“GE Healthcare is committed to making a broad range of parameter measurements available on our powerful monitoring technology, including GE’s own SpO2 technology,” said Matthias Weber, General Manager, Monitoring Solutions at GE Healthcare. “Leveraging our 100-year history of designing life-critical devices, we are focused on delivering innovative clinical measurement technology. Such advances have the potential to support improved care, quality, and patient safety.”

The Nellcor™ Respiratory Function portfolio, which includes Nellcor pulse oximetry with OxiMax™ Technology, and the BIS™ Brain Monitoring system, are now available on many GE Healthcare patient monitors. This includes the CARESCAPE™ Monitor B850 and CARESCAPE™ Monitor B650, which combine GE Healthcare’s strong cardiac and anesthesiology heritage.

The Covidien collaboration reflects GE Healthcare’s commitment to maintain an open monitoring architecture, bringing together streams of patient data and making it usable for clinicians at the point of care. For instance, the CARESCAPE™ Monitor B850 now provides access to Covidien measurements, bi-directional information flows between the monitor and hospital information systems, such as electronic medical records, and electrocardiogram measurements without requiring a separate monitor. Integrated clinical information can provide valuable information for physicians, helping guide their decisions and enhance efficiency of care.

St. Mary’s Health System – comprised of St. Mary's Medical Center in Evansville and St. Mary's Warrick Hospital in Boonville – is part of Ascension Health, the nation’s largest Catholic and non-profit health system.

Ascension Health recently utilized their Emergency Preparedness Advisory Team to conduct a comprehensive review of all Incident Management Systems and ultimately selected emergent company ReadyPoint’s StandTo™ as their primary technology platform.

“Today’s healthcare environment is competitive, and hospitals can’t afford to make mistakes,” says Chris Riddle, founder and president of ReadyPoint Systems. “Our technology is precise and easy-to-use, which enables hospitals to prepare for and manage a wide-range of unplanned events.”

Shaped by more than 25 years of “real world” hospital experience, ReadyPoint is an information technology company whose suite of innovative software services helps hospitals improve processes that enhance both the quality and safety of care.

“St. Mary’s just launched its first drill using the StandTo™ technology,” says Keith Kahre, EMS/security manager and safety officer of St. Mary’s Health System. “Once fully implemented, I am confident that this system will be of vital importance during any emergency, particularly because we face a substantial earthquake risk in Southwest Indiana with the New Madrid and Wabash Valley fault lines nearby.”

ReadyPoint’s StandTo™ technology – a web-based incident management system that automates a healthcare facility’s incident management services – is used by more than 150 hospitals across the nation. Incident management services are the protocols and procedures that hospitals follow to manage emergency and other non-regular incidents that may occur within an organization.

The facilities in St. Mary’s Health System will utilize the StandTo™ system to conduct emergency preparedness exercises and to manage actual crisis events.

ChartLogic is a leading national provider of EHRs to specialty practices and serves some 2,000 physicians nationwide. ChartLogic’s EHR is fully certified and designed for specialty practice workflows. More than 250 ChartLogic customers have qualified for meaningful use incentives to date.

Valley ENT will adopt the ChartLogic EHR Suite including the ChartLogic electronic medical record, ChartLogic Document Management, ChartLogic ePrescribe and the ChartLogic Patient Portal.

• Informatics Corporation of America (ICA) will showcase interoperability technology that enables health information exchange and will be located in the HIT neighborhood.
• The SSI Group (SSI) will be located in the HIT neighborhood and will promote claims management technology.
• Humanscale will join the furniture neighborhood and offer ergonomic work tools that support healthcare-specific technology.
• ergoCentric will present their specialized line of medical grade seating, healtHcentric, in the furniture neighborhood.
• V Alexander will demonstrate their unique capabilities in supply chain management including transportation, customs, compliance, documentation, and security on the services floor.
• Remind America, a leading HIPAA-compliant physician reminder service, will join the services floor and will showcase the company’s customized services that meet the needs of any practice.

Separate announcements were also made for each company including additional information.

“HIMSS will serve as the hub of Information Technology on the top floor of the trade center where we will host technical demonstrations, conferences, workshops, and customer demos,” said Sandra L. Vance, director of global interoperability showcases for HIMSS. “In addition, HIMSS expects to host more than 100 companies inside an interactive exhibit exploring clinical information systems and infrastructure that provides optimum interoperability.”

The Nashville Medical Trade Center is a comprehensive healthcare marketplace that unifies for the first time permanent showrooms, temporary exhibition space, and education and training facilities. The result is a global marketplace for healthcare products, solutions, and services.

That vision of how data can transform healthcare may not be too far off in the future.  Oakbrook, IL-based Advocate Health Care and Cerner have teamed up to create new data-driven models designed to improve patient health outcomes and safety.

The partnership, announced last month, will bring together Cerner’s health care IT and data management capability with Advocate’s population risk and clinical integration expertise to develop predictive models and advanced analytic tools to enhance the care of patients across the entire continuum.

Transforming health care through technology is a key tenet of Meaningful Use.

The collaboration is closely aligned with Advocate’s strategic vision, says Rishi Sikka, MD, the system’s vice president of clinical transformation. “We have one of the largest, if not the largest,  accountable care contracts in the country.  Part of becoming an Accountable Care Organization is the ability to manage a population’s health, not just managing episodes of care. To do that, you need the data, you need the tools, and you need to be able to impact patients at the point of care. So that really is driving where Advocate is going.”

Advocate plans to roll out the project in three steps, the first of which is gathering information from currently siloed data sources contained in disparate systems. “We’re looking at pulling information from our inpatient EMRs, from our outpatient data sources, from our outpatient EMRs, and from acute and post acute sources and bringing it together under one data warehouse so we can understand what’s going on with our patients across the entire care continuum,” says Sikka.

Once the data is warehoused in the cloud, Advocate plans on developing a series of predictive models and advanced analytic tools that Sikka says will be aimed at keeping people healthy and out of the hospital. In addition, the tools will be used to prevent patients from developing complications, improving transitions of care, and predicting where and when adverse incidents may happen so that they can be proactively addressed.

“The third key step is to take the warehouse in the cloud and the advanced analytics and integrate them into clinical workflow in the inpatient side, the ambulatory side, and the post acute side so that these tools are integrated and can impact care before something adverse occurs, before readmission occurs, and before a complication occurs and really gain at keeping patients healthy,” Sikka explains.

Advocate’s timeline is ongoing, enterprise-wide, and fluid.  “The process of building the data warehouse is already started,” Sikka says. “You can’t do it all at once but as you go after a certain data source, get it in the warehouse and verify that the data’s good, you’re then ready to start on the next silo. We’ll keep going after these silos of data over a several year period.”

However, the health system isn’t waiting to get all the data in place to begin the modeling process.  After a silo of data is added to the cloud, Sikka says modeling begins soon after.

Some of the initial modeling work will take place on the health system’s inpatient side, particularly in the areas of reducing readmissions and predicting complications.  However, Sikka expects work to begin rapidly on the ambulatory and post-acute side as well.

Despite the overwhelming amount of change on the horizon, Sikka says the response from clinicians to the initiative has been positive. “It’s a very simple message to understand. Everyone knows what the issue is. We have silos of data that we need to break down to get a true longitudinal picture of a patient. People understand that very intuitively.”

To proactively address some of the change management issues that emerge as the project progresses, Advocate and Cerner have included a job function within the scope of the project to deal specifically with clinical workflow. 

Clinical Process Designers, which will include both Cerner employees and current Advocate employees, will understand the workflow of the health system’s clinicians and ensure that any solutions that are developed during the course of the project are supportive of and integrated into the workflow. “Historically, projects have failed because clinicians have felt that they’ve had to be the ones to adapt. We don’t want to have a situation where the workflow has to adapt to the technology,” Sikka explains.

While the project is in its early days, Sikka says that one of the primary challenges that Advocate will have to deal with is the sheer scope of the project.  “This project is really groundbreaking because we’re taking silos of data from disparate systems that aren’t integrated and putting them together.  I don’t know of many places in the country where that’s happening and we expect that the technical side of this is going to be really challenging.”

That’s where the collaboration with Cerner will come into play.  “Cerner is involved in several ways,” Sikka says. “At the most basic level, they’re providing the funding. At a higher level, they bring extraordinary value on how to understand data, how to break down silos, and how to integrate it into a warehouse. Our strategy is that Cerner is going to be bringing considerable intellectual and people resources to bear to help solve some of the technical challenge.”

Advocate Health Care uses a variety of systems from a variety of vendors.  “The interesting thing about this is that most of the silos we’re attacking are not Cerner silos of data. We’re not a big Cerner empire – we have several different data sources,” Sikka says.

Advocate has a wealth of experience in population risk and clinical integration expertise and has already developed predictive models and advanced analytic tools to enhance the care of patients across the entire continuum. This new initiative, however, will build on those existing tools.

The partnership will initially focus on predicting and reducing incidents, such as readmissions and hospital acquired conditions. The Centers for Medicare and Medicaid Services (CMS) has focused its attention on these events by introducing financial penalties for poor performance. The collaboration will progress to develop health and care delivery models that will strive to prevent and manage complications from chronic disease.

Sikka says that while Advocate has already developed a tool that helps predict a patient’s chances of being readmitted within 30 days, the goal is to go even further.  “We’d like to bring that tool to the next level by improving it and refining it, to not only predict whether a patient will be readmitted within 30 days, but whether he’ll be readmitted within two days or seven days or two weeks. If you know that someone is at high risk of coming back, you can begin to focus in on interventions and resources.”

Patient falls are another example of how the tool is being used to identify, predict, and prevent. “If you know in advance who is likely to fall and when they might fall, you can intervene and focus on them before the adverse event occurs.”

Sikka believes that by beginning to leverage the vast wealth of data within each of its many siloed systems, Advocate can make a significant impact on patient care and health – and one that will be the norm in the future. “What we’re doing right now, these are going to be requirements in a couple of years from now.”

Copyright 2012 Algonquin Professional Publishing, LLC

Principal Investigators Jan Walker, RN, MBA and Tom Delbanco, MD say that while the findings won’t be formally released until later this year, some inferences about what the patient-provider relationship may look like in the future can be made.

“It’s possible that we’ll see patients and doctors writing notes together that could eventually evolve into a contract for care – patients say I will do A, B, and C and providers say they will do X, Y, and Z before the next visit,” Walker explains.

Walker says the OpenNotes concept may also provide a new type of review process that may benefit patient safety. “Patients will be able to give feedback to the note, correct or amend the information that is there and in that way, make a significant contribution to their own safety.”

With an increased emphasis on patient engagement in Stage 2 and Stage 3 Meaningful Use, it’s likely that caregivers and their IT support teams are going to need to focus more fully on leveraging patient portals, creating richer opportunities for educating and involving patients and their families in the healthcare arena, and rethinking the respective roles that patients and physicians have traditionally had. 

OpenNotes began in 2010 as a way to evaluate the impact of sharing encounter notes between patients and their Primary Care Physicians (PCPs) online.  Over 100 PCPs and 20,000 patients from Beth Israel Deaconess Medical Center (BIDMC), a large urban academic medical center, Geisinger Health System in rural Pennsylvania, and Harborview Medical Center, a county hospital and safety net provider in Seattle, WA, participated in the 12-month trial. 

The project’s research design was simple. After patients met with their PCPs, the physicians wrote and signed the note. The patient received an email when the note was available and then a second email reminding them to review the note prior to a follow-up appointment.

Patients were able to view the notes via secure portals where other portions of their medical records were posted: PatientSite at BIDMC, and MyGeisinger at Geisinger Health System. At Harborview, OpenNotes patients were the first to view notes and other parts of their records via UW Medicine e-care, the hospital’s electronic portal.

Walker says that the project tried to answer specific questions about provider and patient behavior concerning notes.  “We asked whether OpenNotes would prove to be an additional burden for the providers, or make them spend more time worrying about and editing notes, or even lead them to change the content of what they write/dictate in their notes.”

The researchers also examined whether patients would actually read their notes, share them with others (and if so, how), find the notes helpful or confusing, and whether having access to the notes would ultimately help them deal more effectively with health and illness.

Walker and Delbanco published their baseline, pre-intervention findings in the Annals of Internal Medicine on December 20, 2011.

Those early findings suggest that patients were overwhelmingly excited about the prospect of having access to their notes and envisioned many tangible benefits and few potential harms.

PCPs, on the other hand, were less enthusiastic and expressed a variety of opinions about potential benefits and harms for their patients and their practices.

However, Walker says that end at the end of the year-long project, even though participating PCPs were given the option to leave the program, none did.

Daniel Sands, MD of BIDMC and a project participant, says that OpenNotes may have a powerful impact upon how he and other physicians interact with their patients. “Information is the key to patient engagement,” he says. 

In addition to being a practicing physician, Sands serves as senior medical informatics director and director of healthcare business transformation as Cisco Systems and is president of the Society for Participatory Medicine.

Sands says that while he understands the concerns his colleagues may have about fully sharing information with their patients, he believes the benefits outweigh the costs. “The shared EHR, used wisely and well, can transform care, both in the office and beyond the office.  Sharing information lowers the barriers to patient engagement.”

Sands said that one of the concerns expressed by his colleagues was that patient encounters would take more time – something that he found wasn’t true when patients had the opportunity to review their notes prior to the visit. 

“I found that the time for the visit itself didn’t change.  However, the conversation that the patient and I were able to have was a more value-added one and that ability to share resulted in better care.”

“As physicians, we’ve used knowledge to make ourselves more powerful,” he adds. “To improve outcomes and transform healthcare, we need to share that power with patients.”

Copyright 2012 Algonquin Professional Publishing, LLC

The suit was filed on behalf of purchasers of Allscripts common stock between November 9, 2010 and April 26, 2012, inclusive.

The action charges Allscripts and certain of its officers with violations of Sections 10(b) and 20(a) of the Securities Exchange Act of 1934, and Rule 10b-5 promulgated thereunder.

The complaint alleges that, throughout the Class Period, Allscripts, which was formed from the merger of Allscripts-Misys Healthcare Solutions, Inc. and Eclipsys Corporation in August 2010, misrepresented its progress in integrating Allscripts’ and Eclipsys’ disparate systems and the Company’s ability to translate its fragmented product lines into revenues.

An Allscripts spokesperson told Inside Healthcare IT in an email that the company will promptly review the complaint, will respond in due course and intends to defend itself vigorously.

Allscripts stock prices have been in a tailspin since the company announced at its April 26 Q1 earnings conference call that earnings were lower than expected and cut its 2012 profit and revenue estimates. 

Allscripts earnings were at 12 cents per share, with revenue rising 9 percent to $364.7 million, Analysts, however, had expected earnings of 24 cents per share and $387.5 million in revenue.

Allscripts’ disappointing first-quarter results sharply diverged from other health information technology vendors.  Cerner Corp.  reported an increase in its first-quarter earnings as a result of strong sales growth and athenahealth beat expectations on revenue growth, although missing estimates on earnings per share.

Revenue of EHR companies has generally improved as the Meaningful Use incentives have encouraged health professionals and hospitals to convert to electronic records.

During the call, Allscripts announced that it had fired Chairman of the Board Philip Pead and that long term CFO Bill Davis would be leaving the company May 18 for another position.

Allscripts did not explain the reason for terminating Pead, saying only that the board held “extensive deliberations regarding the leadership of the company” prior to making the decision.

Three directors, Catherine Burzik, Eugene Fife and Edward Kangas, disagreed with the decision and immediately offered their resignations, according to a filing with the Securities and Exchange Commission.

Industry watchers speculate that the rift resulted from Allscripts’ 2010 merger with Eclipsys Corporation. Pead and the directors who resigned were from Eclipsys.

“If you look at the history of mergers,” Allscripts CEO and director Glenn Tullman told analysts on the call, “sometimes those two companies have a different view of the future and the direction that the organization should go and who should take the organization in that direction.”

Tullman told investors during the call that a number of clients have delayed commitments as they wait for the company to demonstrate a more robust integration.

The company’s bookings performance was impacted by the challenge of integrating the two companies’ sales and service teams into a single organization in the first quarter.

Additionally, unclear time windows for the rollout of new products impacted the company’s bottom line as established and new clients pulled back orders and waited on commitments, the company said.

In a subsequent move, Allscripts announced Dennis Chookaszian as the new chairman of its board of directors on April 30.

Chookaszian has been a member of Allscripts’ board since September 2010. He was the Chairman and CEO of CNA Insurance Cos. from 1992 to 1999, and the CEO of financial advice provider mPower Inc. from 1999 to 2001.

At the same time, the company also that it approved the repurchase of up to $200 million in stock. Allscripts had about $148 million remaining on its previous $200 million stock buyback program, which was approved in May 2011.

Analysts during the earnings call challenged Allscripts CEO Glenn Tullman about his future with the company.

“I am not trying to single you out,” said George Hill, an analyst with Citigroup Global Markets. “But given the performance that’s been reported as the company faces its greatest tailwind in history, I would have expected ... the board to fire any CEO in this position.”

“There is no question that this was a very, very tough quarter, very difficult quarter,” Tullman said. “In my career, I am not sure, I have had one that was this tough.  What I can tell you is that our management team is focused and it will deliver as we’ve done that before.”

Allscripts shareholder HealthCor Management has called for the company to replace Tullman as CEO, saying his 13-year track record of underperformance is unacceptable.

Allscripts stock price closed at $10.71 per share on May 2.

 Copyright 2012 Algonquin Professional Publishing, LLC

Now we see the conversations taking a different turn. As many organizations have gotten over the initial hump of moving from paper to electronic, there’s a new question looming: now what?

“Now what?” is a question the collaboration between Advocate Health Care and Cerner that we explore in our lead story attempts to answer.  As the project progresses, we expect that it will give all of us some clues about how to run a more efficient care system  -- and just as importantly for patients, provide clinicians with the information they need at the point of care to provide the best care.  After all, that’s what healthcare transformation is all about.

As Rishi Sikka, MD, vice president for clinical transformation at Advocate Health Care admits, pulling previously siloed data from a plethora of sources isn’t a walk in the park. Like any kind of transformational event, it will be challenging, from both a technology and a people perspective. 

If data can be collected, analyzed and meaningfully used to predict outcomes and at-risk patients so that the appropriate care can be given,  then this is exactly the type of disruptive project that may have the biggest impact down the road for determining how healthcare is delivered in this country.

In the big picture, Meaningful Use is more than just leveraging incentives to encourage physicians and hospitals to buy computers. It’s about being able to take the next step to use the data to inform healthcare decisions, and that, we hope, will give caregivers an even greater incentive to invest in technology.

Copyright 2012 Agonquin Professional Publishing, LLC

The data migration and data retention services will be performed by Nightingale and its partner, Interware Systems Inc. (Interware), who will assist Nightingale in providing portions of the data extraction and data retention services under this agreement.

"We are excited that Nightingale and our partner Interware have surpassed the stringent requirements set out by the AOHC data migration and retention selection committee," said John Bodolai, Executive Vice President, Nightingale Informatix Corporation.  "While Nightingale continues to lead the market with an innovative EMR offering, this contract validates how Nightingale leads the market in helping healthcare providers migrate away from legacy EMR systems using our Nightingale Data Management Centre of Excellence.  We believe the Data Management Centre of Excellence will allow health centres and health care providers the freedom to choose the best EMR in the market while preserving the value of their past investment."

Nightingale recently established a Data Management Centre of Excellence (DMCE) which includes a set of processes, tools and resources designed to help health care organizations extract data from their legacy EMR applications and populate the data into Nightingale on Demand EMR in a useful format.  To move to the next level of EMR adoption, there is a need to support organizations in migrating from existing Information Management solutions to Nightingale On Demand.  Migrating data is complicated and time consuming, and the tools that Nightingale has built will add the right amount of rigour to ensure that this data is of the highest quality and will be readily available and useable in the Nightingale On Demand EMR solution.  Ultimately, customers need to have confidence in their client's data to ensure that they are providing the highest quality of care, and with the establishment of this DMCE, they will have that peace of mind.

Minnesota Eye Consultants currently operates three ambulatory surgery centers, five laser and refractive surgery centers, with 10 clinic locations (five in the Twin Cities metro area and five in greater Minnesota). As one of the premier ophthalmology surgery centers in the nation, Minnesota Eye Consultants places a strong emphasis on education, research and training for ophthalmologists and surgeons from around the world. NextGen Ambulatory EHR will enable the group to enhance its extensive clinical research trials program with a goal to expand their comprehensive disease management capabilities. Additionally, NextGen Practice Management will aid in optimizing operational efficiencies by automating business processes that currently drain staff resources and capturing accurate measurement data.