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Cerner CEO Neal Patterson dies at 67

Neal Patterson in 2009 (Cerner photo)

Neal Patterson, co-founder, CEO and chairman of health IT heavyweight Cerner, died today at the age of 67. According to the company, Patterson had “unexpected complications” from a recurrence of the soft-tissue cancer that caused him to take a yearlong leave starting in January 2016.

As the “unexpected” explanation suggests, the news comes as a bit of a surprise, since Patterson returned to work early this year. He had made a surprise appearance at the Cerner annual users’ meeting in November.

In another unexpected development, the North Kansas City, Missouri-based EHR vendor named Co-founder and Vice Chairman Cliff Illig to serve as chairman and interim CEO. During Patterson’s leave, President Zane Burke was the public face of the company. Burke gave me a long interview at CHIME last fall.

However, Cerner said in a statement that there has been a “longstanding succession plan” and that “the process to select a new CEO is nearing a conclusion,” suggesting that Patterson had intended to step down fairly soon.

“One of Neal’s enduring ambitions for Cerner was to build a visionary company, not just a company with a visionary,” Illig said in the statement. “He has done that. We have what I believe is the best management team in health IT, and we have associates who think as much about the future as they do the present. As a result, Cerner is well-positioned to have a pioneering impact on the provision of health care in the years to come.”

Patterson, Illig and Paul Gorup founded Cerner as PGI & Associates in 1979 to develop laboratory information systems. They changed the name to Cerner in 1984 and took the company public in 1986.

Cerner is now worth $21.7 billion, based on Friday’s closing price of $65.74 per share. It has become the largest private employer in the Kansas City area, the Kansas City Star reported.

 

July 9, 2017 I Written By

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Health informatics pioneer Larry Weed dies at 93

Lawrence L. Weed, M.D., a pioneer in the world of health informatics and organization of patient information, has died at the age of 93. Weed passed away in Burlington, Vermont, on June 3 after a fall two weeks earlier, his son Lincoln said.

Weed created the who created the problem-oriented medical record (POMR) and the subjective, objective, assessment, planning (SOAP) format of progress notes that became ubiquitous. He had advocated for what now is known as clinical decision support for at least 60 years, talking often about “coupling” patient problem lists with medical knowledge that changes often.

“The unaided mind does not know what data to collect, and does not see many of the significant relationships buried in whatever data are collected,” Weed said in a 2004 story I wrote for Health-IT World, a former spinoff of Bio-IT World. Thus, according to Weed, paper records were inferior to computerization — and they were half a century ago.

While at the University of Vermont in 1976, Weed co-developed an early electronic medical record called the Problem-Oriented Medical Information System, or PROMIS.

In 1991, the Institute of Medicine report, “The Computer-Based Patient Record:  An Essential Technology for Health Care,” (revised 1997) said that the problem-oriented medical record “reflects an orderly process of problem solving, a heuristic that aids in identifying, managing and resolving patients’ problems.”

In a seminal 1968 article in the New England Journal of Medicine, Weed wrote:

Since a complete and accurate list of problems should play a central part in the understanding of and management of individual patients and groups of patients, storage of this portion of the medical record in the computer should receive high priority to give immediate access to the list of problems for care of the individual patient and for statistical study on groups of patients.”

To this end, Weed developed a system of “problem-knowledge couplers,” and founded PKC Corp. in 1982 to market his idea. The company landed a series of government contracts, but struggled to catch on in the public sector. Weed was forced out by investors in 2006, and PKC was sold to consumer health company Sharecare — founded by WebMD founder Jeff Arnold and TV doctor Mehmet Oz, M.D. — in 2012.

Weed described the framework of problem-knowledge couplers in a 1994 article in the journal Medical Interface.

A true Renaissance man fond of quoting Francis Bacon, Tolstoy, Copernicus, Galileo and other celebrated philosophers, Weed was known as a brilliant educator, deep thinker and an engaging speaker. At the age of 89, he commanded the stage for a good 75 minutes at the HIMSS13 Physicians’ IT Symposium, and received two standing ovations.

“The worst, the most corrupting of all lies is to misstate the problem. Patients get run off into the most unbelievable, expensive procedures … and they’re not even on the right problem,” Weed said during that memorable presentation in New Orleans.

“We all live in our own little cave. We see the world out of our own little cave, and no two of us see it the same way,” he continued, explaining the wide deviation from standards of care. “What you see is a function of who you are.”

Lincoln Weed lamented that health IT companies have not always paid attention to these ideas. “The informatics community hasn’t really caught up to my father’s work,” the son said. “It’s not about technology. It’s about standards of care.”

The problem-oriented medical record is a standard for organizing information in a record. Couplers are standards for collecting data to generate recommendations based on the ever-changing body of medical knowledge, according to Lincoln Weed.

Some of Larry Weed’s ideas did catch on, notably, the SOAP note. However, some have recently rethought that format for the digital age, swapping the first two and last two element to create the APSO note. Weed defended his approach in 2014.

Weed stayed active up until his last day alive, according to Lincoln Weed. The day Larry Weed died, he discussed a poorly adopted National Library of Medicine personal health records project with sons Lincoln and Christopher. Lincoln recalled that his father said the NLM tool needs to let patients enter their own health data.

“I’m hopeful that the NLM is close to jumpstarting that process,” Lincoln Weed said. “Dad died with more optimism than he had had in a long time.”

Indeed, it could be argued that Weed was a founding father of patient empowerment. Back in 1969, Weed wrote a book called “Medical Records, Medical Education, and Patient Care.” In that, he said, “patients are the largest untapped resource in medical care today.”

Lincoln Weed said that the late Tom Ferguson, M.D., who founded the journal Patient Self-Care in 1976, “thought Dad was one of the originators” of the empowered patient movement.

With patient-generated data and now genomic information making its way into clinical practice, a system for organizing medical records is more necessary than ever, Lincoln Weed said. Equally important, he said, is a computerized system for matching the patient problem list with all known, relevant information to address specific problems — couplers.

“I’m glad Dad has left me with these things to work on,” said Lincoln Weed, a retired attorney who co-authored “Medicine In Denial” with his father in 2011.

Weed, who earned his medical degree from Columbia University in 1947, is survived by five children, a sister, two grandchildren and two step-grandchildren, according to the Burlington (Vermont) Free Press.  He was preceded in death by his wife, Laura, a physician herself who died in 1997.

Weed’s public memorial will focus on his lifelong love of classical music. His children are planning a memorial concert on Sept. 17 at 4 p.m. Eastern time at Charlotte Congregational Church, 403 Church Hill Rd, Charlotte, Vermont, according to the Burlington Free Press.

Here is a video of Weed from a well-known grand rounds he presented in 1971. It was unearthed by a Weed disciple, Art Papier, M.D., of clinical decision support vendor VisualDx.

June 18, 2017 I Written By

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AHIMA board chair dies

The American Health Information Management Association (AHIMA) announced this morning that board President and Chair Kathleen A. Frawley died Friday at the age of 63. The cause of death was not disclosed.

Here is the text of the AHIMA press release:

AHIMA Mourns Passing of Kathleen A. Frawley, AHIMA Board President/Chair

CHICAGO – July 1, 2013 – With profound sadness, the American Health Information Management Association (AHIMA) announces the passing of Board President/Chair Kathleen A. Frawley, JD, MS, RHIA, FAHIMA on Friday, June 28.  Frawley, 63, also was a professor and chair of the health information technology program at DeVry University’s North Brunswick, N.J. campus.

“Kathleen had an inspiring and unwavering belief in the importance of health information management and how AHIMA members could lead the profession,” said AHIMA CEO Lynne Thomas Gordon, MBA, RHIA, FACHE, CAE, FAHIMA. “She touched the lives of so many of her colleagues in HIM, AHIMA members and her students. She will be missed by the entire AHIMA family.”

Angela Kennedy, EdD, MEd, MBA, RHIA, CPHQ, will serve as Board President/Chair effective immediately. Kennedy became President/Chair Elect in January, which was the same time Frawley began her one-year term.

“On behalf of the board and everyone at AHIMA, our thoughts are with Kathleen’s family during this difficult time,” Kennedy said. “Kathleen’s theme during her presidency was ‘dream big and believe.’ It is incumbent upon all of us at AHIMA to continue to move forward with the work and initiatives to advance the profession and the quality of care for patients everywhere as Kathleen would have wanted.”

For more than three decades, Frawley played an integral role at AHIMA. From 1992 to 2000, Frawley was AHIMA’s vice president of legislative and public policy services. The following year, she was a recipient of the AHIMA Distinguished Member Award. In 2011, she was the recipient of the New Jersey Health Information Management Association Distinguished Member Award.

As an educator, Frawley spent a great deal of time focused on the future of HIM education and making sure her students made the most of their opportunities. In a Journal of AHIMA Q and A from October 2012, Frawley said, “(one) of my projects is identifying and assisting students who are at risk of failing or dropping out of school. I did a presentation (on this) at the Assembly on Education and Faculty Development a couple of years ago; I want to identify barriers that prevent students from being successful.”

Frawley was particularly proud to serve as President/Chair during AHIMA’s 85th anniversary year. She inherited a love of history from her late father, and during her speech at the 2012 AHIMA Convention and Exhibit, she outlined how she always made it a point when she was at the AHIMA office to look at the pictures showcasing AHIMA’s founders and past CEOs. In fact, it was her idea to turn this wall of pictures into a mini-museum to celebrate AHIMA’s history.

Frawley, who spoke on health information privacy issues to a number of national outlets including Good Morning America, earned a bachelor’s degree in English from the College of Mount Saint Vincent. She received a master’s degree in health services administration from Wager College and a juris doctorate from New York Law School.

AHIMA will establish a scholarship in Frawley’s name to honor her contribution to the association as a staff member, board member and president, and long-time AHIMA member.

July 1, 2013 I Written By

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Condolences to some well-known people in health IT

It’s been a sad couple of weeks for at least four people I know in and around health IT, and I want to send personal condolences to them and their families.

On March 26, Dr. Mark Frisse, the Accenture Professor of Biomedical Informatics at Vanderbilt University, lost his wife of 35 years, Catherine Loretta Walsh Frisse, who, according to an announcement posted on Dr. Frisse’s personal website, lost her battle with breast cancer after putting up a strong fight for two decades. Mrs. Frisse was a teacher, volunteer and philanthropist in the St. Louis area, as her husband and daughter both attended Washington University School of Medicine and the family still lived near St. Louis, despite Dr. Frisse’s Vanderbilt job. (I am a Wash U. alumnus myself, though that was for an undergrad degree, not at the prestigious med school.)

On March 29, Dr. Bill Hersh, chair of the Department of Medical Informatics & Clinical Epidemiology at Oregon Health & Science University, lost his father-in-law, retired Chicago Tribune sports editor Cooper Rollow.

Also, Sheila Teasdale, retired editor of the journal Informatics in Primary Care and a former chair of the International Medical Informatics Association’s Primary Care Working Group, is mourning the loss of her father. J.D. Kleinke, who helped found Healthgrades and Solucient and now is a healthcare business strategist, economist, author and columnist, is doing the same for his mother.

Please join me in expressing sympathy for their recent losses.

April 5, 2013 I Written By

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Mark Versel, 1944-2012

My father passed away late last Friday night from a most insidious disease called multiple system atrophy (MSA). It’s a rare, progressive, neurodegenerative condition that presents itself with symptoms similar to those of Parkinson’s disease, but it is far more aggressive and debilitating. Essentially, muscles stop working until the disease kills you. In my dad’s case, he ultimately lost the ability to breathe.

Nobody knows the cause of MSA and there is no cure. There really aren’t even any effective treatments. You can only treat the symptoms with medications designed for Parkinson’s to address muscle stiffness, balance and such, and with physical and speech therapy, but that’s like standing in front a speeding train with a stop sign. It’s a futile battle.

My dad never had any real health issues other than sciatica until he was diagnosed with what was thought to be Parkinson’s less than five years ago (MSA didn’t really come into the picture until maybe a year and a half ago). He ate well, exercised somewhat regularly and generally took pretty good care of himself before the disease came along. Now he’s dead at the relatively young age of 68 after an excruciatingly fast decline that kept him hospitalized for his final month.

He fought the disease valiantly and courageously, but he never got the chance to retire. He was forced to stop working because he was physically unable to continue. He never even got to come home to die. The end came so fast that we didn’t get past the first hospice discussion.

As sad as it is to lose my dad in the way that I did, I want something positive to come out of his ordeal. He was selfless, kind and generous in life, and my family intends to carry on his legacy in some way that we haven’t had time to figure out just yet. I want to use his memory and my little corner of the Internet to help educate people about MSA and about patient safety.

What does patient safety have to do with this, you ask? My dad had pretty terrible care at a poorly run community hospital near his home for more than three weeks before he was transferred to the wonderful Georgetown University Hospital in Washington for what turned out to be his final days. The contrast was striking.

The community hospital was a place of inadequate communication, broken processes, obsolete workflows, neglect and harm. My dad came in with what turned out to be a urinary-tract infection. They treated that with antibiotics, but he developed pneumonia in a matter of days—a condition a doctor admitted he had acquired in the hospital. So he was transferred to intensive care, where the hospital could make a lot more money despite being responsible for the complication. (Perverse incentives rule in American healthcare.) My dad was a Medicare beneficiary, so you and I, as taxpayers, get ripped off by the incompetence.

Meanwhile, the clinicians there, who had been trained to treat the acute symptoms, neglected the MSA for more than a week, even taking him off his regular meds for several days, during which time my dad’s muscles continued to stiffen. Physical therapy was essential to prevent further atrophy. The order went in for him to receive physical and occupational therapy at least three times a week, but the PT and OT were nowhere to be found for a week or more.

Meds that had been ordered didn’t get delivered. One night while I was there, a perky medical assistant or tech or someone of that ilk burst into the room announcing it was time for an AccuCheck test, and nearly went through with taking a small blood sample before I stepped in to ask what was going on. She explained that it was a test for blood sugar (who would know what AccuCheck was if they didn’t have diabetes or some familiarity with the healthcare industry?) only after I enquired, but I stopped her to tell her that my dad did not have diabetes. Because of the MSA, he had difficulty speaking and would not have been able to stop someone acting so quickly. It turned out that the tech had gone to the wrong room. The hospital did require clinicians to scan bar codes before administering tests and meds, but who knows if the system really worked?

Later that evening, the nurse nearly gave my dad an eye drop that had not been ordered. The proper instructions were to administer an ophthalmic drug orally, but only if he had excess saliva. The nurse didn’t see that part of the note, despite the fact that the ICU had a partial EHR (Cerner, for those of you keeping score at home) with electronic medication lists.

The infectious disease specialist at the community hospital was not even familiar with MSA — and he didn’t bother to tell us that for three weeks. It should be his professional duty to call in an experienced neurologist or consult with my dad’s personal physician.

Worst of all, my dad stopped breathing for a few seconds last week under questionable circumstances and was intubated, despite the fact that he had an advance directive on file specifically stating that he did not want to be intubated.

At Georgetown, we saw nothing but compassion and competence. Care was well coordinated. People talked to each other. Clinicians huddled together during shift changes to discuss all the patients on the ward. The medical director of the ICU, a pulmonologist, personally managed my dad’s case. The neurologists at this major teaching hospital had seen MSA before, but that didn’t stop them from talking with my dad’s personal physician. It was too late to save my dad’s life, but he died comfortably and with dignity at Georgetown, without the needless agony he endured at the other place.

I am now vowing to dedicate my own career to educating as many people about MSA as possible and about the danger of uncoordinated care and poorly designed workflows. Interestingly, one of the last stories I wrote before my father passed and before I took leave was a piece in InformationWeek about patient engagement. I love the mantra of the Society for Participatory Medicine that I mentioned in the story: “Nothing about me without me.”

Every patient should live by those words. And every healthcare facility should respect that concept.

Rest in peace, Dad. You have not died in vain.

UPDATE, April 2013: If you would like to make a donation to MSA support and research, please visit our family’s fundraising page, which is helping the Multiple System Atrophy Coalition. Thank you.

May 17, 2012 I Written By

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Healthcare journalist Janice Simmons, 1957-2011

It seems like there have been far too many untimely deaths of late. The most recent is a fellow healthcare journalist, Janice Simmons, who died suddenly last week at the age of 54. Here is an obituary from FierceEMR. She succeeded me as editor of that newsletter.

 

August 22, 2011 I Written By

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Bernadine Healy, 1944-2011

I’m rather shocked to hear tonight that Bernadine Healy, M.D., has died of a brain tumor.

Dr. Healy, who turned 67 on Thursday, was the first woman to head the National Institutes of Health (1991-93). She also served as president of the American Red Cross, was  dean of the Ohio State University College of Medicine and was health editor of US News and World Report. Dr. Healy, a Cleveland Clinic cardiologist, was deputy director of the White House Office of Science and Policy under President Ronald Reagan. She was married to former Cleveland Clinic CEO Floyd Loop, M.D.

I met Dr. Healy once, after she spoke at the Medical Group Management Association‘s annual conference in 2003. For someone as busy as she was, she couldn’t have been more gracious. I lost my job just a couple of months not long after that conference, and was fishing around for freelance opportunities, so I called US News offices in Washington and left her a message. Wouldn’t you know, Dr. Healy called me back. She was more about setting the editorial direction of health stories in the magazine than day-to-day story decisions, but she did direct me to the proper editor there. Alas, my pitches ultimately were rejected, but thanks to Dr. Healy, I was able to open a dialogue with the person responsible for assigning freelance stories.

This news today came as a surprise, because I had no idea Dr. Healy had been sick. Rest in peace.

August 7, 2011 I Written By

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Founder of British interactive patient sites dies

The driving force behind popular British interactive patient sites HealthTalkOnline and YouthHealthTalk has died.

Dr. Ann McPherson, 65, died May 28 after a four-year struggle with pancreatic cancer. Dr. McPherson, a general practitioner at Oxford University, came up with the idea for a patient-experience site 15 years ago while fighting her own battle with breast cancer, E-Health Insider reports.

Dr. McPherson and Dr. Andrew Herxheimer, a former editor of the Drug and Therapeutics Bulletin, founded predecessor site DIPEx in 2001, long before the phrase “health 2.0” gained acceptance. Their organization, the DIPEx Charity, divided the site into HealthTalkOnline for adults and YouthHealthTalk for teens, children and their families in 2008. Numerous British celebrities, including actor Hugh Grant and Radiohead singer Thom Yorke, have become public supporters of the charity.

She co-authored the 1987 book, Diary of a Teenage Health Freak, which has sold more than 1 million copies worldwide, according to an obituary in The Guardian. The book spawned a TV show in the U.K. in the early 1990s, and later, the still-active Teenage Health Freak Web site.

Dr. McPherson won the BMJ’s 2011 Healthcare Communicator of the Year award in April.

 

June 5, 2011 I Written By

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