Company
LingoLogix
25 Highland Park Village #100 509
Dallas, TX 75205
214.252.9522
www.lingologix.com

Product
GoCode computer assisted coding for ambulatory encounter notes.

The Elevator Pitch (provided by the company)
"Improved compliance, revenue, and speed to billing – automatically for ambulatory patient encounter notes, with our Natural Language Processing (NLP) solution, GoCode from LingoLogix.  Physicians do their documentation while GoCode works in the background, without requiring providers to change the way they work.  New intelligence, reporting, knowledge extraction from narrative, free-text digital medical content.  We can work with an EMR or without one, real-time or batch mode, ASP or behind the firewall – no problem. And, the Chief Compliance Officer will be impressed with our consistent coding accuracy that has been demonstrated against audit to exceed 90% accuracy in automatic E&M, ICD9, and CPT coding extraction."

First Impressions
We went right to the the company’s web site, of course. It’s very serious and low key. Can we figure out what the company does and why customers and prospects should care? Let’s jump in.

The good news about all the smarmy criticism that follows: we think GoCode is pretty cool, at least judging from our CIO-level, first-pass review. It passes the first-sniff test. The customer we talked to raves about its ability to bill fairly and consistently (which usually means increased revenue) for its target customer, large organizations that do outpatient billing. Compliance is important, but nobody likes buying compliance solutions, so let’s go with Get the revenue you’re entitled to through accurate, defensible billing advertising approach. Is that the message being sent? Let’s take a look.

The most important web real estate (top left of the home page) has some stock art and a tagline, "The Science of Specialized Languages." That’s not much of a come-on, at least until the company gets huge and has offerings in many industries. It’s true, it’s bold, and it’s broad, but it’s not the best use of the 30 seconds of a casual reader’s attention that you’re apt to get. Redesign the front page with a clearer call to action and a single, constantly repeated message.

We’re serious about the 30 seconds rule. It’s like a date – the evening’s outcome is usually decided in that same 30 seconds. Spend more time creating a shorter message. 

Under The Company, it says, "“LingoLogix was formed in 2002 for the purpose of taking core technology developed at The Mayo Clinic to market.” Nobody’s going to buy just because Mayo wanted to make money. Isn’t your purpose to assure doctors they are coding accurately for maximize reimbursement? Prospects like customers whose very specific mission aligns with theirs. Name-dropping Mayo is fine, but not here. Would you go to a doctor who says, "I went into medicine because I wanted to drive a Porsche?"

Neither is the unremarkable history of the company and the year-old press releases in the News section of the front page. What are you selling? Am I a prospect? Has nothing happened in the year since the last press release went out? What do you want me to do next?

We would write sexier press releases. The news isn’t that the customer signed the agreement to use the product, but that they state that it’s "more accurate than human coders." This is a great story badly told. Don’t be afraid to market yourself – tune the message, focus on what’s newsworthy, and give the press ideas for stories that will generate free PR. 99% of press releases are terribly written, guaranteeing that no reporter in their right mind will do anything except move on quickly.

Since we’re lost at this point, we’ll click on Products. That’s a misnomer – there’s only one (and there’s nothing wrong with that – it shows focus). If I do enough clicking, I can find more specific information. The downloadable brochure is good, but it’s hidden away and is in the PDF form that clickers often avoid. It also doesn’t match what’s on the site – it’s better in identifying benefits, though it stops short of saying it helps you get your money. The testimonials are good and should be on the main site.

It’s better to repeat one focused message than to spray out several of them. Tell me (again) what problem I have and how you’ll solve it. Give me a bullet list of key features (reduces the need for coding specialists, works with free-text dictation without templates, etc.)

There’s a link for Demos. Oops – it’s just a signup form, free of the immediate gratification I’m seeking. Few people will do that. I’m doing you a favor looking for information – why stick a salesperson in between me and what I want to see? Is it top secret? Why can’t I just look at a video or PowerPoint on my own? The product section actually has a link in microscopic letters that links to a screen shot, but there needs to be more of that and it should be easier to find.

Surely something here is innovative (what was that "science of specialized languages" bit?) so where are the white papers, testimonials, architecture descriptions, etc.?

There’s no mention of a sales and marketing executive or of any strategic partners who will resell the product. Prospects might not care, but investors might, so we would talk a little about the distribution channel.

If you redesign the web site, go Web 2.0 and hire a pro. Simplify the message. Make it appealing. Strip away everything that doesn’t add value. Put your best foot forward in 30 seconds or less.

Identify the Problem, The Audience, and Their Fears
The first question we ask a company that’s looking for marketing help: who’s your target decision-maker? What pushes their button? How do you find them and get your message in front of them?

It’s not clear from the LingoLogix site, but its customer tells us the company has three influencers to reach: the CIO, the outpatient manager, and the compliance officer. Since their agendas are wildly dissimilar, why not provide each with a link to click and then hit them with a targeted message? One size does not fit all.

We would say that CFOs and COOs (hospital or large practice) would be the best contacts. They own revenue and compliance issues and have authority to buy a solution. They think big picture. Regardless of title, find out who owns revenue and compliance issues – and that’s not likely to be the CIO, whose only role is probably to veto if the technology is risky.

And like most hospitals, the first question is "who else is using it?" Your customer sites are excellent.

We like the OIG/compliance pitch, but until a provider is busted, how do they know they have a problem? Nobody buys compliance solutions proactively, at least not since HIPAA was found to be a toothless tiger. And in our experience, compliance officers don’t have a lot of clout when it comes to changing systems or workflow. It’s the secondary message to improving billing accuracy, especially since most organizations underbill, according to your customer. Focus on the incremental revenue opportunity, but use compliance as the nobler way to get that message across without making the prospect feel greedy.

Here’s what we’d want to see: some kind of checklist or online worksheet that tells me if I have the problem you’re solving. People buy solutions. That implies problems. How do I know I have one?

Say what you’re selling me – often. A computer product? Peace of mind? Enhanced revenue? Pick an honest yet sexy marketing message and sprinkle it liberally everywhere.

This is the area we’d focus on first since it spans all aspects of marketing the product, not just the web site.

Management Credentials
A small company’s executive team and board attract three audiences: customers, partners, and investors. LingoLogix has a strong team when it comes to investors, but not so strong for customers and partners.

We’d like to see more operational healthcare experience represented. If you’re selling solutions for billing and compliance, get people with impressive experience in those areas. General business experience in leadership gives the perception that a company is a technology vendor rather than a solution provider, which the company clearly isn’t – it has real-life, deep domain offerings. We’d make that statement more strongly, perhaps with a strong advisory board of provider-siders. Get people who are similar to your target prospects.

It’s a well-credentialed team. Get some heavy healthcare experience as an advisory board and it would be much stronger. Or, have a third party "expert" from a well-known consulting company review the product and provide a quote about how great it is (assuming they think it is).

Focus on Results
We see a lot about what the product does, but not enough about what benefits the customer enjoys from its use (and from its customer, there are many). The customer says the ROI is impressive, so tell me about it (or better yet, give me tools to predict it at my place). Show me the workflow before and after. Let me feel what it would be like running it.

ROI is important when it comes to passing that first hurdle. Put it in the prospect’s face.

Business Benefit is Strategic
No problems here. Customers don’t often buy solutions that don’t align with strategy. Who wouldn’t want revenue enhancement and compliance assurance? Companies often miss that point – even a great product won’t get a second glance if it doesn’t solve a strategic problem. This one’s a natural.

Innovation – Why Are You Better?
We recommend more information here. We don’t know who the competitors are or what our strategic alternatives might be. Tell us! You don’t need to be innovative from a technology standpoint (people buy solutions, not gadgets), but give the CIO something to grab onto – architectural diagrams, interfacing information, hosted vs. locally installed, etc.

And if the rules-driven NLP is more sophisticated than the usual text decomposition (which the customer says it is), then tell the CIO. Just don’t expect the rest of the customer’s people to care. They want results.

Do you have any services, support, updates, etc.? Do clients like it?

From what the customer tells us, GoCode is damned impressive at consistently and accurately creating accurate charges from documentation, easily measured and monitored by running it against "gold standard" documents of known quality. That might the most compelling sales point available. Remember Kasparov vs. IBM’s Deep Blue chess matches? Even people who didn’t follow chess got interested in the man vs. machine angle. Pit expert coders against GoCode and publicize the results (no matter who wins). The PR possibilities are endless and the resulting message is razor sharp.

Or, hitting the compliance angle, get statements from neutral third parties on the value of having an unbiased, consistent billing tool vs. humans. The customer has done that. Or, offer an accuracy guarantee or to appear with the customer if billing is called into question.

While doctors aren’t heavily involved in the decision, the customer tells us there’s a strong argument for them. Billing more procedures accurately means higher numbers,which may mean bigger bonuses with no extra work whatsoever. Physicians could help seal the deal.

We wouldn’t talk yet about the tool’s obvious potential to build or mine data warehouses. That would just confuse customers. Stick with the single message.

Conclusion
LingoLogix has a happy prestigious customer, an apparently highly functional product that delivers big strategic benefit, and some smart technology people. Like many or most small companies, they’re still working on their message and positioning.

We like the company’s chances of success. Few have the big-name reference sites that LingoLogix has, plus the strong possibility of some huge deals upcoming. Bring on some sales and marketing expertise after the next big sale, we say, and go looking for investor money if you need it. And be ready to build a strong support organization for a wider user base.

We’re most encouraged that LingoLogix opened themselves up for our critique. We said we wouldn’t mince words (we said it would be like Kitchen Nightmares, where Gordon Ramsay rips into a restaurant to help make it better). We’re confident that the average decision-maker would have similar reactions to ours, although they wouldn’t make recommendations for improvement – they would just move on if they didn’t get the picture quickly.

Now It’s Your Turn …
We said upfront that we would give LingoLogix the chance to respond to our observations and recommendations. Secondly, and arguably most importantly, we offered the expert opinions of HIStalk’s readers. We gave our thoughts for free and invite you to do the same.

Do you agree or disagree with what we said? What advice would you give LingoLogix? What else should they know about their market? What partnerships should they seek?

Add your comments below. I guarantee that a lot of people, including everyone at LingoLogix, will be hanging on your every word.

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From Ralph Hinckley: "Re: replacing Vista with XP. I just did it. Make sure your licensed version of XP on a CD is bootable. Boot from the CD. Nuke the partition when given the chance and install XP. If you attempt to do it while Vista is running and insert the XP CD, that will fail."

From Dnomyar: "Re: Epic .NET rumor. At the Epic User Group Meeting last fall, one of Carl’s announcements was an intention to move the Hyperspace environment from a native client to the web in an incremental fashion. As I remember, he estimated that that the full conversion would take at least five years, although some specific modules or applications (e.g. Prelude) might be deployable on the web sooner. Haven’t heard whether Epic has picked .NET for their toolset, though."

From Geek99: "Re: Epic .NET rumor. Epic moving to web deployment (regardless of whether they use .NET or some other application tier) does not necessarily have anything to do with the ‘end of Cache in healthcare’. Epic is a client-server application moving to an n-tier application. It’s highly unlikely that they would change databases on the back end just because they are changing the presentation layer."

From B: "Re: Epic boycott. Probably worth noting that Epic itself doesn’t support PP – certain employees do. Each employee gets to direct a portion of the yearly giving to area/national charities of their choice. Kind of sad that it comes to this, as I imagine this will end up affecting where some people want to have their charitable giving directed." Actually, as a reader pointed out, that page the first reader sent in is over two years old, which I missed because it looked like a news item. So, whatever the boycotters hoped to accomplish apparently hasn’t happened since Epic seems to be doing just fine. Nothing to see here, move along.

From Arse-Enio Hall: "Re: Epic’s non-compete. Here’s the latest list of companies that Epic identifies as competitors for non-compete purposes." On the list: Allscripts, Cerner, eClinicalWorks, Eclipsys, GE Healthcare, Google’s healthcare area, InteGreat, McKesson, Misys, Meditech, NextGen, and Siemens, along with all parent companies, affiliates, joint ventures, etc. including those pending. I’m pondering: is being on the list a good thing since that means Epic is taking you more seriously than other vendors?

From Roy Loney: "Re: Firefox. For some reason, HIStalk causes the Firefox 3 Beta 5 browser to consume a very high percentage of CPU. IE uses less than 2% after the page is loaded. It’s not HIStalk and it’s not Firefox, but the combination is a problem. Maybe FF3 is inefficient with those separate Flash objects for sponsor ads and will be cleared by by the time it’s GA." I noticed that it handles Flash poorly on other sites, particularly video (always stopping a couple of seconds in). It also doesn’t work with my employer’s web E-mail client or portal. Guess that’s why it’s a beta, but I’m still using it.

From Dash Riprock: "Re: VA. VistA is bulletproof when run in one instance per hospital, with at most an hour a month for maintenance. What has happened since the VA’s reorganization and move to regional data centers  is unprecedented in scope and inconceivable to staff. This is more than 30 outages in the past six months. Most are 1-2 hours long so they don’t make the press." Link. An April 10 outage in 12 medical centers was caused by hardware failure in the VA’s Denver data center. In addition, Qwest had a one-hour outage just as the VA began troubleshooting its own problem. Stakes are higher when you centralize IT.

From Dr. Chumley: "Re: CEO Enrichment Index. How about this one? The interim CEO at Grady Memorial Hospital is a state representative who missed 177 of 233 House votes this year. She is managing partner of her  law firm, a Grady board member, and was appointed to the Grady non-profit corporation. After firing the CEO, she took the position herself and accepted the $600,000 salary, She has never been a CEO." State Rep. Pam Stephenson was named a couple of months back. Here’s a little reporting error: a Grady official was quoted as saying that Stephenson is "imminently qualified to run the state’s largest public charity hospital." Unless she’s expecting a just-in-time dose of executive experience, I think the intended word was "eminently." A fellow Representative said he will introduce legislation prohibiting board members from taking executive positions at hospitals they oversee, calling Stephenson’s appointment "a conflict of interest of epic proportions."

From Carb Venturi: "Re: Cerner. I’ve noticed that web search tracking tools are showing a spike in searches for  ‘cerner layoff’ and ‘cerner layoff age discrimination’. I report this, but I have no idea what it means."

From McK-Nuggets: "Re: McKesson. John King, son of former McKesson/HBOC CEO Graham King, is appointed to SVP of sales, central region, for Mckesson." It is good to be King.

Here’s a reader’s submission for "Name That Hospital". Looks kind of ominous to me.

Patient Privacy Rights (Deborah Peel) issues a press release about the NEJM article on PHRs. "Contrary to popular belief, the ‘P’ in HIPAA does not stand for ‘privacy.’ Rather, HIPAA allows millions of healthcare businesses to snoop in our personal health records without our permission for ‘treatment, payment and operations’ (TPO), which allows data mining, marketing and the sale of our electronic records." The NEJM article seems to be getting a good deal of attention.

Look for a fun writeup on Monday or so: HIStalk 911. You asked for more coverage of small vendors, so we offered to give a volunteer company a CIO-level first impression. We got information from an executive there, did a telephone interview with a customer, and sifted through everything on their Web site and our e-mailed question responses. Inga and I will offer our thoughts on how they could improve. The company won’t see our conclusions until they read along with you, so you can bet they’re sweating right about now. HIStalk 911 is a dramatic but misleading name (the company isn’t desperate and we’re not passing ourselves off as esteemed experts), but we thought it was fun. Best of all, we’ll ask for your thoughts, too. Companies willing to accept public critique in return for visibility are welcome and we’re doing it pro bono, of course, although it does take a fair amount of time so we can’t do it too often. See you then.

A new study says healthcare IT needs 40% more people to implement advanced systems on a national level.

Jobs: IT Director of Business Applications (NC), Consultant (MA), Cerner PathNet Consultant (PA). Gwen has a deal for HIStalk sponsors running position listings.

Meditech co-founder and MIT professor Ed Roberts wins an MIT entrepreneur mentoring prize.

Clinical reference provider Epocrates, fresh off its iPhone stage time with Steve Jobs and apparently unafraid of a terrible stock market, files for a $75 million IPO. It’s profitable, anyway.

If you subscribe to Google Alerts and are getting updates from Advance for HIE, I’d ignore them. They apparently screwed something up and are blasting out all kinds of undated news story links that are years old (I don’t know why you’d ever post a news story without a date, but they do). Inga was atwitter over a QuadraMed news alert she received today that was interesting, but when I found the original press release, it was from early 2006.

All the geeks are aroused over Second Life, so I gave it a try and left unimpressed, at least for its business usefulness (maybe it was a pop-up offer to buy avatar genitalia about 30 seconds into the orientation that did it). It was a resource hog and isn’t easy to figure out, although it’s kind of cool. Maybe I’m being curmudgeonly, but it seemed like yet another time-waster for Internet hermits desperate for phony friendships or cybersex. I can’t imagine companies building Second Life storefronts and training centers will get their money’s worth.

This guy is interesting: at 26, he earned OHSU’s first PhD in biomedical informatics and is now a Harvard Medical School instructor. His interest and doctoral dissertation topic: working on the Nationwide Health Information Network.

E-mail me.

The PACS Designer’s Open Source Software Review

TPD was happy to see our fellow blogger Shahid Shah posted a list of 100 open source software programs for medical professionals. TPD has decided to review some these programs for HIStalk readers. It will  be a review of their usefulness in daily work activity and not much about their technical aspects. The first review is about Debian, which is an alternate operating platform than you would traditionally see in a medical practice.

Debian looks like it would be useful in work environments of small practices where one of the staff members has a broad knowledge of operating platforms and has done some previous installs of similar systems. Since there will be frequent bug fixes, you will have to evaluate each fix as to how it will affect your system. It would probably not be useful in large institutions unless it was first tested in a pilot of a select group of users.

Debian is available on the hardware platforms of  Hewlett Packard, Dell, and a few other hardware suppliers. Support functions can be outsourced to them if Debian is deployed in your practice. There is also a broad developers network and many universities across the world are using Debian.

TPD Usefulness Rating:  8.

Link 1, Link 2, Link 3, Link 4.

An Epic Customer’s Impromptu Visit to Verona

I’m a general surgeon and Epic user. You might be amused by my impressions of Epic and my poor cell phone photos of the campus.

While I was in Madison WI, my wife and I drove out to Verona. We could not find Epic’s address in our GPS, so we just drove out. Once in town, my wife just went up to the counter of a mini-mart and asked them, "Where is Epic?"  Everyone knows where Epic is! We got directions with only one turn, and voila!, we were looking at the familiar view from Google Maps.

We just drove around this HUGE campus, with many buildings still under construction, and nervously parked our car at what appeared to be a visitor’s parking spot and walked up the steps and hill to the Mecca. All around you see whimsical little sculptures and paintings and themes, like this one of Humpty Dumpty sitting on a wall holding a laptop that says "Epic!"

There are multiple finished buildings in a general circle of top of one hill all generally constructed in a brown, red, and grey theme, but each one designed differently. Across an artificial ravine, about 1/2 mile away, there is another massive office building of green and chrome glass, presumably an office and training center, which will dwarf this current new campus.

We walked inside and introduced ourselves to one of three secretaries and explained we came on short notice to visit. She said she would arrange a tour. In the entry lobby, we got the impression of the Pacific Northwest, with artificial trees, tree trunks framing a staircase nearby, and little ceramic photos and items hanging on the walls. Wood paneling and dark browns and greens mingled with Geek cultural icons like the head of Yoda of Star Wars perched on some end tables where visitors wait. 

There are some photo books that I should have picked up, 24 Hours in the Life of Epic, featuring photos of employees getting up, getting ready for work, driving into work in minus 11 degree weather, and at work around the world, in airports, and on site.

It turned out there was no one to give us a guided tour, so we were given a four-page color brochure of Epic’s "Intergalactic Headquarters" and map of the campus and told we could take our own unescorted tour. We were introduced to the "Lake Conference Room" (on a lake theme with a rowboat in the side of the room framing a large paper tablet). More scenic sites were hard to figure out, "Wall of Hands," "Sunroom and Fireplace," or "Galaxy" or "Ice Palace." We were perfectly free to wander around and look inside offices and conference rooms which seemed to be about 1/3 full and 2/3 unoccupied.

People were pretty preoccupied. There were a few people sitting on couches with laptops, dress was casual, there were grease boards up in every office, many computers and laptops about, and all sorts of juxtaposed sculptures, furniture, artwork in whimsical arrangements and themes — an overview of our popular culture. It was at once distracting, interesting, and full of play.

There seemed to be little concern for stealing trade secrets or unauthorized access. In several very large auditoriums, there seemed to be large employee orientations going on, teaching them principles of responsibility and responsible reporting.

Different buildings had different themes and names. We did not venture into the dining area, "Cassiopeia" but we found out that building "Formalhaut" was in a New York City theme with city streets, park benches, subways, and stuffed dummies adding to the décor. We did meet a few denizens of the building "Ganymede" who showed us around a little.

We were late for a dinner, so we stopped by the entrance, said goodbye, and drove off, musing at what is in store for Epic, a privately-held company with business expansion, lots of employees and space, and no significant financial debt. It looks like a company to watch.

Inga’s Update

Seems as if some TriZetto shareholders aren’t pleased by the company’s plan to be acquired by Apax Partners for $1.4 billion and are filing a class-action lawsuit. Mr. H predicted the acquisition might not be a slam dunk.

Medford Medical Clinic in Oregon is deploying Krptiq’s eScriptMessenger for eRx.

The University of Tennessee Medical Center selects GE Healthcare’s Centricity Perioperative Solution.

E-mail Inga.

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From Mr. FA Queue: "Re: MUSE. Not a rumor, but certainly a head-scratcher. Replacing John Cleese as the keynote speaker at the 2008 International MUSE Conference… drum roll … Fran Drescher. What don’t I know that makes her appearance pertinent?" What’s all this, then? She wrote a book about her cancer experience. I’d rather see her in character as Bobbi Flekman with the lads.

From Spurious Emissions: "Re: GE. GE’s disappointing earnings at the corporate level are finding their way down to their hospital and physician customers. 30 FTEs in their physician solutions area (Flowcast and Groupcast) have been laid off and more may be impacted. After a long winter in Burlington, this is a tough start to the usual joyous spring." Unconfirmed. That does kind of suck – the only advantage of being absorbed by a humorless conglomeratized beauracracy is job security, then one bad quarter unleashes the pink slips (not a new concept for those in Burlington since the acquisition, unfortunately). I bet FAHC is getting pummeled with IDXers hoping to learn Epic.

From Ovid: "Re: EHR vendors. Lots of communication going on between eMedicalFiles (MDAware) and Propractica (StreamlineMD). Word is that these two CCHIT-bearing companies might be joining forces. Also lots of talk about a biometric application that might be adaptable to any existing EHR vendor platform."

From Pat Robertson: "Re: Epic. To all those Christian healthcare organizations spending tens of millions on EPIC’s EMR. Did you know EPIC supports Planned Parenthood? How does that compute with your healthcare ministry?" Link. Epic is newly added to a pro-life organization’s boycott list for supporting Planned Parenthood, along with Oracle and Merck. Already on the list: American Automobile Association, Kaiser Permanente, American Cancer Society, Girls Scouts, Kiwanis, Rotary International, March of Dimes, Susan G. Komen Breast Cancer Foundation, and American Diabetes Association. There’s nothing I can say that won’t make somebody mad, so I’ll just ride the fence.

From Jill St. John: "Re: Epic .NET rumor. If Epic decided to move to .NET, it would take billions of dollars and a decade or so. Can you call Epic or ask a big client?  This really would be game changing info and likely mark the beginning of the end of Cache in healthcare." Confirmation, anyone? I’m pretty sure Judy won’t take my calls, so if anyone knows, chime right in. 

From Pastor Taco: "Re: Sunquest. The situation at the ‘new and improved’ Sunquest has not changed. People continue to bail left and right. They still have leftover Misys executives who live in Raleigh (makes sense, huh?) and other senior management from the Misys era. Over the past several months, key senior managers have been pushed out of the organization without as much as a severance. Check with your sources – they will validate that not all is well at the good ole SQ. Everyone there is in fear for their jobs and under dictatorship rule. The numbers look good, but Vista really needs to look under the covers." Unverified, but confirmation welcome. It didn’t make sense to me either that they kept all the old Misys management and left them sitting thousands of miles away from the troops, as though the inconvenience of relocating to run the new company was too much to ask. I know nothing about them, but I would have cleaned house just to shake the Misys cobwebs off.

From Mikey Likes It: "Re: Art Vandelay on Epic. He states ‘the company supplying the consulting services is making the gold mine’. In my humble opinion as a grunt consultant, we earn every dime. Epic installs and go-lives are no picnic:  a) being away from home 14 days straight because an implementation manager scheduled me one day off during a go-live; b) working a 15-hour day correcting the instruction manuals because the client let his staff slip their due dates; c) being assigned a work space for five months smaller than my powder room at home with no intranet connectivity and being told ‘you figure it out’. I make a good salary, enjoy implementing Epic, and chose my profession, but please don’t whine that consultants make good money. 99.9 percent of us are dedicated to your success, willing to do whatever it takes, and we earn it every day."

From Tommy Pischedda: "Re: HIMSS booth race. All the companies I talk to are looking at ways to scale back on HIMSS booth size and investment. Times are very hard and HIMSS will really have to pad the numbers to show an increase if things progress as it’s looking. Many small start ups with small HIMSS booths are dying by the wayside – they are  way undercapitalized and in the midst of the recession (whether we call it that or not) that’s hitting healthcare and HIT." How about some multilateral HIMSS disarmament? Everybody cut back 20% from what you spent this year. Agreed? And I’m sure HIMSS will show an attendance increase, even if it means offering cheap day passes again (like this year) to move the turnstiles. Maybe that’s another reason to hold it in the puzzling choice of Chicago – more locals who’ll commute over.

From Rogue: "Re: XP support. MSFT support for XP is due to expire June 2008.  Please sign the petition at http://weblog.infoworld.com/save-xp/ to persuade MSFT to keep XP around another year or two until Vista or its successor can come up to snuff. I love my XP and if anyone can send Mr H. a good link on how to uninstall Vista and install XP (my new home desktop – no other option from Dell), I’d be way grateful."

From Mr. FA Queue: "Re: Hackensack. My deep inside source tells me that Siemens has not been booted from Hackensack University, but that they are looking at other vendors, including EPIC. This source tells me that the reason this is on the table is not because of Soarian, but because Siemens has not addressed the replacement of technology that already exists within their Invision environment. Plus the fact that Soarian Financials are way past due and there doesn’t seem to be much light at the end of the tunnel."

From Leroy Brown: "Re: Soarian. Siemens has web information showing Soarian implementations. The install activity and number of live applications is growing, but I’d estimate that Siemens has only 15-20 US customers live with one or more Soarian applications. Not a lot after all those years and billions." The most recent newsletter link is here. Leroy compared it to previous issues to draw conclusions. It says 80 customers, but I’ll trust Leroy’s number-crunching.

From The PACS Designer: "Re: Zimbra. As we move forward in bringing new concepts to healthcare, it would be nice to have tools to support this activity.  Zimbra is a next-generation messaging and collaboration software tool from Yahoo that has seen some application in educational institutions and may be a good tool for teams planning to improve the efficiency of working together daily. Ohio State, UCLA, and Georgia Tech are some of the universities already using Zimbra." Link.

Listening: 60s cult faves Flamin’ Groovies. Also, Fine Young Cannibals.

Two Children’ Boston doctors (at least one of them a long-time HIStalk reader) write an NEJM article warning of the privacy implications of personal health records, specifically those offered by Microsoft and Google, and the fact that those companies aren’t bound by HIPAA. We might as well raise the white flag right now and admit that HIPAA hasn’t done much for privacy except to raise awareness.

If you work in a hospital, give me a few seconds and be (anonymously) counted in my three-question survey (what’s your job description, what hospital do you work for, and what city is it in). I’m curious who’s reading. Thanks.

New poll to your right: what will happen to Cerner’s share price after its April 22 earnings announcement?

Call center software vendor Amcom Software says it grew 68% in its just-ended fiscal year.

Quantros announces its Disruptive Event Manager software for hospitals. That’s not defined, but other references suggest it means harassment, discrimination, and medical errors (but I’m still not sure). I guess if you’re a prospect, you’d know.

A British surgeon suspended for not keeping computerized records after being ordered to do so by overseers says he was misled. "My only problem is computers. I didn’t like computers. I was not computer literate and I was misled. I was told computers were coming, but not that it must all go on computer. You can do it manually as well."

Bringing home the pork: a Vermont counseling service gets $191,000 in federal money to pay for an EMR system, allowing it to move its own money into a big construction project, the opiate of nonprofit healthcare.

Bizarre: some Philippine surgeons are in big trouble after a YouTube video showed the entire OR crew laughing, cheering, and taking cell phone video during surgery on a male patient brought in after a New Year’s drinking spree and one-night stand with a male partner. The surgeon extracted six-inch long metal canister from the patient’s rectum, triggering a shout of "Baby out!" and resulting cheers from those in attendance. The doctor then chased staff around the room, spraying the can’s contents at them. Med and nursing students from the OR next door came over for the festivities. The patient says he was too drunk to remember how the can got there.

The Cayman health authority gets GE PACS for George Town Hospital. I only mention that because I’ve been there a few times. It was darned expensive even before the dollar went to hell.

WellPoint announces some kind of vaguely described medication surveillance system that will detect adverse events. Hopefully they’re not selling patient information to drug companies.

A West Virginia ambulance chaser gets a law passed to hide damages sought in personal injury and wrongful death lawsuits. He was prompted by a WV suit against McDonald’s that claimed a guy’s two Quarter Pounders Without Cheese were actually Quarter Pounders With Cheese, causing him a near-death allergic experience worthy of a $10 million lawsuit. Peering under the bun, even to preserve one’s frail and ephemeral human existence, was apparently beyond the plaintiff’s capability.

I haven’t done a CIO Salary of the Week for a very long time (and I’m not sure if anyone really missed them), but here you go: Albany Medical Center, Albany, NY: $310,433. HIStalk CIO Enrichment Index: 443. Wakemed, Raleigh, NC: $256,441. HIStalk CIO Enrichment Index: 38. Baylor Health System, Dallas, TX: $419,287. HIStalk CIO Enrichment Index: 154. Extra points if you can remember how to calculate the Enrichment Index because I couldn’t.

Thanks for reading, commenting, and e-mailing. It keeps me interested during the very many hours I sit here alone in front of the computer. Feel free to use the secure and anonymous Rumor Report to shoot me juicy stuff.

E-mail me.

Inga’s Update

From Greg Focker: "Re: VISICU. Talking to a VISICU sales rep, they are waiting for some of their installs to publish results of remote ICU citing positive patient outcomes and (of course) a huge economic benefit. They then expect to double their sales and support staff to handle the anticipated orders flowing in." Unconfirmed.

NextGen announces (warning: PDF) that Arkansas MSO Practice Plus will implement its EMR/PM suite. Practice Plus will utilize the PM product for its 200+ physicians and EMR for its employed physicians.

Apparently to Mediware’s surprise, Constellation Software of Toronto purchases 6.1% of Mediware’s outstanding stock. The stock price has fallen more than 50% over the last year.

The Rural Wisconsin Cooperative Information Technology Network selects HMS to provide EHR infrastructure for four Wisconsin community hospitals. The hospitals will share a data center and eventually exchange clinical data.

This week we ran Mr. H’s Inside Healthcare Computing 2006 editorial about the HIMSS booth arm race. Q posted a comment that he/she disagreed with my self-proclaimed curmudgeon boss who said he didn’t know anyone who enjoyed the exhibit hall experience. Like Q, I love running into folks I haven’t seen in years and find the people-watching aspect very entertaining. Q – I happen to be an ENFJ, so I totally get what you were saying.

A reader asked if we knew if many readers were planning to go to AONE. If you are a nursing exec heading to Seattle this month, feel free to drop us a note with updates.

Infosecurity Europe surveys 576 office workers and concludes that women are more likely than men to give away their passwords to strangers in exchange for chocolate. In fact, 45% of women and only 10% of men felt a chocolate fix was more important than security. If it were dark chocolate, I am pretty sure I might be inclined to share all sorts of secrets! Anyway, you have to love those crazy Brits for their ingenious marketing techniques.

A Florida radiologist will pay the government $7 million to resolve a healthcare fraud case. The doctor is accused of billing for procedures not performed, not ordered, and not deemed medically necessary. Seems the government also thought he was paying other physicians for referrals. A whistle-blowing ex-employee gets $1.75 million of the money.

Eclipsys announces that Cancer Treatment Centers of America has achieved 100% CPOE adoption on the first day using the Sunrise solutions. The Centers just activated the system simultaneously at all of its hospitals (four, I believe).

SCI Solutions  releases an upgraded version its Order Facilitator online order communications tool.

Arkansas convicts its first HIPAA violator, a nurse who accessed a patient’s PHI. The nurse’s husband took the information, called the patient, and threatened to use the information in an upcoming legal proceeding. The nurse pleaded guilty to wrongfully disclosing a patient’s health information for personal gain and faces up to 10 years in prison and a $250,000 fine.

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 didn’t learn much at the HIMSS conference last week (despite having attended several purportedly educational sessions.) However, I did arrive at one conclusion: the exhibits are out of control.

I’m a confessed curmudgeon not entirely thrilled to see the Neon Gulch exhibit hall outgrow all but a handful of convention centers, a marketplace in which vendors pay millions for a few hours of exposure to the largely indifferent masses.

We all know that decisions aren’t made and contracts aren’t signed at HIMSS. In fact, real decision makers are so vastly outnumbered by vendor staff that the yellow badgers often demo their latest PowerPoint-powered vaporware to each other just to kill time before their expensive dinners. Booth traffic seemed to be down this year even by Tuesday, with shell-shocked attendees wandering around like the confused zombies in Dawn of the Dead, seeking familiar comfort from free pens and phony sales smiles.

I’ve yet to meet anyone from either the vendor or provider side who actually enjoys the exhibit hall experience. Odd, since it’s hard to dislike a place with free cookies, scantily clad rent-a-babes, and chances to win sporty midlife crisis mobiles. Maybe because I know it’s all fake. Interchangeable booth employees are eagerly trying to convince low-ranking non-decision makers that their product is Hot and Wonderful and maybe even Sucks Less than it did last year.

You might believe this after your first HIMSS conference, but surely not after your second.

Attendees are steered to the exhibits like cattle in a slaughterhouse. Hmm, I wonder why no educational sessions are scheduled for Monday afternoon or at other obvious times? It’s to make vendors feel good about their foot traffic, best measured in quantity rather than quality.

HIMSS encourages the booth arms race. You want to erect an acre’s worth of steel on two levels? No problem, as long as you can afford it and have your HIMSS points. Throw it out and start over next year? Do it! Bring your best gimmicks, your toothiest glad-handers, and your choicest trinkets and beat your competitor. It’s fun! Don’t be a tightwad! We reward big spenders by letting them spend even more!

Does anyone remember when HIMSS limited booth sizes to something like 20 by 20 feet, which was enough when you didn’t have booth babes, cookie and popcorn machines, cheesy celebrity look-alikes, and a fleet of cars to be raffled off? Were you really less well-informed when you didn’t need a sponsor’s trolley to haul you around the sprawling acreage of magicians and massage tables? If you’re really going to buy, won’t your vendor come to your place instead of waving you over at HIMSS?

We’re mostly a non-profit customer base. The country’s economy and competitive advantage are getting destroyed by escalating healthcare costs. Many of our organizations struggle with capital shortfalls and indigent care. And yet our big conventions (whether HIMSS or RSNA or ASHP or whatever) are looking more and more like Comdex 1999, apparently encouraged by us fun-loving representatives anxious to live it up on someone else’s dime. You know it’s bad when even the keynote speakers make fun of the excesses.

I personally could enjoy HIMSS with smaller booths, fewer gimmicks, less noise, and better disclosure of which demonstrated products are real vs. wishful thinking. I’d like to see little companies be able to exhibit without being slandered as “struggling” by their bigger-boothed competititon. I’d like to go home after the conference less tired, less embarrassed at wasting my employer’s money in sending me there, and better informed. But, that’s just me.

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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The views and opinions expressed in this blog are mine personally, and are not necessarily representative of Texas Health Resources or its subsidiaries.

Culturally Relevant Leadership
By Ed Marx

One of my favorite things to do as a youth was to visit my dad’s office. To get into the French Army compound unnoticed, I had to be smuggled, cloaked in an air of mystery and suspense. I’d hide under the dashboard of our military sedan as French security forces saluted our vehicle through the gate. Once inside, my dad would park the car in front of the U.S. Forces headquarters and, when given the clear signal, I would run inside where I savored a free existence among the U.S. military and civilian officials.

As my dad worked, I would pull up a chair to the massive wooden conference tables and desks and play office. I toyed with paper clips, erasers, pens, rubber stamps and other office paraphernalia. I loved using the electric typewriters and placing my classified papers into filing cabinets that filled much of the hallway space. I made pretend phone calls to other consulates and raided whatever candy jars were available.

Fast forward…

In recent years, I have entered ex-IT leaders’ offices to discover that not much had changed since my youth! Searching desk drawers, I was surprised to unearth rubber stamps, legal pads and stickers. (Remember those gold stars teachers used to put on report cards?) With the exception of computers, these offices were even equipped with yesterday’s furniture. Although digital automation was functioning, you’d never know it by the amount of documents printed and processed via historical methods. Despite all the digital storage media available, I’d speculate that we still store more paper than ever before.

We have an aging leadership issue, and I’m not necessarily referring to chronological age. Evidence supports the likelihood that our antiquated styles and methods are creating hindrances in raising the next generation of IT leaders. These future leaders need our wisdom; but are our succession plans hip enough to give us credibility? I am not the most avant-garde CIO out there, but I am cognizant of my need to continuously update my team and myself lest we become irrelevant to those whom we lead and serve. So I push myself. I still have a long way to go.

If I have offended you thus far, check your desk drawers before you reply.

Cultural relevance manifests itself in many ways: how we dress, lead, talk, use tools, interact with staff, innovate, etc. Assuming you already have the requisite IT skills, endeavor to keep up with cultural trends. What was relevant when you graduated is not so for today. Here is a test. Bring your father into your office. If he is comfortable with the tools you use on a regular basis, give yourself an F!

How to stay culturally current:

• Hire and promote it. Do not be afraid to hire new blood right out of school. Promote talented individuals even if they don’t have years of experience. If they’re talented, they’re teachable.
• Hang out with culturally current people. Having had two teenagers in our home has acted as a catalyst for me. I have also created advisory groups to keep me on my toes. The best one was made up of second-year residents who gave me advice. I first learned of wikis and the power of blogs from them.
• Experiment. If you don’t already have a LinkedIn and MySpace account, you are way behind. Bonus points if you conduct business via SecondLife.
• Hang time. Set up monthly after-work parties at the local watering hole, where people will be more likely to let down their guard and deepen relationships on a different level. You’ll reap the benefits back at the office. I even had a foosball table in my office that helped eliminate intimidation and similar barriers.
• Cross-pollinate. Avoid spending your conference investments solely in health care. Attend non-healthcare venues and get to know people who don’t look like you or share the same points of view.
• Wardrobe. Honestly, how old are your suits and ties? I picked the sharpest dresser in my IS shop and had him stop over to my house. He systematically eliminated about 75 percent of my work wardrobe. He then took me shopping — and not where my dad shops.
• Read voraciously. Read blogs! Read from non-traditional sources of media. Gain fresh perspectives on everything from innovation to leadership. Managing Gen X requires different diplomacy than Gen Y, which requires completely different techniques than do baby boomers.
• Speak and write. This process will force you to differentiate and expose yourself to new ideas, vocabulary and trends.
• Reduce e-mail. Email is from the 90s. As my kids say, e-mail is for when you want to send a thank-you to your friend’s mom for having you over for dinner. Push the limits with IM, txt msg and video.
• Furniture. My office furniture has no place to store paper. There is no table, except for coffee. There is no trashcan. There is no printer. Everything (phone, projector, tablet) is wireless. We are tearing down several cubes in favor of contemporary design that encourages innovation and collaboration.
• Music. Hey, I love 80s music. But I do my best to mix it up with the latest in sound. Listen to all — yes all — that your employees listen to, from Mozart to Moby. Admittedly, I still struggle in Texas with country.
• Phones. Do you still have a flip phone?

Being culturally current cannot be delegated. Be proactive, otherwise you’ll end up only attracting employees who like to stamp documents and store them in mammoth filing cabinets. Candy jars are acceptable.

Ed Marx is senior vice president and CIO at Texas Health Resources in Dallas-Fort Worth, TX. Ed encourages your interaction through this blog. (Use the “add a comment” function at the bottom of each post.) You can also connect with him directly through his profile pages on social networking sites LinkedIn and Facebook, and you can follow him via Twitter – User Name “marxists.”

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