From Sterling Moss: “Re: cranky doctors. Docs may be cranky because they are smart and don’t make as much money as the salesmen who push drugs at them (or the lawyers in BMWs, or the venture capitalists, or …). However, cranky or not, just because doctors are ‘smart’ doesn’t mean they are adept at business or money making. In fact, the opposite is just as likely. From my own personal experience as a doctor involved in starting my own manufacturing company and participating in someone else’s startup and working as a sales consultant for yet a third company, I can attest I and my medical colleagues are not very adept at the skills necessary in making money in the non-clinical world. Maybe this is just the best we can be.”
From Grant Beesknees: “Re: physician incomes. I’m a physician and I think Ian Morrison is a little off. Anyone can get earning statistics for the US Bureau of Labor Statistics. On average, physicians out-earn any other career group. Additionally, physicians out-earn their peers practicing in almost any other country you can think of. So, I don’t think there is much for most doctors to be angry about in terms of their total income. Now, if top doctors want to compare themselves only to graduates of the top business schools or top law schools, then they might find that they don’t compare as favorably. However, many in the business or legal world spend years working their way up the ladder until they take responsibility for multi-million or multi-billion dollar organizations, along the way, out-earning physicians. I don’t know for sure, but I think that most physicians’ practices are substantially smaller enterprises. Even so, physicians can reach the higher earning levels of their profession rapidly even if they don’t provide a particularly high standard of care or produce results. In other industries, that is somewhat less likely. In my opinion, in America, doctors earn a good living without too much risk and generally deserve what they earn.”
From Julius L’Orange: “Re: NextGen business services. I think the little announcement you made about NextGen business services deserves some more attention. Did athenahealth think that the ‘standard’ ambulatory EMR vendors were just going to sit and watch them? You can bet Allscripts, GE, and eCW are all gearing up to offer some sort of RCM service via their PM systems in the coming months, thus making sure their current customers don’t feel the pull to AH, but more importantly, capturing other customers who like the SaaS model for RCM, but want a more mature EMR than AH currently has.”
From Art Vandelay: “Re: nurse barcoding. I believe nurses are defensive about the comparison to a grocery store clerk because nothing substantial is being done to change their situation. At least the grocery store clerk’s technology tool belt has grown to increase precision and efficiency. Nurses are working with outdated processes and supported by outdated models of staff roles, training, and technology. We analyze one small area at a time, followed by a rush to introduce technology. Examples include the continued proliferation of individual-use devices and singularly focused decision-support tools in support of metrics. The most promising work I have seen is from the American Academy of Nursing through a Robert Wood Johnson grant. Maybe the momentum from this work can be parlayed into a win for nurses, staff, and patients.”
From DrCool: “Re: selling patient data. In July 2007, Paul Tang said that ‘some electronic health record and personal health record vendors have placed in their contracts stipulations that would obligate healthcare providers to violate privacy rules.’ He further said that he has personally seen the contract language, but declined to identify the vendors or how he came to see the offending contract provisions. ‘That wouldn’t be fair,’ Tang said. ‘It’s just those things are in there.’ I’m sorry – Tang is acting as a patient privacy expert, and is saying that he knows of potential illegal activity, but it would not be fair TO THE VENDORS to reveal who is doing this? The arguments would be more powerful if they were specific. And it seems much more likely these days that the main privacy problems we have are people leaving unprotected laptops full of data in their back seats. Have we ever really had a story where an EMR vendor or any other business entity actually sold identified patient data since HIPAA was passed? Finally, as a minuscule investor in IMS, and even as a physician, I have to admit that it does not surprise me, nor even bother me, that the pharma companies know what I prescribe. It is not like they have access to specific patient data (apparently, they used to, but that has changed). I’m a capitalist by nature and every other business gets to use data intelligence to figure out how to do things better. I have no problems letting the pharma people do the same. If it bothers a doc too much, they can ban pharma reps from their office. No one is making them see the Pfizer barbies.”
Speaking of selling data, guess what companies are among those trying to block a Maine law that would let physicians decide individually whether to allow data-miners to sell their prescribing information to drug companies? McKesson, Wolters Kluwer Health, SureScripts, Cardinal Health, NAHIT, and the eHealth Initiative. Money certainly drives the first four, but why are non-profits and supposed industry advocates NAHIT and eHI weighing in on a practice that shouldn’t concern them? Ditto, probably: some of their members are data-sellers and buyers who profit from the practice by pushing high-margin but not necessarily optimal drugs. Too bad patients themselves aren’t profitable – they might have more advocates if they were.
Sumter Regional is looking good to win the MRI machine, but give them some votes just to make sure. They’ll know in a couple of weeks.
EnovateIT moves to its new headquarters in Ferndale, MI.
Misys says its healthcare division showed slight growth in the six months ending November 30.
CDC is developing technical standards for sending healthcare-associated infection data to its National Healthcare Safety Network.
IBM is running several healthcare IT projects in India: data sharing, wireless hospital access, medication sensors, and drug supply chain tracking.
athenahealth kicks co-founder Todd Park upstairs, creating a Chief Athenista position and giving him a board seat, but removing him from the management team.