Friday, February 26, 2010

Client News: Botsford Hospital Receives Trauma Center Designation

Botsford Hospital (Farmington Hills, Michigan) has been verified as a Level II Trauma Center by the Committee on Trauma (COT) of the American College of Surgeons (ACS). The hospital’s trauma program offers a full range of surgical procedures around the clock with entire teams of medical professionals on site or available within 15 minutes of notification for most critically injured patients. Botsford Hospital is a multi-specialty community hospital with 330 licensed beds and cares for more than 17,000 inpatients and almost 60,000 emergency patients each year with a team of 2,400 employees, 400 volunteers and more than 600 physicians. A not-for-profit hospital, Botsford provided almost $27 million in community benefit during its 2008 fiscal year.

We are speaking today at the Florida Association of Healthcare Access Management (FAHAM) chapter meeting at Mease Countryside Hospital

Friday - 2/26/2010
Time: 11:30 a.m. to 12:30 p.m.
Florida Association of Healthcare Access Management (FAHAM) Chapter Meeting
Mease Countryside Hospital

"Physician Orders - the value of a low cost, free standing, online order."


Bob Grass, Principal Consultant
Cell: 314-795-5248

George M. Giorgianni, National Director for Perioperative Solutions
Cell: 404-915-6439

Thursday, February 25, 2010

Photo of the Day - Some neat pics from Coos Bay, Oregon

Just posted some great pics on Facebook that were taken by Leslie Neilson, our Senior QA Analyst, of scenery from her visit to our clients at Bay Area Hospital in Coos Bay, Oregon. Visit Our Facebook Page Here!

Thanks for sharing Leslie!!

Wednesday, February 24, 2010

Client News: Inova Fairfax Hospital Named One of America's 50 Best Hospitals

For the fourth year in a row, Inova Fairfax Hospital (Falls Church, VA) has been named one of America's 50 Best Hospitals by HealthGrades, an independent healthcare-quality ratings organization that analyzed patient outcomes at all 5,000 of the nation's non-federal hospitals. Inova Fairfax Hospital's outcomes places it in the nation's top 1 percent.

According to HealthGrades, a patient admitted to an America's 50 Best Hospital is 27 percent less likely to die, and 8 percent less likely to suffer from a major complication. Inova Fairfax Hospital is the only hospital in the Washington, DC, region to make the Top 50. In addition to naming Inova Fairfax Hospital among the Top 50 hospitals, HealthGrades has also ranked the hospital number one in Virginia for cardiology services for 2009-2010 and among the top 5 percent in the nation for treatment of stroke.

Inova Health System is a not-for-profit healthcare system based in Northern Virginia that consists of hospitals and other health services, including emergency- and urgent-care centers, home care, nursing homes, mental health and blood donor services, and wellness classes.

Monday, February 22, 2010

Client News: WellSpan Rehabilitation opens new facility

Pictured on left: Senior physical therapist Joel Garcia instructs Michelle Wilson on the use of a piece of rehabilitation equipment. The new facility at Queensgate Towne Center features cardiovascular and strength equipment and a multi-cervical unit for treating neck pain.

Patients who need rehabilitation services now have another outpatient location option. The new facility opened at Queensgate Towne Center, 2501 Springwood Road in York last week. “This is an exciting time for WellSpan Rehabilitation,” Hawk said. “From the construction of the Surgery and Rehabilitation Hospital to the new outpatient sites, we are making tremendous strides to improve the availability of rehabilitation services for area residents. I’m thrilled to be a part of this journey.” Read more about it on WellSpan's website

Wednesday, February 17, 2010

A Meaningful Ruse?

By Frank L. Poggio, president of The Kelzon Group

At the risk of being a called a Cassandra, or at best a contrarian, I will attempt to explain why the federal government’s HITECH Act and Meaningful Use (MU) incentive program is a wolf in sheep’s clothing and why the better response for a provider would be to run, don’t walk, from this wolf.

First let’s review the basics. When a hospital or physician’s practice purchases and implements an electronic medical record (EMR) or Computerized Physician Order Entry (CPOE) before 2011 and files with the federal Department of Health and Human Services (DH&HS) the yet-to-be-developed regulatory documentation to declare their meaningful use (MU), then starting in 2011 that provider will be potentially eligible for an MU bonus payment. For physician practices, that could amount to a total of $44,000 over three years. For hospitals, depending on the number of discharges, somewhere between $2million to $3.8 million total. These incentive amounts are to be paid over three stages, or years, starting in 2011.

On the other hand, if a provider does not implement an EMR or CPOE, or purchases and implements a system but cannot show meaningful use, then a penalty will be incurred on Medicare payments in years 2015 thru 2017. This penalty will be in the form of a reduction to the legislated increase in Medicare payments for that year. Note: this is not a reduction in overall Medicare payments, but a reduction on the yearly Medicare inflationary adjustment factor. The first year the penalty is a 33% reduction of the adjustment, the second 66%, the third 100% (or in effect, you will get no adjustment at all).

Before I explain why I believe there is a wolf at your door, let me say I am a believer in the benefits of EMRs and CPOEs. There can be significant benefits in both, but not unless they are incorporate a sound work flow re-engineering processes prior to installation. Unfortunately there are very few if any MUs that are workflow-focused.

There are at least four major reasons why I believe your facility will never see an MU bonus.

1) MUs are, by the DH&HS’s own admission, a moving target. As stated in the Interim Final Rule (IFR) published in the Federal Register, December 30, 2009, on page 314, “We expect to issue definitions of meaningful use on a bi-annual basis beginning in 2011”. Hence, MUs will evolve over time. That will allow DH&HS to make them as easy or as onerous as they choose. How can you predict you will hit a moving target that you can’t even describe today? And if you believe the Feds may try to make it easier to foster participation, read on.

2) If you hit all but one MU, will you get the full bonus, or 95%, or 50%? Nobody knows and the question is not addressed in any IFR or other documents. I am willing to wager you will get nothing, and my reasoning follows.

3) The federal government has stated they are funding the HITECH program with $34 billion for MU bonuses. They also have stated repeatedly they expect to save over $200 billion to help fund the new national health plan. That’s about a seven-to-one expected payback in only a few years. When was the last time you had a seven-to-one ROI on any IT project over three years? If the feds do not see the seven-to-one payback in time, how many providers do you think will get to cash an MU check?

4) Our government is under extreme pressure to cut the federal deficit. In the President’s recent State of the Union Address, he stated he will freeze the government budget for ‘non-essential’ items to save $250 billion, to alleviate the trillions of dollars in deficits predicted by the OMB. Essential is currently defined as Social Security payments, interest payments on debt, entitlement programs, Medicare benefits, and the defense budget. These taken together make up over 80% of the total government expenditures. So the freeze has to come from ‘non-essential’ departments and programs. Medicare payments to providers are not considered part of Medicare benefits, they come under the DH&HS /CMS department operating budget. So, although the benefits to the seniors will not be reduced, the payments to the providers are fair game. And therein lays our wolf.

I noted earlier that if you fail to purchase and install an EMR / CPOE, you will be penalized by a reduction in the increase in Medicare inflationary adjustment in future years. Based on the above reasons, I believe there will be little or no adjustment increase in future years. If you don’t think this will happen, look at what Congress and DH&HS had allocated for the adjustment ‘increase’ in 2010 for physician Medicare payments. DH&HS wants to apply a -21% adjustment for physician payments. Yes, that’s minus twenty-one percent. Then, to get the AMA on board with the national health initiative, the Administration and Congress was going to delay this adjustment, but now even that agreement is up in the air.

On the hospital side of the world, look at what the Medicare adjustment increases have been over the last five years. The most they have been is 2% and the average is around 1%. If you run those numbers for a typical 200-bed community hospital with a Medicare utilization percent of 50%, the one percent increase amounts to about $300,000. Hence, reduce it by a third and you will miss out on $100,000 that year. Again, and that’s assuming there is any increase at all in future years.

Lastly, let history be your guide. I have worked in the healthcare world for 35 years as a CFO, CIO and multitude of other roles. As a CFO, I saw Medicare renege on many case mix adjustments, TEFRA adjustments, and DRG adjustments,all in the name of national budget deficits and health care cost controls. At one point, they set up a Medicare Payment Advisory Committee, then disbanded it when the Committee disagreed with too many DH&HS adjustment policies. I doubt the future will be much different, in fact probably worse.

So, run the numbers again, in future years if the Medicare adjustment increase is zero – because the feds and DH&HS say we can’t afford an increase due to overall deficits and budget freezes, then reducing the zero adjustment increase by 33% will incur how many penalty dollars?

What’s a shepherd to do?

The bottom line is there is no need to “horse in” a new EMR/ CPOE regardless of what vendors say. Secondly, horsing in a system as complex and far-reaching as EMR/CPOE and while hitting the expected glitches along the way is going to cost you far more than any Medicare adjustment penalty.

My advice … take your time, do it right ,and install components that will give you the most ROI the fastest. And watch out for the wolves.

[posted on HIS Talk "Readers Write 2/15/10"]

Monday, February 15, 2010

Visit us in BOOTH # 2706 at HIMSS10 in Atlanta!

Healthcare Information and Management Systems Society
Annual Conference & Exhibition
March 1-3, 2010
Atlanta - Georgia World Congress Center

We are in BOOTH 2706, if you are attending please stop by or call Stephanie Speth at 314-878-6050, ext. 143 to set up a time to see a private demo.

We're also giving away a fabulous HD television. To enter, simply stop by and fill out an entry form for the the drawing!

For more information on the conference, go to

Friday, February 12, 2010

Partner News: Amerinet names Christina Smith as VP, Clinical Advantage

Amerinet Inc (St. Louis, MO) promoted Christina Smith to the position of VP for Amerinet Clinical Advantage. She joined Amerinet in 1998 and most recently served as senior director for Amerinet Clinical Advantage. Prior to joining Amerinet, Smith’s professional expertise included more than 18 years of healthcare experience as a nurse manager, director and perioperative nursing staff member. Learn more about Unibased's relationship with Amerinet here - [PDF]

Client News: Huntsville Hospital is on track to open Alabama’s newest acute care facility in Madison - February of 2012.

Madison Hospital is a 60-bed acute care facility that is being built by Huntsville Hospital in Madison, Alabama. The hospital was approved for construction by the State of Alabama in 2009 and is projected to open in early 2012. Madison Hospital will be located in the Madison Medical Park on U.S. 72. Huntsville Hospital is a community-owned, 881-bed regional referral center located in nearby Huntsville, Alabama.

"We've designed this hospital to start at 60 beds, grow to somewhere in the 180-200 range," said David Spillers, the Huntsville Hospital CEO. "We've got all that designed into the plan."

Thursday, February 11, 2010

Unibased's BI tool, ForSite Analytics, quickly and effectively provides insights into your Key Performance Indicators

The Right Information When You Need It – Working the Way You Think’s what it takes to run your organization. Tomorrow’s leader needs the right information at the right time to make important business decisions. Unibased Systems’ business intelligence tool, ForSite Analytics, quickly and effectively provides insights into your Key Performance Indicators (KPIs) that affect and improve business processes and outcomes, simplifying analysis by pairing the right metrics with the right relationships for all different perspectives. Utilizing the power of QlikView technology, this powerful tool is highly flexible and intuitive, and designed to work the way you think, enabling easy drill-down to the underlying data in order to perform a more detailed analysis without the assistance of IT resources. By selecting from a library of KPIs, ForSite Analytics supports a more in-depth analysis of those critical business areas you wish to scrutinize in more detail, allowing you to keep a finger on the pulse of your business. Supporting what to measure and what to manage is finally made simple with this easy-to-use, fast and responsive solution that empowers individuals to improve organizational performance and drive innovation. Learn more...

Tuesday, February 2, 2010

Client News: Inova Fair Oaks Hospital (Fairfax, VA) Earns Spine, Joint Replacement 'Gold Seal of Approval'

Inova Fair Oaks Hospital’s Spine and Joint Replacement Surgery programs have earned the Joint Commission’s Gold Seal of Approval™ for healthcare quality. The Joint Commission awarded the hospital "Disease-Specific Care Certification" for its Cervical and Lumbar Spine Surgery, and Knee and Hip Joint-Replacement Surgery programs. View Article

Client News: Jewish Hospital (Louisville, KY) Named Blue Distinction Center for Knee/Hip Replacement and Spine Surgery

Anthem Blue Cross and Blue Shield in Kentucky has designated Jewish Hospital as Blue Distinction Center for Knee and Hip Replacement and Spine Surgery. View Press Release

Client News: Des Peres Hospital (St. Louis, MO) Recognized for Quality Orthopedic Care

Anthem Blue Cross and Blue Shield of Missouri has designated Des Peres Hospital as a Blue Distinction Center for Spine Surgery and a Blue Distinction Center for Knee and Hip Replacement. View Article Here