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News 3/5/08

March 4, 2008 News 8 Comments

From Bill Shatner’s Ham: "Kaiser said it added 13,000 total members in 2007, which includes an unpublished addition of 20,000 new ‘Charitable Coverage’ members added during the year (the biggest annual increase in that program’s history). Had it not been for the new 20,000 unpaid members, Kaiser would have posted its first annual member loss since 2003. Giving coverage to poor, uninsured people is a noble thing. Using that coverage to hide true membership losses is a new level of dirty." Link.

From Paul Pott: "Re: Stanford. I heard they’ve delayed their Epic go-live over two months and sacked Perot Consulting despite a long-term agreement. Accenture won the job and it will be interesting to see how they handle it. Stanford continues to cut parts of the project out (surgery, barcoding, ED) to see if they can get something live." Unverified, updates welcome.

From Jerry Rivers: "Re: ROI. I’m a grad student and hadn’t heard of you prior to the Ingas thing at HIMSS. I’m hoping you can point me in the right direction. I’m interested in learning about models of ROI for adoption of EMR. Ohio State University Health System posted a paper about their own ROI, but I can’t find anything else like it. Thanks for your beautiful Ingas at the conference." Can anyone help with some citations? I haven’t seen much. Glad you liked the Fake Ingas, although you missed the best one of all (Real Inga).

Listening: The Red Thread. Sadly defunct, but "Wax Museum" makes them immortal in my book.

Vista is a failure in terms of both technology and sales, so does that mean that Windows XP was Microsoft’s last decent OS? I liked Computerworld‘s arguments until they got into that Steve Ballmer "wave your hands over the coffee table" thingie from last year’s HIMSS as the next generation. Still, Microsoft can’t lower the Vista price enough to unload copies because of driver problems, resource hogging, and lack of benefits. Looks like another Windows ME dog.

Palomar Pomerado has a video about its Second Life hospital project.

Legacy Health (OR) bails out of its five-hospital Cerner implementation and goes with Epic. I’m beginning to feel uneasy about Cerner’s prospects. The stock is doing poorly, they’ve laid off staff, projections have been reduced, and the HIMSS booth thing may have had more of a back story (I’ve heard rumblings that they had planned to pull completely out this year). Hospital finances aren’t good, the clinical systems market is surely near saturation, and Cerner’s desperate search for growth in other markets and overseas won’t feed the Wall Street wolves in the near term. Cerner is the industry’s bellwether, so if they have problems, so does everyone else (although being publicly traded makes theirs much worse).I hope they do well, but the signs aren’t good.

Speaking of that, I weigh in tomorrow in Inside Healthcare Computing: Clinical Systems are Cooling Off: What Systems Will Drive the Market Now?

My reader survey is here if you’d like to set HIStalk’s direction. Thanks. Speaking of voting, Cerner’s HIMSS pullout is running 73% "Good Idea" in the reader poll to your right.

A couple of vendors who exhibited at HIMSS say they’ll write something up to describe the experience (cost, traffic, problems, etc.) Your thoughts are welcome, especially if you run the company and can assess value received (I’ll use only de-identified info, of course).

MUSC picks Oacis for its data warehouse.

The New York Times runs a piece (This Blood Test Is Brought to You by …) on the ad-sponsored Practice Fusion EMR, with a screen shot showing an ad. The company selling ads for them says they can get ten cents per view or more, making it possible to keep giving the app away. Trivia: the product is written in Adobe Flex, which sounds interesting. It doesn’t seem to exactly be selling (or not selling) like wildfire with only a couple of hundred docs using it to some unknown degree.

Optical imaging vendor Optio Software will be acquired by financial transaction solutions vendor Bottomline Technologies. You probably saw Optio at HIMSS since they have a big healthcare customer base. Or did.

Meditech will open its Fall River building next month, spending at least $40 million the new home to 500 employees. They’ll stick with the plan of open seating, but the water view is nice.

A nurse violates hospital policy and avoids using her hospital employer’s medication barcoding system, killing a patient with another patient’s medication, this time at Marion General Hospital (IN). I think they’re a Meditech shop and a Most Wired hospital in the rural category.

The president of the Massachusetts Senate is pushing a bill that would set aside $25 million for a statewide medical records system and would make it illegal for drug reps to offer gifts or for physicians to accept them.

Sponsor Updates and Housekeeping

Welcome to surprise new HIStalk Platinum Sponsor QuadraMed. I say "surprise" because it came out of the blue after they did an HIStech Report about their Care-Based Revenue Cycle. I nearly turned them down because not all of the conversation about them here has been positive after their recent offshoring decision (or any other broad vendor, but they’re the first to sponsor) and I wanted to be aboveboard about that with them. I give them credit for signing the standard sponsor agreement that spells out that we’ll keep saying whatever we think and believe, sponsor or not.(Disclaimer: I’ve been an Affinity customer and have nothing bad to say about that experience, but I should disclose that bit of history). Anyway, welcome to QuadraMed. I appreciate their support. I interviewed CEO Keith Hagen two years ago. I also saw him in the breakfast line at the Peabody Orlando last week, but that’s hardly newsworthy since half the industry’s leadership seemed to be waiting for a Beeline Diner table and a $13 omelet that doesn’t come with toast.

Speaking of HIStech Reports, a couple of folks have asked if we’re still doing them post-HIMSS because those fancy reprints we did were the first collateral to run out as attendees grabbed them up. Yes, we will continue to do them. They’re a lot of work, but fun.

To your right: you can sign up for updates when I write something new here or for the weekly Brev+IT e-mail newsletter. You can also Google all five years’ worth of HIStalk for people or company names. And, send me secure rumors via the Rumor Report button.

AT&T is handling a voice and mobile broadband in-building wireless network for Thomas Jefferson University and Hospital (PA).

Those sly dogs at EnovateIT snapped a pic of our little autographed signs we made for the HIMSS booths of sponsors (earning Tammi from AT&T an Inga hug for delivering them all over the hall). Notice the crafty way they worked their own logo and cool cart in the picture. I can’t figure out how everyone and their brother was blatantly shooting video and flash pictures all week and I got busted for taking one non-flash Fake Inga picture. Seems like HIMSS should just drop that policy. It’s not like there are nuclear secrets in there.

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Inga’s Update

I am in my post-HIMSS frenzy (which is different from my pre-HIMSS/during-HIMSS frenzies). I am in definitely catch-up mode. The swelling in my feet has finally gone away after too much walking in beautiful shoes and too few places to sit down!

Anyway, I have noticed a few comments on some other blogs about HIMSS in general as well as HIStalk and the HISsies. Here are a few of my favorites. Amy Gleason (of Bond Medical, I guess now Medi-Bond) brought a crew to the HIStalk party (wish I had met them because they sound like a fun bunch) and shares some insights on speakers and the convention in general. The handsome Scott Shreeve provided a great summary of Jonathan Bush’s HISsie acceptance speech. He also says the best part of that evening was chatting with Mr. H and me, which is an incredibly nice thing to say given all the interesting folks there.For a very comprehensive overview, check out John Moore’s Chilmark Research site. He touches on booths and vendors and the overall buzz.

In reading the posts the last few days (here and other places) I have determined I must be the only person who kind of liked McKesson’s Vegas-light inspired booth. Yeah, the booth was huge and flashy but, I found it kind of cool. My biggest complaint about it was that it always seemed congested. Either the setup was not conducive to the number of people and demo stations, or, there were too many people like me who walked through it like a short cut to get on the other side of the hall.

The McKesson talk reminds me of a clever nametag I saw the HIStalk party. A lovely lady had on her nametag that she worked for, “Frequently bashed vendor”. She admitted to me she works for McKesson.

There have been some recent posts about one vendor possibly outselling another, with the loser being the one that actually had a better product. Dog of war said he/she thought it was sad situation and that perhaps vendors should invest more in influence peddling. I think the conversation misses the point. My opinion is that most purchases (other than simple commodity items) should include considerations that go beyond determining what product is “best”. Equally if not more important are factors such as company stability, future product plans, integration capabilities, implementation record, management, etc. If functionality were the only consideration, all we would ever need is a demo CD from each company. There are hundreds of examples of companies in this space that have had slick products but have disappeared because of problems in other areas of the company. Organizations need quality salespeople make sure prospects understand the big picture of the company’s offerings. And, that all being said, of course some salespeople are better than others.

From iphone dude: "It was a good show for us. Going through our leads this morning, we had two booths and we didn’t have a lot of repeat visitors between them. The second booth was a last minute strategy placement which worked out – so yes, the second booth definitely was beneficial. [One of our featured products] got a lot of attention. [Competitor] stopped by at least four times, [another competitor] two or three, and I caught [competitor #3] once. The third competitor rep resorted to subterfuge by switching badges, which I figured out the next day when I stopped by their booth and the same person had a different name. Kinda silly. It was really weird, so we started taking pictures of competitors in our booth." One fun aspect of HIMSS is seeing what the competition is doing and comparing their products to yours. Too bad Mr. H and I didn’t have any cool anonymous blogger cocktail parties to crash.

Two cardiologists plead guilty to embezzling about $840K total from the University of Medicine and Dentistry in New Jersey. The pair admitted to taking the money and providing no meaningful services in return except for referring cardiac patients. Both face 10 years in prison and $250K in fines.

From I’m Not Inga: "I was one of the vendors in the Siemens booth STALKER section. You know, back behind the control room, at the end of the aisle, near the private meeting rooms, and in front of the restrooms. We had NUMEROUS Histalk readers that found us for the ‘I’m Not Inga’ buttons. And they really had to work to find us. So thanks for playing along and making this a fun HIMSS deal for us. This was our first time exhibiting and it seemed that when we were discouraged by lack of booth traffic, someone would come up looking for a button." Thanks to the fun Active Data Services folks for making me feel like some sort of superstar. I actually wore the button for awhile until a friend saw it and decided he had to have it.

iMedica announces a new program to equip physicians with a tablet PC loaded with iMedica’s EMR/PM software to test for one week. I think that is a great move. I am sure that other vendors offer try and buys, though perhaps begrudgingly. The fact iMedica is promoting their program is smart. Apparently the sales rep will “train” the doctor how to use the program and then the doctor is on his or her own. If a product is easy to use, then the doctor should be able to figure out how to navigate the application – that is, if the physician actually takes the time and effort to try it out and doesn’t just let it sit around on a back desk. I bet car dealers would say that people who take a car home for a weekend test drive are more likely to buy and I suspect iMedica will find similar results.

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Currently there are "8 comments" on this Article:

  1. Re: Jerry Rivers, I found the following publication from HIMSS.org very useful in trying to undrerstand ROI Modeling and understanding various metrics to be measured.
    Beyond Return on Investment: Expanding the Value of Healthcare Information Technology
    by Pam W. Arlotto, MBA, FHIMSS, Patricia C. Birch, MBA, Susan P. Irby, MS

  2. pix at HIMSS – don’t forget that it was just this sort of thing that caused that ugly little tiff between Epic and IDX over the University of Wisconsin contract. Epic came in with pix from trade shows like HIMSS to show that none of the items that were alleged was proprietary…

  3. RE: ROI in healthcare – Lynn vogel has written several articles on ROI in healthcare – a pubmed search for Vogel LH brings several of them up, including one from JHIM Fall 2003 “finding value from IT investments- exploring the elusive ROI in healthcare.” I think there are other articles in that issue related to ROI. Grad students may want to try “return on investment AND healthcare” in pubmed too.

  4. The fake Inga photos were a clever idea, but I was frankly shocked that a vendor of McKesson’s stature (and woman-run as well) would have a model flaunting as a booth draw. Did Pam even know what Relay was doing?

  5. Jerry Rivers, go and ck the govt. grp, AHRQ (Agency for Healthcare Research and Qualtiy) as they’ll probably have some reports. They also held a conference last Sept which had a session addressing this topic. You might find copies of the presentations over on the AHRQ site. Went to that session, key takeaway: Common metrics used to measure to measure IT ROI in other industries are ill-suited to healthcare.

    And Inga, you are correct, much more goes into the sale of a product than just technology. I can think of others off the top of my head that have used in advising clients: Channel to market, Service, Pricing and Viability.

  6. Hi Inga,

    I think you were missing my sarcasm (hard to portray in type ;).

    Of course many factors contribute to a healthcare organization’s decision to choose one vendor or another.

    I’m simply suggesting that vendor salesmanship should play a much smaller role than whether the product actually does what it’s supposed to do, how easy (and costly) it will be to implement (custom interfaces, order sets), etc. Company stability should definitely play a role in purchasing decisions, but so should how a company chooses to invest its resources.

    Good evaluation teams are able to separate vendor puffery from evaluating to what extent a system meets their requirements. Good evaluation teams define “good” salespeople as those that are able to provide them with timely, accurate, and honest information . Evaluation teams that allow slick salesmanship and influence peddling to cloud their evaluation of the facts are doing their organizations a disservice.

    Salepeople tasked to sell poorly-interfaced crap don’t want the evaluation to focus on the product itself. Salesman who work for well-financed companies that sell poorly-interfaced crap have more tools and resources at their disposal to shift the focus.

    That said, problems with implementing EMRs are too often blamed on one vendor or another (see today’s story about throwing out Cerner and replacing it with EPIC). As if EPIC is that much cheaper or easier to implement than Cerner. ANY EMR implementation is going to have many of the same challenges…

    I also agree that differentiating “the best” among the leading vendor products is quite difficult – they all have some strengths and they all suck in many ways. There is no “killer app”. But as long as those who purchase systems (and their executives and boards) allow themselves to be sold with the kind of sizzle that only the largest vendors can afford, we’ll be stuck in the status quo.

  7. The Perot out of Stanford rumor, I’ve heard it too. Please consider it still unverified because I heard it from a headhunter trying to dissuade me from taking a job with Perot (so I could go to work for him…).

  8. I’ve also heard the Stanford rumors from someone very high on the Stanford Hospital org chart. Perot is on the way out and Accenture will likely be leading the Epic install. Does Accenture have enough Epic certified resources?







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