From Will Weider: “Re: EMR. You mentioned the Marshfield Clinic as a developer of their own EHR. I have blogged about them in the past.” Link.
From Economist: “Re: pricing. I am trying to figure out how pricing for software applications usually works in this industry. There are two issues I am unclear about: Is pricing usually done according to the number of users or in another way? If it is done by users, is it usually done by named/registered users or concurrent/active users? Do vendors offer a set of predefined software packages or do they offer a variety of modules and let you “pick and mix” according to your needs?” I’ve done a lot of contracts and they were almost always based on occupied or licensed beds, although Epic and Cerner started the trend of increasing fees based on volume of lab tests, patient days, etc. (I dislike that a lot because you can’t budget for it and you are paying more for exactly the same product and service, a disincentive to use it more widely). I’ve seen concurrent users listed on occasion, although that’s more common for underlying technologies like database licenses. All vendors I’ve seen offer a long list of applications, for which one can likely negotiate a discount (from the fictional list price) for purchasing multiples of them. The main thing to remember is to look at total cost over an expected life of 7-10 years since implementation services, annual content fees, maintenance fees, and third party licenses quickly eclipse the upfront capital cost.
From Sanka Coffie: “Re: Intel. Intel recently launched a website to help it keep abreast of industry trends. It had used it internally, but decided to open it to the public. My point is, if you click on the Healthcare site, there are no entries. Kind of says it all for leading software technology – zip, nada for healthcare. Just had to share.” Link.
From Cigarettes and Water: “Re: Micromedex. Rumor has it that Thomson Healthcare is looking to sell its Micromedex business unit, which generates approxiately $40 million in earnings on $120 million in revenue. The problem is that it’s not growing significantly and is probably at its most valuable. Thomson continues to organize itself around solutions for preformance management.”
From The Cooler King: “Re: a certain UK practice management company not named Misys. The rumor inside is that the whole company is up for sale this time, but the healthcare division may have a better breakup value to interested parties.”
From Just Asking: “Re: HIT Summit. I am surprised to see your support for HIT Summit. Seems like just another boondoggle for CIOs and vendors at one of the most exclusive hotels around. Sounded like you were going to go?” I’ve been to two conferences like this one and found them worthwhile for executives with broad strategic interests, networking interest, and budget. It’s very much like flying in first class: great for making important contacts in a much more intimate setting than the usual conference, a more relaxing and upscale experience, but not necessarily for everyone. With the HIStalk discount, the registration fee and hotel will run less than $2,000. Not cheap, but not way out of line, plus you could always pick a less expensive hotel. I won’t be there, but at least one reader is going and offered to report back. The speaker lineup is impressive.
From Whitby Bevil Sr.: “Re: WebMD. I heard from a reputable source that Google is in acquisition discussions with WebMD. This would be an interesting counter move to Mr Softie’s HealthVault. It may also explain why Google’s top healthcare person recently left without much explanation.” Wouldn’t surprise me a bit. I’ve heard similar rumblings.
From Josef Grool: “Re: EMRs. Isn’t there a software entrepreneur out there who would fund an X-prize for hospital EMRs, then sell it through a non-profit? The current 12 vendors all have such significant shortcomings that a well-funded team could probably build a much better system without all the baggage. Ambulatory EMR systems are much better than any acute systems.”
Barry Schoenbart, MD, medical director for Reliance Software Systems and an old friend of HIStalk, wrote me about Care Plus Next Generation, the clinical system his company is developing for Henry Ford Health System. It will include a full-featured EMR for both inpatient and outpatient care venues. Modules include EMR/EHR, result delivery, order entry, clinical documentation, physician portal, document imaging and document management, and care coordination and reporting. Community physicians will be able to order labs and rads electronically. User acceptance testing is starting and Ford will go live in May. RelWare will sell the system commercially as RelWare’s OneRecord. Good update.
William Crawford from Children’s Hospital Informatics Program in Boston e-mailed about Dossia, for which CHIP has taken over PHR development. “First, factually: Dossia is neither being developed by, or operated by, the employers. It’s being developed by CHIP, based on the Indivo platform. Indivo is open source and always has been, and it will continue to be so. That’s about as transparent as it gets. Founder company employers have no role in operating the system, either – the only people who will have access to the operational system will be CHIP technical operations staff and selected employees of our hosting partner. Just to make it really clear, further in the article you’ll also see that Colin Evans directly goes on record saying that the employers will never have access to the data. Second, philosophically: I find it very hard to believe that anyone from the Dossia Founders Group would have asked for back door access to employee healthcare data. It doesn’t make sense – the entire purpose of engaging outside partners to create the system was to make absolutely sure employees could trust that nobody would be looking over their shoulders. The goal here is to give millions of employees tools to better navigate the healthcare system and make more informed choices about health and wellness. That’s much, much more valuable than any decision that could be made around a single employee–or any value that could be realized by selling data out the back door. So Dossia won’t be doing either of those things, and CHIP certainly won’t be enabling them to do so. One of the main points of alignment between CHIP and Dossia is that the employers would not have access to the information stored by Dossia. That’s why we call it a Personally Controlled Health Record – we really are letting patients make the decisions about who sees their data. And it’s not an obligatory system, either – nobody has to opt into having a Dossia record.” Thanks for that. While I believe patient privacy is in good hands with CHIP’s development efforts, there will always be that patient suspicion (unfounded or not) that centralizing patient information electronically could be tempting to those who could benefit financially from it. Maybe the result will be that fewer users will sign up, or that the information they record will be incomplete. Reassurance will be important.
My newsletter editorial for Wednesday: “Smoking the CIO-Doctor Peace Pipe: Let Practices Choose Their Own PM/EMR Gift”.
SAP will buy Business Objects for $6.8 billion, guaranteeing software vendors and customers that Crystal Reports will get even more expensive for producing labels and reports.
North Carolina Healthcare Information and Communications Alliance (NCHICA) gets a HHS contract to develop NHIN interfaces and transaction sets.
Three Georgia nurses are fired for HIPAA violations. Apparently the trio was intrigued by a patient in the SICU who had a knife through his skull. They used their cell phones to take pictures.
Ascension Health, Catholic Health Initiatives (CHI) and Catholic Health East (CHE) have joined together to form CHV II, LP a $200 million VC fund focused on investments in the healthcare industry. This is the second fund venture for Ascension and the first for CHI and CHE. They will target expansion to late stage medical device companies, and healthcare technology and service companies.
Siemens announces that they really do have clients using their EDM and Soarian HIM solutions. If you are going to the AHIMA, you can visit the Siemens booth and talk to some of their real clients. (Did anyone else reading this press release interpret their main message as, “We have clients”? Or maybe I am just turning cynical like Mr. H.)
Set your DVR’s to CNBC! Wednesday morning at 9:30 a.m. ET Allscripts CEO Glen Tullman is presiding over the NASDAQ opening bell.