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News 8/22/07

August 21, 2007 News 6 Comments

From Madrigal: “Re: Meditech. Meditech is teaching MAGIC programming at UMASS.” Link. The CONNECT people could use some help with HTML layout for non-IE browsers, obviously. Anyway, classes will be given in Fall River and Meditech may hire some of the grads for the new office there. Five weeks and 30 hours gets you MAGIC training plus an overview of healthcare informatics and maybe an entry level job. Not bad, depending on what you were doing before.

Art Vandelay, one of my favorite posters because he’s thoughtful and analytical, did a great writeup about Wal-Mart in healthcare in HIStalk Discussion. Good predictions: one-stop shopping, reselling its franchise model to employers, targeting small business, steering its own employees to in-house services, using technology to brand their operation as high throughput, rapid diagnostics, and several more. Art gets five stars for this one. It will make you think (maybe even enough to post a reply with your own predictions).

Private Joker e-mailed me from an old HIStalk post he ran across in which employees of a certain (name expunged) HIT company were ripping it. I extracted a few of the less inflammatory comments about his time there as an employee: “Worst time of my life … ones who stay have probably lost the edge to get out into the competitive market or are happy to be treated like dogs … totally unplanned and unrealistic deadlines … the software is full of bugs and the database and application architecture is so badly designed that a very robust RDMBS like Oracle 10g comes to a grinding halt … I’m glad I’m out of there and have regained some of my dignity and life back.” Makes me feel better about my job – how about you? In fact, if you really like your job and employer, how about giving me some details since I rarely get those?

A sartorial update from Paul Burmaster, who chides CIOs for casual dress at conferences: “I’m at a great CIO conference, not just for healthcare, and a few are walking around in shorts while everyone else is appropriate business/resort casual. I bet no one wears shorts during the sessions at CEO conferences. The black tie ceremony will be interesting.” A lot of them are former programmers, so shorter inseams alone aren’t as bad as it could be. Nothing’s more depressing than a balding, graying, paunching ex-flower child who still wears wire-rim glasses, hiking shoes, and a backpack. Can anyone look at a ponytail-wearing or do-ragged grandpa without suppressing a giggle?

Scott Shreeve points out that HHS Secretary Mike Leavitt has a blog. It actually sounds like maybe he writes it himself instead of having some overzealous staffer cranking out babbling politician-speak. He mentions AHIC 2.0, as he calls it. He allows approved comments, including one from some other blogger who incessantly pitches his own stuff under the pretext of commenting (I zap that stuff right out when I get it).

From Sales Reporter: “Re: HBOC. Even guys who weren’t the big fish had days of the month exceeding 31 for contracts in their sales regions. Ask any of the reps. Maybe following orders, but not innocently.”

From EMR-Dude: “Re: Allscripts. Seems you have missed the VP of Marketing for Allscripts depature. This link shows Guy Mansueto is now working local in Tampa. Maybe this is better for the family life.” Link.

Also from EMR-Dude: “Re: Allscripts. Misys/A4/Allscripts longtimer David Bond is leaving the Allscripts Healthmatics division at the end of the year. David has been the president of that division since John P. McConnell’s depature. Maybe Ray and David will resurface at some spinoff of Med3000, which is where Steve Ura (the old Chief Technology officer for A4) went this past summer.”

From Breakers: “Re: PHRs. I’m just not that excited about PHRs. I’m a physician, and it’s even a challenge for me to manage my mother’s health records, and I understand what all the terms mean. All but the most curious and persistent don’t have a clue what happened to them in any detail beyond ‘I had a virus’ or ‘the Xray was normal’.  I just can’t see people actively managing this kind of information. When it comes down to it, someone who is caring for them will manage the information for them, and we already have a chart for that.” I’m with you. Any plan for a useful PHR better include feeding it data, since most Americans don’t have the time, interest, or literacy to sit down and document anything you’d want to use for making treatment decisions. If it’s the electronic equivalent of stuffing your old tax receipts into a file folder, then it might work. Asking someone to describe how they PREPARED their taxes? No.

From Holy Crap: “Re: This is the first time I’ve seen a grammatical misprint on HIStalk. Are you not perfect? LOL. Also, have you thought about updating HIStalk2 a few days before Histalk so you migrate folks to the new look and feel?” Guilty as charged on the misprint – my fatigue was showing through. Here’s a recap on how the sites work: I consider the primary site to be the new one (you go there if you just type www.histalk.com in your browser, but the actual URL is www.histalk2.com). I still keep the old Blog-City one updated as a backup, but I can tell you I rarely look over there otherwise. For e-mail updates, I suggest signing up for the new one (the “Subscribe to Updates” option to your upper right) and if you’re still getting updates from Blog City, unsubscribe from that one via the link at the bottom of the e-mail. A little complicated, I know, but you’d be amazed at the number of new readers who’ve come over since I put the new site up (not uncommon with a migration to WordPress and a sexier design, I’m told).

And speaking of signing up, here’s one last sneak preview of the Brev+IT weekly newsletter. I’ve gotten quite a few positive comments, most noticing how it doesn’t really overlap with HIStalk at all (it’s a summary with more analysis of the five biggest stories of the week). Help me make it popular: sign up using the Brev+IT subscription box to your right (with the logo) and forward the e-mail to others who might be interested. It has 390 subscribers so far, but I’d feel better about spending the time if it had a few more.

And speaking of Wal-Mart, an HIStalk reader has started a blog called Healthcare IT: Analyst’s Views and he’s tackling the Wal-Mart topic, too. Blogging is hard work (even when it doesn’t look like it), so give him a click and some feedback. It’s lonely when you’re just getting started and no one (and I mean NO ONE, in the early 2003 days of HIStalk) is reading.

Terry Wilk is named VP/CIO at Henry Medical Center (GA). He comes from Southern Regional Medical Center (GA).

Three Scottish health boards sign up for Carestream Health (formerly Kodak) PACS.

Another non-news press release: Mediware announces that its medication reconcilation product “is exceeding expectations” (right at this minute?) but doesn’t bother to tell the reader what either the expectations or the sales were. I’m inferring that both were modest. As a PR professional who reads HIStalk pointed out, that’s usually the mark of a company that lets just anybody write up press releases with no oversight or professionalism since the pros know it should at least sound like imperative news even when it isn’t.

An Oregon heart surgeon who created one of the first surgery outcomes databases has died. Urlin Scott Page started what is now Axis Clinical Software in 1980 but had developed outcomes tracking software years before.

Partners Healthcare chooses AgilePath for service-oriented architecture consulting services.

Lean Six Sigma, like all quality fads, has been one-upped. Now there’s the new and improved Supply Six Sigma. It’s trademarked, of course, and proprietary consultants will tell you all about it once the meter starts running.

Siemens is named yet again as being the benificiary of a questionable hospital bidding process, this time in the Czech Republic. Three hospitals chose the low bidder, then expanded their bids and invited only Siemens to participate. The lame excuse of one hospital: nobody complained by the due date. Siemens won in one hospital despite a bid higher than that of Philips and Toshiba. At my old employer, they bribed damn near everybody involved with the PACS decision with phony fact-finding trips to Germany. Despite being ranked dead last by the selection team, they nearly won the bid anyway because the thankful junketeers were prepared to override the decision until cooler heads prevailed (the complex, “no capital required” contract was going to end up costing something like $50 million over a few years, our non-junketeer finance people nicely pointed out).

A couple of readers enjoyed the partial list of interviews I’ve done. Thus encouraged, here are the rest. I have my favorites and I enjoy re-reading them.

Peter van der Grinten, dbMotion
Robert Connely, Novo Innovations
David Blauer, Click4Care
Don Schoen, MediNotes
Andy Ury, Practice Partner
Glen Tullman, Allscripts
Girish Kumar, eClinicalWorks
Gerard Dab, VisualMED Solutions
Keith Hagen, QuadraMed
Denni McColm, Citizens Memorial Healthcare
Jon Phillips, Healthcare Growth Partners
BB Babowsky, Sales Guy Who’s Been Around
David Wortman, Mezzia
Kevin Fickenscher MD, Perot Systems
Editor of WhereTheMoneyGoes.com
Scott Shreeve, Medsphere
Erik Johnson, The Advisory Board Company
John Holton, SCI Solutions
Paul Egerman, eScription
Kipp Lassetter, Medicity
Mark Groper, DINMAR
Todd Cozzens, Picis
Howard Messing, Meditech

I read and appreciate every e-mail sent to me. If you have news, rumors, or opinion, why keep it to yourself? E-mail me, or use the anonymous Rumor Report to your right.

Inga’s Update

Sprint and GE Healthcare announce a collaboration to provide in-building wireless communications services to hospitals. The communication networks will leverage GE’s CARESCAPE Enterprise access and include Sprint handsets. Hospitals will require only one installation for voice and data communications over secure cellular, Wi-Fi and telemetry. You have to hand it to GE for their efforts to penetrate every area of healthcare.

I have been thinking about Mr. H’s question about what impact Wal-Mart’s in-store medical clinics will have. While Art_Vandelay definitely covered the topic extremely well, I thought I would throw out my less articulate and less well-thought out ponderings. Actually, I was thinking back on the days I use to travel quite a bit. When I was in a new town, I would often find myself looking for Starbucks for coffee and Fed-EX Kinkos for copies. Why? Because I knew exactly what those establishments had to offer. Over the years I had been sick on the road a couple of times and had to schedule a doctor’s visit. Rather than hunting to find a clinic, then wonder if they would take my insurance, and question what kind of care I would get, I think I would have preferred going to a Wal-Mart. Presumably there would be some consistency between clinics, including the quality of care and insurance options. Also, I would assume that if I had been to a Wal-Mart clinic in Topeka this week and Miami the next, my medical records would be available on line. I think consumers will embrace the concept, and, I am sure that at least the primary care world will feel the effects. Clinic hours convenient for working parents with sick kids or the “working sick”? Great! Free parking? Awesome! Socks on aisle two and paper towels on aisle 12? Works for me!

MediNotes releases the results of an internal study of their 4,300 clients’ top concerns for selecting an EMR. Top was the need for successful implementation and support, followed by total cost of ownership over a three- to five-year period, functionality and interoperability, IT expertise, and time necessary to make the paper-to-EMR transition. MediNotes also claims that they have achieved a 94% implementation success rate since January 2006, compared to 40-60% for all EMR’s. I am not sure how scientific their study was, but the purchasing concerns sound about right to me. In regard to the implementation success…I suppose the first question to ask for a definition of “implementation success.”

Yuma Regional Medical Center in Yuma, AZ contracts with MEDSEEK to develop an enterprise eHealth strategy called eMap.

Appalachian Regional Healthcare (ARH) announces it will deploy McKesson’s Horizon Ambulatory Care EHR system to more than 190 employed and affiliated physicians in rural communities across eastern Kentucky and West Virginia. ARH will offer the purchase of the EHR at substantially reduced rates to affiliated physicians in its service areas and will provide maintenance and technical support. ARH already had several McKesson products including pharmacy automation and a physician portal.

Inga’s listening.

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Currently there are "6 comments" on this Article:

  1. I understand what you are saying about Wal-Mart convenience, but having stopped by there just this evening to return some socks, I am really concerned that their overall hygenie in the stores is going to impede this concept. I think people may step up to Target for their minute clinic just because they don’t have to trip over trash on the way into the store. But I could be wrong/overestimating the public’s concern with things like this – price may rule.

  2. GE Healthcare has lost managed care customer Fallon. Appears they ploy to go after managed care insurors has fallen by the wayside. Meanwhile, the California market (one of the last bastions of capitation other than Minnesota) is undergoing a fundamental shift away from capitation style contracts to more common PPO discount fee for service operations further tilting the playing field against the old IDX MCA product.

    Would be interesting to see you find a healthcare IT executive from California – preferrably a payor and not some hospital IT CIO/Lemming-in-a-suit to talk about the market change. The impact to GE is just a variation on a theme of too big to understand healthcare version 1010 and not too remarkable. The market shift is interesting and has implications for the rest of us.

  3. Re: Wal-Mart. I like Target, too, but they have about 1500 stores versus Wal-Marts 4500 (in the US.) CVS had about 6,500 pharmacies, but they are serve only 35 states (Target is not in every state either.) Wal-Mart serves rural communities far bette than anyone else. Plus, I just noticed that Wal-Mart is currently taking pre-orders for the Eagles first new album in 28 years! (I just placed my order.)

  4. Exceeding expectations in medication reconciliation may be legit, since the bar should be very low to begin with! I have never been invovled in a project that has produced more resistance from clinicians, especially because of its questionable worth in hospitals with CPOE/EHRs, and the view that it is just another make-work, regulatory process.

  5. We all are aware that MDs were supposed to be responsible for med rec but resisted, as they have many “chores” they don’t get reimbursed for or seem to value.

    This process is not just admission and discuarge, but every time the patient transfers within the facility. It’s a good idea and should be able to be automated with not that much difficulty, but depends on design of orders (and integration with Rx) system. And it’s been clearly shown, if the admission meds aren’t right, the problems flow “downstream”..

    NOTE, The Joint Commissin was at an impasse on this since compliance was spotty, but community hospitals don’t own MDs (other then hospitalist, intensivists) – short of taking away priveledges, no one can “force” them – or at least wants to.

    Noticed on the last med rec update, The Joint Commission is now saying rather than MD responsiblitiy (wink wink) this is the HOSPITALS resonsibilty-which means nurses (and pharmacists if we can get some of their time) – but we all know who will do this, as they do today for the most part.







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