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July 4, 2007 News 9 Comments

From The PACS Designer: “Re: iPhone. TPD wants HIStalk readers to be among the first to see the developers’ site on how the iPhone works and how it can be a good tool for accessing healthcare information and image files. Link.”

Also from The PACS Designer: “Re: AdoptWeb 2.0. TPD was reading the eHealth weblog and came across a posting on AdoptWeb 2.0 and thought it would be good reading for HIStalkers this Holiday Week. TPD wishes all Americans a Happy and Safe 4th!” The link didn’t work for me, but it may be down temporarily. And, I’ll add my holiday greetings as well, flag flying and John Philip Sousa-ing on my end.

From Ingo Montoya: “Re: Vanderbilt. I was watching ESPN2 when who should appear on my TV screen but Jim Jirjis, CMIO of Vanderbilt University Medical Center, in a propaganda commercial for the cable TV industry. Dr. J talked about how (paraphrasing) ‘we tried to bring doctors and patients together online for years, but there was one thing stopping us [makes mouth noises imitating the sound of a dial-up modem connecting].’  He goes on to explain that broadband Internet connectivity provided by cable TV companies was the missing link in Vanderbilt’s ability to do e-health (one direct quote that I caught: ‘Competition from cable revolutionized medicine.’)  I’m glad that e-literacy issues, the digital divide, privacy, security, determining responsible provider for each patient, handling provider cross-coverage, and oh yeah, interoperability across multiple platforms were non-issues for Vanderbilt. Apparently the biggest challenge they faced was having to look at the top of some cable guy’s butt crack while he installed their cable modem. On the other hand, it IS nice that health IT now has a high enough profile to make us attractive whores for feel-good testimonials for the likes of the National Cable & Telecommunications Association, who (in small print) paid for the ad. NCTA, me love you long time – call me!” Vandy’s done some good informatics work (the stuff they turfed off on McKesson being a notable exception) but they’re not shy about horn-tooting. I’ve known a few folks from there and they speak of “Vandy” in reverential, Ivy League-wannabe tones, causing an anticipatory autonomic reflex (gagging) just from the sight of them gearing up for pontification. Actually, that’s probably overly harsh, as I’ve met a couple of them in leadership roles who were pretty cool. I usually root for them in football in any case.

From Jolly NC: “Re: Misys. Former Misys Healthcare Physician president Rob Kill is now president and COO of Virtual Radiologic, a MN-based company that provides virtual radiology interpretations.”

From Russel Ziskey: “Re: Healthvision. It seems that Healthvision is laying off some of its people. Do you know why? Good or bad for the company?” Covered here last week, but I’ll repeat. Healthvision hitched its wagon to RHIOs, which are nearly universally fizzling out (HIMSS hoopla to the contrary.) It’s bad that Healthvision had to lay people off, but carrying too many FTEs when revenue isn’t up to snuff is worse. When I interviewed CEO Scott Decker in February (after correctly predicting VeriSign’s investment in the company per a reader’s report) he was perhaps overly optimistic about RHIOs, but sold on the connectivity concept: “I wouldn’t say Healthvision is wed to RHIOs, but to disparate groups sharing information. RHIOs brought it back up to the attention of boards and providers. We see all kinds of hybrids – health systems, IPAs, payors. There are a lot of RHIO-like models that aren’t the Washington, DC model, and that’s good for us and good for healthcare. Our pipeline of opportunity is ten times what it was 24 months ago.” The $64,000 question: can Healthvision get that other business now that its most highly targeted prospects aren’t buying and with far larger players elbowing them aside? Scott’s a good guy, but I wouldn’t want his job.

I like to check out the sites of sponsors and wandered over to that of R. Gaines Baty Associates. An idea for candidates: “Create an RGBA Career Connection for consideration for opportunities (immediate and future) that fit your desires and criteria. Be advised of outstanding career opportunities without actively ‘looking.'” They’re also offering a free electronic newsletter. Just thought I’d give them a shout-out.

Several folks are e-mailing me that Picis has withdrawn its IPO request (right before the trading holiday.) Since I posted that very item on the Discussion Forum at 8:00 Tuesday morning, I’m concerned that I haven’t mentioned the “Latest Topics from HIStalk Discussion” headlines to your right enough times (only if you go to www.histalk.com or www.histalk2.com and not the Blog City page since I haven’t made it work there so far.) Inga and I will sometimes post new stuff there early in the day, so it’s worth checking those headlines occasionally (or setting up to read in your RSS reader.) And if you post in the Forum, your headline will show up there too.

Related to Picis (but written before the IPO news came out) is my editorial in this week’s Inside Healthcare Computing electronic update: “Private vs. Public Vendors: I’ll Take the Former,” in which I argue that the now-trendy private equity investment is replacing IPOs as the primary way for companies to grow. I have to admit that I felt traitorous when I wrote it because Picis is my sponsor and my argument is that current customers historically have fared worse after a vendor goes public (my vendors, anyway) but now I can feel OK about it. I still have confidence in Picis and I bet there’s a positive reason they changed their IPO mind.

And speaking of sponsors, at least four new ones are coming online very shortly. I’ve hooked up with a graphics person who’s pretty darned good at creating Flash ads, so I’m now offering that at no extra charge for Platinum sponsors who need some graphics help.

Nice gesture: someone pretty high up in Cerner invited me to their big barbeque contest that will be held on July 20. I probably won’t go (the anonymous thing is always a problem) but I appreciate the thought, barbeque being my favorite food and my past experience with Cerner bash-throwing being entirely positive. Thank you.

HIStalk nearly always scoops the other so-called news sources because loyal readers keep me informed, to the point that I don’t even go back and check any more to see when I first reported something. However, I was Googling for something on Dairyland and ran across these entries, giving you several months’ advance notice despite company denials. Bet they were mad.

  • December 1, 2006: “From Anonymous: Dairyland is being shopped around to potential buyers, so I hear.”
  • February 5, 2007: “From Venny: Re: Dairyland. I have heard from more than one source that the Dairyland principals are looking for potential suitors. I haven’t heard any reasons, though.”
  • February 12, 2007: “From HITman: “Re: Dairyland. I met with some Dairyland folks today and they denied any talks or that the company is even on the market. DHS is an ESOP company and some folks stand to make a lot of money if the rumors are true, but it is all denied as of now.”
  • February 14, 2007: “A reader who should know confirms that Dairyland is (or at least was) shopping itself for sale, their previous denials to the contrary.”
  • June 29, 2007: Dairyland announces that it has been acquired by Francisco Partners.

Tragedy in Belgium: at least 17 patients received incorrect radiation doses because of malfunctioning software in Brainlab‘s Novalis oncology radiation aiming system. Nine have died, but not necessarily because of the problem. Also confirmed: Cleveland Clinic and Valley Medical Center (WA) use the same model (stopped since, I’m sure.)

Former Fairview CIO-turned-COO Gary Strong joins competitor Allina as chief administrative officer. Met him once, nice guy, a rare case of a CIO’s excelling in a bigger chair.

I struggled with this press release‘s headline: “Thru Executive Thought Leader to Serve on DFW HIMSS Board.” Was it missing some punctuation or maybe some words? And exactly what is a Thru Executive – a spelling-challenged C-leveler who’s been fired? Nope – the company’s name is the ever-so-precious Thru. Which I did – up. I really hate gibberish company names, especially those created around a misspelled word (although I save much of my wrath for those indecisive merged entities that give up and simply jam their previous separate names together to create an ugly conjoined twin, i.e. McKessonHBOC or PricewaterhouseCoopers). Another reason to hate lawyers – fear of lawsuits drove us to making up names.

Police are investigating the deaths of two University of Chicago Medical Center patients after excessive insulin levels were found post-mortem. If I had to bet, I’d put my money on an incorrectly compounded IV. Happens quite a bit, especially with insulin. The value of all traditional clinical information systems in preventing that error: zero.

Coming shortly: a weekly HIStalk e-mail update for executives, with the top five healthcare IT stories of the week with background and opinion. Inga and I did a trial issue and we think it’s cool – about a five-minute, portable read that can make even non-IT experts fluent in industry developments. We’ll have the sign-up form online soon. Here’s a sample entry I wrote yesterday (one of five) as I developed the format. Your suggestions welcome. We figure it will be free since we like giving stuff away (it makes us feel important).


Headline
Mediware CEO Resigns

Facts
James Burgess, president and CEO of Mediware Information Systems of Lenexa, KS announced he will step down by September 24. The company sells systems for blood bank, operating room, and medication management. Also announced: VP John Damgaard of the blood bank division, is promoted to a newly created SVP/COO position, effective immediately.

Opinion
The company’s institutional investors are losing patience with this industry laggard. Damgaard’s division was its only bright spot, so he gets his turn in the hot seat. Plus: decent earnings and a PE of just 25. Minus: a market cap of only $58 million, cost and transparency of being publicly traded, and a product line made up of mediocre specialty products when the market shows a vast preference for integrated offerings from Cerner, Epic, and Eclipsys. The stock is down 40% from December 2005 in a healthy healthcare IT market.

Musings
Revolving door executive turnover continues.
Forced customer upgrades have created revenue at the expense of goodwill.
Going private might be an option.
Prospects are bleak.


Florida-based medical products distributor PSS World Medical buys a 5% stake in athenahealth for $22.5 million and gets the rights to distribute the company’s physician practice software. PSS signed a deal with GE in 2003 to resell that company’s EMR software. I don’t know how that deal turned out.

The Irish government is still shoveling millions on the PPARS healthcare payroll and personnel system that was mothballed two years ago. The system, estimated to have cost at least 30 times its original budgeted amount, was provided by SAP and Deloitte and Touche. Great things happen when you mix government, ERP, and consultants.

Huge non-profit consulting company RTI International will host a free July 26 Webinar describing its creation of a perinatal EMR for a Zambian teaching hospital, funded by the Gates Foundation and now available under a free and open source license. Nice.

The Feds put up a new NHIN website covering CCHIT, HITSP, NIST, and ONC. According to the metadata, Booz Allen Hamilton did the design. Wonder what that cost? Just for fun, I ran it through an accessibility checker (that’s why government web consultants get big bucks). It failed.

Banking security guy Troy Moritz joins Allscripts as chief security officer.


Inga’s Update

Greenway Medical announces their EMR product is now integrated with DrFirst’s Rcopia e-prescription technology. Last week, Greenway also made news for being one of the first two products to receive 2007 CCHIT certification (NextGen was the other).

Toothpaste alert: McKesson Corp said it was recalling its China-made EverFresh brand after it was identified as containing trace amounts of the chemical known as diethylene glycol, a compound used in anti-freeze.

More hospitals are allowing cell phone use, according to a recent CHIME survey. 23% of the respondents said the benefits of improved patient care and satisfaction outweighed any negligible effect of interference with medical equipment.

CMS is considering no longer allowing providers to e-prescribe to pharmacies. If the new ruling is passed, providers will require all e-prescriptions to be in the Script standard as part of the 2008 physician fee schedule. So how would this affect providers (and their vendors) who are don’t offer this format? Well, the providers go back to paper scripts. (All together now … isn’t faxing a little outdated anyway? Who – besides those in healthcare – fax much of anything these days?)

A couple of weeks ago there were a few postings after I mentioned the recent AC Group Functionality Ratings that are published twice a group by Mark Anderson. There were a couple comments that suggested Mark and consultants in general tended to favor certain products over others, to which I said that of course consultants have a bias – that is what an end user pays for. Blindsided Vendor also that his company “runs for the hills” when they learn the AC Group is involved.

Well, I was able to catch up with Mark Anderson and asked him if he cared to provide us with a comment – to which he graciously agreed.

“The best way to respond is to ask our clients if they thought we were fair and impartial. We do no marketing and 80% of our business comes from references from our clients. If they were not happy, they would not refer us. As far as favoring vendors, they are right. We favor vendors that prove that their company and products are strong. We will tell our clients the plusses and minuses of each vendor and our Top 10 matches everyone else’s Top 10.

A number of vendors do run away because we challenge them to perform. When they cannot perform, it’s easier to run and to blame the consultant. My Top 10 vendors are listed in my published report that comes out twice per year. The Top 10 has changed slightly in the past seven years, with five new vendors added and five removed. We have found that vendors “do not always tell the truth.” However, if you ask the right questions, you can get to the truth. The problem is, most people do not know the right questions to ask.

If the vendor runs away, it’s because they cannot meet the functionality requirements. My point – let them run. My clients would not be happy with them anyway.”

Talk to me.

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Currently there are "9 comments" on this Article:

  1. BrainLAB would like to clarify that the radiation therapy incident in Belgium was not related to the BrainLAB radiosurgery system Novalis as mentioned in one posting.

    The University Hospital of Ghent, Belgium (UZ Gent),
    was using a hospital specific radiosurgery configuration sold by Elekta to the hospital. This configuration did not contain any BrainLAB software, but some mechanical components from BrainLAB.

    BrainLAB informed its customers in June about an incompatibility between hardware and software in a very specific configuration that is in clinical use in 2 hospitals in the US (Cleveland Clinic and Valley Medical Center (WA)) and in 4 in France. This incompatibility lead to a shift of 1.25mm. This is not related to the incident in Ghent where no BrainLAB software was used.

    For any questions, do not hesitate to contact eva.schuster@brainlab.com

  2. Regarding RHIOs fizzling out, RHIOs are the government’s prime example of the “Ready, Fire, Aim!” syndrome. It just isn’t a good idea to hand out cash, send everyone in 50 different directions and then hope someone comes up with something. Instead, get the standards figured out and then let the vendors do the work of subscribing to them. In the mean time, spend our hard-earned grant monies putting decent HIT into healthcare organizations so that once the “roads” are built to them, they actually have something worth sharing.

  3. Note the GE Healthcare IITS announced a reorganization of the management team. Nothing spectacular there and more like re-arranging the deckchairs on the Titanic. Intriguing though is the breakout of products and services. Smells like the old GE Jack Welch, Fix it, sell it, close it, process is underway.

  4. Re: Small Town CIO’s message above

    I agree that the focus of RHIO efforts shouldn’t be at the national (i.e. NHIN) level, but at the community level. Isn’t working – for the good of the patient – what the healthcare providers in communities should be doing anyway?

    “It just isn’t a good idea to hand out cash, send everyone in 50 different directions and then hope someone comes up with something” It’s not as if the gov’t handed out all that much cash, which is part of the problem. And what 50 different directions? Sit down with the other stakeholders in your community and figure out what’s important to you (collectively). Then prioritize and go do it.

    “let the vendors do the work of subscribing to them.” Isn’t this what the gov’t has actually invested in (CCHIT, HITSP)…in conjunction with the vendor community?

  5. Re: GE Healthcare Reorg

    It is standard practice at GE to move execs around giving them exposure to the various operations under their control. Would be cautious to not read too much into any changes occurring within the executive ranks of their healthcare division.

  6. Dogofwar – My point is that if the standards are being developed as you indicated (and I agree), then why fund a variety of other RHIO initiatives that are using home-grown standards? In actuality, I believe the standards SHOULD be on the national level. Community-based RHIO initatives can be productive, but because they almost certainly rely on self-developed standards, they shouldn’t be undertaken at the expense of putting good HIT technology into facilities that still need it (e.g. rural healthcare). It isn’t good enough to say we need information exchange – we all agree on that. But timing is everything – concentrate on the national standards and in the mean time, lets use our resources to put quality HIT into facilities that still need it.

  7. We’re in agreement on the need for national standards. What I was referring to was the money and attention spent on prototyping the national network…when there are a paucity of EMRs implemented (or community/regional exchanges to feed it). Cart before the horse, even though this was only ~$18M.

    Believe me that there’s plenty of work to do – as a community – to establish the conditions for health information exchange before any IT systems are built…perhaps including (as a community) coming up with a plan/guidelines for EMR/EHR implementation and interoperability for the various providers in the community…. It’s not either implement an EMR or participate in a RHIO (in fact, it could/should be for some providers: implement an EMR BY participating in a RHIO).

    I disagree that there’s been too much money thrown at health information exchange/RHIOs to date. Cooperating – for the good of the patient – across providers in a community is oftentimes an un-natural act…and it won’t happen on its own. And interoperability (i.e. for a patient’s different providers in a community to have more complete information for a patient, God forbid) won’t magically happen if each of the provders in a community takes the position that HIT is only inside their four walls.

  8. Contrary to the notion that RHIOs are fizzling, they are booming all over the country. Per Smalltown CIO’s comment that the government is messing them up, well, what doesn’t the government mess up? RHIOs seem to be doing fine otherwise, with many springing up each month. So perhaps the issue with Healthvision isn’t a lack of marketplace, but rather an inability for them to effectively address it.

  9. “Per Smalltown CIO’s comment that the government is messing them up, well, what doesn’t the government mess up?”

    So how exactly has the government messed up RHIOs?

    By sponsoring a group to harmonize standards (led by Dr. Halamka no less)?
    By sponsoring a group to look at privacy and security laws?sponsoring prototypes?
    By creating loopholes in Stark law for HIT?

    If anything, in my opinion, the gov’t hasn’t done ENOUGH.







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Reader Comments

  • FLPoggio: What this piece totally ignores is that you and the provider (roofer) dealt directly with each other. Now what if you ha...
  • AC: That's not an apt comparison. Imagine instead if while the roofer was doing his thing, another random roofer dropped by ...
  • HIT Girl: I've worked in EHR design & support for the last 14 years or so, and when I was hospitalized in I think 2007 I got m...
  • Joy Goodspeed: So funny about the physician card. I wrote my 3rd HL7 Lab and microbiology interface in my 20-year career this past yea...
  • Anonymous: Did you just compare Healthcare to roofing business ? Imagine a surgeon operating with a body cut open, should they take...

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