From Captain Grammar: “Re: spelling. I find it disturbing that an industry as small as ours can’t agree on how to spell our name. Is it ‘healthcare’ or ‘health care’?” I use the former, but as a staunchly traditionalist grammarian, I really should insist on separate words. Opinions?
Practice Fusion, the “free if you’ll look at Google ads” EMR, announces that it will put Healthline’s medical search toolbar on its application. It’s probably a good match – Healthline is a “free if you’ll look at Google ads” medical search engine. I’m really not getting the business model. Will doctors really click on ads for stuff related to the condition of the patients they’re treating? Would you want to see a doctor that has to Google your condition?
Speaking of which, my idea of giving away a free EMR by jamming drug company ads in the faces of doctors is too late. Amplus HealthNet has what it calls an EHR (not likely) that offers on-screen drug company logos. “Every time a physician clicks on brand content, payment to that pharmaceutical brand occurs. For a brand manager, physician-initiated contact indicates a strong possibility that s/he is preparing to prescribe a product. ROI thus becomes needs-driven, highly- focused and target-specific. Better yet, this occurs at a much lower fraction of cost than traditional journal ads.” Damned annoying Flash and stock music site, I’ll say. I’m guessing its “EHR” solution is a lightweight. And I still refuse to call products EHRs unless the vendor can prove that it’s not just an EMR renamed to seem cooler (none have so far).
And speaking of free EMRs, RemedyMD is making its EZ Office suite free. I interviewed CEO Gary Kennedy in April, getting some good business lessons in running a healthcare IT company in the process.
A RICO lawsuit against McKesson for its alleged involvement in inflating published benchmark drug costs via First DataBank is certified as class action.
The local paper runs a story on Canada’s new Brampton Civic Hospital and its technology, including a picture of William Osler CIO Judy Middleton.
A ValueAct Capital partner ups his stake in Misys PLC to nearly 14%.
Modern Healthcare names its 100 most powerful people in healthcare. Sure, it’s just way to get the attention of readers too distracted to read anything substantial and instead lure them with pictures and cute graphics (I’m thinking about doing an HIStalk “100 Biggest Idiots in Healthcare IT”). Privacy fanatic Deborah Peel is #4, Newt Gingrich is #25, McKesson CEO John Hammergren is #38, Kaiser’s George Halvorson is #60, Suzanne Delbanco is myteriously #69 (parting gift?), CCHIT’s Mark Leavitt is #79, and HIMSS’ Steve Lieber is #100. I’ll move my hopes to next year.
I’ve never heard of oncology practice systems vendor Rabbit Healthcare Systems (TX), but if they’re being honest about increasing last year’s $165K revenue to $750K this year, somebody must have. Rabbit’s revenues are multiplying! (sorry).
August will set another record for HIStalk visits and the millionth one will drop by in October or so. Thank you for reading and thanks to the sponsors who make it possible. If you’re a Brev+IT newsletter reader and like it, drop me a line with a comment or two that I can use for pitching it to those who don’t read (what?) Several folks are surprised that it isn’t just an HIStalk rehash – it’s got more background and opinion that I’ve got space for here. The five biggest stories in the most recent issue involve Epic, Siemens, iSoft, Cisco, and at #1 … well, you should really sign up.
The Johnstown paper writes an article about now-independent hospital Windber Medical Center (still working on that interview with CEO Nick). An early challenge: a $3.5 million computer system replacement for what Conemaugh was providing. One of these days I need to get back up that way, if for no other reason to eat at my old favorite Oakhurst Tea Room just down the road.
CompuGroup has pulled out, so iSoft goes to IBA. For now. I mentioned a fact no one else has observed: private equity firm General Atlantic has a stake in both CompuGroup and iSoft.
Speaking of private equity companies, the 20 highest-paid private equity fund managers in the US average $658 million in compensation (and that was in 2006). I’m guessing some exceeded $1 billion a year in compensation, making outrageous CEO salaries seem paltry by comparison. I suppose they’re worth it if they provide big returns to investors, but that means investors lost that huge skim. They’re like Milliken’s junk bond kings – livin’ large now, but subject to investor fear of unregulated markets.
An Indian outsourcing firm buys medical billing company MedAssist Holding (KY) for $330 million. They like that BPO business overseas.
Bart Ponze, director of computer services for LSU Health Sciences Center, has died of cancer. Condolences.
If you’re an Epic Systems customer, here’s what those high prices provide: a $100 million learning center seating 5,300. Some say it looks like a horseshoe, but to me, it’s either a question mark or dollar sign (both appropriate). Note the Godcam-view company logo on the roof. Maybe Judy should have made the “most powerful” list. (Thanks to Romeo for the link. Photo from builder J.P. Cullen & Sons, Inc.)
I’m here.
Inga’s Update
I was thrilled to get an e-mail yesterday from Ralph Nader!! I knew that HIStalk had wide readership, but never imagined that folks I have actually seen on TV would be reading. Anyway, his email was not that nice (he called my postings “average”) but he did have an interesting comment about the Misys/iMedica partnership:
“My dear … If you had bothered to research anything about iMedica and its offerings, you would have the answers to yours (and others) questions about “Why iMedica”. The Mysis sales guys (and gals) should be dancing in the streets!”
(See what I mean about it not being that nice, especially since I did say some good things about iMedica? Now that I think about it, I wonder if this guy really is Ralph Nader. I mean, he had a grammatical error and even spelled Misys wrong. What does “dear” Ralph know – he has lost the presidential election, like five times hasn’t he?)
A consultant who was not claiming some phony name also sent me a note about iMedica/Misys. He indicated that iMedica had been losing money and needed to raise capital, thus, from a cash infusion standpoint, the arrangement is beneficial to iMedica. However, beyond that, he did not see much advantage of the partnership for either vendor since they sell similar products. “I think it makes them both look desperate, especially Misys. You have to give credit to Nissenbaum (iMedica’s CEO) for making one of his competitors resell his software for agreeing to refer his clients to only a segment of what Misys offer, such as their EDI services. How would you react to a Misys sales rep that has been touting their wares, now coming at you with one of their competitor’s applications? What about all the small practices who just purchased Misys? Why would they go through a reseller when they can go direct to iMedica? I also suspect that the Misys field reps will be disenchanted with having something else to promote. I suspect they will devote a sales force that will only focus on the small practices, similar to how GE uses their VARs.”
Yet another e-mail this week came from Obiwan Kenobe (by the way, keep all that sweet e-mail coming … I get so excited to hear from you all!) Obiwan thought I was “absolutely correct” in my comments about what really matters when it comes to enjoying your job. “You took the words right out of my mouth. Having been a sales person in this business a long time, you are absolutely correct in your statement. I have worked at a number of well-known and not so well-known companies. I am having an incredible time and success and much, if not all of it, directly relates to the things you mentioned that really matters.” Obiwan also mentioned he worked for HIStalk sponsor SCI (and I really don’t think he was trying to give them an extra plug, or even suck up to his bosses – I think he just really likes his job.) “I have never worked for such a fine company as SCI. I have a simple philosophy – it starts at the top! I believe many organizations and the people who work there reflect the attitude of their CEO and senior level management. It all starts with John Holton, our CEO, and filters down.”
I played “Heart Full of Black” (by Burning Brides) on Guitar Hero for the first time today (Xbox360, for those of you not into such toys.) Gosh I was good. I am thinking if this gig with Mr. H doesn’t work out, I may look into some of those Guitar Hero contests and start a new career.
Microsoft’s Azyxxi announces a new contract with Novant Health, a North Carolina-based healthcare system that includes eight hospitals, two nursing homes, and an 800-physician medical group.
Inga’s waiting.
From The PACS Designer: “Re: middleware. TPD has commented on service-oriented architecture in the past and wanted to expand on it since it’s the ‘middleware’ software concept that employs SOA. Middleware is a term for software applications that allow various software programs to communicate with each other. Many HIStalk interviewees have discussed middleware. Since it is a fairly new concept, not much has been published about it, even though it’s growing rapidly according to Oracle, which recently stated that it is now a billion-dollar business for them. With the diverse environment within healthcare practices, it sounds like SOA middleware is the concept to bring healthcare new efficiencies for daily activities that wasn’t available in the past. Oracle Magazine had an article about middleware in their July-August 2007 edition titled ‘Hands-free Management’.”
From XSQ: “Re: Windber. A few weeks ago, Mr. HIStalk posted a blurb about the Windber Medical Center breaking away from the Conemaugh Health System (CHS). Intresting note on CHS that it’s Sidney Goldblatt’s (of Sunquest) home turf and he’s on the board. I agree Nick Jacobs from WMC would be a great interview.” You’ll be pleased to know that CEO Nick Jacobs has agreed to do an HIStalk interview, which I sought at your suggestion. We just have to work around our full-time jobs to find a time.
From Stan Saber: “Re: GE. Are you hearing anything from the GE user group meeting in Boston? Any promises of what’s coming from IHC?” I haven’t heard anything, so I’d appreciate an update from someone who went.
From Neeve deMick: “Re: wireless. Wireless comes up in every market survey as a key obstacle to EMR adoption. Hospitals spend millions on EMR/IT, then get limited or no return because of poor networks. Many EMR benefits are tied to point-of-care and network performance and reliability. COWs sit in the hallways and trench nurses deal with poor solutions while their ‘most wired’ CIOs do national IT speeches. No wonder there is a huge disconnect between dollars spent and user adoption and satisfaction.”
From Jeese: “Re: iMedica. You have mentioned several times that iMedica was started by former Millbrook execs. This is not the case. The former Millbrook execs came to iMedica after Millbrook was sold to GE around 2002-2003. The company was already up and running with a product. Most of the current senior management at iMedica is made up of former Millbrook execs.”
From Bumblebeast: “Re: QuadraMed. The Keith Hagen interview makes interesting reading in light of two happenings since then: (a) Quantim has lost its VP of product management and three product managers, and (b) with the Misys CPR acquisition, you have to believe that Affinity will be relegated to the dust bin, especially since Affinity and Quantim couldn’t be integrated as easily as Quantim and other clinical systems.”
From Portia Control: “Re: IBA. I hear that a juicy scandal will be coming out related to IBA and a deal in Thailand.”
Sorry if you got multiple copies of the e-mail update message about Misys today. The good news is that I had found (and hopefully fixed) a hopelessly obscure server problem that may have explained why some folks haven’t been getting the updates. If you’re a Unix geek, it involves changing the batch submission to a cron job to avoid auto-killing and restarting the Apache HTTP services that run the bulk mail script after memory consumption redlines.
Motorola is suing wireless network vendor Aruba Networks for patent infringement.
I mentioned in Brev+IT what sounds like to me a big waste of taxpayer dollars paid to SAIC for building and maintaining the DoD’s AHLTA system. Someone who should know e-mailed me that the original bid spec specifically said that the public domain VistA could not be used because the DoD was jealous. DoD reneged later, allowing SAIC to use the free VistA for its $1 billion bid, tweaking it enough to ensure highly lucrative annual maintenance. If you’ve got first-hand info, let me know. I hate $900 hammer guys.
Wake Forest Baptist University Hospital (NC) will roll out (no pun intended) a ton of products from EnovateIT: infection control keyboards and mice, barcode scanners, wall mounted articulating arms, CPU holders, and med carts. I’ve been to that hospital (872 beds!) and it’s as highly regarded as Wake Forest University, which has the med school there.
Bruce Friedman was especially pithy in his open letter to Siemens and Intel about their decision to get into the blood banking software business in Malaysia. “Developing a blood bank computer system for even a single small hospital is a project that will reduce grown men to tears … Simple computer errors in blood banking software can easily kill patients. Blood bank software is the only healthcare software that the FDA has chosen to regulate. This regulatory environment plus the complexity of the software has caused many of the U.S. vendors, previously active in this area, to defer to a small number of domain experts.” Soarian blood banking, anyone? Better re-check those bids.Picis hires two new SVPs for professional services and R&D.
The fired CFO of Mee Memorial Hospital (CA) is accused of setting up an automatic electronic payment on the hospital’s account to pay off his personal credit card each month. He’s charged with stealing $96,000, which included donations to his church.
This article definitely sounds like an Intel informercial disguised as news. It’s supposedly about nurses and IT, but it has a lot of background on bit player Intel, including talk about their nursing research and the Motion computing device.
Design Clinicals will integrate FDB’s medical knowledge base into its MedsTracker medication reconciliation software.
A psych patient in physical restraints breaks loose from an orderly and gouges out his own eyes before the orderly can restrain him again. The patient’s guardian is suing for over $10 million. The hospital then billed him for the $2.2 million in care it delivered, which the plaintiff’s attorney calls “mean-spirited”. Only in hospitals is trying to collect what’s owed you considered to be a heinous insult, although granted the ridiculous prices charged to private pay patients almost put me on the patient’s side.
Congratulations to HIStalk reader Ed Marx, formerly CIO of Cleveland’s University Hospitals, just named today as SVP/CIO of Texas Health Resources. That’s where David Muntz was until a year ago when he left for Baylor. I like to think that Ed’s HIStalk-gained knowledge got him the new gig, but that’s a bit presumptious.
I’m here.
Inga’s Update
I loved the posting from Insider Outsider about loving his/her job. Made me wonder what readers believe are the best and worst jobs in this industry. My best job was probably a few years back when I got paid ridiculous sums of money to work trade shows and “demonstrate” software. I got to stay in great hotels, wear fabulous outfits, and always got offers for free dinners. There were some downsides, such as static cling and four-inch heels, but all in all, it was fun.
So, what makes a job “good?” I personally think company culture has a lot to do with it. As Insider Outsider said, more money could be made elsewhere, but it isn’t always about money. I think what really matters is working with people you like and respect, promoting a product or service that has value, and receiving a fair wage is worth more than being the best compensated programmer or salesperson or nurse in the industry.
The Professional Association of Health Care Office Management (PAHCOM) has negotiated a “discount” for members for athenahealth’s PM and EMR services. That part is not so interesting in and of itself, but I sure liked this quote from PAHCOM”s founder Richard Blanchette, a retired Lieutenant Commander in the US Navy’s Medical Department. “I would equate the operational capability of athenahealth to one that is so well coordinated that the U.S. Navy would be dutifully impressed.” (In layman’s terms, I think he was saying things were “ship shape” over at Jonathan Bush’s place).
Acer is buying Gateway Computers for $710 million. Does that mean all those cows will be put out to pasture?
MedAssets, Inc. has filed a $230 million IPO. MedAssets is an Alpharetta, GA-based provider of software to improve operating margin and cashflow for hospitals and health systems.
After all the weeks of rumors about Misys and who they may or may not purchase or partner with, it was interesting to hear that iMedica was the selected company. I have heard their product has a lot of functionality and offers all the bells and whistles that the Misys EMR product lacks (SQL, .net, and a single PM/EMR database.) It also sounds like an ASP offering is in the works as well. The announced plan is to offer the solution at the low end, where Misys EMR has had a hard time competing (due to price and dated technology). The biggest question I have is why would Misys announce this agreement today, while also stating in their press release that the “initial products, including ASP service offerings, will be announced this November?” It would seem to me that Misys is going to have a hard time selling too many systems – at least at the low end – until buyers see what the new offerings are all about. If I were a Misys salesperson I think I would be frustrated and wondering if the light at the end of the tunnel will ever come.
First Consulting Group wins a contract with NYC-based RHIO NYCLIX to build their RHIO infrastructure. FCG’s FristGateways technology will be used for the secure data exchange between provider organizations and the largest hospitals in Manhattan and the other boroughs. FCG will host the data.
A Moscow woman set fire to her ex-husband’s privates as he sat naked watching TV and drinking vodka last week (there’s a picture). While I don’t think it was a very nice thing to do (he claims it was “monstrously painful”) I don’t buy his story that he doesn’t know “what I did to deserve this.” Come on ladies, he “knows,” doesn’t he?
Inga’s waiting.
Misys Healthcare announced this morning that it will license practice management and electronic medical records products from iMedica. Misys will pay $8 million for minority ownership in iMedica plus $5 million in licensing fees. Misys will also get a seat on iMedica’s board of directors.
iMedica was founder by former Millbrook executives in 1998. Michael Nissenbaum is president and CEO.
New Misys-labeled product offerings, including an ASP product, will be announced in November. Misys CEO Mike Lawrie said the deal will allow the company to quickly market a small practice product, an area identified earlier as a weakness.
From Lacey Underall: “Re: VA. I wish I could have been in the room when the House Appropriations Committee scolded the VA for buying vendor EMR systems that weren’t interoperable. I would have laughed out loud. Next time I am looking at systems, I am going to be requiring (particularly if they state HL7 compliant) that the vendor be able to receive and post every single transaction type that they send out. Currently, I am working with an Atlanta vendor that won’t accept any flowsheet data from other systems. They are trying to keep their clinical documentation close to home. We have several systems that allow the input of clinical data elements, however we have to send them into our clinical record as text blobs. The clinicians cannot trend that data in our clinical record. How about stepping up for patient care?” Well said. I like that idea of requiring vendors to receive and manage the same transactions they send. Vendors won’t integrate unless customers demand it, especially the broad-line ones that refuse to acknowledge that customers might cherry-pick.
From Inside Outsider: “Re: liking your job. I’ve been in the industry for 15 years or so. I worked for Sunquest back in the day when it was just growing beyond the Mom & Pop business of Sid’s to the bureaucratic mess it became prior to the Misys purchase. I got out and was happier for it. I moved to the business side of healthcare for a few years before moving to a small consulting company. I love my job. Been here for about 7.5 years so far. We are small, but we all work hard. The company does not push us to bill 80 hours a week, they pay us decent wages, and we can earn bonuses. There is not really much deadwood in the company, unlike everywhere else I’ve worked. We are out there to make other people’s jobs easier, despite many of the negative comments I’ve heard about consultants on your blog. Our customers like us, and I think we do a good job. So yes, I do like my job. I could make more money out there in the ‘real world’, but I’d probably have to put on clothes every day and go to an office. I don’t want that, and I don’t need that. The owners of the company are awesome. I hope they never sell our company to a big company, because that will probably be the day I go.”
McKesson is hiring 120 people to call people to remind them to refill their high-profit prescription medications … uhh, I mean “to improve patient outcomes by increasing adherence to prescribed drug regimens.” The shocking thing about this practice is that it took manufacturers a long time to figure it out. I was arguing that it was a great business tactic 20 years ago. Why chase new patients when it’s cheaper to just keep current ones taking more of the same drugs under the banner of compliance?
West Penn goes live on Eclipsys and claims nearly 100% CPOE in just a few weeks.
This letter to the editor sounds like something I would have written: “One area that he and Michael Moore missed in the conversation on costs is hospital waste, inefficiency, lethargy and plain stupidity. In my 15 years in the industry, I have witnessed unbelievable waste and ridiculous decision-making on the part of hospital administrators and health care technocrats. For instance, my employer makes imaging software that easily outperforms the GEs and Siemenses of the world at one-tenth the cost. But key hospital decisions are not fully researched; the best solutions are shelved in favor of ‘this is how we have always done it.’ We live in an age of marketing, not of patient care, intelligent decision-making and financial discipline. Our hospitals could function as true health care institutions if they were not consistently in a battle to build Taj Mahals.” I agree, with a caveat: the really dumb and financially irresponsible decisions are made almost entirely by big hospitals and IDNs, whose large egos and bankrolls allow it to happen without disastrous consequences. Little hospitals don’t have that luxury or that motivation. I’ve seen greed, corruption, and stupidity first-hand in hospitals, but never in one under 200 beds.
Here’s a local story on an Ohio hospital’s smart IV pumps (which the article calls SmartPumps). It claims the hospital’s “chemical coordinator” had to “write software”.
Cardinal Health is recalling the Pyxis Anesthesia System 3500 because it can lock up while being rebooted. Only 17 hospitals use it.
This must have been interesting: the 20-year-old doctor asking a 14-year-old girl in a chat room for nude pictures was actually a 72-year-old doctor hitting on an undercover agent. One of the deceitful parties faces a minimum 15-year sentence.
FDA will get access to Department of Defense electronic medical records to monitor prescription drug usage. It isn’t mentioned whether patients have to consent.
iSoft is tired of the one-upping between prospective acquirers IBA and CompuGroup, so it says it will auction itself off if another bid is made.
A UK paper says the Cerner Millennium implementation at its first London trust is “besieged by problems”. Bigwigs called them “expected teething problems”. Worker bees weren’t so nice: “It is an American system and is so long-winded. It has not been adapted properly for British use. Every day someone bursts into tears in my office. One woman is thinking of retiring early because of it. These are not teething problems – the system is rubbish.” They must have some terse software over there.
Say, I wonder who this internal e-mail is referring to? “Blogs” are casually mentioned as part of a list, sort of like that scene in American Graffiti where underage Terry tries to buy liquor: “A Three Musketeers, and a ball point pen, one of those combs there, a pint of Old Harper, a couple of flashlight batteries and some beef jerky.” Anyway, the e-mail concludes, “I trust all of you to exercise good judgment”, which must not be exactly true since an e-mail warning was necessary. I don’t blame the company, though. They should be encouraged that I didn’t get a copy of it for nearly four hours … I often get stuff like this in minutes, so maybe the loose lips are tightening up.
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