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News 11/21/07

November 20, 2007 News 6 Comments

From Dr. Lisa Cutty: “Re: Agfa. We had a big rumor going around at MEDICA. GE buying Agfa Healthcare and they wanna announce at RSNA. Confirmation, anyone?”

From Fish n’ Chips: “Re: Sutter. Does the $500+mil Epic install at Sutter include the cost of maintaining the old systems for the next 10 years or so? Seems that Judy doesn’t want her database polluted with legacy data. The solution? Keep the old boxes running for next xx number of years.”

From Nasty Parts: “Re: SureScripts. I understand that one of the primary factors standing in the way of EMR vendors getting current CCHIT certification is that they are mandated to use Surescripts. I know this is an issue for several vendors that already have other solutions for this area. My question is why a vendor-neutral organization is in essence giving a monopoly to another company. Why the mandate?”

From Thaddeus Balbricker: “Re: reading list. I recently re-read ‘Healthcare in the New Millennium’ by Ian Morrison. Do readers have a recommended reading list or would they share what they’re reading?” Good question. Have recommendations of the healthcare, business, or IT variety? Use the Rumor Report to your right to send them my way and I’ll compile. I’m always on the lookout for something to read.

From Millie McPilli: “Re: CIO’s Healthcare CIO Summit. Anybody have vendor or attendee feedback?” Link. I’m interested myself, if you’ve participated, please give me your opinion.

From Wompa1: “Re: DUI story. It would be interesting if the hospital’s information could be used as evidence. Hospitals working in concert with law enforcement? It sounds like they already believe they are part of the government.” And the odd thing: maybe they are, depending on organizational structure. Remember that Nassau University Medical Center CIO who got in trouble for taking hockey tickets from Cerner who claimed she didn’t know she was a public official? That may well have been true given the complex organizational structure issues involving publicly funded hospitals.

From A Competitive Kaiser Doc: “Re: Sutter. Competitively speaking, I see this as a win for Kaiser. How so?If Kaiser spends several billion without reasonable return and Sutter avoids that trap, Kaiser would lose, relatively speaking.” Sounds like a rousing RIO testimonial: “Spent billions with minimal benefit, but still less than our competitors.” I don’t actually know about the “minimal benefit” part, but HIT history leans that way.

From The PACS Designer: “Re: PACS/RIS. Lately TPD has been asked about which is more important, PACS or RIS, to department flow. While RIS has been around more frequently in hospitals and is more stable, it is still important to have a good RIS in place when contemplating a new PACS install. What has changed recently is PACS is being interfaced to existing RISs at a much more frequent number of institutions, so there are more questions about which is the best solution for the most efficient interface. If a RIS is in place and a PACS is to be added, it is important that the RIS/PACS interface be fully tested before going live with the new system. To avoid the requirement for an interface, I advise buyers it would be good to also consider buying a PACS with RIS from the same supplier so a proven solution that has already been installed and  resulted in happy customers will limit the need to use an existing RIS. I tell potential buyers that both systems are important, but the integration between the two systems is even more important.”

Scot Silverstein sent a note about AMIA vs. HIMSS. I like his comparison that postulates that, as a trade show, HIMSS is based on an identifiable management information systems culture. “It is process and control oriented, which in many circumstances it needs to be, and has some of the characteristics of a religion (e.g., dogma, central tenets that must not be challenged, a belief that its approaches are the best approaches and even the only approaches to any information problem at hand). It is very different from the culture of medicine and medical informatics. The latter cultures take the scientific method seriously, are probing, inventive, and results-oriented. In MIS, it seems there’s a belief that you can get to the moon in a balloon if there’s enough workflow analyses, process, and people put to work on the problem. In the medical culture, there’s just no time for committee meetings and K-T analyses in cardiac arrest situations.” That’s interesting, and probably correct (although maybe a bit MIS-heavy than today’s shops) from my observations: IT folks decry physicians and the culture that teaches them to behave in certain ways, but IT has its own set of beliefs that probably drive doctors equally nuts. The standoff: IT overrides the docs and the docs refuse to play. Someone could write an interesting article on how to recognize and mitigate those behaviors in a way that would increase the chances of clinical IT project success.

Someone who should know sent positive comments about CEO James Burgess of Mediware, saying he is great to work for and will take any role needed and will meet with anyone. Says he’s honest with clients and didn’t come into Mediware with the attitude that he was the expert and anyone who didn’t agree could hit the street. Glad to know that. I don’t know him and haven’t been critical other than to observe that he’s been involved with layoffs at more than one company (which in healthcare IT just means you’ve worked at more than one since, unfortunately, most of the big ones like to dump staff to prop up earnings).

The Revere Group is a new HIStalk Platinum Sponsor, for which I’m most grateful. The company has grown amazingly since its 1992 founding into a major global consulting force. In its healthcare vertical, The Revere Group provides services to providers, payors, life science companies, and associations. They have lots of case studies and white papers on their site. You may have seen the August announcement of the company’s acquisition of consulting firm Tryarc, LLC. The Revere Group has a skilled Microsoft Solutions Practice (Gold Certified) covering all the cool stuff: SharePoint, BizTalk, SQL Server, Visual Studio, System Center, and more. I notice they also have a full-service Microsoft BI group that handles SQL Server, Transact-SQL, and other BI/OLAP expertise, too, and I don’t know of many hospitals who don’t have a lot riding on their BI programs (and more coming with all the quality and outcomes data analysis needed). Anyway, it’s great to have The Revere Group on board with HIStalk and its readers, for which I thank them.

I received some excellent feedback on informatics programs. Greg suggests first checking this list of programs that have received federal funding through NLM. Among the schools on it that he recommends as first tier: Stanford, Yale, Indiana, Harvard, Columbia, OHSU, Pitt, Vanderbilt, and Utah (the first column contains the programs most likely greared toward provider computing, I would think). The second resource is AMIA’s list of programs, which contains those additional schools that arguably would comprise the second tier of programs, which Greg says could be programs that lost a strong leader or that may have cobbled together a degree by mixing a few IT courses with a splash of healthcare. The good news: degrees from either list will probably be just fine for working in healthcare IT. If your goal is to be an academic or researcher, then schools on the first list would be safer. Sara is in Northwestern’s MMI distance learning program, along with consultants, physicians, nurses, and hospital executives. She says the program is challenging and requires coordinating group work, but the professors are supportive. Michael also recommends the NLM-sponsored programs since they focus more on academic topics, such as vocabularies and natural language processing, but not necessarily general or project management. He says the four programs I originally mentioned are relatively new, so the NLM programs will provide networking and instant recognition which worked great for him. For training of a more professional nature instead of academic, he recommends consider the 10×10 program from AMIA first. He also mentions that many CMIOs don’t have formal training.

Former Carilion CIO and KLASser Greg Walton has taken El Camino Hospital’s CIO position, I’m told.

The 31 IT employees of Wyoming Valley Health Care System (PA) move into a new building they’ll share with the School of Nurse Anesthesia. No jokes about both groups putting people to sleep, please.

A hospital in Denmark uses Hyland OnBase to share electronic medical records. I like its EMR system name: Cosmic EHR.

Listening: Saxon, old pop-tinged metal. Driving music.

UK’s NPfIT has lost almost all its physician support: down to 23% of GPs (compared to 56% three years ago). Fewer than half now think it should be an NHS priority, down from 80% five years ago.

An interesting profile of 94-year-old Morrie Collen, a father of electronic medical records (he built a system in 1969) and a founding member of the Permanente Medical Group.

New Zealand healthcare workers are disciplined for using an electronic medical records system to look up the records of celebrities. The system wasn’t fully named, but it appears to be Canadian vendor CHCA’s Concerto. Doesn’t matter which system, of course, but I was curious.

MetroHealth (OH) signs with AT&T for an Aruba wireless network and security solution.

23andMe, the company owned by the wife of Google co-founder Sergey Brin, launches its $999 personal genetic profiling service.

Odd: Chinese doctors warn viewers of the pirated version of the latest Ang Lee movie not to try the sexual positions shown, which censors cut from the theatrical release, unless they have gymnastics or yoga experience.

I’ll probably skip writing Thursday since nothing much will be happening and few would read anyway, but I’ll make sure to have a Monday Morning Update to get you reconnected next week. If you’re going to RSNA, bundle up and travel safely. Thanks for reading. It’s never a chore to interact with so many smart people. Happy Thanksgiving.

E-mail me.

Inga’s Update

The Ohio State Medical Association will begin a process in January that allows EMR vendors to certify their sales contracts with a Standards of Excellence designation. For example, the contracts must allow for refunds if implementations “fail,” must allow for installment payment based on achieved milestones, and must allow software license transfers. The Coker Group helped with the project that is designed to make contracts more physician-friendly. It will be fun to see what vendors balk because the requirements don’t align with their objectives.

The Minnesota Medical Association is also in the news for publishing a report on the state’s P4P programs. Their conclusion: “Although research on the efficacy of these P4P programs to improve the quality of care is increasing, there is little evidence about their value that is statistically significant or overwhelming.” The Association also had some recommended steps for improving P4P programs, including common measurement sets and financial incentive for EMRs.

Kings County Hospital in Brooklyn will use MediKiosk self-service kiosks in the ER for check-in and triage. I personally think this technology is cool, but I wonder how well the masses are embracing it?

The FCC announces (warning: PDF) the 69 winners that will share $417 million in grants to promote broadband telecommunications. Recipients come from 42 states and 3 US territories.

It’s a great time of year to reflect on the many gifts in my life and give thanks for the good stuff. Most of my “stuff” sounds pretty simple but I’m happy for simplicity:

I am thankful that I’m healthy, have great friends and family, and never have to worry about having enough money for food or shelter.

I am thankful to live in a country where I can feel safe and have had the freedom to choose where and how I live, where I’ve had great educational opportunities, and where I’ve had the chance to choose my career (more than once!)

I am thankful for the opportunity to work with Mr. H. I am really not trying to suck up … I have been having an amazingly fun time the last few months and I have had the chance to grow and learn. How lucky is that?

E-mail Inga.

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Currently there are "6 comments" on this Article:

  1. From Nasty Parts: “Re: SureScripts. I understand that one of the primary factors standing in the way of EMR vendors getting current CCHIT certification is that they are mandated to use Surescripts. I know this is an issue for several vendors that already have other solutions for this area. My question is why a vendor-neutral organization is in essence giving a monopoly to another company. Why the mandate?”

    SureScripts has already been certified to meet the Pharmacy Network criteria. Any Ambulatory vendors using a different network are free to submit a joint application. As long as both the Ambulatory system and the network meet the criteria, they can be certified.

  2. Re: Informatics Programs – I interviewed for a hospital IT job at one of the schools mentioned. I asked the head of the informatics program how many of their studies were adopted by the hospital. He reacted as if that was a novel idea.

  3. DUI Story: The original story concerning the alleged DUI conviction from assumed hospital toxicology screen sounds like a story directly staged from Michael Moore’s examination of U.S. healthcare in SICKO.

    Conviction from toxicology results is highly structured legal chain of custody process that must be executed didactically including 100% demonstration of traceability, accountability and review by Medical Officer for interpretation. Toxicology analysis must be performed under the guidelines of SAMHSA/NIDA accredited testing facility to be admissible as evidence in a court of law the last time I read the regulations. DUI is not a dipstick urine test performed in the Emergency Department and held for further pending litigation. The rationale for ED toxicology screen is for clinical staging of the patient status unless a chain of custody is initiated. Direct Access Patient Testing that would convict the subject under DUI/DWI/OMVI requirements appears highly “suspect” to me.

    Remember the disturbing announcement about radio talk show host, Rush Limbaugh as an example and his prescribed pharmaceutical regiment? Where were HIPAA and the oversight regulations during the pubic media announcement of his medical treatment specifications? The total conversion of “pulp” medical data to digital database is the prime directive of healthcare information technology; HIPAA requirements for portability and a safeguard to privacy ; )

    Please Paul Harvey, tell us the rest of the story!

  4. CMS is mandating Surescripts or equivalent for all electronic prescriptions by 2010, I believe. Hence it makes sense to use SureScripts for CCHIT as well.

  5. You can’t lay the blame on pulling the plug on the RAD product solely on Misys. Mssrs Atkin and Snow had a hand in that I am sure. Some day soon, perhaps Vista will wake-up to the snow job that is being handed to them and get rid of some of the kings men and their yes men. Why there is still a Raleigh office for Sunquest is still a bit baffling as day-to-day leadership needs to be in Tucson and not remote via email or tele-conference.

  6. Re: Fish n’ Chips…I don’t know what you’ve heard, but one of the first things the “analysts” I work with did for our Epic implementation was to turn on interfaces with our legacy systems and flood a perfectly good Cache box with hundreds of GB of garbage.

    Pattern matching? Why bother. If the last name matches, merge the patient data. Whoops! How did John Smith end up with 600 diagnosis? Oh…someone call Epic.







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