley Healthcare Solutions

Accent on Integration® Murphy, TX Contact: Marc Andiel (888) 788-8264 E-mail: [email protected] Web: www.accentonintegration.com

Nuance Communications, Inc. Burlington, MA (888) 350-4836 Web: www.nuance.com/healthcare Nuance Healthcare’s clinical understanding solutions improve the clinical documentation process—from capture of the complete patient record to clinical documentation improvement, coding, compliance, and reimbursement. More than 450,000 physicians and 10,000 healthcare facilities worldwide leverage Nuance’s solutions. See our ad in this issue

WIRELESS DEVICES

TELEHEALTH/TELEMEDICINE

(877) 494-2528 E-mail: [email protected] Web: www.StanleyHealthcare.com

WIRELESS NETWORKING Rees Scientific Corp. Trenton, NJ Contact: Sales (609) 530-1055 E-mail: [email protected] Web: www.reesscientific.com

Claricode Waltham, MA Contact: Andrew Needleman (800) 635-5284 E-mail: [email protected] Web: www.claricode.com

WORKFLOW SOLUTIONS InfoMC, Inc. Conshohocken, PA Contact: JJ Farook (484) 530-0100 E-mail: [email protected] Web: www.infomc.com

STORAGE GNAX Health Atlanta, GA Contact: Matt Mong (855) 280-4629 E-mail: [email protected] Web: www.gnaxhealth.com

WORKFORCE SOLUTIONS

Stanley Healthcare Solutions (877) 494-2528 E-mail: [email protected] Web: www.StanleyHealthcare.com

SUPPLY CHAIN MANAGEMENT MediClick Raleigh, NC Contact: Christine Struckmeyer (919) 861-4400 E-mail: christine.struckmeyer@ mediclick.com Web: www.mediclick.com

Stanley Healthcare Solutions (877) 494-2528 E-mail: [email protected] Web: www.StanleyHealthcare.com

www.healthcare-informatics.com

Kronos Incorporated

Rubbermaid Healthcare Huntersville, NC (888) 859-8294 E-mail: customer.service@ rubbermaidhealthcare.com Web: www.rubbermaidhealthcare.com Rubbermaid Healthcare is the premier provider of medication carts, wall-mounted workstations, mobile computing solutions, and telemedicine carts for healthcare facilities striving to enhance patient care, safety, and staff productivity. The company’s product portfolio is designed to reduce user fatigue and improve workflow while adapting to multiple clinical environments. Product development focuses on providing caregiver workflow advantages and improving the integration and acceptance of technology into the patient care process.

Chelmsford, MA Contact: Mitch Moffett (800) 225-1561 E-mail: [email protected] Web: www.kronos.com/healthcare

Healthcare Informatics

December 2012

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SPECIAL ADVERTISING SECTION

WORKSTATIONS, WALL-MOUNTED

SPECI

VER AL AD

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EXECUTIVE

ON

SEARCH

k MediClicNC

er Struckmey Raleigh, Christine Contact: 400 (919) 861-4 ick.com r@medicl E-mail: truckmeye christine.s .mediclick.com Web: www

ZirMed

KY e Louisville, Kent Row Contact: 032 (877) 494-1 @zirmed.com sales m s E-mail: Infor matic .zirmed.co Web: www one of Healthcare a nationally anies, is ZirMed, Top 100 comp ring revenue cycle delive magazine’s ders, leader in care provi ers. recognized solutions to health nt care provid manageme than 115,000 health ology to cure serving more ges the power of techn se cash flow, ZirMed leverave burdens and increa e but thrive. administrati ders to not just survivverification, ility enabling provions include eligib s managessing, claim ZirMed soluti tance /check proce onic remit credit/debit compliancy, electr merce, and g ment, codin t statements, e-com advice, patien lock box. issue ad in this See our

Optum

ie, MN Eden Prair Sales Info Contact: 793 (800) 765-6 optum.com info@ ight.com E-mail: .optumins Web: www

REVENUE ENTERPRISE MENT MANAGE

Experian

re

Healthca

e, MN Maple Grov deth Wilson Meri Contact: 095 (800) 930-9 .com @experian hcare E-mail: ealthcare healt experianh .experian.com/ revenue cycle Web: www Healthcare provides ed by data services power systems, Experian consultative health products and analytics that allow lty healthcare ced s, and specia and advan critical medical groupeffectively manage hospitals, ns to more izatio organ decisions. financial

Software Health Care le, NJ

) Inc. (HCS

Farmingda Trajkoski Sue Contact: 038 actant.com (800) 524-1 eting@hcsinter mark ctant.com E-mail: .hcsintera Web: www

Huntersville, NC (888) 859-8294 E-mail: customer.service@ rubbermaidhealthcare.com Web: www.rubbermaidhealthcare.com Rubbermaid Healthcare is the premier provider of medication carts, wall-mounted workstations, mobile computing solutions, and telemedicine carts for healthcare facilities striving to enhance patient care, safety, and staff productivity. The company’s product portfolio is designed to reduce user fatigue and improve workflow while adapting to multiple clinical environments. Product development focuses on providing caregiver workflow advantages and improving the integration and acceptance of technology into the patient care process.

Inc.

Vero Beac Simmons Ed Contact: 844 (772) 492-1 elleoaks.com ed@b .com E-mail: .belleoaks issue Web: www our ad in this See

Witt/Kieffer k, IL

es Oak Broo Linda Hodg Contact: 370 tive (630) 990-1 .wittkieffer.com leading execuwho Web: www er is the nation’s s IT leader Witt/Kieff ship to finding and leader dedicated search firm healthcare business For more inate IT solutions. . can transl successful into wittkieffer.com needs visit www. formation,

BUILDING

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Trenton, Sales Contact: 055 c.com (609) 530-1 @reesscientifi sales tific.com E-mail: .reesscien Web: www

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E-PRESCRIBI

Strongarm Designs, Inc.

Rubbermaid Healthcare

of America Belle Oaks h, FL

Alpharett 000 son.com (404) 338-6 estInfo@mckes Requ n.com E-mail: .mckesso Web: www

DSS, Inc.

h, FL oras Juno Beac Kelly Kavo Contact: 155 com (561) 284-7 ooras@dssinc. kkav m E-mail: .dssinc.co Web: www

Horsham, PA Contact: George Peel (215) 443-3400 E-mail: [email protected] Web: www.strongarmhealthcare.com Only arm solution with 100% internal cable management. Crevice-free for optimal cleanability, and comes pre-cabled and fully assembled to save you installation time and money. Robust aluminum construction-perfect for larger displays. Secure lock-in-place feature for sitting or standing height adjustment. Integrated work surface with keyboard drawer. Antimicrobial powder coat finish. Customer-specified track lengths and color available.

Healthca

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December

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2012

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AL AD VER

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Interactio Technolo n Information gy-P

SECTI

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ace+ Mesa, AZ Contact: John Hopk (866) 359-3 ins 829 E-mail: jhopkins@ Web: www interacti w ntech.com .pace-plus actio .com

ENTERPRI RISE PLANNIN RESOURCE G/ BUSINES INTELLIGENC S PROCESS E/ BUSINESS MANAGEMEN T

simplifyM

InterSyst

ems

Corporation Cambridg e, MA Contact: Jackie Gent (617) 621-0 ile 600 E-mail: info@ Web: www intersystems.c om .intersyste InterSystem ms.com in software s Corporation is a HealthShar for connected care. global leader e® is a strate InterSystem platform gic health s for care inform within a hospiinformation excha nge and analyatics tal network, region, or tics and across nation. a community, See our ad in this issue

Alpharett D a, GA Contact: Michael Brozino (877) GO-S IMPL E-mail: info@ Web: www simplifymd.com .simplifym SimplifyMD d.com understand and comp s the amou lexity added nt of stress and their to the life staff when buying and of physicians software. We deplo of physicians are dedicated to simpl ying EHR ifying the simple exper and administrato life rs manageme ience to Electronic by providing a nt. simpl ifyMD EHRHealth Records rors your chart, uses your workfl your forms software mir, ow. Our operationa EHR soft and preserves ware stream l and increa workflow, lowers lines ses operating medical practirevenue without disruption costs, ce. to your

EMR/EHR TRAININ CERTIFICAT G AND ION

PHICON Corp Health Infor orations Insti tute

matics Atlanta, GA Contact: Anth

NTT DATA (formerly Healthcare Technolo

gies Los Ange Keane) les, CA Contact: Larry Kaise (800) 699-5 r 329 E-mail: lawre Web: www nce.kaiser@ntt data .nttdata.c om/ameri .com cas

for

ony O. Olon (800) 713-9 i, MD, MPH 925, ext. E-mail: 8 instit Web: www ute@phiconcor p.com .phiconco rp.com/hi

ENTERPRISE

Dimensional

Insight, Inc. Burlingto n, MA Contact: Ed (781) 229-9 O’Brien 111 E-mail: sales Web: www @dimins.com .dimins.co m

iDashboa

rds

Troy, MI Contact: Jonathan (888) 359-0 Kucharski 500 E-mail: jkuch Web: www arski@idashbo ards.com .idashboa iDashboard rds.c s enterprise-c om/healthcare tion helps lass soft hospi leverage inform tals and healthcare ware applicaorgan ation in real-t rich, intera ime throu izations ctive and gh visual Learn more personalize and down d dashboardsly iDashboard load a 30 . day trial at s.com/healt www. hcare.

IMAGING Kronos Inco

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Sigmund

Brewster, Software NY Contact: Cory Valen (800) 448-6 tine 975 E-mail: cvalentine Web: www@sigmundsoftw are.com .sigmunds oftware.c om

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December

Chelmsfo ated rd, MA Contact: Mitch Moff (800) 225-1 ett 561 E-mail: healt Web: www hcare@kronos .com .kronos.co m/healthc are

Agfa Heal

2012

Healthca

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Greenville , Contact: SC Jim (877) 777-2 Banghart 432 E-mail: sales Web: www [email protected] .agfahealt Agfa Healt hcare.com to healthcare hCare delivers inform providers atics soluti McKesso efficiency to advance ons n and Alpharett patients. With the safety of care their improved a, (404) 338-6 GA archive ICIS our PACS-neutral, they deliver to 000 vendor-neu E-mail: tem) workfl (Imaging Clinical tral Requ Inform ow-centric Web: www estInfo@mckes data conso services platfo ation Sysson.com .mckesso lidation is rm, imagi n.com drive both lift clinical advaned to the enterprise, ng ICIS make to ces and MedeAna s radiology patient-centric imagiIT efficiencies. Emeryvill lytics and multi e, CA -disciplinar ng data, from available Contact: across the y Doug Hart enterprise. imaging, readily (510) 379-3 300 E-mail: Informat doug ics Web: www .hart@medean alytics.com .medeana lytics.com

www.heal thcar

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Visit the HCI Resource Guide online at http://directory. healthcare-informatics. com throughout the year! Contact companies directly through e-mail, website, and social media links.

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December 2012

Healthcare Informatics

www.healthcare-informatics.com

AD INDEX ADVERTISER ......................................................................PAGES Amcom Software ..................................................................................11 AMDIS .................................................................................................. 57 Bright House Networks, LLC .............................................................. 31 Carstens, Inc......................................................................................... 13 GCX........................................................................................... 23, 25, 27 Henry Schein ........................................................................................ 17 InterSystems Corporation .................................................................... 1 MedeAnalytics, Inc. ............................................................................. 19 Nuance Communciations, Inc. ........................................................... 33 Psyche Sytems ....................................................................................... 5 Sedona Learning Solutions .........................................................CVR 4 SSI Group Inc., The ........................................................................CVR 2 Sunquest Information Systems ........................................................... 7 Verizon Wireless..................................................................................... 3 ZirMed .................................................................................................. 29

Healthcare

Informatics Healthcare IT Leadership, Vision & Strategy

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CAREER PATHS

Developing Hiring Standards for Temporary Workers CONTRACT WORKERS ARE PROVING THEIR VALUE IN THE NEW ECONOMY BY FILLING GAPS IN THE LABOR POOL, BUT HIRING MANAGERS NEED TO BE VIGILANT IN THE SCREENING PROCESS BY TIM TOLAN

H

iring permanent employees usually involves a relatively thorough process, as contacting references, conducting assessments and multiple interview screens are all part of the procedure. This also includes ordering criminal background checks that contain state, federal and sexual offender reports on all new full-time employees. But what about temporary Tim Tolan workers? Taking shortcuts and lowering the hiring standards of short-term temp employees could be a problem when it comes to how smoothly some organizations function. That’s where it gets a bit dicey for CIOs. The change in the economy over the past few years has increased the demand for temporary workers. Contractors are often used to fill the gap in the labor pool when you include new large-scale enterprise implementations or the sun-setting of older departmental solutions. This demand for increased temporary hiring is likely here to stay for the foreseeable future. In fact, the U.S. Department of Labor estimates that employment of temporary workers is expected to grow 19 percent through 2018. When you combine that information with the aging baby boomers and dire projections of a significant shortage in the number of qualified workers, as well as the growing demand for HCIT workers, the situation seems like it’s only going to get worse. Temporary positions across the healthcare enterprise are not just limited to IT personnel, either. Many organizations are finding help filling voids in the executive suite when a senior-level hospital executive suddenly departs. This includes C-Level executives, finance executives, healthcare delivery workers, and yes—HCIT staffers. These people, whom you’ve barely met, will be here today, gone tomorrow before you will be able to remember their names. Let’s remember that the 64 December 2012 • www.healthcare-informatics.com

temporary staff has access to a significant amount of valuable information during their short stay. For a “go-live” implementation or a change in departmental system, you may think that only having this person on board for a matter of six to 12 weeks minimizes your exposure. Nothing could be farther from the truth. A lot of damage can be done in a relatively short period of time. All of these workers have access to your IT infrastructure—vital to the day-to-day operations of your facility—and like permanent employees, they should go through a complete screening process. If the new normal is to hire more temporary workers, then more diligence needs to be done on each and every person on the team, regardless of the length of their assignment. This new paradigm is a real game-changer. All of a sudden, temporary workers are serving in critical roles and have a significant amount of influence over their sphere of responsibility. They need to be screened the same way you screen permanent members of your staff—period. If the wheels come off, and there is a huge problem with the temporary worker, someone higher up will take the fall. Lots of finger-pointing could take place while both sides argue who is to blame. Long story short: if your staffing partners are worth their value, they should be supplying you with all of the background information and screening they’ve done to vet out a temporary worker. When the demand for talent eclipses the available supply side, there’s a tendency to fill the slots no matter what. It becomes a commodity game and quality all of a sudden becomes secondary. Makes your strategy includes a thorough vetting process—even for temporary workers. The staffing firm you hire works for you, and it needs to follow your standards of excellence in hiring. Don’t let anyone take shortcuts with your organization—it will wind up sacrificing quality. In the end, you will have to pay for it one way or another. ◆ Tim Tolan is a senior partner at Sanford Rose Associates Healthcare IT Practice. He can be reached at [email protected] or (843)579-3077ext. 301.His blog can be found at www.healthcare-informatics.com/tim_tolan.

You’re invited to our 6th Annual Healthcare Informatics IT Innovators Awards Reception at HIMSS!

Please Join Us at The Palace Café Owned and operated by Dickie Brennan Monday, March 4 6:00-10:00 pm

Mingle with ith h key k industry i d t executives tii andd enjoy j the t “Flavor of New Orleans” cuisine and drinks on historic Canal Street. RSVP at www.healthcare-informatics.com/rsvp

SPONSORED BY: