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Remember, HIMSS is a marathon, not a sprint

At the risk of sounding too cliché, I’m going to say that HIMSS is a marathon, not a sprint. (Actually, I said it twice, if you count the headline.) And I’m exhausted already.

Planning for the annual madness, which starts this weekend here in Chicago, is almost as grueling as the conference itself, and I got a late start because I didn’t know until a couple weeks ago who I would be covering the event for. In case you were still wondering, I’m now a full-time staffer for MedCity News, so you can read my work there. In less than a week on the job, I’m already feeling a better vibe than I ever did with the last attempt at full-time work.

I have a feeling others are as exhausted as I am, or at least can empathize with all the scheduling that has to go into HIMSS  for a journalist. I need to find stories, but I also need to leave myself time to, you know, actually write the stories. We shall see if I succeed, because I feel overscheduled already.

How do I know it’s a common feeling? This semi-exasperated tweet I sent out a few days ago has gotten favorited a dozen times, which is just about a record for me.

 

The “1,400 of you, one of me” line has kind of become a mantra for me when dealing with people who are begging for a bit of my time. I did not violate my Rule #2 of HIMSS, which is never schedule back-to-back meetings in different locations. (Rule No. 1, of course, is wear comfortable shoes.)

I just hope I can get all my work done, and that I can get a solid six hours of sleep a night next week, even though it’s a home game for me this year. I’m not terribly far from McCormick Place, but it’s a pain to get to from where I am on the North Side. It’s either an hour-plus on public transit, with one transfer, or $21 per day to park. I’d ride my bike down there, but you probably don’t want to see me in spandex. I still may do that on Saturday before most of you are in town. Be warned.

I probably won’t be blogging on this site during HIMSS, though I may have some multimedia to post at some point. If you want to read my coverage, head over to MedCity News. My HIMSS preview should be up by the time you get to town this weekend. And if you haven’t done so already, click on the above tweet and follow me on Twitter.

Welcome to Chicago.

 

April 9, 2015 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

I’m joining MedCity News

Three months after my ill-fated decision to take a job with Clinical Innovation + Technology (I never did get an explanation or even a returned call from that cowardly boss, but it probably was about money), I am taking another plunge. Starting next week, I will be a staff writer, covering health IT for MedCity News, just in time for the HIMSS conference the following week.

How do I know it will be different and that I won’t be cut loose after less than three weeks? MedCity has new ownership as of January, namely New York-based Breaking Media. (The press release is still up at the top of the home page.) Breaking Media, which operates online publications in a half-dozen industries other than healthcare, seems committed to growing MedCity, and won’t run out of money, as CI+T’s publisher apparently is; three other reporters were let go a few days before I was cut loose.

You may have noticed that I’ve been contributing commentary to MedCity once a week for the last month or so. That has been on a freelance basis, as is the piece that should appear over the weekend. I’m still winding down some other freelance work, so I won’t be able to dive right in and write a lot for MedCity starting Monday, but I should be cranking out a lot of stories by the time HIMSS rolls around.

And now I know what I’ll be doing during HIMSS, it’s time to get back to all the publicists I’ve shooed away for a month and piece my schedule together. I’ll have to have time to cover some of the pre-conference, keynote and educational sessions and then write about three stories a day, so I won’t be scheduling a whole lot of vendor meetings, but I’ll see what I can do. As I’ve said for a long time, I can either meet with a lot of companies at HIMSS or I could get my actual work done.

I’m excited about this new chapter and I’m ready for the challenge of covering my 14th consecutive HIMSS conference. Best of all, I can sleep in my own bed this time.

April 3, 2015 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

So you want a meeting at HIMSS15?

HIMSS15 is less than a month away. The vendor requests for meetings of course have started coming in.

Every year I seem to do fewer and fewer, for several reasons. First off, they’re exhausting. The exhibit hall is huge. This year, it looks like exhibits will fill the entirety of the McCormick Place North Building (705,500 square feet of exhibit space) and South Building (840,000 square feet), and that doesn’t even count the meeting rooms or auditoriums for keynotes. The press room and many of the educational sessions are in the West Building, at least a 15-minute walk from the show floor.

HIMSS says to expect more than 1,200 vendors. I think that’s a conservative estimate, given that there were 1,300 last year and the number seems to grow every year. In any case, that’s a lot of vendors. Remarkably, even as the HIMSS conference has grown over the years, there is only one of me. I can maybe manage 10-12 vendor meetings during the entirety of the conference, so statistically, you have less than a 1 percent chance of snagging one of those spots.

Of course, the more meetings I schedule, the less time I have to do my actual work — you know, the reason why I go to HIMSS every year.

At this point, with my career in a bit of flux, I don’t know yet whom I will be covering HIMSS for. Until I know my assignments, it’s hard to schedule meetings. Please bear with me.

I notice others have recently expressed similar concerns about their own scheduling. For years, I’ve had a “Rule No. 1” for people attending HIMSS for the first time: Wear comfortable shoes. The people at HIMSS have caught on. “Don’t forget to wear your comfortable shoes!” reads the main Exhibition page on the HIMSS Conference site this year.

Joe Goedert at Health Data Management wrote a nice piece last month with “Tips for Meeting with Reporters at HIMSS15.” Among his advice: Give us the biggest news, not your entire media kit/life story; bring customers, not marketing managers; understand and respect our knowledge and get to the point rather than giving health IT reporters background on the HITECH Act; avoid buzzwords; and respect the reporter’s preference of meeting in either the press room or exhibit hall.

Personally, I hate the exhibit hall. It takes forever to get anywhere, and I don’t need to be stopped every 50 feet for a carnival barker or “booth babe” to ask me to enter to win an iPad in exchange for adding my business card to a marketing list. I’m not your target customer.

I would add to Joe’s list the fact that there is a lot more to HIMSS than just the “show.” There are more than 300 educational sessions, many of which are better uses of my time than a product update. It’s astounding how many vendor reps I speak to each year who haven’t left the exhibit hall all week.

Hopefully I’ll have the coverage question resolved in the next week or two. As for the other issues, well, that’s up to you.

March 13, 2015 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Back at it

Well, that didn’t last long. My full-time job ended abruptly today, less than three weeks after I started. So here I am back to freelancing and blogging. Any leads would be appreciated. Meantime, stay tuned for new content.

 

February 19, 2015 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

I’m joining TriMed Media’s Clinical Innovation + Technology

I have some big news to share with you this Friday afternoon. I have accepted an offer to become digital editor of Clinical Innovation+ Technology, a publication you may be familiar with. I’ll be responsible for the daily e-mail newsletter, among other things. It’s my first full-time job since the end of 2003.

Clinical Innovation + Technology is published by TriMed Media Group of Providence, R.I., which also publishes Health Imaging + IT, Cardiovascular Business, Healthcare Technology Management, Health CXO and the recently revived CMIO. (I freelanced for the first few issues of the original incarnation of CMIO, which later became Clinical Innovation & Technology.) This is a telecommuting job, so I will remain in Chicago.

Of course, this means I will have to give up most of my freelance work, in part because I won’t have the time and also because I don’t want to be in direct competition with my new employer. At least in the short term, I do intend to keep up this blog, since it never really was my primary outlet or source of income anyway, Lately, I haven’t been posting more than 2-3 times a month anyway, so you may not even notice much of a difference. Once I figure out my routine at the new job, I’ll decide on whether or not to continue this site.

I don’t know all the details yet on what kinds of things I’ll be focusing on, so please do not start inundating me with pitches. The last time I did multiple newsletters a week, I got burned out in no small part due to the volume of e-mail I received. Do note that “clinical” is the first name of the publication, and that TriMed has other titles devoted to the business side of things. That should be a clue as to what I’ll be interested in. As far as I know, there is no change to the staff of the print magazine.

January 23, 2015 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Athenahealth-EHRA news significant only that it shakes up the status quo

By now, you’ve likely heard the news that Athenahealth has decided to quit the HIMSS EHR Association. As Athenahealth’s Dan Haley put it in a blog post: “At the end of the day, athenahealth left the EHRA because we never really belonged there in the first place. The EHRA was founded in 2004 by a group of EHR software vendors. Today, a decade into the age of cloud technology, the EHRA is still dominated and governed by a group of EHR software vendors.”

Athenahealth long has billed itself as a services company, not a software vendor, going so far as to hold a jazz funeral for the “death of software” at HIMSS13 in New Orleans. Athenahealth didn’t join the EHRA until 2011 anyway. It sounded like a bad fit.

I contacted Athenahealth, and was told that the company remains “fully committed” to the CommonWell Health Alliance, a coalition of health IT companies — also including Allscripts, Cerner, CPSI, Greenway Health, McKesson and Sunquest Information Systems — that came together for the stated purpose of “developing, deploying and promoting interoperability for the common good.” (There’s also the unstated purpose of fighting the dominance of Epic Systems.)

Athenahealth is staying on the interoperability path, but as is befitting the corporate culture, is going rogue when it comes to EHRs. It’s not the first time. It won’t be the last time, because it’s not like most of the other vendors/service providers, if for no other reason than CEO Jonathan Bush doesn’t fit the buttoned-down model of an executive. For that matter, neither did his co-founder, Todd Park, whom I often called an “anti-bureaucrat” during his time with the federal government. Park’s brother, Ed, is COO of Athenahealth, and also has unconventional tendencies.

I can relate to this mentality in a way. I quit the Association of Health Care Journalists years ago because it didn’t feel like a good fit for me. That group tried to include health IT in its programming, but it really was an organization for consumer and scientific reporters, not those of us in the business and trade press. Eight years later, I still don’t think the national media are doing such a great job covering health policy or explaining the nuances of this complicated industry. And, as I’ve said many times before about healthcare, the status quo is unacceptable.

 

April 23, 2014 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Health Wonk Review, post-HIMSS

While all the health IT reporters like myself were in Florida last week for HIMSS14, plenty of other things were going on in healthcare. David Harlow of HealthBlawg has a roundup of opinions in the latest edition of Health Wonk Review, entitled “In Like a Lion.”

Yes, HIMSS was a big deal, even for non-IT people, as I captured the top mention in a HWR for, I believe, the very first time, with my podcast interview with HIMSS President and CEO Steve Lieber.

(David, per your note, I only suffered superficial injuries this year, with a couple of scrapes on my face. No stitches needed, and no deaths in my family, though my uncle did lose his mother-in-law the day after I returned. I also broke a wine glass in a restaurant, though it was not my glass, it was empty and I was sober. The moral of this story: I need to avoid HIMSS in Orlando, which will be hard, since it’s on a three-year rotation. But next year, the conference is right here in Chicago, and it will be April 12-16 to avoid the dead of winter. The last time it was here, in 2009, I had bronchitis all week. Good times! The following HIMSS will be in Las Vegas, Feb. 29-March 4, 2016.)

Because it was HIMSS week, Harlow featured other IT posts prominently, including one from Lygeia Ricciardi and Adam Dole of the ONC—new national health IT coordinator Dr. Karen DeSalvo said they’re trying to call it “the ONC” instead of just “ONC” these days—about the recently launched Blue Button Connector. Harlow, an attorney, also referenced one of his own posts about HIPAA compliance audits.

Another section of this HWR examines something that I’ve been saying for a long time, that the mainstream media has been not telling the whole story about the Affordable Care Act, a.k.a., Obamacare. Later, Harlow talks about teamwork and collaboration for the purpose of patient safety. Kudos for highlighting those areas.

Click here to read Harlow’s rundown.

March 3, 2014 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

My HIMSS agenda

After a couple of weeks of uncertainty, I now know I will be covering HIMSS for MedCity News. A lot of vendors and PR firms have of course pitched me for meetings, and the reality is, I’ve not always found vendor meetings all that interesting. In fact, the absolute worst thing about the annual HIMSS conference—and I’ve covered every one since 2002—is the few weeks beforehand, when I’m trying to juggle my schedule.

I have occasionally double-booked or simply forgotten to enter appointments into my calendar, but these things do happen when you are juggling dozens if not hundreds of e-mails, you don’t have a secretary and, oh, by the way, have regular work to do a the same time. Sometimes I’ve scrambled to change appointments up to the moment I get on the plane. It’s just a mess most of the time because of the sheer volume of requests and the need to fit it into my normal routine. (Interestingly, and scarily, it’s similar to how healthcare often operates, and mistakes made in healthcare can be deadly.)

The bottom line is, there are more than 1,200 vendors at HIMSS these days, and there is one of me. I can maybe meet with 10-12 of them over the five days of HIMSS, counting Sunday and Thursday, and most of the vendors have gone home by Wednesday evening. One thing a I’ve found is that lot of vendors don’t understand that there are also more than 300 educational sessions to choose from; HIMSS doesn’t just happen in the zoo known as the exhibit hall. I tend to find a lot of great stories from those sessions, so I make them a priority.

Anyway, I have about 10 stories to do for MedCity News during and immediately after HIMSS, and some have fairly specific requirements. (I also have to find time to, you know, write the stories. Sometimes, it’s a trade-off between covering a session/meeting with a vendor and doing my work. Doing the work necessarily wins. Two years ago in Las Vegas, I had to cancel two or three vendor meetings after CMS and ONC dropped the proposed Meaningful Use Stage 2 rules during a town hall-style session. If you recall, the thousands of people trying to download the proposal all but crashed the public Wi-Fi network at the Venetian.)

Two stories are about companies I discover at the new Startup Showcase. If you’re among the startups on display there, let me know. I’ve got one story to do on the Intelligent Hospital Pavilion and another on the Interoperability Showcase. I’ll probably just spend an hour or so walking through and asking questions, but if you’re there and think you have a compelling angle for me, I’m listening.

That’s four stories right there. Three more are from coverage of specific sessions, so those are already booked. I’ve also got three opinion/analysis pieces to write in the week after the fact, and I’m pretty flexible on those. I’m just going to see what I discover and what jumps out at me. A theme usually emerges by the second day.

Away from the madness, I will be at the fifth annual New Media Meetup on Tuesday evening, Feb. 25, hosted by the one and only John Lynn, who also hosts this very blog as part of the Healthcare Scene network. It’s free, but there is limited space, so you do need to preregister.

I will see you in Orlando in a little more than a week.

 

February 14, 2014 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

‘Escape Fire’ leaves out IT, ultimately disappoints

I finally got the opportunity to catch the documentary film “Escape Fire,” a good 15 months after it went into limited theatrical release and became available in digital formats. I thought it would be an eye-opening exposé of all that ills the American healthcare industry, particularly for those who somehow believe we have the greatest care in the world. I excitingly ran this graphic when I first mentioned the movie on this blog back in October 2012:

The well-paced, 99-minute film interviews some notable figures in the fight to improve American healthcare — safety guru and former CMS head Dr. Don Berwick, journalist Shannon Brownlee, integrative medicine advocates Dr. Andrew Weill and Dr. Dean Ornish — as well as some lesser-known people trying to make a difference. It goes through a laundry list of all the culprits in the overpriced, underperforming mess of a healthcare system we have now, and examines approaches that seem to be producing better care for lower cost.

I expected the movie to have a liberal slant, but it really stayed away from the political battles that have poisoned healthcare “reform” the last couple of years. About the only presence of specific politicians were clips of both President Obama and Senate Republican leader Mitch McConnell both praising a highly incentivized employee wellness program at grocery chain Safeway that reportedly kept the company’s health expenses flat from 2005 through 2009, a remarkable achievement in an era of escalating costs.

However, filmmakers Matthew Heineman and Susan Froemke did discuss all the lobbyists’ money presumably buying off enough votes in Washington and at the state level that has helped entrench the status quo. They even scored an interview with Wendell Potter, the former top media spokesman for Cigna, who became a public voice against abuses by health insurers because his conscience got the better of him. As Brownlee noted in the film’s opening, the industry “doesn’t want to stop making money.”

Other reasons given for why healthcare is so expensive, ineffective and, yes, dangerous include:

  • direct-to-consumer drug advertising leading to overmedication;
  • public companies needing to keep profits up;
  • fee-for-service reimbursement;
  • the uninsured using emergency departments as their safety net;
  • lack of preventive care and education about lifestyle changes;
  • a shortage of primary care physicians;
  • cheap junk food that encourages people to eat poorly; and
  • severe suffering among the wounded military ranks.

The filmmakers also kind of imply that there isn’t much in the way of disease management or continuity of care. Brownlee described a “disease care” system that doesn’t want people to die, nor does it want them to get well. It just wants people getting ongoing treatment for the same chronic conditions.

One physician depicted in the movie, Dr. Erin Martin, left a safety-net clinic in The Dalles, Ore., because the work had become “demoralizing.” The same people kept coming back over and over, but few got better because Martin had to rush them out the door without consulting on lifestyle choices, since she was so overscheduled. “I’m not interested in getting my productivity up,” an exasperated Martin said. “I’m interested in helping patients.”

Another patient in rural Ohio had received at least seven stents and had cardiac catheterization more than two dozen times, but never saw any improvement in her symptoms for heart disease or diabetes until she went to the Cleveland Clinic, where physicians are all on salary and the incentives are more aligned than they were in her home town. As Berwick importantly noted, “We create a public expectation that more is better.” In this patient’s case, she was over-catheterized and over-stented to address an acute condition, but not treated for the underlying chronic problems.

The film also examined how the U.S. military turned to acupuncture as an alternative to narcotics because so many wounded soldiers have become hooked on pain pills. One soldier, a self-described “hillbilly” from Louisiana, got off the dozens of meds he had become addicted to and took up yoga, meditation and acupuncture to recover from an explosion in Afghanistan that left him partially paralyzed and with a bad case of post-traumatic stress disorder. The only laugh I had in the movie was when he told the acupuncturist at Walter Reed Army Medical Center in Washington, “Let’s open up some chi.”

I kept waiting and waiting for some evidence of information technology making healthcare better, but I never got it. After leaving the Oregon clinic, Martin took a job at a small practice in Washington state where she was seen toting a laptop between exam rooms, but, for the most part, I saw paper charts, paper medication lists and verbal communication between clinicians.

What really bothered me, however, is the fact that there was no discussion of EHRs, health information exchange or clinical decision support, no mention of the problem of misdiagnosis, no explicit discussion of patient handoffs, continuity of care, medication reconciliation and so many other points where the system breaks down. You can’t truly fix healthcare until you address those areas.

 

January 21, 2014 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Podcast: MMRGlobal’s Bob Lorsch addresses the ‘patent troll’ issue

Two weeks ago, I picked apart a terribly misleading, ideologically steeped Fox News story that wrongly linked the initial failure of the healthcare.gov Affordable Care Act insurance exchange to the Meaningful Use EHR incentive program. Among my many criticisms was the reporter’s apparent confusion between an actual EHR and My Medical Records, the untethered PHR offered by MMRGlobal.

In that post, I said, “I haven’t seen a whole lot of evidence that MMRGlobal isn’t much more than a patent troll.”

Bob Lorsch, CEO of that company, posted in the comments that I should put my money where my mouth is and interview him. (I had interviewed Lorsch before, but never wrote a story because of my longstanding policy of not paying attention to untethered PHRs since none that I know of has gained any market traction, despite years of hype.)

As this podcast demonstrates, I took Lorsch up on his offer. It was at times contentious, in part because I challenged many of his statements in the Fox story and to me, and in part because he challenged some of mine.

He asked me a pointed question, whether I still thought he was a patent troll. Based on the fact that MMR actually earned patents on a product it actively markets and didn’t just purchase someone else’s patents for the point of suing others, it’s hard to conclude that he is a patent troll.

Investopedia defines patent troll as:

A derogatory term used to describe people or companies that misuse patents as a business strategy. A patent troll obtains the patents being sold at auctions by bankrupt companies attempting to liquidate their assets, or by doing just enough research to prove they had the idea first. They can then launch lawsuits against infringing companies, or simply hold the patent without planning to practise the idea in an attempt to keep other companies productivity at a standstill.

By that definition, MMR is not. I still don’t think an untethered PHR is a good business model, a belief supported by the fact that publicly traded MMR is a penny stock, currently trading at less than 3 cents per share. I have said that patient engagement, called for on a small scale by Meaningful Use Stage 2 rules, could change the landscape for PHRs—with a better chance in pediatrics than for adult populations—but it certainly will take a few years.

I stand by my original statement that the Fox News story did health IT a huge disservice by latching onto one problem and trying to tie it to an unrelated issue simply because it fits an ideological narrative. As for MMR, well, take a listen and then judge for yourself. It’s a long podcast, but I went through the trouble of breaking it down by discussion point so you can skip around as necessary.

Podcast details: Interview with Bob Lorsch, CEO of MMRGlobal, recorded Oct. 18, 2013. MP3, mono, 128 bps, 49.5 MB, running time 54:07

2:03        About My Medical Records
3:26        Why he believes his product is better than traditional EHRs
5:00        My skepticism of untethered PHRs
6:28        Lorsch’s interview with HIStalk from February
6:40        MMR’s user base
8:00        Why he thinks MMR could facilitate health information exchange
9:40        Health information exchanges vs. health insurance exchanges
10:15     Patient-centered HIE as an alternative to multiple patient portals
12:20     Physician trust of patient-supplied data, and other workflow issues
15:05     Emergency use case
15:50     How MMR is different from other PHRs
16:32     “Last mile” of connectivity
18:17     His assertion in Fox story that patients lose control of health information and privacy under ACA, despite HIPAA
24:15     MMR carries cyber liability insurance
25:00     Scope of MMR’s patents
26:45     “Likely” infringement of patents
27:45     Lawsuits and licensing
29:30     Patent troll?
31:10     Negotiations with WebMD and others
33:00     MMR’s reputation
35:00     “We build and sell what we have intellectual property rights to.”
36:25     Other vendors ignoring patients?
36:50     Standardization in health IT
38:38     MMR’s low stock price
39:20     Patient engagement boosting PHR use?
42:00     Interest from WellPoint
42:48     Payers building trust with PHRs
44:18     Other features of MMR’s PHR
46:45     Segmentation of sensitive parts of medical records
49:08     Putting me on the spot
50:35     His objective in asserting patent rights
51:15     MMR’s issue with Walgreens
52:25     Revenue sharing vs. licensing

October 31, 2013 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.