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Video: athenahealth’s Jonathan Bush at HIMSS11

As has become custom at HIMSS, I sat down with Jonathan Bush, chairman, CEO and president of athenahealth, at the 2011 conference in Orlando, Fla., last week. But due to some technical difficulties in getting the room we thought we had reserved and in getting my audio recorder to work (OK, OK, I didn’t have fresh batteries on me), I busted out the HD video camera. (Wouldn’t you know, the battery was losing steam there, too, so I had to plug the camera in. I have since determined that the USB port wasn’t working, so I exchanged it this past weekend. But I seriously digress.)

In this interview, we talk athena’s business, meaningful use, 5010/ICD-10, ACOs, cloud computing and health reform. We poke a little fun at the “boat show” that the vendor expo has become and make plans for the “Cloud Cavalry” to ride into Las Vegas at HIMSS12.

YouTube recently raised the maximum video length to 15 minutes, but we went on for about 20, so I had to break the interview into two parts.

Part One

Part Two

Don’t forget to check out my fledgling YouTube channel,

February 28, 2011 I Written By

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

On the road to meaningful use

If you follow my Twitter feed, you know I had a little accident early Wednesday morning during the just-concluded HIMSS conference. I stumbled into the bathroom in my Orlando, Fla., hotel room in the dark about 6:30 a.m., did my business, then turned to my left to use the sink. Unfortunately, the sink was not to my left. I fell down and hit my face against the edge of the bathtub and immediately started gushing blood.

It took a while, but I mostly got the bleeding stopped with the help of some towels (I’m sure the cleaning

The result of my clumsiness

The result of my clumsiness

staff wondered if I had murdered someone), ice and, courtesy of the front desk and a Walgreens across the parking lot, moist towelettes, antibiotic ointment, gauze pads and surgical tape.

The clerk at the front desk offered to call an ambulance to get me to an ER. I have a high-deductible health plan, so this early in the year, I’d have to pay the hefty bill entirely out of pocket. I wasn’t going to die from a cut just above my eye. Fortunately, there was a Walgreens right across a parking lot from the hotel, so I was able to get some other first-aid materials to clean the wound and completely stop the bleeding.

After going back to sleep for a couple hours, I got myself over to the convention center around lunchtime, still wondering if I needed to get the cut checked out. This being HIMSS, there were plenty of clinicians around. I happened to be in a session where HIMSS Vice President Pat Wise, R.N., and Chicago medical informaticist Lyle Berkowitz, M.D., were present. They both recommended I get medical attention as soon as possible. (Too bad nobody carries suture kits to IT conferences.)

With the help of Google Maps on my BlackBerry, I found two options: a hospital 0.7 miles south of where I was in the convention center or a walk-in urgent care clinic 0.9 miles north. The single review connected to the clinic listing said it wasn’t worth it, go to a real hospital instead. Again, though, I have a high-deductible plan and this wasn’t a life-threatening injury. Having followed this industry closely for more than 10 years, I think I have more realistic expectations of how a healthcare consumer should behave. I chose the urgent care clinic.

Rather than waiting hours in an ER, I was in and out in about an hour with six stitches slightly below my eyebrow. Instead of a $300 (minimum) ambulance ride plus who knows how many hundreds—if not $1,000 or more—for ER services, I got there for $7 in a taxi. This clinic, which doesn’t accept insurance as a way to keep costs down, charged $55 for the visit (after a $20 coupon that I didn’t know about until they volunteered it), plus a couple hundred for a physician assistant to clean and stitch up the wound.

This clinic was in an aging, shabby strip mall not far from the tourist traps and second-class chain restaurants of International Drive. It seemed like a typical, old-fashioned, paper-based practice. I filled out my medical history and presenting condition on the hated, ubiquitous clipboard, then sat down in the waiting room, surrounded by outdated magazines. Shortly thereafter, a nurse brought me back into an exam room, took my vitals and got everything ready for the PA to fix the cut.

After the stitching, I was pleasantly surprised to learn that the practice wasn’t so stuck in the past after all. The PA ran my credit card, then told me to sit tight for a few minutes while he documented my case so I can take a report back to my own physician when I get the stitches removed next week. He sat down at a computer and started typing away. About five minutes later, I was handed a printed, detailed, discharge summary.

That’s right, this practice, that seemed old-fashioned on the surface, had an electronic medical record (I didn’t catch or bother to ask who the vendor was). Since the practice doesn’t accept Medicare, Medicaid or any other insurance plans, it’s not eligible for federal EMR incentive payments, but it probably wouldn’t qualify for “meaningful use” anyway since it’s not totally electronic. I didn’t see any orders entered electronically (though they still may have been), nor was I offered the option of receiving the clinical summary electronically. I think they ran the lidocaine they ordered as a topical anesthetic through an interaction checker to make sure it didn’t contain any sulfa, which I had indicated I’m allergic to.

I imagine this is where countless thousands of small medical practices are on the road to meaningful use. They have some elements of an EMR that fit existing workflow, but nothing comprehensive and no interoperability. I’m glad the summary was at least typed so there won’t be any issues with handwriting when I go to my regular internist next week. I’m also happy they checked for drug-allergy interactions.

Score two points for patient safety and one more for consumerism. I’m confident I got the right care for a reasonable cost, and that I’ll recover quite nicely.

February 25, 2011 I Written By

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

Final HIMSS attendance figures

ORLANDO, Fla—HIMSS just released final attendance figures for the annual conference, which wraps up in a couple of hours. This year’s crowd totaled 31,225, breaking the previous record by several thousand. (If my memory serves, HIMSS08, right here in Orlando, approached 28,000, then the economy took its toll on conference spending for the last two years.)

Professional registration—that’s excluding the representatives from the more than 1,000 exhibitors—was 14,639, up from 13,672 last year in Atlanta.

I take back most of what I said about Orlando being my least favorite major convention city. Maybe it’s because I actually stayed within walking distance of the venue this time, but I didn’t feel so isolated. HIMSS11 was confined to one of the three Orange County Convention Center buildings, so even though the exhibit hall was, I’m told, literally a mile long, things seemed pretty easy to get to.

Also, I had a positive experience with a local healthcare provider, which I’ll detail in another post. That also explains why this blog was dark yesterday.

Soon, it’s off to Orlando International Airport, then back home to Chicago. Once you get past the crowds of overpacked families who don’t travel often and thus don’t quite understand the security procedures, MCO is really a great airport. The free Wi-Fi doesn’t hurt. So, thanks, Orlando, for a positive experience and some much-needed sunshine.

February 24, 2011 I Written By

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

Kolodner on ONC

I just ran into Dr. Robert Kolodner at the HIMSS conference. As you know, Kolodner was the second national coordinator for health IT, serving from 2006 to 2009. While he doesn’t have any insight on who might be the next head of the Office of the National Coordinator for Health Information Technology—or if he does, he’s not sharing—he did put the decision into perspective.

The first coordinator, Dr. David Brailer, was kind of the entrepreneur, starting up the office with little money and no statutory authority, just what President George W. Bush delegated to him in an executive order. Kolodner was the one who “made it real” in terms of hiring permanent staff and setting up programs to assure the long-term viability of the office. The current coordinator, Dr. David Blumenthal, who will leave in April, is the policy guy, leader of efforts to implement the health IT provisions of the American Recovery and Reinvestment Act.

The question Kolodner has for the Obama administration is: What qualities should the next coordinator have? Do we need another policy specialist or a hands-on implementation leader?

February 22, 2011 I Written By

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

The dirty little secret about ‘Blue Button’

Since last summer, various government agencies, notably the Department of Veterans Affairs, have been touting the Blue Button Initiative as an easy way of  sharing electronic data with patients. Just click the blue button in the patient EHR portal and download data into a personal health record or a printout. Sounds simple enough.

Late yesterday, my successor at a publication I was the primary writer of until late last year, cited the importance of the Blue Button, particularly when coupled with Microsoft’s HealthVault PHR platform. (If I turned in my story as late as 4:52 p.m. for that client, I would have been docked at least $150, but that’s neither here nor there.)

The fact that HealthVault and other “untethered” PHRs are non-starters when it comes to the public notwithstanding, Blue Button has a serious, perhaps fatal flaw. It outputs data in unstructured text form that’s not easily readable by an EHR. There’s no Continuity of Care Record, no Continuity of Care Document, no form of Clinical Document Architecture at all.

Just. Plain. Text.

One techie doctor I know calls this data essentially useless.

UPDATE 10 a.m. EST: The techie doctor I mentioned is Dr. Enoch Choi of Palo Alto Medical Foundation, per his comment below. He tweeted about this last month.

I Written By

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

The life of a journalist at HIMSS

Ever wonder what the life of a journalist is like during the annual HIMSS conference?

For one thing, it’s filled with e-mail. For weeks, I’ve been receiving requests from vendors to meet with them at HIMSS. I only accepted a few, and for good reason: I’m human. There are more than 900 vendors out there on that madhouse of a show floor, and I can’t possibly meet with more than a few of them in the four days of HIMSS. (Actually, it’s a three-day event for vendors because they clear out on Wednesday while those of us here for the conference—not just the “show”—stick around until Thursday.)

The e-mail flood started up again last night, as companies put out news releases for HIMSS, talking about their mere presence here (yawn), new product information (half-yawn) and information about successful implementations of their products (often quite interesting.) Wait, did I say “products”? I meant to say “solutions,” because that’s what all the vendors call their offerings.

A major pet peeve of mine is the incessant use of the word “solution” as a synonym for “product”
or “service. That word was popular when I started covering healthcare circa 2000. It’s tired. Time to come up with something better, or just call what you sell a product or service. What’s wrong with those terms anyway?

Pardon my digression there. Back to the e-mail.

Following are the hedlines of press releases I’ve received since yesterday morning:

  • Clinovations has invited you to HIMSS Networking Happy Hour 2011
  • HIMSS: Interested in meeting with KP?
  • ONC Announces New Project to Harmonize Standards that Support Meaningful Use of EHR Systems
  • CDIA Press Briefing Tomorrow, News Release Today
  • eHealth Initiative CEO Available for Interviews at HIMSS 2011
  • 4medica Hits Milestone: 27,000 Providers Now Have Access to 30 Million Electronic Patient Records
  • HP Healthcare News: Telehealth Solutions with LifeBot, Canvys, MedWeb and Parental Health
  • Health Level Seven Announces Upcoming Release of the greenCDA™ Implementation Guide
  • DICOM Grid Advances Interoperable Medical Image Management & Collaboration with 2 Million Imaging Studies on Grid
  • Medicity Demonstrates Certified Meaningful Use Modules on the iNexx Platform at HIMSS11
  • Saint Luke Health System’s Debe Gash named a Computerworld Premier 100 IT Leader
  • Dramatic AppCloud Growth Propels Covisint, a Compuware Company, to Become the Nation’s Largest Healthcare Identity Management Service Provider
  • MedeAnalytics HIMSS11 Press Releases
  • News: Iron Mountain Delivers Cloud-Based, Vendor Neutral Storage for Patient Data (booth #2712)
  • Philips showcases commitment to standards-based interoperability at HIMSS11
  • Health Language Launches LEAP I-10, a User Friendly, Cloud-based ICD-10 Conversion Solution at HIMSS11
  • GE, Cisco to offer hospitals new mobility tech for patient flow, asset mgmt.
  • GE Healthcare Announces Collaboration with CDC, EMR Certification & Strategic Alliance with Cisco
  • Sage news release: Sage Healthcare Division to Integrate HealthUnity’s Health Information Exchange with Electronic Health Record
  • HIMSS Releases Policy Priorities for 2011/2012
  • SK&A to Measure EHR Adoption for U.S. Government
  • Oracle Healthcare:  New Solutions Unveiled at HIMSS11 Support Meaningful Use, EHR Requirements

I’d file most of these—not all—into the yawn category. And yet, I have to process them. Any wonder why HIMSS is such an endurance test?

February 21, 2011 I Written By

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

Lots of ♥ for Health Wonk Review

Valentine’s Day came and went, but the love lingers with Health Wonk Review. Louise and Jay Norris have the Valentine’s Week edition of HWR at the Colorado Long Term Care Insider blog. They’ve included my recent podcast with Evan Steele of SRSsoft, and there’s plenty of other news about health insurance reform, Accountable Care Organizations and shared decision-making between patients and providers. Check it out.

February 19, 2011 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: HIMSS CEO Steve Lieber

The 2011 HIMSS conference gets underway this weekend in Orlando, Fla. For the fifth year in a row, I interviewed HIMSS President and CEO H. Steven Lieber to preview the annual conference. Check Health Data Management’s HIMSS microsite now and MobiHealthNews next week for write-ups of parts of this interview, but this is the only place you can hear the whole thing.

The audio is pretty clear, but you may hear faint music in the background. The recorder seems to have picked up some radio interference. That’s not entirely unexpected in a downtown Chicago office building, namely HIMSS headquarters at 230 E. Ohio St. Ah, well. Enjoy the podcast, and I’ll see you in Orlando.

Podcast details: Interview with HIMSS CEO Steve Lieber. MP3, stereo, 128 kbps, 30.6 MB. Running time 33:26

0:30 Attendance “well in excess of 30,000”
1:00 Increasing interest in health IT because of meaningful use
1:35 ICD-10 and 5010 somewhat “sidelined” but still important
2:40 The march toward meaningful use
3:00 25 percent of membership already at Stage 1 meaningful use
4:20 “Uncertainty” about future stages replacing confusion about what Stage 1 meaningful use is
5:15 Questions about whether early Stage 1 attestation shortens the timeline for Stage 2
6:00 Efforts by some new members of Congress to repeal or cut funding to HITECH
7:30 Questions about meaningful use he hears from HIMSS members
8:40 Balancing meaningful use with 5010 and ICD-10 compliance efforts
12:00 Incentives from private payers
12:40 Quality vs. cost savings
14:00 Public perception of healthcare reform
16:10 PPACA hasn’t had time to make an impact yet
16:55 Expectations for David Blumenthal’s HIMSS keynote and politicization of health IT
19:10 Speculation about next national coordinator?
21:25 New, parallel HIT X.0 conference-within-a-conference
24:30 Mobile and wireless technology at HIMSS and in healthcare
27:10 Hype cycle in mobile apps
28:10 Home care and telehealth reimbursement
30:00 Technology and ACOs
31:00 Berwick speaking at HIMSS this year after several previous attempts to get him

February 18, 2011 I Written By

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

Welcome to my new blog site

Welcome! Just in time for HIMSS11, I’ve migrated my blog over to the new Healthcare Scene blog network. You should expect the same news and analysis I offered at my old blog site, just more of it. All of my archives are here, so you won’t have to go far to find old posts, either.

Stay tuned this afternoon for my first “real” post on this new site, a podcast with HIMSS CEO Steve Lieber. Meantime, check out my story for Health Data Management based on that interview.

Thanks for your continued readership.


I Written By

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

Welcome to Meaningful HIT News!

Welcome to the latest addition to the Healthcare Scene blog network: Meaningful HIT News with Neil Versel!!

We’re just getting everything set up and ready to go, but shortly you’ll find some of the best healthcare IT content on the web by longtime healthcare IT journalist, Neil Versel.

Check out the other members of the Healthcare Scene network of blogs:

More information coming soon and a proper introduction to the change from Neil!

February 15, 2011 I Written By

John Lynn is the Founder of the blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of and John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.