From Fresh Prince: “Re: P4P. There are several patient satisfaction measures in P4P that makes it a horse of a very different color. Medicare will hold back 5% of total Medicare payments, then you have to ‘earn’ it back through quality measures, like patient satisfaction surveys. I think it’s inevitable that it will turn hospitals upside down more so than DRGs in 1983. Think about this: you can give the patient the best medical care on the planet, but if he/she has to wait four weeks for an appointment, gets bumped due to ER cases, or has to sit outside X-ray for an hour, do you think they’ll say they are satisfied? Oh yeah, and what about that hospital food? There isn’t an HIS system out there ready to deal with it.”

From Artie Lange: “Re: eClinicalWorks. eCW may have implemented their systems in MA, but looks like they aren’t working. I wish you would have asked their CEO a question on this.” Link. Reported here earlier – Mass BCBS says EMRs aren’t worth the cost to doctors. But, that has nothing to do with eCW or any other EMR not working. In fact, it says the opposite – that EMRs provide value to everybody except the physician who’s expected to foot the bill. I agree that I should have asked Girish about this – it’s a conundrum that isn’t going away soon and I bet he has an interesting take on it. Maybe he’ll respond.

From LaToya Jackson: “Re: Walnut Creek. I’ve heard that there is a big Epic implementation going on in Walnut Creek, CA. I think this would have to be Kaiser or John Muir. Kaiser is a known Epic site but, I thought that JM was a McKesson shop. Anyone know who is doing the project?”  

Intercepted e-mail snips about Misys/Allscripts: “Misys has a huge client base running the old +Medic/Tiger product. In the new environment this old COBOL based system cannot survive for long. Just think of the product mix/mess these guys are in. +Medic/Tiger, Misys Vision PM, Misys EMR, Healthmatics PM, Healthmatics EMR, Touchworks EMR (and all the jumbled pieces that make up Touchworks), Imedica. What the heck will they be selling, and what will they sunset? [A Misys rep who lost a deal] had offered a 60% discount!!! … The two ugliest people in town just got married, and it’s scary to think of what the kids are going to look like.” A bit exuberant, perhaps, but I tend to agree in general. Few will buy until the dust settles, which will take at least a year. Neither company was exactly tearing it up on sales, so now competitors have another weapon to create FUD in the minds of those hospital CIOs and big practice administrators who tend to buy stuff like theirs. Does having Misys involved make Allscripts more attractive to prospects or vice versa? It wouldn’t to me.

To put the Allscripts dilemma into perspective, here’s how the shares of some publicly traded HIT companies did over the past year, sorted from best to worst.

Eclipsys – up 2%
Dow Jones Industrial Average – no change
McKesson – down 3%
Nasdaq Composite – down 8%
Quality Systems (NextGen) – down 18%
Cerner – down 31%
QuadraMed – down 36%
Misys – down 41%
Allscripts – down 66%

The two worst-performing companies will hold a shotgun wedding, with the one that’s burned through 2/3 of its shareholder value in the past few weeks providing all the management talent under the board oversight of former competitor that’s down 41%. I’m not seeing the magic, especially looking at the science fair of products soon to be under one roof. People keep talking about “footprint” and “combined sales”, but what would make you like the two companies combined that you didn’t like about them separately? Or, what synergies will help them boost sales against the same formidable competitors like eClinicalWorks, e-MDs, athenahealth, and NextGen? Sure, the Misys customer base has low EMR penetration, but so does the entire industry – that doesn’t mean they’re going to buy an EMR from Allscripts or anybody else, especially at high prices. Allscripts keeps trying to sell vision instead of results, while Misys just wants to protect its big but steadily eroding maintenance revenue from old sales. And the kicker is that fickle investors who were quick to bail out on Allscripts will now have even higher expectations for the MDRX/newco shares after all the flowery talk about synergies.

So, here are my predictions. Odds that the Misys/Allscripts merger will get shareholder approval (especially with John McConnell as a major MDRX shareholder): 60%. Odds that the proposed management team will survive a year intact: 40%. Odds that the market cap of MDRX will increase in one year after the deal closes: 20%. But, I’ve been wrong before.

Jobs: Business Intelligence Analyst Developer, Senior Network Analyst, Senior PR Account Executive, Sales Executive – Healthcare IT. Sign up for weekly job alerts.

I messed up a couple of Inga’s links in the last issue, so those are fixed now. It wasn’t a devious ploy to get more readers for Scott Shreeve’s blog since that’s where the links mistakenly pointed.

Great idea: the Michael J. Fox Foundation offers up to $1 million in grants for the development of web-based clinical assessment tools for patients with Parkinson’s disease, which will allow clinical research to be performed without the burden of patient travel. Proposals are due May 14 and funding will be available in October. Thanks for that tip from the guys at Healthcare IT Transition Group, who also report that their cartoon announcing the HISsies winners has been viewed more than 2,000 times (the connection being, of course, that they portrayed Jonathan Bush as Marty McFly from Back to the Future in the cartoon because he kind of looks like MJF).

UCLA’s psych hospital, fresh off the Britney Spears debacle and a new incident where patient photos were published on a social networking site, bans cell phones and laptops.

Guess HIMSS gave up on the idea of blogging live from the conference. Its HIMSS Live! site now brings up a “page not found” error, although HIMSS still owns the domain. And speaking of fun domain name facts to know and tell, who knew that Cerner has pre-emptively registered CERNERSUCKS.COM?

Speaking of HIMSS, I checked the hotel site for HIMSS09. The cheapest Chicago hotel is $225 a night. I may Priceline it since that’s worked before.

A couple of folks expressed interest in producing something about medical device connectivity. I’m thinking we could put together an informal white paper for CIOs from multiple viewpoints. If you’re interested in helping, e-mail me. I’m curious to see if we can harness the collective knowledge of HIStalk’s readers to create something useful for the industry.

Inga wants me to brag on how well she and I are doing (for now) in the unnamed vendor’s NCAA basketball pool. We may have peaked Friday night, when a lucky Siena pick over Vandy (time for McKesson to buy the team?) propelled me to #1, with Inga right on my heels at #3. She was quick to conclude, “You and I are clearly geniuses.” Some bad luck since sent us to #2 and #8, respectively, and I’ve got some early losers going deep that will hurt me. I’m thinking of handicapping the pool by choosing schools that aren’t on the Most Wired Hospitals list.

Speaking of Inga, she’s in touch with HIStalk’s sponsors regularly and reminded me of something important. Some sponsors are interested only in page views and ad clicks like with any other advertisement (which is fine), but many/most of them support HIStalk because they believe in what we do. I can’t explain how gratifying that is. Magazines and other online sources would kill to have our loyal sponsors and readers. Just in case I haven’t said it lately, I sure do appreciate it. Thank you.

Deborah Peel renders an opinion on the data mining agreement signed by genetic medicine vendor Perlegen and an unnamed EMR vendor, calling it The New Tuskegee.  I want to know who that EMR vendor is. Everybody seems to be beaming about their data deal, so let’s name names. If you know (and especially if you have documentation to prove it), use the confidential Rumor Report to your right to tell me about it. It’s ironic that the EMR vendor is demanding privacy about its deal to sell patient information.

British researchers are working on an enhancement to the Da Vinci robotic surgeon that will allow it to be controlled by the surgeon’s eye movements.

Rural hospitals in Tanzania are using the Internet, scanners, and digital cameras to connect with a referral hospital for telemedicine services, important in a country where transportation to the hospital can cost several months’ of the average wage.

It took a TV station’s intervention, but a Sentara Norfolk ED patient finally gets his medical record corrected to show that he had not, in fact, delivered twins there.

SafeMed, a San Diego decision support engine vendor, will provide Google Health’s drug interaction and treatment recommendation capabilities. Former Amicore CEO and Microsoft manager Richard Noffsinger is CEO. For those who say nobody ever sells anything at the HIMSS conference, Google execs happened to pass SafeMed’s HIMSS06 booth in San Diego and asked for a demo, which was followed by a deal.

Harris Corporation gets an HHS contract to plug federal healthcare agencies into the Nationwide Health Information Network.

I’m sure it will offend someone, but I’m still wishing you a Happy Easter in a non-denominational, rabbits-and-eggs sort of way.

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From Gail Kafka: "Re: P4P. Do you or your readers have any data on the Patient Reported Outcomes market and the IT providers in it? I rarely see articles on this topic unless they are from academia or IHI/IOM. If P4P comes to be, which seems inevitable with consumer cost and awareness increasing, then why isn’t there more chatter about measuring performance from the patient’s perspective?"

From Larry Lezure: "Re: Misys/Allscripts. It’s a reshuffle of the deck with two players holding bad cards. All they have in common is overpriced products and getting their asses kicked by eCW, which will benefit even more as they try to retire products. The most interest part of the story is currency arbitrage — a UK company getting a big discount because of the low value of the dollar against the pound." New poll to your right: is the merger a good idea? So far, 76% say no.

From Stan Zloty: "Re: Medcomsoft. I know eCW doesnt like athena’s EMR, but looks like Medcomsoft sure does." Link. The Canadian EMR vendor gives up on direct sales and seeks partners to create an athenahealth-like business model.

From Nicholas Birdcage: "Re: medical devices. With today’s mention of device connectivity as well as Isarona, any thoughts at doing a piece on the players in these market?" I like the idea, but would need some help since I haven’t followed it all that closely.

Intellect Resources will host a webinar on becoming an independent consultant on March 25 at 8:00 Eastern. They’re also starting e-mail newsletters for job seekers and employers, with sample issues coming soon.

I hope everybody made the transition off the old Blog City HIStalk site. Put your e-mail in the "Subscribe to Updates" box to your right if you aren’t getting an e-mail blast when I write something new. You can sign up for the Brev+IT newsletter over to your right, too. And in looking over there, I just realized that HIStalk’s fifth birthday is coming in June.

My editorial this week in Inside Healthcare Computing: "In a Capitalist Society, Somebody Will Always Sell a Fat Man a Speedo or an Unprepared Hospital a Clinical System." A CIO e-mailed me to say he liked it, so I’m relieved (I bet the free mags don’t work a Speedo reference into many headlines, at least unless it’s one of those lame puns they love).

The New England chapter of HIMSS will host a killer HIT forum (warning: PDF) in Norwood, MA on April 9. Speakers: Senator Richard Moore, Blackford Middleton, Karen Bell, Francois de Brantes, Girish Kumar, and Jonathan Bush (there are other big names, including CEOs). Frankly, I like the lineup better than HIMSS, plus it’s one big day for $80. I should have had an HIStalk bash there.

Maine Medical’s CEO, Vince Conti, quits for unnamed reasons.

More on Misys/Allscripts. Most of the UK analysts think Misys is paying too much, while most US analysts think Allscripts sold out too cheap. Since the deal has to be approved by shareholders, that could come up in the voting. And, it’s subject to Allscripts getting a better offer, which has happened with similar companies (iSoft, for instance). I doubt John McConnell would make a run of his own on MDRX, but I wouldn’t rule it out. I just have this vague feeling that it isn’t over yet, especially since the response from all camps has been underwhelming.

Stock and HIT expert Sonomaca had some good thoughts on the Allscripts stock message board. He says it will help Allscripts because the company can focus on long-term strategy and not quarterly results. Also, since the market seems unimpressed from the current share price, ValueAct Capital could buy up more of the company. From his calculations, Allscripts shareholders get a Misys Healthcare for four cents per share, based on the one-time dividend (or, looking at the other side of the coin, the market is valuing the combined company at just $4.40 per share, or 10x earnings). Maybe that’s why the Brits were howling.

And in more Allscripts news, former star customer Tennessee Oncology is suing them.

Orion’s Rhapsody integration engine will be used to integrate systems in Saudi Arabia.

A Minnesota hospital admits that a chart error caused surgeons to remove the wrong kidney from a cancer patient, leaving the patient with only its still-cancerous twin.

E-mail me.

Art Vandelay on Cerner

As Mr. HIStalk noted, Cerner is diversifying its revenue streams in a coming bear market. Cerner’s medical device and drug-development are long lead-time investments with major barriers to entry. The barriers include human capital, systems, and process & procedure knowledge to navigate regulations. They also have to handle new competitors. I see this strategy being copied by all the major clinical systems vendors.

The approach we will likely see from vendors will evolve to full venture capital investments. There is power in using some of the de-identified data that should be captured with the vendors’ systems to find potential investments. The vendors can then use the data to prove the value of further investment independent of the necessary FDA regulations (ex: 21 CFR 11). This could keep investors interested. To make this real for everyone, only organizations with "Stage 6" EMR deployment can reliably make this happen.

For Medical Devices, expect copycats to mimic Cerner’s CareAware or Cisco’s Cisco Compatible Extensions (CCX) strategies. Vendors will likely certify and partner as opposed to developing medical devices.

Is this a distraction from their core business? You bet it is. The vendors will view it as a necessary strategy to preserve their publicly traded prospects in a bear market.

What does this mean? Three things. First, R&D will be negatively impacted. The enhancements you expect from your vendors will be slower in coming. Expect the vendors to ask you to share the burden of investment for new functionality saying it is beyond standard maintenance arrangements. In other words, "great idea, you want the function, help us develop it (with your human AND financial resources)." Second, the privately-held companies will be even better positioned to weather the storm. Third, companies that are already diversified (ex: McKesson, Cardinal) have a chance to catch-up or pass their competitors if they focus their investments.

Inga’s Update

For the parsimonious (like Mr. H) here is a great list of free or cheap software products, with substitutes for such programs as Word and Adobe Photoshop plus anti-virus tools.

Time Magazine also published a recent article, Is shrink-wrapped software dead? which included a handy side-by-side comparison of the free solution versus the commercial option. The article’s title reminds me of the bright yellow tee shirt Jonathan Bush was seen wearing at HIMSS which said "Software Is Dead" – to the 4th power. Apparently Jonathan tried to convince his PR handlers to let him to wear the shirt for his CNBC interview conducted during the conference, but eventually was persuaded to wear a more Street-pleasing coat and tie.

I guess I didn’t sound pathetic enough when asking for advice on the NCAA basketball brackets. I had to fly solo on my selections and ended up picking Duke to take it all. I actually hope I am wrong because I have a favorite team I’d rather see crowned, but I wasn’t willing to risk my $10 bet on them.

From Nasty Parts: “I was one of the early guys calling the Misys/Allscripts merger. I’ve been talking to guys from both sides of that divide. Here’s the scary part: both of them think they are in charge. Could be a slow motion train wreck. Wait until the long knives come out and folks start fighting for their areas of authority -  it won’t be pretty. Plus, we are not even yet talking about product go-forward strategies.” If Nasty is right, maybe John McConnell was the smart one to get out of the way now.

From Poo Flinging Monkeys: “Most Allscripts folks feel like they are getting the short end of the stick, as the big M is generally seen as a dead carp around someone’s neck. There are a LOT of folks who migrated from Misys to Allscripts who groaned out loud at the announcement. The Misys folks are a bit relieved as the last few months and years really have been obviously leading up to SOMETHING, but nobody knew what. All knew Vern was coming in, stripping it down, and selling it off. Most think that Misys EMR should have died a while back. The Allscripts product will be the flagship EMR and there will be an obvious push to get the Tiger folks introduced to it. Big open market there. The Allscripts PM is okay, but generally not as shiny and end user intuitive as Tiger, so there will probably be a push to interface those 2 products while sun-downing the Misys EMR product.” Heard that Misys had a town hall meeting for employees today. I doubt that Vern has answers to all the questions, particularly the one that employees are asking most: how does this affect me?

And if you haven’t heard enough on the topic, check out Scott Shreve’s posting at Crossover Health entitled The Lawrie Dowry: Misys Acquires Allscripts in Rushed Marriage. Lots of interesting points out the new “Allscripts-Misys-I-am-NOT-giving-up-my-name Health Care Systems” company.

Minnesota law will require all healthcare providers to use an EMR by 2015. It provides six-year, no-interest loans to help providers get there. The first two loan recipients are Swift County-Benson Hospital and Mille Lacs Health System, which are borrowing a combined $2.3 million.

I haven’t heard if Dr. Peel is gnashing her teeth on this one or not, but genetic research company Perlegen Sciences announces a collaboration with an unnamed EMR vendor for access to the clinical treatment and outcomes data on about four million patients. The information will be supplied from the EMR vendor’s information warehouse. Perlegen will use highly specific inclusion and exclusion criteria to identify and develop genetic markets for predicting patients’ likely response to specific medication treatments. What I find curious is that the EMR vendor remains anonymous. If this particular EMR company believes providing the data is ethical and not in violation of any customer agreements, why not allow themselves to be named?

Duke University will implement Premise’s PatientFlow Platform to facilitate patient flow across its three hospitals.

Big controversy brewing in Texas over who owns the ankle. Seems like podiatrists and medical doctors are both claiming it’s theirs to treat and are going to court to let a judge decide. Lawyers for the podiatrists claim “you don’t have an ankle” because is really part of the foot…no foot, no ankle. Of course the orthopedic surgeons say that if ankles don’t exist then why do podiatrists want to operate on them. Quite the conundrum obviously. I have been told I have nice ankles and I don’t think my feet are nearly as attractive, so I’m thinking I will go with the MDs on this. If the podiatrists win then I’ll have one less appealing asset.

E-mail Inga.

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Inside Healthcare Computing has graciously agreed to make previous Mr. HIStalk editorials available from its newsletter as a weekly "Best Of" series for HIStalk. This editorial originally appeared in the newsletter in February 2006. Inside Healthcare Computing subscribers receive a new editorial every week in their Electronic Update.

I’ll confess that I’m paying minimal attention to the RHIO craze. Everybody’s starting one, conferences are showcasing speakers who’ve done nothing more than announce theirs, and tiny grants are getting the whole industry atwitter. It’s like living the dot-com frenzy all over again, irrational exuberance and all.

I’m not against RHIOs, but they’re as annoying as CPOE was awhile back, taking resources away from projects that could provide more benefits to patients without the minefields.

I recently interviewed Denni McColm, an award-winning CIO of a 74-bed rural hospital no different than 80% of those out there. Oh, except that they’re 100% paperless and 100% CPOE, something virtually none of the celebrity CIOs and Taj Mahospitals have been able to accomplish. I’ll listen to her, thanks.

First, Denni believes that organizations should be banned from using the word “interoperability” until they can bring their own electronic information to the table. If your IT house isn’t in order, RHIOs don’t need you. Anything short of everyone’s contributing information equally will cause the whole concept to collapse like an imploded 1960s Las Vegas hotel, so paper jockeys need not apply. Work instead on projects that will help your patients more than the begrudging swapping of routine lab reports with your cross-town competitor. Or, integrate all those systems you already have. Your admission ticket should be a checklist of what data elements you can supply electronically right now.

Second, Denni advocates a patient-centric RHIO model instead of the common payor-centric one. Do you like insurance companies enough to let them control patient information?

By patient-centered, I don’t mean personal health records. People are too irresponsible to reliably collect and store data with life and death importance. On the other hand, they could be given control over the trusted information generated by hospitals, physician practices, and other providers.

Suppose everything resided in an Al Gore-type lockbox that contains everything from discrete electronic data to scanned documents fed over the Internet. Either the patient controls the key (similar to a password) or only they can initiate data delivery to a provider. If they don’t want you to see it, you won’t.

This model makes most privacy concerns go away. It avoids the largely unsolved problem of how you assign some sort of universally mandated patient identifier (aka “political suicide”) to sort out the throngs of people sharing the same name. The patient simply says, “send my data to Dr. Jones” and it’s done. They keep control and there’s no arbitrary “regional” service area beyond which lies a medical no-man’s land.

Maybe some RHIOs work this way. Like I said, I don’t follow them. And, if I can’t see a quick and obvious patient payoff, I probably won’t start following them any time soon. I’ve got plenty of challenges working on clinical system projects that will hopefully save lives right now.

This editorial is copyright-protected by Algonquin Professional Publishing, LLC., publishers of Inside Healthcare Computing. Please do not copy, forward, or reproduce this material without prior permission.  To obtain permission or for more information about Inside Healthcare Computing’s reprint policy, please contact the Customer Service Department at 877-690-1871 or go to http://insidehealth.com/ihcwebsite/reprints.html.

Mr. HIStalk’s editorials appear each Thursday morning in the subscribers-only version of Inside Healthcare Computing’s E-News Update.  To subscribe, please go to:  https://insidehealth.com/ihcwebsite/subscribe.html or call 877-690-1871.

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From Joe Bob: “Re: consultants working on percentage of savings. I find it not only deplorable, but outright thievery and total ignorance. Children’s Hospital National Medical Center is an example. They were a top pediatrics hospital, then a new CEO hired consultants based on percentage of savings. The hospital is out of top 20. P.S. Hasn’t everyone had enough of HIMSS and their organization, or is it just me?”

From The PACS Designer: “Re: One Portal. TPD mentioned the concept of looking at personal health information in the same light as a personal online banking account. Now it comes to light that Denmark has had an online health portal for recording your health history called One Portal since 2003. It could be used as a model for other countries to emulate and get the PHR/EMR process started as an online solution.” Link.

From Niven David: “Re: economic concerns. I would have to imagine many vendors and hospitals are seeing an impact from current economic concerns, with sales slowing and hospitals tightening the purse strings. Any comments or perspectives?”

From Reggie: “Re: Allscripts. There is a rumor that McConnell quit the Allscripts board in disgust at what he felt was a low-ball offer.” It must sting. Allscripts, Glen Tullman, and John McConnell were on top of the world and McConnell’s former company Misys was on the ropes. Suddenly, one bad earnings report sends MDRX stock reeling from the high 20s to below $10, allowing Misys to gain control on the cheap. What could be lower on the HIT totem pole than having Misys as your new daddy? I bet Glen Tullman won’t like reporting to the board-controlling Brits very much. Can two struggling companies combine to make one good one while maintaining their traditionally high prices, complex technologies, and indifferent customer bases, not to mention keeping their antsy shareholders happy as the inevitable product and people consolidations occur? In this market, with nimble competitors nipping at their heels, and with the current economy, let’s just say they’ve got plenty of work to do. I expected a much better outcome for Allscripts. Mothers, don’t let your children grow up to be publicly traded.

Update: John McConnell did resign in protest from the Allscripts board Monday night. See the comment I posted at the end of this article.

From Reggie: “Re: Allscripts. There is a meeting in New York tomorrow where both Misys and Allscripts management teams will answer analyst questions. I am not clear on whether this was an emergency meeting designed to convince obviously skeptical Allscripts shareholders that this is a good deal. On paper, this is a $13 deal, which is why Tullman described it as a ‘big premium.’  Since the stock closed at $9.75, the market has priced in $3.25 worth of doubt about the combined entity’s prospects. Clearly what Allscripts needed was the help of a big operator like GE, Perot, CERN, or EDS. Were any of these companies interested?” Surely others peeked up their skirt and passed before Misys got a turn, although the overused prospect of synergy has led to many a troubled marriage.

From the conference call announcing Allscripts-Misys Healthcare Solutions, Inc. (boy, talk about an uninspiring first decision – that name reeks, at least when it’s not screaming “YOU give up your name – we’re not budging on ours.”) Sounds like some products will not be developed further (the first step to sunsetting, of course). Synergies are predicted. They like the idea of selling into the minimally EMR’ed Misys customer base (which Inga suspects means that Misys EMR and A4′s EMR are goners – they can’t walk in the prospect’s door waving competing systems). They talked about merging a year ago, but Allscripts was too expensive (the stock market took care of that little problem). I heard the two companies huddled hard for days right before HIMSS, which I assume means they desperately wanted to make the announcement there.

Someone sent me the communication sent from Misys to customers. Other than the sudden love between two formerly bitter competitors, the most interesting point was the standard boilerplate, “connect all stakeholders through the continuum of care.” Wasn’t the utterly failed Connect strategy of Misys supposed to do that? And do stakeholders, in the form of customers anyway, really care about connecting to the rest of the continuum of care? Only if you’re trying to sell to hospitals and their affiliated practices, which the new, badly named company will try to do.

Lost in the shuffle: Misys PayerPath and Home Care. They probably should deal off the latter to Sunquest or somebody, but PayerPath has promise with a bigger sales footprint (unless they sell it off for cash to QuadraMed or McKesson, which wouldn’t surprise me since it isn’t even being mentioned in all the pleasantries).

HIStalk ran plenty of speculation from readers that the Misys-Allscripts deal would happen. I admit that I was skeptical, but I said all along that bringing in ValueAct Capital was a sign that Misys wanted to shed its healthcare lines. All of you who called the shot early – nice going. Nobody else was even talking about it until it ran here. Even the high-powered analysts at the HIStalk HIMSS event were buzzing a little because I’d mentioned it the night before, plus HIStalk readers had just voted Allscripts “most likely to be acquired.” Smart readers. I didn’t mention it, but the Allscripts PR person tried to get me to kill the HISsies because Allscripts didn’t want to be named as an acquisition target. For good reason, as it turns out.

Connectologist (you know him) posted a very nice writeup in HIStalk Discussion about medical device connectivity. This stood out: “A perfect day for an IT person is to fix every problem that comes up from their desk, monitoring systems, rebooting servers, documenting support, etc. A perfect day for a biomed is to go to the point of care and work one on one with clinicians solving problems with training, problem diagnosis, and repairs. This is part of the ‘great divide’ between biomeds and IT.” Worth a read.  

Thanks to the 134 of you who responded to my consultant survey. Great information. I’ve e-mailed out the results to those who participated and supplied an e-mail address. A reader already contacted me and said the results were helpful in making a career decision, so he or she appreciates it. Also, thanks if you completed my reader survey, which I’ve now closed. I saw some very nice comments there, so I’ll have more about that once I’ve digested your thoughts.

Fair Warning did a webcast last week on EMR privacy and compliance challenges, including HIPAA enforcement. John Wade was one of the presenters and over 400 folks tuned in. It’s archived for playback.

Jobs: Manager of Lab and Pharmacy IT, Clinical Information Systems Analyst, Manager of Clinical Support Systems. That first listing had an ingenious leadoff: “If you attended the HISTALK party at HIMSS, you know that the ‘most significant IT sale of 2007′ was the Epic contract with Cedars Sinai. I guess that would make these the ‘most significant HCIT job opportunities of 2008′. Read on.”

Medical device data integrator iSirona gets a $1 million private placement. Joining its board are industry long-timers Carl Witonsky and Jim Hall.

Ohio State and Wake Forest Baptist choose the ClairVia staffing system from AtStaff.

Little doubt about it: the iPhone will be big in healthcare.

Thailand medical tourism hospital Bumrungrad International, birthplace of what’s now called Microsoft Amalga, installs the first robotic drug management system in Asia, going with Swisslog. The hospital’s CEO, Mack Banner, appears to be an American from his educational background, which I didn’t realize.

The Australian Medical Council will move its Visual Basic systems to the web-based Ruby on Rails platform.

Merge Healthcare delays yet another SEC filing, this time its annual report. I swear its accountant must be a moonlighting shoe salesman from the local H&R Block.

Holy Cross Hospital (FL) chooses the E/Point ED charging application from LYNX Medical Systems (aka Picis).

Two doctors who were sued for $67 million by John Ritter’s family are acquitted. The family already received $14 million in settlements from other clinicians and a hospital. I don’t mean to speak ill of the dead, but I never found his mugging, camera-aware style anything more than annoying, but to each his own. It’s still a shame, of course. Maybe he really would have made another $67 million in future earnings like the suit claimed. Your Honor, I call Adam Sandler to the stand.

What else could they mess up? Haywood Regional Medical Center (NC) fires a nurse and former Army lieutenant colonel for giving state inspectors information about hospital medical errors committed there, saying the Army taught her to discuss and fix problems, not hide them. She’s suing. So is another former hospital employee turned whistleblower who was canned for giving CMS information about medication errors (CMS agreed and stopped reimbursement to the hospital). The loss of 68% of the hospital’s revenue led to the resignation of the hospital’s CEO, board chair, HR director, and nursing VP. Now the hospital is fighting the press to keep the former CEO’s compensation private despite its being public record. The board is thinking about selling the facility. Good idea.

E-mail me.

Inga’s Update

DR Systems announces nine new contracts for Unity RIS/PACS worth more than $3.8 million.

Thomson Healthcare releases its 15th annual 100 Top Hospitals. To come up with the winners, Thomson analyzes data from Medicare Provider Analysis and Review data for 2005 and 2006 and Medicare cost reports for 2006 and evaluates hospitals on eight measures of clinical quality, operating efficiency and financial performance.

Does anyone care to explain this MedCom Soft press release for me? Is there: 1) no real message at all; 2) an announcement they want to increase US marketing efforts; or 3) a well-hidden announcement about “right-sizing” the organization?

Walgreens announces its new Health and Wellness division that will manage its health centers and pharmacies located at large-company work sites. They are also buying a couple of companies providing work site health centers, raising their total number of work site and retail health clinics to 500. Walgreens estimates the potential for onsite work site clinics will grow to 7,600 corporate campuses with at least 1,000 employees each.

One of our fun sponsors asked Mr. H and me to participate in a NCAA basketball pool (I am not naming them in case the IRS reads this blog, even though they claim winnings go to charity). I was hum-ho on the whole thing until I read this section of the memo sent to all employees: “This year, we have added a Group Message Board option, which is a convenient outlet for those of you who may want to elaborate on their respective bracket picking strategies, defend seemingly half-witted picks, talk smack, or just have daily alternative to your Mr. HISTalk addiction.” I may have to participate to ensure folks don’t inappropriately make basketball more important than HIT gossip. Since I like winning and don’t really consider asking for advice equates to cheating, feel free to send me your best picks.

From Insider Outsider: “In regards to your note about Bill Gates appearing before the US House Committee on Science and Technology, and his predictions, my only response is …yawn. Bill G. has never been one to have very good or accurate predictions. He is usually very general – ‘technology will get smaller and faster’ (duh) or he is very wrong ‘within 5 years, all computers will use voice commands and the mouse will disappear’. Billy G. predicted that spam would be solved in 2 years (still waiting), that OS/2 would be the most important operating system of all time, that no one would ever need more than 640k of memory, etc. Yeah, he’s gotten some right, but even a broken clock is right twice a day. He made his fortune by buying someone else’s technology and reselling it. He’s the used car dealer of technology. As for the future, his best picture of the future is to look at what Steve Jobs is doing and to copy that.” Yeah, but he’s rich. Doesn’t that count for something?

My favorite part of the interview with eClinicalWorks Girish Kumar Navani was is brief commentary on various vendors. You have to be pretty confident to swagger the way he did.

Thanks for all the Linked-in invitations. (Do people like Linked-in and other network sites because it makes them believe they are popular – or at least have friends?) Regardless, it helps me with my swagger.

E-mail Inga.

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Misys announced this morning in London that it will spin off its US-based Misys Healthcare Systems and merge it with Allscripts, paying $330 million in cash for a 54.5% stake in the combined entity through a complex financing arrangement that also involves hedge fund ValueAct Capital, which will underwrite a new share placement to finance the transaction.

Glen Tullman of Allscripts will remain CEO, while Misys CEO Mike Lawrie will become chairman of the board. Misys will appoint six board members, with four from Allscripts. Allscripts shares will continue to trade under the MDRX ticker and the new company’s headquarters will be in Chicago.

The announced name of the new company is Allscripts-Misys Healthcare Solutions Inc.

Misys shares are up 20% on the London Stock Exchange.

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