From Sir Lord Baltimore: "Re: hospitals not like hotels. These two are at least taking steps in the right direction. The first is for a Group Health project in Bellevue, WA . The second is the new SSM facility in KS." Link 1, Link 2. Interesting, especially from a design standpoint, but unless they decline to accept insurance, they’ll still be ruled by the treat ‘em and street ‘em mentality that makes hospitals more like quick lube places than the quiet, restful places in the country they used to be back in the "sanitarium" days. Can you imagine a hotel being paid to see how quickly they can get you to leave? Maybe the whole concept of insurance was a socialist experiment gone bad, especially when the social goal of "healthcare for all" really means selling everyone insurance.

From Samuel Kershaw: "Re: Firefox. This sucks big time." Link. Google, in a rare retreat, pulls the plug on its Browser Sync and says competitors’ products were better than its own anyway.

From Trampas McClure: "Re: employer award. Our hospital IT department won one of those magazine awards for being a great employer. Management put signs around to remind employees how good they have it and pretending it to congratulate staff for something or other. Just down the hall is a bulletin board full of open position postings. If it’s so great, why did all those people leave?"

New poll to your right: should hospitals require prospective CIOs to have specific application or vendor knowledge?

Forsyth Medical center (NC) gets a mention in the local business journal about its upcoming Microsoft Amalga implementation, although only the first four paragraphs are visible to non-subscribers (like me).

Over in the UK, it sounds like there’s a good possibility that BT will slide into Fujitsu’s former role of implementing Cerner Millennium, at least in the south trusts. That’s what I hear, anyway.

A warm welcome to RelayHealth, now an HIStalk Platinum Sponsor. Inga and I had worked with the folks there on our interviews about the company (Virtual Information Exchange and Financial Clearance Services) and we thought they were pretty cool with their Fake Ingas and badge ribbons at HIMSS, too. So now we’re all hitched and everything. They’re a sponsor of HFMA’s ANI, which starts Monday, June 23, and I’m sure they would appreciate your stopping by to say hello (on behalf of HIStalk, since I’ll be slaving away at work instead of playing the slots in Las Vegas). They’re a load of fun in our book (the people we know, anyway) and they really want to support HIStalk’s readers. Thanks to RelayHealth.

Listening: to HIStalk Radio, of course. Most recently played: L7, Bikini Kill, Yeah Yeah Yeahs, Operator, and Go Betty Go. If you haven’t listened to new music since college, jump on, at least if your tastes are like mine (girl singers preferred but not required; punk, prog, and surf  influences OK; no soft rock or singer-songwriter warbling; no rap or so-called country that’s really insipid pop; and anything indie, emotional, and rough around the edges preferred over formulaic corpo-rock and choreographed posers).

Ministry Health Care (WI) will move to the clinical system developed by Marshfield Clinic, discussed in my November interview with former Director of IT Tanya Townsend. CattailsMD even has its own web site, the tone of which (and the successful pursuit of early CCHIT certification for it) suggests that maybe Ministry will be the alpha site before commercialization, either by the clinic or maybe by an interested vendor (hmm … guesses who would be interested? although GE’s lack of results from Intermountain should be a cautionary tale). Will Weider, CIO of both organizations, has more. I told him he’ll be a media darling now – he’ll get that USA Today photo yet.

Tennessee’s Shared Health HIE upgrades its Clinical Xchange, with technology from Allscripts, IBM, Initiate Systems, MedAI, Oracle, and Orion Health.

Here’s to the power of shared knowledge and inspiration. Several weeks ago, a CIO reader took me to task for some comments I’d made, leading me to write an editorial called Perfect is the Enemy of Good Enough: Waiting for IT Nirvana Kills Projects and Patients (her comments inspired me to dash the whole thing off in one sitting in a Panera while eating one of those orange-iced "scones," stretching that definition to to ease the customer’s guilt over having dessert for breakfast). Anyway, another CIO e-mailed me yesterday to tell me that he planned to use the editorial to launch some discussion among his team. Pretty cool.

A Cerner intern wins a prize for developing a mobile phone application that lets college students sell their used textbooks locally. 

The author of that Newt Gingrich interview article I mentioned last time, e-mailed me to mention that it was actually published in State Legislature Magazine and came from the Forum for State Health Policy Leadership, part of the National Conference of State Legislatures. Also suggested: readers should check out their web site and state legislative tracking database.

Here’s a great article on Epic Systems. Tidbits: nobody had heard of them locally until they started building the new HQ; the company was small (and confident) when they decided to build the monstrous $205 million campus; new construction will push its Verona, WI facilities investment to $500 million; and the company is actively going after business outside the US. Snips: "A contemporary photo of Faulkner, 64, is impossible to find, and a brief trade-news account of her 2002 speech to the Accelerate Madison tech group (she reportedly stipulated that her talk could not be recorded) is treated by Epic watchers as the Rosetta Stone for understanding Epic’s idiosyncratic approach to personnel … Epic is famous for its rigorous screening of job applicants and providing its staff a world-class work environment. Private offices for everyone (not the cubicles so common in the tech world), imaginatively designed conference rooms for work-team meetings, art-filled buildings, gourmet food, an anything-is-okay dress code, generous stock plan, the sabbatical program and more. All to spur creativity, productivity and loyalty."

The new AVP and "chief growth officer" at Inova Loudoun Hospital (VA) is former CIO James Rohrbaugh.

Interesting technology: a retired ED starts a company to market his invention, an $8,000 imaging machine that highlights patient veins for nurses trying to start IVs.

Two Mayo Clinic retail pharmacies in Rochester are shut down temporarily because of unspecified software problems.

Odd: a Georgia doctor and two office assistants are charged with false arrest after allegedly refusing to allow a female patient to leave the office when she couldn’t pay her bill immediately. Her lawyer claims she was told her visit would cost $98, but when she couldn’t come up with the $755 final charge, she was locked in a room, forced to look up her bank records on the computer, and was walked outside to retrieve a payroll check from her truck while staff kept her keys.

GE Healthcare lays off hundreds of Waukesha workers because of declining imaging sales.

This article on a Santa Rosa (CA) clinic’s EMR implementation has a great quote from the medical director: ""We don’t really have a health care system. We’re building a model for efficient, safe, timely, patient-centered care so that when we have a national health system, we can be part of that solution."

A Michigan paper does a pretty good job describing a physician group’s use of Covisint’s physician service, which includes e-mail, results, and claims. I saw it at HIMSS and was impressed, at least given my rather quick perusal.

Idiotic lawsuit: a 52-year-old female cop is suing Victoria’s Secret after she claims her eye was damaged when a thong she was putting on shot a piece of rhinestone trim into her eye, requiring her to use ointment. Her attorney tried to stave off "idiotic lawsuit" eye-rolling and also declined to say how much she’s suing for, saying "In terms of money, that’s not what we really want here. We want to make Macrida fully redressed for her grievous injury." Money, in other words. She might want to either choose a non-thong next time, consider bumping up a couple of sizes, or re-sew the bling with some 50-pound test fishing line. I’m pretty sure I don’t want to see a 52-year-old traffic cop in a V-string in any case.

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From Cousin Carl: "Re: EHR study. NYT’s piece on barriers to adoption of EHRS by small groups -points to most EHRs being designed for hospitals or large groups. Does highlight athenahealth’s EHR being used." Link. Inga mentions it below. Interesting David Brailer comment about EHRs that appeal more to hospitals selecting doctor systems than the doctors themselves: "What we see is a deficit in innovation, and that is something innovators and the capital markets can address."

From Enrico Pallazo: "Re: your Inside Healthcare Computing editorial. About time someone opened up this dialogue. Go for it! This needs to be a national conversation." It was called If Uncle Sam Doesn’t Like Healthcare Administrative Costs, Why Did He Create Them? A sample sentence: "Uncle Sam, as the biggest payor, is the also most demanding, bureaucratic, and arrogant." I don’t know the topic well enough to do anything more than raise the issue, so the movement will need to recruit.

From Larry Leisure: "Re: Misys. Rumor has it that the Misys sales force has been reduced." We ran some comments assuring us that would happen, so if it did, it’s not much of a shocker. One rumor was that nobody was making quota, so with the merger impending, that’s going to happen.

From The PACS Designer: "Re: Firefox 3. TPD downloaded the Firefox 3 release and found it to be much faster when accessing web sites versus the old version. Also liked the enhanced graphics and new highlighting features for recent sites visited. As always, there will be some security problems with this new version and the first problem appeared on release day, but will be fixed quickly according to the Mozilla representatives. Firefox is available in over 45 languages, thanks to the contributions from Mozilla community members around the world."

From Rodney A. Rippy: "[Physician EMR vendor] had an invite-only meeting in NYC last week looking for someone to buy or be bought in a ‘merge to keep us alive’ attempt. After their home healthcare buyout firm screwed the pooch, they’ve realized that the only asset their have is their software (not very good, really) and their clients (worth something). ~$30m in debt, need $5-10m to stay open, hoping for an angel. The real problem is that they fired a lot of the people who knew what they were doing in order to make room for the New Order, who didn’t. Familiar story?" Inga’s trying hard to confirm, but seems to be getting the runaround. This is a pretty big vendor with quite a few awards. Maybe David Brailer should buy them.

Next, on a very special Listening: I created a Pandora radio station with the stuff I like. You can stream this bad boy and hear all kinds of good stuff for free, 99% of which you will never have heard of. I’ll keep tweaking it, so it will improve over time. We can listen together while reading HIStalk and sipping that Starbucks latte that Inga mentioned. Playing now: Dressy Bessy.

Jobs: Principal Pharmacy Systems Analyst (VA), Soarian Consultants – $5,000 Sign On (MA), SQL Developer (TX).

Insurance company Health Care Service (sounds like the kind of crazy, out-of-the-box name a bunch of  insurance company types would dream up after one too many wine spritzers) will buy case management and data exchange vendor MEDecision for $121 million. Quadruple the share price? Are they nuts? CEO David St. Clair hits another home run, having sold GMIS to McKesson HBOC in 2001, although master money man and industry long-timer Carl Witonsky was the company’s board chair and CEO during its IPO (he’s currently chairman of Sentillion’s board and they’re doing great too, so I’d put my money there if I had enough of it to get Carl’s attention).

How did I miss this? Cerner and a division of Steelcase are burning up a fortune in gas on a multi-city tour of the Smart Semi, an 18-wheeler mobile showroom. It was in Manhattan Thursday, then headed back to the Midwest (hitting three Wisconsin cities, but steering a wide berth around Madison). It’s booked through the end of the year, including some conferences.

Final tally: Firefox 3.0 easily breaks the world record for one-day downloads with 8.3 million, two of which were me (one for home, one for work). You can get it here, although if you’re like me and don’t warm up to the so-called "awesome" address bar, you can go back the old one with this plug-in. It’s even faster than Opera, making Internet Explorer feel like sprinting with hip waders on.

Fujitsu has two weeks to pay back $132 million to NHS for walking out on its contract. Doh!

And speaking of the UK, a leaked document obtained by The Guardian suggests that the Lorenzo situation there is worse than acknowledged, with IBA shifting resources from the more important second phase to try to keep the first one going.

Concord Hospital (NH) fixes application delays after consolidation with WAN optimization.

All hospitals like to point out their new construction is being "like a hotel." Surely nobody’s buying that beyond first glance. Hotels don’t lock you up in airtight rooms with no view, have unannounced and sometimes surly people shuttling in and out of your room to probe your private areas, serve food from the same outsourced companies that specialize in portion control for prisons, and don’t charge you $2,000 a night for the crappiest mattress and TV channel selection possible. No matter how nice the architecture, hospitals are about as unlike a hotel as they could possibly be, other than strangers sleep there. Nobody in their right mind wants to be in one or, God forbid, die in one. With all the discussion about changing physician practice models, it would be great to rethink how hospitals work from the ground up. They’re more like a factory than a restful, respectful place to recover.

Some local paper gives Newt Gingrich some softball healthcare questions, sounding worshipful toward his Center for Health Transformation but not picking up on the fact that it’s a for-profit business run by an ex-politician (but I’m still a fan, sort of). He says healthcare will exceed the rosy $77 billion in annual savings that the federal government just said was a pipe dream.

If you’ve e-mailed me lately, I’m really behind. Sorry about that. I just can’t find enough hours in the day to keep all the plates spinning. I’m trying and I read and appreciate every e-mail, so don’t be offended.

E-mail me.

Inga’s Update

Seven new healthcare organizations have selected Sentillion’s provisioning solution in the last six months.

Company-sponsored health clinics for employees are on the rise, according to a Dallas newspaper. Employers with as few as 2,500 employees are offering this perk for staff and proponents, claiming they lower costs for everyone.

The Wisconsin Health Information Organization (WHIO) is collaborating with Ingenix to create a statewide repository of health claims data.

LinkedIn has raised $53 million in financing and is now valued at over $1 billion. I’m confident that valuation would be significantly less without the 123-member HIStalk fan club. For those keeping track, I now have 106 connections compared to Mr. H’s 139.

Southwest Washington Medical Center enters into a three-year agreement with Novo Innovations to facilitate health information exchange between the hospital and at least 14 practices.

The University of Wisconsin Health System is partnering with OnBase to integrate disparate patient information into the EMR. (Isn’t OnBase the one with the fun baseball theme booth at HIMSS? And offering beer at 11:00 in the morning?)

WellSpan Health System (PA) claims a 28% reduction in annual A/R and a 98% cash collection rate since it implemented Eclipsys’ Sunrise Access Manager and Patient Financial applications at two acute care facilities. The press release calls it WellSpan Health Systems, that last word apparently being both incorrectly pluralized and superfluous.

Former Misys and GE Healthcare exec Kathy Blum is named CEO for Applied Computational Technologies, a software company providing dose calculation technology for radiation therapy treatment.

athenahealth announces the resignation of Christopher E. Nolin as SVP, general counsel, and secretary in order to spend more time with his family. Current deputy general counsel Daniel H. Orenstein will be the company’s new general counsel and secretary.

McKesson reaffirms its earnings forecast for fiscal 2009, predicting between $3.75 and $3.90 EPS.

RelayHealth announces expansion of its healthcare connectivity offerings to include patient education programs and care management support services, and solutions for integrating medication record data and expediting claims processing.

ProHealth Care, Inc. contracts with Orchestrate Healthcare to provide application integration consulting services. Speaking of Orchestrate, one of its clients needs a NeoTool expert, so we said we’d give it a mention.

Martin Memorial Health Systems (FL) selects Allscripts EHR and PM product for its 80-physician group. Martin already uses Allscripts’ Care Management solution in its hospitals.

Massachusetts General Physicians Organization signs a multi-year licensing agreement with Virtual Radiologic for teleradiology services. The organization is the largest multi-specialty group practice in New England and partners with Mass General.

Incidentally, Virtual Radiologic’s CEO and founder Sean Casey wins the Entrepreneur of the Year award in the technology category for the Upper Midwest region.

Survey results from a New England Journal of Medicine EMR survey confirm that physicians continue to resist EMRs. Highlights: only 4% of physicians have full EMRs, 42% report they are in the process of setting up an EHR system or plan to do so in the next two years, and less than 9% of 1-3 physicians groups have any sort of EMR. Those using EMRs report positive effects, but financial barriers (still) are preventing most from adopting the technology. Another major barrier, according to 54% of the 2,758 respondents, was finding an EHR system that meets their needs.

The installation of Epic in Cerner’s backyard seems to be going well. The University of Kansas Hospital reports it is now live on EMR in the ED, the latest phase in their $50 million, three-year installation.

I thought the Ms. CIO piece in this week’s Reader’s Write was quite fun. We are encouraging more folks to provide interesting commentary. It could be your 15 minutes of fame!

E-mail Inga.

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Submit your article of up to 500 words in length, subject to editing for clarity and brevity. Use your real or phony name (your choice). Submissions are subject to approval and become the property of HIStalk. Thanks for your thoughts!

What to Call Your Boss in 10 Years: Ms. CIO
By Kristin DeBell

Since the first computer nerd was named manager of a hospital’s billing system, the chief information officer role has been dominated by men. As the CIO moved from the basement to the executive suite, rarely did hospitals have to make allowances for a female executive washroom. Folks, the times they are a-changin’.

Parity in the CIO ranks will come within the next 10 years and here are a few reasons:

1) More senior CIO roles will be coming available. The CIO role really hasn’t been around that long and only evolved to the executive level in the last 25 years. Many of the “original” executive-level CIOs are men or nearing retirement. Look for CIO more openings over the next few years. As these men retire, more qualified women will have a chance at these positions.

2) The perception that CIOs must be technologists is changing. Hospitals are looking for executives that can communicate business concepts. I’m not suggesting women aren’t technologically savvy, but in your average hospital you’ll find a lot of talented women beyond the walls of the IT department. As hospitals look for potential executives, a strong leader will win over a strong technologist who can only talk bits and bytes.

3) The world of nursing is changing and many nurses are looking for new roles. There are still far more female nurses than men so assume that the majority of the nurses I’m discussing are women. More nurses are coming out of school and looking for healthcare roles outside of bedside care. And why shouldn’t they: nurses are underpaid, underappreciated, overworked, and stressed out. However, they are well educated and have valuable skills that are in demand. The new nurses will be working their way through the ranks and in time plenty will be ready to explore that CIO role.

4) Also ready for new roles: senior level nurses with great management experience, with hands on technology experience, with excellent execution skills, and who are terrific coaches and expert communicators. Sure, not all of them, but there are plenty that fit this bill so need I say more?

5) Money. We want more of it and will look continue looking for opportunities to advance our careers.

6) Because we are female. Hospital boards understand the need to have more balance in their senior executive ranks. The CNO shouldn’t be the only female member of management.

7) Qualifications. Rightly or wrongly, healthcare institutions are looking for CIO candidates with advanced degrees. Anyone been noticing that more women than men have been getting those degrees in recent years?

I could probably come up with 10 reasons and I realize I’ve oversimplified a few things. However, if you are a senior technology type, I would encourage you to look around you and identify a few potential candidates to groom and don’t overlook the fairer sex. There are too few female role models in the CIO ranks but there is no reason that can’t change. Women are excellent leaders, organizational experts, and communicators. Truly – just think of at your mother.

The PACS Designer’s Open Source Software Review – Mirth Project
By The PACS Designer

The goal of the Mirth Project is to continually improve Mirth, an open source cross-platform HL7 interface engine that enables bi-directional sending of HL7 messages between systems and applications over multiple transports. By utilizing an enterprise service bus framework and a channel-based architecture, Mirth allows messages to be filtered, transformed, and routed based on user-defined rules. Creating HL7 interfaces for existing systems becomes easy using the rich client interface and channel creation wizard which associates applications with Mirth engine components.

HL7 has established itself as a prime method of healthcare information exchange. To integrate your existing services with HL7 systems, you must implement an adapter layer to transform messages between your domain and the HL7 world. Mirth makes this step easy by providing the framework for connecting disparate systems with the required protocol adapters and message transformation tools.

Mirth uses a channel-based architecture to connect your systems with other HL7 systems and it consists of the following:

(1) Endpoints(both inbound and outbound)
(2) Filters
(3) Transformers

Endpoints are used to configure connections and their protocol details. Inbound endpoints are used to designate the type of listener to use for incoming messages, such as TCP/IP or a web service. Outbound endpoints are used to designate the destination of outgoing messages, such as an application server, a JMS queue, or a database.

Multiple filters and a chain of transformers can be associated with a channel. The Mirth web interface allows for reuse of filters and transformers on multiple channels.
Mirth can be configured to listen and send HL7 messages and connect to a variety of protocols:

(1) TCP/MLLP
(2) Database (MYSQL, Postgres, Oracle, MS SQL, ODBC)
(3) File (local file system and network shares)/PDF
(4) JMS
(5) FTP/SFTP
(6) SOAP (over HTTP)

Mirth’s open architecture allows for the easy addition of custom and legacy interfaces.  Mirth has processed millions of messages and is in use in hundreds of production environments.
The Mirth Project has an active Support Forum and also has a fairly quick response mechanism when it comes to bug fixes needed by Mirth participants.

When dealing with HL7 interface issues, it is never easy satisfying everyone through application programming interfaces, so Mirth is a welcome addition to interface professionals in healthcare who need to solve communications issues between systems. New participants can look forward to a large contingent of professionals who have worked to solve HL7 interface issues using Mirth.

TPD Usefulness Rating:  8.

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From Dr. Know: "Re: CIO job at Caritas Christi. You are on to something here. Unfortunately many CIO jobs are down in the weeds and not viewed as strategic. In this particular example, I can see the handwriting on the wall: just keep Meditech running; there is nothing new going on here.  Also, it highlights a common problem with headhunters and HR folks — they just don’t get the ‘strategic CIO’ argument."

From Jimmy B. F. James: "Re: lawsuits. The problem with requiring plaintiffs to pay if they lose is that a small guy may back out even if he knows he’s right because he knows the big guy’s 100 lawyers will cost him a fortune if he loses. Before Microsoft knew (or cared) what the Internet was, a guy came out with an application called Internet Explorer. He owned the name. Along comes Microsoft and they call their application (wait for it) Internet Explorer. The man sues. Microsoft takes him on in courts. Man runs out of money and eventually goes bankrupt. Microsoft wins. I agree that we need tort reform in this country, but our less-than-wise government has not had a good record of late of protecting its citizens. It’s been all too concerned about protecting businesses, though." I found coverage of the 1996 lawsuit.

From Madrigal: "Re: Epic. Interesting article. The more I read about Epic, the more I see their similarities with Meditech." Link. Worth a scroll down to see what I hope is an old picture of Dave Garets, sporting what looks like a monstrous set of Texas longhorns made of hair under his nose. All he needs is a boater hat, a red vest, and three guys behind him singing Sweet Adeline.

From Wayne Newton: "Re: Emageon shareholder proxy. Emageon represents a huge amount of intellectual/IT capital, significant enterprise imaging software market share (7-8%), and long-term recurring revenue agreement with some of America’s finest facilities. These Carl Icahn wannabes (OPP) from New York wouldn’t know a decent investment in digital imaging  if it bit ‘em on the butts. The bubbas from Alabama deserve another chance to smack the cheeks of GE, Philips, Agfa, Siemens, and McKesson once again. OPP are flippers looking for a quick buck without any knowledge about healthcare IT or imaging. I hope they lose their A$$."

Listening: Union Carbide Productions, Swedish psych-punk, defunct since 1992, but still kickin’ out the jams with Chameleon Ride here in HIStalk Music Heaven.

McKesson says it has reinvented revenue management and made up a word to describe it: enterprise revenue management. It sounds like a marketing package that includes applications, RelayHealth, InterQual, and consulting.

Futjitsu bailed on NPfIT four years into a 10-year contract because it has lost an estimated $670 million so far and new terms being sought would have made it worse. That’s almost to the penny the amount Accenture hemorrhaged before ran for NPfIT cover two years ago (note to self: don’t hire Accenture to negotiate contracts).

Doctors at Sault Area Hospital (ON) are questioning lab results after problems interfacing its Meditech EMR to its contract outpatient lab.

Six-hospital SSM HealthCare-St. Louis axes 75 management employees, many of them bigwigs. I would say that’s close to unprecedented. I don’t know about you, but I’m seeing quite a few hospital layoffs that nobody seems to be noticing, trend-wise.

Some Sunquest employees have registered www.sunquest.org and put a discussion forum there. Not all of them are happy.

Jobs: Senior Systems Engineer – Healthcare Vertical (Symantec), Clinical Analyst (MEDHOST), Consultant (Healthia Consulting). Sign up for job blasts. A hospital HR person sent this to Gwen: "We’re extremely pleased with the response of applicants we received from HealthcareITJobs.com. Within 24 hours of our Director of Information Systems position being posted, we had received numerous qualified applicants. This is the first time we had used this website and we were very pleased with the response. We had a very nice applicant pool to choose from."

Here’s the zillionth story of a doctor who decided EMRs were too expensive, so he developed his own and wants to sell it. He ran the design by some advertising company programmers and got the advertising company owner’s wife market it. He says the Cerner system used by nearby Clarian is "as popular as malaria." From the screen shots, it appears to have been designed in ColdFusion, certainly the kind of underpinnings a technical novice might choose, but web-based nonetheless. For the same $5,000 upfront for the first doc and $200 a month for hosting, you could buy well-established and CCHIT-certified systems with pretty good support, of course, but maybe this one’s better (being nice). And down the street, a programmer is running a Craigslist ad to perform discount surgery, claiming that, as a former surgical patient, he’s entirely qualified to undercut people who wasted all that time in medical school. (that’s what you call your satire right there).

Dell donates $75,000 worth of computer equipment for the EMR project at Mercy Medical Center of Northwest Arkansas.

I upgraded my SnagIt to the new Version 9. I wish healthcare software companies were as well run as Techsmith. They send great newsletters, their software is unendingly powerful and flexible, and they make it easy to upgrade or to migrate to a new PC.

Speaking of a new PC, I got one of those too since mine was getting long in the tooth: AMD 6000 dual core, 4 gB, big SATA hard drive, Asus motherboard, WinXP, neon-lit case with a humongous fan, and Fedex shipping – all for $580. Got a 22" Acer LCD coming from Newegg for $199. It’s fun times in the nerd-cave. Mrs. HIStalk is demanding to know what we’re going to do with the four obsolete towers and three monitors already in here, but I might need them someday (right).

GE Healthcare will integrate EKG data with EMRs from e-MDs, eClinicalWorks, GEMMS, McKesson, Medinotes, and Medtuity.

QuadraMed completes a one-for-five stock reverse split, hoping to boost share price to the $5.00 minimum that would allow it to move up from Amex to Nasdaq. That’s looking good so far, as shares are at $10.35 after the split.

Taxachusetts will give the state’s life science industry $1 billion over ten years.

Ambulance chasers didn’t wait long to file a class action suit against University of Utah Hospital and its courier company after last week’s theft of backup tapes from a courier’s car.

Idiotic hospital lawsuit: an illegal immigrant was an inpatient at Martin Memorial Hospital (FL) for two years, racking up an unpaid $1.5 million bill before the hospital paid his way back to Guatemala. He sued for being sent home and the hospital has spent $250,000 so far in its defense. Half the hospital’s births are to illegal immigrants who don’t pay a cent, so they’re kind of steamed that the feds aren’t interested.

Idiotic citation: a patient flakes out in a 40-bed hospital’s ED at 2:00 a.m., leading frightened staff to call the police. They came and subdued him with a Taser, after which he was medicated and transferred to another hospital with a psych unit. The state’s health department cited the hospital for the incident, saying it should have been better prepared for psych patients.

E-mail me.

Inga’s Update

I was so very sad Friday to hear that Tim Russert died. In my mind, he was the expert who knew exactly how to take all the political rhetoric and boil it down to simple terms for the rest of us. I’ve decided Mr. H, who claims he never watches TV and hardly knew who Russert was, is the Tim Russert of the HIT world; he has the same passion about his work and is an expert at reading the lay of the land and communicating his take on things.

The University of Maryland Medical System is in the process of going live on CareMedic System’s Financial Record revenue cycle software.

The AMA is discussing the pros and cons of provider-sponsored secret “shopping” to evaluate physicians and healthcare facility performance. Personally I would be happy to volunteer for the shopping gig if it enabled me a free Botox treatment or the like. On the other hand, I’m not sure hanging out for hours on end waiting for some medical treatment would be the most exciting job, regardless of how many People magazines were in the waiting room.

Picis announces a new social networking website to facilitate interaction among its clients. Picis Exchange Network was announced at the company’s Exchange Customer Conference that finishes up Wednesday. Also during the conference, Picis recognized five customers who have improved their organization’s performance using Picis software.

Last week a reader informed me she had figured out my “true” identity but would keep it top secret if she could be a fake Inga next year at HIMSS. I not sure she really has it figured out, but I am happy to support a fake Inga or two. In fact, I am thinking about creating a new line of Inga attire that goes beyond the original “Kiss me, I’m Inga” or “I’m Hot, I’m Inga” sashes. I could set up a site on eBay. Maybe it will include The Inga shoe, which I envision as a very high-heeled red pump. If you are a fashion aficionado, I’m open to suggestions.

Actually, speaking of HIMSS, I was on their site recently and see that attendees can start reserving rooms online for next year’s meeting. I also checked out the prices of those Chicago hotel rooms. Ouch. I’ll need to sell a ton of Inga goodies just to pay for the hotel room!

A Commonwealth Fund-supported study concludes hospitals that implemented Leapfrog-endorsed patient safety practices, including CPOE adoption, reported better quality of care and lower mortality rates.

Interesting article about why women quit IT careers. The top reason is not (perhaps surprisingly) because of family and work life balance issues but because of the “machismo that continues to permeate these work environments.” An estimated 51% of women are out of IT before age 40.

The Association of Academic Health Centers reports that HIPAA is negatively impacting biomedical research. The biggest issues include burdensome administrative procedures associated with HIPAA and declining participant recruitment.

John Hammergren, with the help of a few employees and execs, will Ring the Opening Bell at the NYSE Wednesday. McKesson is celebrating the 175th anniversary of its founding.

Sunquest announces a $4.6 million sale to ACL Laboratories for its CoPathPlus Anatomic Pathology System. ACL has been a Sunquest client since 1987 and runs several other Sunquest applications. In another press release, Sunquest congratulated sales rep Patty Miller for winning the Clinical Laboratory Management Association Member of the Year Award. CLMA is an international association with 5,300 members.

And speaking of Sunquest, a number of employees and former employees have recently shared company commentary on the HIStalk Forum. In case you’ve missed it, there is quite a mix of happy and disgruntled posts about the company, its various owners, and managers.

E-mail Inga.

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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.

CIO reDefined: Chief Interview Officer
By Ed Marx

The roles of a CIO are as varied as the companies and sectors they serve. Even within these roles are multiple combinations and permutations that are expressed according to circumstance. The moniker “CIO” itself is not limited to “Chief Information Officer.” No, to be effective in our calling we must stretch the traditional definition beyond this commonly accepted interpretation. This post continues a series on how the “CIO 2.0” will push the boundaries of conventional thinking surrounding the role. We continue with the “Chief Interview Officer.”

It shouldn’t surprise you to hear me say that an organization’s greatest asset is having the right people in the right places. If we lived in a perfect world, this process would be occurring naturally. But we don’t. Instead, the selection and development of talent may be the single most challenging responsibility for a leader. Selection of talent is more often a quantity game than a quality endeavor. Many organizations bring in as many candidates as possible to fill numerous positions in a department with the focus being more statistical than productive. Although this has spawned a billion dollar industry that gives us tools to attract and select the right people, by the end of the day it still comes down to a 50/50 crapshoot.

As the leader, it is my responsibility to ensure my department is hiring only the top shelf of candidates, especially when it comes to senior leadership ranks. For starters, we must offer a compelling employment proposition to attract the right people, a topic I’ll tackle on another post downstream. Assuming you are reaching the right candidate pool, how do you elevate the 50/50 crapshoot to 75/25 or better?

Absolutely, you must leverage the tools typically available through your HR division. I am not big on “requirements” filters, but I see value in sophisticated “cultural fit” assessments that show a scientific correlation between candidates’ scores and performance outcomes. These tools are good grounds from which to build and make the following even more effective.

As suggested and supported by Gallop research, we create a talent profile for each leadership position. Some leaders have gone on to create talent profiles for all their positions, a practice I endorse and applaud. Determine what talents are common to your most productive and effective leaders and use these as the baseline during your interview process. Engineer correctly, your questions can help you unearth an interviewee’s talents. If they have what’s critical to the success of the position, consider everything else fluff.

Common to all leadership talent is the ability to lead, think, and communicate. Using the conventional interview, these talents are hard to access and evaluate. Anyone who has reached this point in his/her career will be good at answering questions regarding his thought processes or how she communicates, etc. Once the top 2-3 finalists have been identified, the greatest differentiator in singling out the best candidate is the “presentation.” We require each candidate to choose one of two real world business/technical scenarios. He/she then returns in a week and presents his recommended solution to a jury of peers. This separates the great from the good.

Through the “presentation” technique, you’ll observe an actual real-time demonstration of these talents. In the standard interview, any candidate can tell you that she can handle conflict and even throw in an anecdotal example. During a presentation, however, a peer will deliberately disagree with a point so you can watch how the candidate responds. Is he nervous, timid, aggressive, thoughtful, etc? During the interview, a candidate can share the academic, five-step process on how she tackles a complex situation; during the presentation, she’ll have to apply that five-step process (or not!). How much research did she do? Was her process rational? Did she communicate clearly? Did she reach out to others? Oh, the things you’ll pick up on that are impossible to discern in the conventional interview.

And the bonus? You get free consulting! Sometimes the solutions are ones you’ve missed and can now apply.

Let’s face it, interviewing to ensure you hire only the best is not easy. Ensuring that the right people are in the right places, especially at the leadership ranks, is one of the most critical functions of the Chief Interview Officer. Whatever interview process you use, those around you will follow your example and carry the tradition down through the ranks. So do it right.

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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