Physicians will expand range of mobile activities to include administrative and patient care tasks by 2012. This bold statement is courtesy of Manhattan Research’s announcement of a new report – “Future of Physician Media”. Among other things, the press release (because I’m sure not buying the report) restates the prediction that physician smartphone adoption will reach 81% by 2012 (originally announced in October)… In all seriousness, while the highlighted take-aways are ridiculously obvious, the report is based on interviews conducted among 1,900 US physicians. I’m sure they’ve been able to uncover some insightful gems.

M*Modal partners with Intelligent Medical Objects (IMO) to improve ease of use of electronic medical records. Combining M*Modal’s speech recognition and understanding technology with IMO’s clinical terminology interface, the two companies aim to improve physicians’ ability to create, review, reconcile, and update clinical diagnoses, problem lists, and medical histories in electronic health records using physician narrative dictation… I missed this release amongst the HIMSS hubbub, though I did spend a bit of time with both Nuance and 3M, where I learned quite a lot about the various methods of both capturing and transcribing dictations. In the next couple of weeks, I’ll try to provide a comparison of the different companies and technologies and where they each “play.” 

Glide Health Corporation announces unified platform for EMR and PHR, new mobile PHR application for the iPhone and new board members… I was going to try to give you a highlight of the press release, but it has to be the most convoluted one I’ve ever read – it also includes the announcement of a major customer win in Integrated Medical Professionals PLLC. I’ve mentioned the company in the past and think their cloud-based OS looks promising. Their technology is definitely enough of a paradigm-shifter as to require clear, concise and delicate messaging. This ain’t it.

I receive periodic product update announcements from Practice Fusion (btw… can anyone tell me why their landing page is identical to Mint.com?) Though I would generally defer to Inga to cover such matters, I feel compelled to comment about the most recent. Not that I have anything particularly interesting to say about the release – it looks like they did a major overhaul to their scheduling system. My comment is really just that building an EMR looks like such a “tar baby.” I actually worked with a start-up over the last year and a half or so, exploring whether we should build a hosted, integrated EMR and PMS. We were interested in giving the technology for free but using it as the platform to provide critical services, beginning with revenue cycle management… Similar to the AthenaHealth model before they went public.

On the surface, building an EMR appears to be achievable. If it didn’t, there wouldn’t be 1,000 vendors clamoring for the same business. Unfortunately, each feature becomes a solution unto itself, bringing along its own enormous overhead – in terms of product development, support, integration, usability, etc… Then, just when you think you’ve got it all covered, a new requirement or feature comes out that you have to support. And, if that weren’t enough, your users will NEVER be satisfied. According to the Practice Fusion product update email, “Our VP of Engineering, Matthew Douglass, reports that a whopping 80% of all feature requests from our users make it directly into the EHR.” I find that just plain scary.

I tend to think the only way to be truly successful in the small office environment is to not let the EMR become a “tar baby.” For starters, if you’re going to compete in the small office space, stay there. While bigger business is nice to have, it also requires changing the solution in some profound ways, generally to the detriment of your smaller customers. Another thing, just because your customer has an opinion does not mean that you should listen to it. This is true for every vendor, not just EMR, or healthcare, but everyone. The smaller the footprint, the better. Clearly the solution needs to do what it was designed to do. Once it is doing that, whatever “that” is, fight the urge to add. Every little subsequent bell and whistle will diminish the usability and the value of the solution.

Maybe this is just my pitch for “Hire a mobile solution developer.” While we all agonize over form versus function decisions, the ultimate test is proving yourself on a 3 1/2” screen. The more I think about it… maybe this is just about making myself feel better because it supports what those of us in mobility have always known – smaller is better.

In other random thoughts… At HIMSS, someone asked me what I thought of the term “mHealth.” To be honest, I’ve deliberately avoided it. I think it sounds really cheesy. It reminds me of all those i-, e-, and m- companies that emerged during the dot com era (most of whom have gone away). It makes the whole sector sound like a fleeting fad. What’s more, those using the term most vociferously are among its newest advocates. I much prefer the words “mobile” and “mobility”, though I must confess that the resulting “mobile healthcare” is more suggestive of mobile clinics or mobile radiology units than nifty little devices that mobilize health information. After much deliberation, I have personally accepted mHealth to describe the use of machine-to-machine (M2M) devices used in remote monitoring and various telehealth applications, such as glucose monitors that transmit information to a cell phone, which, in turn, relay that information to a back-end disease-state application. mHealth suggests a well-defined package. After interviewing approximately 40 companies over three days at HIMSS (and missing many others), I can assure you that just about every healthcare IT vendor participates in mobility on some level, or in some fashion. A much smaller number engage in mHealth.

Short news blast following last week’s melee…

Apple made it official Friday, announcing the iPad will go on sale April 3 with pre-ordering starting March 12. Apple says it will first sell its Wi-Fi enabled iPads on April 3 and will sell Wi-Fi and 3G equipped models "in late April." On March 12 you’ll be able pre-order either model. Apple says iPad will be available in Wi-Fi models on April 3 in the US for a suggested retail price of $499 for 16GB, $599 for 32GB, $699 for 64GB. The Wi-Fi + 3G models will be available in late April for a suggested retail price of $629 for 16GB, $729 for 32GB and $829 for 64GB. iPad will be sold in the US through the Apple online store, Apple retail stores, and select Apple authorized resellers. As part of the launch of the iPad, Apple says it will also officially release the free iBooks app for the iPad that gives the iPad e-book functionality. Starting on April 3 the iBooks app will be available along with Apple’s iBookbookstore – available through iTunes. Apple says availability of the iPad will first be in the United States, Australia, Canada, France, Germany, Italy, Japan, Spain, Switzerland and the U.K. Pricing for countries outside of the U.S. is expected in late April.

FCC broadband czar defends national plan. Blair Levin, executive director of the Omnibus Broadband Initiative created last year by the Federal Communications Commission, said he is confident the final version set for release March 17 will meet the enormous mandate set by Congress. One part of the plan, released at the end of February, aims to free up 500MHz of spectrum for mobile broadband use.

Palm releases WebOS version 1.4.0 upgrade. The most substantial change in a fairly large release gives users the ability to capture, edit, and share videos. It’s pretty nice that device owners don’t have to go out and buy a new phone in order to gain such a substantial feature. Other changes include enhanced shortcuts, such as calling directly from a messaging conversation, or by pressing and holding a highlighted number in a web page, email, or message. The LED in the gesture area now lights and pulsates if a message or notification has been received. Despite the frequent updates to an elegant device, Palm is under increasing pressure. It’s stock fell to an 11 month low following last week’s announcement that it would not meet revenue forecasts.

Here’s a nice, short video from AT&T that touches on a few of their partners who are offering some of the hottest mobile solutions in healthcare today, including AirStrip and Wallace Wireless’ WIC Pager. Based on my current poll to the right of which is the hottest new app in healthcare, it would have been nice to see Voalte included in the video.

There are a few other mobile apps getting quite a lot of interest, including the WIC Pager, which I did not include in my poll. Send me a comment or an email letting me know who I left out.  Who do you think is the hottest mobile company or mobile app in healthcare today… and tell me why?

Just got back to North Carolina after my six hour return drive from Atlanta. As much fun as HIMSS was, I’m glad it’s over. There’s just too much to process, beginning with the ridiculous amount of press releases and faux “news”. I’ve asked the same question that Inga asked a dozen times over the last three days – why does every company feel the need to publish press releases during HIMSS?

I think it’s MAD – as in mutually assured destruction. Apparently the best defense against a competitor’s break-through announcement is to drown it out with noise. And, because the noise is so overwhelmingly loud and effective, it begs the better question – why would any company with something meaningful to say do so during HIMSS?

Pushing the envelope of absurdity, companies provide advance copies of their press releases under an embargo so that the media can disseminate at the precise moment the green light is given. This strategy, applied on the HIMSS battlefield, is a little like dropping a smart bomb at the epicenter of a nuclear wasteland.

HIMSS is about meeting people. And for that reason, it was a great success. I know many more today than I did four days ago. And I know a lot more about the companies and their products because of the people – not because of the gibberish propagated over the wire. Maybe I’m just plain old-fashioned, but a nice, friendly, sincere person who feels passionate about their company and their product is far more likely to win me over.

I mentioned some of those people in the two previous posts.  A few others:

Stanley Crane, Chief Innovation Officer at Allscripts. I met Stanley half-expecting someone who has all the answers. I’m sure that expectation stemmed from my perception of the company as one that is trying to run before it can walk. Instead, I had a conversation with Stanley that I can only describe as fun. He’s got some great ideas. He’s passionate about what he’s doing, and he has high expectations for the work that Allscripts is doing. Yet, he comes across as firmly grounded.

Michael Armstrong, Director of Marketing for Enovate. I didn’t know very much about Enovate before meeting with Michael. He was gracious, knowledgeable and remarkably succinct in communicating the company’s evolution and current product line.

Bob Zemke, UC Consultant with Siemens’ Healthcare and Life Sciences group. Bob is clearly a communications expert, and yet he was very courteous in humoring my inane questions. In many ways, Bob is symbolic of a sea-change that is occurring among some of the larger vendors. He was interested in discussing innovative, smaller-scale projects. He is pursing partnerships with small start-ups, and focused on open-standards. Bob came-across as surprisingly entrepreneurial for someone in such a large company as Siemens. It’s amazing that one person can have such a profound effect on my perception of the company as a whole.

Peter Hudson and Dr. Wayne Guerra, CEO and CMO, respectively, of Healthagen – the developers of the iTriage app for iPhone and Android smartphones. Peter and Dr. Guerra were walking the floor as hard-working entrepreneurs, no booth necessary. The two are passionate about what they are doing, and with good cause. The company has built substantially more than a simple iPhone app. In fact, they have the most promising platform for assisting and enhancing the consumer-oriented healthcare movement that I’ve seen. Their solution is rich and deep, and I think next year they will be forced to get a booth.

Cathleen Asch and John Zaleski, CEO and CTO, respectively, of Nuvon. I read their press release and didn’t have a great sense of what they do. After meeting with them and learning more about their solution and their vision, I left excited for them.

The whole crew at Access. They are passionate about their Logical Ink solution which offers clinicians a familiar interface to speed adoption of newer technology, including EMRs. In an environment where so many are pushing the technological envelope, they are excited to better use tools that are already available.

Scott Garmon, Senior Product Manager, Mobility Systems, Honeywell. I met with Honeywell, keen to see the Dolphin 9700 (a cool device, btw). I spent the majority of my time getting an education on Windows Mobile 6.5 and the future of Windows Mobile versus Windows Phone Series 7 operating systems. I’m going to harass Scott some more in the weeks ahead to see if he can either do an interview or submit an article on some of the things we discussed.

These are just a few of the many great people that I met during HIMSS, and they’ve all got stories to tell. Rather than trying to jam everything into meaningless sound bites, I’m going to work over the coming weeks and months to cover each of these stories with the attention they deserve.

If you’re just looking for the news…

Verizon launches IT platform to help accelerate adoption of electronic health records.

IQMax partners with Transolutions, Inc. to deliver mobile dictation platform to leading acute care facility.

InfoLogix announces worldwide launch of ST7 Mobile Workstation and Healthcare Mobility Solutions Suite.

Emdeon introduces mobile application for healthcare claim reporting software, Emdeon Vision.

Concerro introduces iPhone app for RES-Q scheduling.

UPMC brings key patient records to the bedside using BlackBerry smartphones.

Another crazy day. As I walked the quarter mile from my hotel to the HIMSS bus line, cold rain turned to snow!  Hats off to HIMSS logistics. Despite the poor traffic and the weather conditions, they managed to get everyone to the show fairly efficiently. (Can’t quite make out the snow in the photo)

In the news…

Nuance previews a suite of Dragon Medical Mobile technologies and solutions, including:

• Dragon Medical Mobile Dictation – an app that allows clinicians to dictate patient notes, emails and text messages instead of typing them on a mobile device. The server-based app performs all of the speech recognition “in the cloud” using advanced real-time streaming capabilities.
• Dragon Medical Mobile Search – the Search app will allow clinicians to simply speak a request to conduct fast and easy searches on various medical websites, including MedScape, MedLine, Epocrates and Google.
• Dragon Medical Mobile Recorder – a voice-capture app that will allow clinicians to conduct on-the-go dictation on a smartphone. The voice file is then forwarded through Nuance’s background speech recognition technology and onto transcription where a draft document is created and then sent back to the clinician for review and sign-off.
• Dragon Medical Mobile SDK – the software developer kit will be offered to third-party healthcare information technology companies and partners to allow them to incorporate Nuance’s Dragon Medical Mobile capabilities.

Eclipsys adds next generation of mobility applications to Sunrise Enterprise portfolio. I had the chance to meet with Kevin Whelan whose heading up the mobile development effort, and I have to say I really like Eclipsys’ approach. The Company’s mobile offering is still relatively early in development, but leveraging the Helios platform, they’ve been able to cover a lot of ground in a short period. Unlike previous attempts by large HIS vendors, Kevin’s team looks to be investing considerable effort into user-experience and leveraging the full native capabilities of the end device. I saw a demo of their app, including the embedded Nuance dictation functionality. It’s pretty darn slick. Furthermore, and I’m really interested to see how this plays-out, Eclipsys is committed to making Helios an open-platform to simplify integration and third party development.

Merge Healthcare launches eFilm Mobile. The iPhone application provides users of eFilm Workstation v3.3 secure access to worklists and studies. I had a chance to meet with Merge and get a demo of the solution. There is no question that this is going to be a very successful application for radiologists who use the eFilm Workstation. The Company has put a lot of thought and effort into the design. More than showing radiological images, the application acts as a remote control to facilitate the movement of dicom file transfers across multiple eFilm Workstations.

Connexall announces partnership with Voalte.  The partnership will extend both companies’ capacity to integrate multiple communication devices and clinical equipment within hospitals. This announcement follows closely on the heels of Philips’ announcement that Voalte has integrated its technology with the Emergin interface adapter. At the risk of overly promoting a sponsor, I have to say Voalte brings a breathe of fresh air with their pink scrubs and boundless enthusiasm. Based on the activity at their booth, I’m not the only one to notice.

Gold Standard/Elsevier launches Clinical Pharmacology Mobile. The mobile device-optimized web site offers users access to the features and functions of the drug information and medication management reference Clinical Pharmacology.

3M partners with PCTS to offer the Amelior 360 degree Hand Hygeine. Apparently I’m not the only one who thinks the PCTS solution looks promising. I’ll be checking out the solution at 3M’s booth tomorrow.

I don’t know if 2010 will prove to be a break-out year for unified communications (UC), but as I alluded to yesterday, there are a number of organizations, including previously mentioned Voalte, who are focused on converging multiple communication modes and multiple devices into a seamless solution. Some of the distinctions between the offerings are fairly nuanced (at least from my perspective) and often depend on existing infrastructure and legacy investments. In no specific order, companies showcasing UC solutions include: Aruba Networks and Motion Computing, Motorola, Polycom, Avaya, and Philips.

Ingenious Med announces support for Blackberry smartphones. The new IM Practice Manager for BlackBerry devices will further enable Ingenious Med’s 6,000 users to access the charge and data capture application virtually anywhere. The mobile solution also facilitates interoperability with Thomson Reuter’s Clinical Xpert Navigator which operates on a number of mobile platforms, including Blackberry. Both companies’ web-based applications have already been tightly integrated.

Nuvon extends its VEGA platform to bring true mobility to point of care. The San Francisco-based company announces the introduction of the IDM-MG 1000, an appliance that enables both patients and devices to be truly mobile while transmitting valuable biomedical device data in a fully secure environment wherever the patient or the clinician may be located. Nuvon is also on my schedule for Wednesday, so I should have more information on the solution.

Wolters Kluwer expands CDS offerings with launch of Medi-Span Clinical. The solution delivers a full slate of medication-related clinical decision support (CDS) features, including drug interactions, route contraindications and drug allergy alerts. It also provides links to supporting medical evidence, the ability to turn off individual interactions or allergic reactions and flexible screening capabilities. Medi-Span Clinical is comprised of a suite of Application Programming Interfaces (API) that support seamless 3rd party integration.  

PatientKeeper announces new solution for Computerized Physician Order Entry (CPOE).  PatientKeeper CPOE enables hospitals to deploy computerized order entry for their physicians without requiring them to install a new HIT system. Major features of the solution include: Personalized Order Sets, Order Routing, Mobile Platform Support, and Support for Hybrid Paper and Electronic Processes.

PatientKeeper also announces that Basset Healthcare Network has selected full suite of PatientKeeper applications. Bassett Healthcare Network, which delivers healthcare across eight counties, covering 5,000 square miles in upstate New York, selected PatientKeeper’s enterprise suite of applications to tie together its existing health information systems and provide physicians with a single software environment to automate daily workflow.

On the subject of PatientKeeper, I wanted to thank them for becoming the latest HIStalk Mobile Platinum Sponsor. I interviewed Paul Brient a couple of weeks ago, when he shared his thoughts on CPOE and, more specifically, PatientKeeper’s focus on providing a broad set of applications to support provider organizations in meeting Meaningful Use criteria. PatientKeeper provides a great alternative to organizations that are looking to meet the physician adoption and use related criteria without replacing legacy investments. If you’re at HIMSS, make sure to check them out today at booth #4808. Again, thank you Paul and everyone at PatientKeeper for the great support.

Though not quite news, I had the chance to swing by Epic’s booth to check out their Haiku iPhone app. I met Carl Dvorak at the HIStalk Afterparty and mentioned that I’d been wanting to see it. Sure enough, next morning one of Epic’s developers called me up to give me a demo. As with any core HIS or EMR vendor, you expect a much richer set of functionality on their mobile solution given their direct, bi-directional access to the underlying data. That said, Epic has done a very nice job of separating the mobile experience and use-case from the back-end system. It’s not overburdened with illogical features – a mistake often made by core system vendors. The challenge will be to maintain that discipline as the application evolves. As with Eclipsys, Epic has made tasteful look and feel decisions, and has done an excellent job incorporating some of the cool tools and tricks native to iPhone, such as a carousel coverflow sorter on the patient list when the device is held horizontally. At this juncture, the application does not store data on the device. As Haiku evolves, I wouldn’t be surprised to see that change. Haiku requires the latest version of Epic, so look for the user-base to grow substantially over the next few months.

Finally, just wanted to put in a quick word about VeriWave. I mentioned their Mobile Healthcare Test Suite a few days back. I had a chance to meet with Eran Karoly and Glen Chagnot from the company, and as I confessed to them, I was a bit apprehensive… WiFi network testing and performance optimization, while no doubt critical, is a fairly in-the-weeds technical problem. Without going into too many details, because they have a pretty big product release coming up in the April time-frame, they have the ability to monitor and visually display using heat maps WiFi coverage and data throughput. I think it’s an incredible way to demystify a lot of the uncertainty of WiFi management, and I suspect a lot of CIOs and IT staff will be interested come April.

I don’t have enough time to cover all the news today, so I will try to pick-up anything I missed tomorrow along with any feedback I have following meetings with a number of vendors.

What a day! I was fortunate enough to get on to the floor before it officially opened at 1230pm. What an impressive and odd site. Like a massive – and I mean massive – ballroom before the guests arrive. Companies and union crews scurrying to make last minute preparations. Mostly taping down carpet and steaming wrinkles out of floating overhead signage.

As I made my way around the floor, companies of all sizes were having their final team meetings in preparation for the thousands of soon-to-arrive attendees. It was an odd combination of cheer-leading, marketing message “tune-ups”, and presentation dry-runs. It reminded me a bit of Blade Runner – replicants passionately running through their scripts for imaginary audiences. Allscripts, with its massive booth, has an equally massive army of company representatives – all wearing orange. On the other end of the spectrum, companies with only a handful of representatives were also huddling, organizing and psyching themselves up for what they hoped would be a throng of new leads from the wave of attendees soon crashing the floor.

It’s an amazing spectacle that no picture can possibly capture. The sheer scale of marketing bling under one enormous roof is outlandish. And that’s the thing – it’s not under one roof. After circling the main hall about a dozen times, I realized I couldn’t locate a number of companies, including a number of large ones that would have a more noticeable presence. Finally, I resorted to looking at booth numbers rather than just meandering until I found what I was looking for. Odd, I thought, why does the numbering start at 4000? Ok, so maybe I’m not the sharpest tool.

When I finally made my way over to the C hall, I could not believe it was just as a big as the first, or so it seems to me. It’s just crazy. There is no other way to describe it.

I met with a number of companies and saw some pretty cool stuff. Just about everyone I met gave me their press kit that includes their press releases. Furthermore, as I was making my way around the show, press release after press release hit my email in a relentless barrage. I eventually stopped checking. It was simply too much to follow.

The news item I found most interesting and newsworthy – filtered with my own particular biases and the fact that I have about 100 press releases that I still need to go through – Epocrate’s announcement that they will be offering an EMR in the Fall to solo and small offices.

Unlike the thousand other “me too” companies in the space, I think Epocrates has a number of key things going for it that makes its bid serious. First, the company was probably the first to prove that you can build a relatively technology-heavy solution and still gain widespread adoption among clinicians. It is probably the only company in the enterprise space that has a real consumer savvy. After all, just about all other competitors in the EMR market start or end-up in the larger practice segment because it is just plain too hard to reach the massive and highly-fragmented small office market. Epocrates already works with a huge percentage of them, has proven adapt at “reaching” them, and perhaps most important of all, has earned their trust and loyalty. If you then consider their technology, and the fact that they tend to be pretty smart deploying it… They are going to offer a true thin-client, hosted solution that will run on the iPhone, iPad, and any other platform. They’ve got a highly-coveted, special relationship with Apple. I’ve been told they will offer an integrated PM from day one. All in all, I’m very impressed. I think this time next year, everyone will be talking about how rapidly they’ve been able to gain market share. And this year? They’ve got a postage stamp booth with a handful of company representatives. I like it. I like their style.

I had the chance to get a demo of the Wallace Wireless WIC Pager at the AT&T booth. It’s just as slick as I imagined – simple, yet powerful. There are some really impressive companies pushing unified communications this year, including Avaya, Philips, Voalte, Vocera and a number of others. Without going into all of the details, there’s a great mix of solutions from the simple to the complex.

Over the coming days and weeks, I’ll do my best to parse through all of the information and follow-up with a number of the companies and products.  Tomorrow, I’ll try to give a concise overview of the mobile news.

By the end of the show, my legs and hips aching and suffering a splitting headache, I can honestly say that I was dreading going to the HIStalk After Party – not because I didn’t think it would be fun. I was just too battle weary. All I can say is, thank God for the kind lady (I was too delirious to get a name) who gave me some Motrin. It’s amazing what a few orange pills, water and some fresh air can do for you. As I stumbled over to Max Lager’s I had built enough strength to commit myself to “maybe an hour”.

After last-call four hours later, I disbanded with the dozen or so other lingering party goers. Two great surprises kept me energized and engaged well past any logical comprehension – after all, I still had to get back and write my post. The first surprise – and I know it shouldn’t be one – the After Party was just plain amazing. Where else can you share drinks and conversation with Ivo Nelso, Jonathan Bush, Judy Faulkner and on and on? And everyone seemed to share just the right amount of cynicism and irreverence to make me think – maybe not everyone takes themselves too seriously. The second surprise? Jonathan Bush, who I’ve only briefly met once before in the past – someone who I just assumed (how do I say this appropriately?)… that I wouldn’t find terribly interesting – he was hysterical announcing the HISSIE Awards. He’s obviously a very sharp guy. No doubt someone who likes to talk, but very good at it, very quick on his feet… funny, self-deprecating.  Very impressive. 

Judy, who we all sort of assumed wouldn’t show up, did.  She arrived a little after the Awards ceremony. I didn’t have a chance to talk with her, which is a bit of shame given that she was among the very last to leave. That fact alone goes a long way towards shattering my image of Epic being aloof and inaccessible.

If you didn’t make it this year, all I can say is definitely sign-up next year and you better move fast when Mr. H sounds out the invitation.

Looking forward to tomorrow.