College of American Pathologists
Printable Version







December 2007

Raymond D. Aller, MD
Hal Weiner

bullet Electronic health records service making its mark

Why give up a thriving orthopedic practice? To focus on a thriving electronic health records service, says Eric Fishman, MD.

And so it was that the former orthopedic surgeon shelved his scalpel last spring, invited some employees of his office-based medical practice to join his latest career venture, and permanently hung his shingle on, the online EHR service he founded in 2004.

The free service, which uses a proprietary computing method to help physicians choose the best EHR software for their practices, has taken off since CAP TODAY first reported on it in September 2006 ("No need to shop 'til you drop, thanks to Web-based EMR service," ). The company's turnaround time for providing EHR recommendations has been cut from two to four days to one to two days, the list of EHR vendors that can be recommended has increased to about 340 from 300, the number of users accessing the service has grown by about 20 percent annually, and the company now has 12 full-time employees.

What separates from the growing number of companies offering similar services is the amount of information collected from and distributed to physicians to aid in decisionmaking, says Dr. Fishman, who serves as president and CEO of the Palm Beach Gardens, Fla.-based firm. On the information collection end, physicians can fill out a questionnaire that takes about 60 minutes to complete or a shorter version that takes about 30 minutes, he says. For small physician practices that have one or two doctors and budgets of less than $5,000, Dr. Fishman offers a free self-serve feature that allows physicians to answer seven questions and then receive an instant recommendation.

On the information distribution end, Dr. Fishman began offering an online journal, called EHR Scope, in April. The journal includes synopses of 240 systems along with articles contributed by a variety of professionals, including physicians, EHR vendors, and investment bankers. "What's interesting about EHR Scope is that physicians can search it as they [would] search a database looking for their specialty or particular operating system," says Dr. Fishman. Those interested can download the quarterly publication from the company's Web site,, or receive it via e-mail.

The first edition of the online journal addressed the company's name change from to "I wrote an extensive article in the first edition of EHR Scope that basically indicated that there is a general consensus that EHR is rapidly becoming the more common acronym for the industry," says Dr. Fishman. "I do continue to use the names somewhat interchangeably," he adds.

Along with EHR Scope, Dr. Fishman introduced a series of short Web-based videos that demonstrate how EHR systems can be integrated with Nuance's Dragon NaturallySpeaking Medical speech-recognition software, which markets and distributes. Dr. Fishman plans to expand the video series to include dozens more systems. "It's one of the things I'm pretty proud of," he says. "We've gotten good reviews on that."

Dr. Fishman has also been enhancing the company's color-coded matching system, called Matrix, which narrows the number of EHR matches physicians receive to about five or so. The company has moved to a second version of Matrix, which has substantially improved its ability to provide a higher percentage of "spot-on" recommendations, he says. "The EHR vendors tell me that the appropriateness of the match is improving," Dr. Fishman adds. is expected to release a third version of Matrix next month. This version is designed to improve the process of completing the questionnaire on which the recommendation is based. Those interested in voice-recognition software, for example, will automatically be presented with a more extensive set of questions about this feature. Those not interested in such software will skip through the questions related to voice recognition and be directed to more relevant questions.

In the meantime, due to a backlog in the U.S. Patent and Trademark Office, continues its nearly two-year-long wait for patent approval for the algorithms and methodology used in the Matrix system, Dr. Fishman says.

Yet the holdup has no effect on the company's day-to-day operations. Dr. Fishman continues to run as a commission-based business. He has agreements with some vendors to receive a fee if physicians purchase those vendors' systems based on recommendations from his company. However, he says, referrals are not linked to whether or not a vendor has entered into a fee agreement. More recently, Dr. Fishman has assigned a staff member to contact the thousands of physicians who have accessed the EHR service through the years to see if they used it to make a purchase. Until a few months ago, tracking of sales had been inconsistent, which Dr. Fishman deemed "a flaw in the business model."

Recognizing that there is always room for improvement, Dr. Fishman continues to seek ways to further refine methods and improve matches. And shuttering his office-based practice has allowed him more time to do just that. It was "the best decision I've made in a long time," he concludes.

bullet Global Med Technologies providing validation services for blood banking

Global Med Technologies recently announced that its PeopleMed subsidiary will offer complete validation and consulting services to the donor center and hospital laboratory markets to help facilities with the transition during software implementation.

Global Med realigned the business operations of its PeopleMed subsidiary to meet the need for validation services presented by clients of Global Med's Wyndgate Technologies division and others.

"The establishment of this new service within the PeopleMed subsidiary allows customers to obtain assistance from the experts who know the company's products best while maintaining independent objectivity as a separate business unit distinct from Wyndgate Technologies' operations," says Tom Marcinek, president and COO of Global Med Technologies.

Wyndgate markets SafeTrace, SafeTrace Tx, and El Dorado Donor Doc software for blood donor centers and hospital transfusion services.

bullet Orchard Software releases Copia upgrade

Orchard Software recently announced that it has upgraded its Orchard Copia version 4.0 front-end outreach system.

Copia provides Web-based access or electronic medical record integration with user labs' customers for remote order entry and results delivery. It is designed to work with Orchard's Harvest laboratory information system or other legacy lab systems.

The upgraded version of Copia offers such features as:

  • order screen that is customizable by location or user
  • customizable order-entry rules
  • customizable result-evaluation rules
  • schedules that allow results to be delivered according to user-specified criteria.

Copia is geared toward more complex outreach business scenarios, such as those found in hospitals and reference laboratories with multiple labs and collection stations and serving multiple business entities.

bullet Nuance Communications to acquire Vocada

Nuance Communications has entered an agreement to acquire Vocada, a provider of critical test result management solutions.

Vocada's Veriphy solution, delivered through a software-as-a-service, or SAAS, model, is designed to help pathology departments better communicate critical test results.

The acquisition allows Nuance to broaden the capabilities of its Dictaphone Healthcare solutions and accelerate its revenue growth through SAAS offerings.

"By combining forces with Dictaphone, we can tap into new capabilities and resources through the Nuance team to expand our market penetration and continue technology advancements to improve clinical communications and minimize risks," says Vocada CEO Peter White.

bullet CCHIT announces first EHRs certified for hospitals

The Certification Commission for Healthcare Information Technology recently announced that it has certified six electronic health records designed for use in acute care hospitals.

The products are marketed by Eclipsys, Epic Systems, Healthcare Management Systems, Prognosis Health Information Systems, and Siemens Medical Solutions.

All of the products underwent CCHIT inspections that demonstrated their compliance with 100 percent of the commission's published criteria for ensuring that they can offer clinical management support and exchange information seamlessly and securely.

The newly certified vendors represent 25 percent of the companies selling inpatient EHRs.

bullet Practice Fusion and ZyDoc forge relationship

Practice Fusion has announced that it will integrate ZyDoc's medical transcription service into its practice management and electronic health records software.

Users of Practice Fusion systems will be able to dictate via telephone or a handheld digital recorder that downloads audio files to ZyDoc transcriptionists. The information will then be automatically inserted into the patient's electronic health record.

bullet NLM Web site now links to VisualDxHealth

The National Library of Medicine has announced that its Web site,, will now link to the site, developed by Logical Images. features more than 2,000 medical quality images and information on over 150 diseases. The site tailors pictures and disease information to its consumer users' needs. Content and images for a specific condition are customized based on factors such as age group, gender, and skin color of the Web site visitor. provides information from the NLM, National Institutes of Health, and numerous other sources in the form of a health encyclopedia, dictionaries, tutorials, news stories, and links to other health care resources on the Web.

bullet Contracts

Four hospitals in the Dallas-based Tenet Healthcare system recently licensed Mediware Information Systems' HCLL transfusion management software system, bringing to nine the number of Tenet hospitals that have entered into agreements with Mediware. The latest four to license HCLL are Frye Regional Medical Center, Hickory, NC; Spalding Regional Medical Center, Griffin, Ga.; and Cypress Fairbanks Medical Center and Houston Northwest Medical Center, both in Houston.

The U.S. Department of Veterans Affairs has signed a contract, effective for nine years, to use Cerner's Millennium PathNet laboratory information system in more than 150 hospitals and 800 clinics in the Veterans Health Administration system.

The Michael E. DeBakey Veterans Administration Medical Center, Houston, has contracted for TheraDoc's real-time electronic surveillance and expert clinical decision support systems. The medical center will implement TheraDoc's Expert System Platform and Infection Control Assistant and Antibiotic Assistant modules.

Dr. Aller is director of automated disease surveillance and team lead for disaster preparedness Focus B, Los Angeles County Department of Public Health. He can be reached at Hal Weiner is president of Weiner Consulting Services, LLC, Florence, Ore. He can be reached at