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News 3/28/08

March 27, 2008 News 6 Comments

From Cherry Rojas: “Re: PHR fiasco. The State of Washington issued a $2 million dollar RFP for a demonstration project to link the EMS system in four counties to PHRs last fall. An out of state vendor won it December 12 using smart cards to verify patient ID and to hold their critical patient information, readable by portable reader. Two in-state consultants who wanted to sell the state proprietary software and (and who sat on the Health Information Infrastructure Advisory Board) got their legislators to cancel the RFP before the contract could be signed in February. SMART Association, the apparently successful vendor, had no idea it was an inside game. All references to the RFP have been pulled down from the DIS web site (but we have copies). How will we ever change healthcare if it’s just another inside game? Some DIS staffers were so upset that they were ready to quit.”

From Bruce: “Ars Technica, a popular tech news web site, has posted an interesting article on EHRs and PHR. Very high level, but it’s interesting to see this hit the mainstream tech community.” Link.

From Up to You: “Re: Scott Wallace stepping down as NAHIT CEO. This was WAY overdue.”

From Dutch Treat:
“Re: PHR/EHR. EMC and InterSystems are testing the PHR/EHR waters in Northern Europe. IBM runs Denmark. Who’s next? Case in point: unlike RHIOs in in the USA, governance and funds make a difference in Euroland.” Link 1, Link 2.

From Art Vandelay: “Re: dumb EMRs. Many specialists using Epic find the EMR dumb until more configuration is done. This is always a tough position for hospitals or medical groups rolling out Epic. In the typical Epic EMR implementation, the first step is to focus on primary care in the ambulatory setting and hospitalists in the hospital setting. To make it more usable by the specialty physicians, a second round of tailoring then occurs. It is much easier for the implementation team to initially go with SmartText macros for notes and a few order sets for specialists. The team comes back again later with more focused templates for specialists. This causes many headaches in organizations without strong leadership, a large team, and good content management capabilities. By now, a couple of years have gone by and it is time for an upgrade, so progress may stall while the upgrade is tested. Still later comes the health maintenance reminders with the specialists saying, ‘WOW, you mean I get to use some of the discrete data I entered?’ Next, comes the focus on making sense of the order set and template proliferation. Few places take content management seriously and later have clean-up to do. It may or may not be time for another upgrade or the roll out of more specialty models. At last, many places then get to publishing queries in Clarity (data warehouse) for more advanced users to use in delivering care where some reminders may not exist. As with larger clinical systems, it is a toolkit. If the organization doesn’t have the right size team to match the hospital or clinic’s desire to implement and strong sponsorship to focus attention on the goals of the implementation, it is a rough uphill climb. It takes time, money, super-users, technology resources and a strong infrastructure to deliver the product. A place implementing an EMR can learn from Allina and Kaiser. Allina seems to have had great super user involvement. Kaiser has a content management discipline and content teams to quickly go area-by-area.”

I got an e-mail from Bryan Walser, MD, JD, CEO of Perlegen Sciences, Inc. about the company’s activities with the unnamed EMR vendor. Actually, it was the same “letter to the editor” sent to other publications, so I don’t see much point in running it here. I asked him for an interview and he declined. I’m mostly interested in the EMR vendor, of course, and I’m still trying to find out who it is.Design Clinicals has a new web site, I noticed.

Philips will buy Irish cardiology software vendor TOMCAT Systems. Lots of informatics activity in Ireland, it seems (field trip!)

Information Week digs around the Gnutella file-sharing network using LimeWire peer-to-peer software to see if business documents might actually be found there. Downloaded:  banking passwords, credit card numbers, credit reports, tax returns, cell phone numbers of senators, meeting notes, and medical documents listing patient names with HIV status. The default setup of those P2P clients is often confusing about which PC folders you’ll be sharing with the world, so it’s likely that employees were so anxious to start downloading that they were sloppy in its setup.

Jobs: EMR Developer, Clinical Improvement Analyst, Meditech Clinical Consultants, Physician Liaison. There’s a ton of new jobs listed, I see, so take a look and sign up to get Gwen’s weekly job listing.

A few folks missed the HISsies cartoon, so I’m listing the winners below.

HIStalk readership will break another record this month. It’s nearly there already with four days left in March. Sitemeter projects 66,796 visits and 101,700 page views. Thanks to those who read, sponsor, e-mail me stuff, and spread the word among colleagues. It means a lot. I’ll have an update on the broad themes from the reader survey in a couple of days. One of them: everybody loves Inga (and rightly so).

New text ad to your right: InteGREAT Healthcare, which offers consulting services in the areas of application integration and interoperability.

California will delay for two years its plan to track prescription drugs to prevent counterfeiting, moving it back to January 1, 2011. Everybody in the drug supply chain said they wouldn’t be ready and would have to stop selling drugs in California (riiiiight). How about that nimble pharma industry, of which Pfizer says it will need 5-7 years just to put serial numbers on its products, even though it’s already doing that for some of its high-profit drugs like Viagra?

Allscripts files a new 8-K that describes the mechanics of its proposed merger with Misys Healthcare. It says the per-share value to MDRX shareholders is $14.30 to $16.20, an 85% premium to the share price the day before the announcement. Shares closed today at $9.06 if you want in.

Cerner shares hit a 52-week low today. Share in athenahealth are dropping, too, and PSS sold some of its pre-IPO stake Wednesday. Nothing’s going to do consistently well in this market, of course.

Former Harvard Vanguard CIO Tom Congoran will fill in as CFO of Massachusetts practice group Atrius Health, which has cleaned house on its executive team after parting ways with former CEO Debra Geihsler.

Harvey Picker, founder of the Picker Institute that promotes measurement of the way patients experience healthcare, has died at 92.

Cambridge Consultants says its Vena single-chip platform can allow medical devices to transmit data wirelessly for less than $10.

RemedyMD will integrate the disease models and biospecimen management system of GulfStream Bioinformatics Corp. into its Investigate research software.

The all-lower-case api software (annoying, yes?) acquires EPEPCS, a tool that estimates required nursing hours and skill mix.

E-mail me.

Inga’s Update

Dr. Deborah Peel’s Patient Privacy Rights organization has posted a summary outlining each remaining presidential candidate’s stand on patient privacy. It’s worth a read if the topic concerns you.

Mediware announces that its blood management software systems are ready to accommodate ISBT 128 labeling.

Oshsner Health System is implementing new DocuSys technology for pre and post surgical care. The solutions will be used across Oschner’s 28 operating room and 15 other anesthetizing locations.

Some not-so-good news for McKesson. A US District court certifies a $7 billion nationwide class-action lawsuit against McKesson on behalf of consumers and third-party payers. It has the potential to be the third largest class action suit in the US. It charges McKesson engaged in a scheme to fraudulently inflate the price of more than 400 prescription drugs.

While it’s unlikely to cover the extra $7 billion, McKesson is partnering with Clorox to develop and promote disinfection protocols for mobile equipment and handheld devices.

Nebraska’s Great Plains Regional Medical Center selects Eclipsys Sunrise Clinical Essential for EMR and medication management. They’ll add additional Sunrise products after Essentials is deployed.

Thank you Wheaties Gal for sending me this link for an inspiring new bingo game. “This does not have to do with big mergers or company layoffs- has to do more with passing time in those boring IT meetings where they think nothing of rattling off acronyms and trying to put together sentences around the latest business buzzwords. Here is a site that you can print out ‘B-S Bingo’ cards. I think you would have to be careful not to yell out (like the girl in the TV commercial). Some meetings I have been in lately, I could get a cover-all in 30 minutes- or less.” I am on the same page as you on this, Wheaties Gal. Going forward, for all mission critical enterprises Mr. H and I will simply set our goals, leverage our resources, and just get it done.

Speaking of getting it done, I was making up some pretty charts for Mr. H showing the growth in readers over the last 18 months. The number of monthly visits has doubled during that time period, which is pretty darned impressive. So keep telling your friends because it sure seems to make Mr. H happy!

E-mail Inga.

HISsies 2008 Winners

Smartest vendor strategic move
athenahealth, for its initial public offering (IPO)

Stupidest vendor strategic move
Medseek, for laying off employees right before Christmas

Most impressive vendor sales deal
Epic, Cedars-Sinai

Best healthcare IT vendor
athenahealth

Worst healthcare IT vendor
Cerner

Best provider healthcare IT organization
MD Anderson

Vendor most likely to be acquired in 2008
Allscripts

HIS-related company in which you’d love to be given $100,000 in stock options that can’t be cashed in for 10 years
athenahealth

Most promising technology development
Software as a Service/Service Oriented Architecture

Most overrated technology
RHIOs

Biggest HIS-related news story of the year
athenahealth’s IPO

Best speaker you heard at a conference in 2007
Jonathan Bush

Most impressive vendor at the HIMSS Annual Conference in 2007
athenahealth

Most overused buzzword
Interoperability

Most effective CIO in a healthcare provider organization
Judy Middleton, William Osler Health Centre

HIS industry figure with whom you’d most like to have a few beers
Jonathan Bush, athenahealth

HIS industry figure in whose face you’d most like to throw a pie
Neal Patterson, Cerner

HIStalk Healthcare IT Industry Figure of the Year
Jonathan Bush, athenahealth

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Currently there are "6 comments" on this Article:

  1. Not sure what’s up…but you do seem to have a big crush on Bush and Athena…
    suggest you spead the love a little more ’cause when Athena goes bust ( and mark my words it will) you’ll have alot of egg on your pretty face.

    From Mr. HIStalk: I assume you’re referring to the HISsies results since my only other mention is that the stock isn’t doing well. You’ll have to take that up with the folks who nominated and voted for the HISsies.

  2. Hi There,

    Was wondering about the picture of a man having pipe and discussing about healthcare, Across the world “There is message “Smoking is injurious to health” shouldn’t we have a good picture rather than a pipe.

    Regards
    Dipesh Shah

    From Mr. HIStalk: That was a very intentional bit of irony. It’s a 50s doctor (note the head mirror thing) and many of them smoked back then, with some even appearing in cigarette commercials.

  3. Response to HISJunkie,

    The revenue sharing that is achieved through improving payer receipts is the basis for athenahealth’s operating style and is a concept that will over time cause other vendors to emulate since it can be highly profitable if done right. Having worked with customers directly over many years has given me the confidence that working together is a win-win for both parties if both are committed to positive results.

  4. Revenue sharing is nothing new. It used to be called ‘at risk’ or ‘performance payments’. If that’s the way Athena likes to operate, so be it. Many vendors have done it in the past but abandoned it after clients refused to pay exorbitant fees. In some cases payors like Medicare outlawed it ( a la DRGs ) because they felt vendors were gaming the system and pushing the envelop way over the legal limits.

    That’s what happens when government makes things way too complex. A vendor comes in with a magic formula, makes a killing, then the government squashes it. Then we move on to the next big buck opportunity…

  5. Living here in Washington State has been comical. The state government is so crooked I am not surprised that this happened. Everything I have been involved with here has been decided prior to RFP’s being issued and this is not the first time they have pulled a process when it did not go the way they wanted it. Too bad we just can’t get our act together out here.

  6. I read the other day that a group is issuing a grant to have work done on defining an EMR, EHR and PHR. Can’t remember who it was…my blackberry blacked out just as I read it!
    There’s beautiful irony in this. Here we are with hospitals spending hundreds of millions of dollars on an EHR-EMR-PRH (whatever) and nobody really knows what they are or are supposed to do!
    Now consider this…if you couldn’t describe /define what an airport is supposed to do how could you get an architect and construction engineer to build one for you? We’ll try this design first…no that won’t work…poor more concrete over here…oops no good…break it up…and around and around we go. No wonder hospitals spend millions and never seem to get finished.







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Reader Comments

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  • AC: That's not an apt comparison. Imagine instead if while the roofer was doing his thing, another random roofer dropped by ...
  • HIT Girl: I've worked in EHR design & support for the last 14 years or so, and when I was hospitalized in I think 2007 I got m...
  • Joy Goodspeed: So funny about the physician card. I wrote my 3rd HL7 Lab and microbiology interface in my 20-year career this past yea...
  • Anonymous: Did you just compare Healthcare to roofing business ? Imagine a surgeon operating with a body cut open, should they take...

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