News 7/25/08

From: Dr. John. “Re: Purkinje. EMR vendor Purkinje is going to focus on its Medicare Advantage insurance and cut/reduce is EMR software sales business. Guess they see the insurance business being more profitable than the EMR software business….duh. Unfortunately, they let go some really talented folks!” I reached out to the Purkinje folks but didn’t hear a response back, so currently unconfirmed.

From: Steve McGarrett. “Re: Hawaii. The situation in Hawaii is a mess, especially the Neighbor Islands. The North Hawaii Community Hospital situation is a bit different since that’s a private hospital as opposed to Kona which is part of the state system. If you can believe it NHCH even kicked Earl Bakken to the curb. Something is wrong when that happens to the guy who developed the wearable pacemaker, especially when you consider that he helped found the hospital a dozen years ago. If you want more info regarding the situation both Big Island papers have run numerous articles. The Kona paper is at www.westhawaiitoday.com and the Hilo paper is at www.hawaiitribune-herald.com. Keep up the good work while Mr. H is away.”

From: HERbie. “Re:  HERtalk. Hi Inga – the acronym is fine as is. Whenever you try to type ‘EHR’ in an MS Office document, spell check auto changes it to HER. I’m sure I’ve sent dozens of emails with ‘HER’ instead of ‘EHR’ thanks to the spell checker (Of course I could always go to the custom dictionary and fix it once and for all.) The story could be that you tried to create the blog as EHRTalk but spell checker changed it to HER.”  That makes perfect sense to me, especially since I’ve never figured out how to make the custom dictionary not auto correct HER (see – it just did it again.)

From: ElsieEHR. “Re: This and That. HERtalk — Simple: HER = Healthcare Electronic Records… Especially since any time you type "EHR" in MS Word, the AutoCorrect option changes it to HER. Hospital Layoffs — UMDNJ may cut 300 jobs, according to today’s Star Ledger (Newark, NJ). You say tomato — C-C-H-I-T vs. C-CHIT; H-I-S-talk vs. HIStalk. I always sort of slurred the name, saying H-I-S-stalk (as in ‘stalker,’ but I guess it could have other meanings as well).”

From: HERcules. “Re: I wonder, while you’re busy changing HIStalk to HERtalk, whether you want to send up any test balloons on changer HIMSS to HERSS. What on earth would THAT acronym stand for? Love your blog. Keep up the good work in Mr. H’s absence.”  I’ve been working on this one all day and nothing yet, so creative assistance appreciated.

From: Mountain Man. “Re: Layoffs – What does all this mean? It means that margins are razor thin, that reimbursement is down, expenses are up. Healthcare is not immune to the economic strife that the rest of the country is in. Starbucks closed stores, GM and Ford can’t make it and your small business owner is closing at alarming rates. We have to do more with less. This my friends is where we are all so important to the solution. The solutions we provide to the end user, will help us deliver better quality care at an overall lower unit cost. Technology is the only way Healthcare can be delivered in a more efficient way that is safer for the patient. The use of Technology to drive real change will be the salvation of healthcare as we know it today. These layoffs are treating the symptoms of rising costs. The cure is to be more efficient and the magic pill is technology.”  I am afraid Mountain Man (LOVE that name) is right.  Healthcare institutions are cutting back, as well as the vendors.  Look for more sales reps to become more virtual because companies can’t afford to send them to every last hospital and doctor’s office. Which will lead to more competition for those post-cheerleaders wanting to become drug reps.

From: Angela. “Re: Microsoft’s Health Solutions Group. I recently sat through a support presentation with Microsofts Health Solutions Group. I left confused. They keep referring to themselves as NOT Microsoft? One of the value propositions for us is that they ARE Microsoft and we can assume the same quality care and support that we are used to getting. The speaker made it sound like they had their own support group and infrastructure. Needless to say this was a huge turnoff for most of the staff. Granted Microsoft’s support had some issues in the past, but our Premier contract ensures that we get the help we need when we need it. I am really puzzled by this. Can anyone out there confirm that the Healthcare group is starting their own support organization? I mean when you have a world class support structure why in the world would you re-invent the wheel? Not a very strong selling point. We are still discussing the opportunity but someone needs to tell the healthcare group that coming across as a stand-alone company does nothing to enhance the sales process.” I was able to connect with Bill Crounse, Senior Director for Microsoft Worldwide Health. His comment: “Thanks for drawing this to my attention. I think the speaker from HSG was misunderstood. While our Health Solutions Group is developing their own sales and support channels, they are very much a part of Microsoft. If anything, their desire is to exceed the service levels people have come to expect from Microsoft.”

Yesterday’s Guest Writer was athenahealth’s Jonathan Bush, who raised questions about what can be done to encourage small groups to use EMR. No one seems to have a reasonable model that addresses the true effect of EMR, especially in a small office. Jonathan closed his post saying, “One of the core reasons I like Mr. HISTalk, Inga and this blog so much is that it has emerged as a disruptive presence in how folks in our industry get their news and discuss topics and trends. So let’s discuss this…maybe we can get an actual dialogue started here that will begin to disrupt our industry’s stagnant approach to the small physician market.” The dialogue has clearly started with many folks weighing in. The only consensus so far is that the issue is complex, and, that the smaller the office, the more the human factors affect the project’s success or failure.  I wonder if there are any doctors out there in small practices that want to brag about all the extra money in his/her pocket because of a great EMR install.

Misys announces its preliminary annual earnings for the fiscal year ending May 31. Overall revenues were up 6% and operating profits 37%. In the healthcare division, both revenue and total order intake were up 2%, though ILF revenue declined 2%. Maintenance and Payerpath revenue seem to be sustaining the group with revenues up 6% and 4% respectively. An 85% increase in operating profit from 11% to 20% indicates all the cost-cutting activity has had an impact.

McKesson announces their Q2 earnings (flat,) though profits rose 9%. Actual profits were $.03/share less than analysts’ predictions, coming in at $.77/share. McKesson raised its full year earnings prediction to $4-4.15/share.

Hayes Management Consulting and InterSystems are partnering to provide InterSystems Ensemble to the global healthcare IT market. Hayes plans to develop solutions to integrate disparate healthcare systems for business and clinical end users.

For those of you missing Mr. H’s music recommendations, give Inga Radio a try, though I should point out tastes are definitely different than Mr. H’s HIStalk Radio. Some recent favorites: Jon Nolan, Keb’ Mo’, Andrew Lipke, and Etta James.

Medavant (aka Proxymed) has had numerous troubles over the last year or so, including upper management turnover, a troubling auditor’s report, sell-offs of multiple assets, and major revenue declines. When Medavant filed for an extension on their 10-Q in May, Mr. H noted that it "wasn’t a good sign." This week Nasdaq issued a notification that the stock price had failed to maintain a minimum $1 stock price for more than 30 days. The fact the company filed for Chapter 11 bankruptcy protection Wednesday is thus not much of a  surprise. With problems going back so many months I don’t believe you can simply blame the situation on a softening economy. However, it does make one fearful that over the next few months we’ll see more HIT vendors struggling to their keep their lights on.

Coming soon: a new online source for deciphering your elderly mother’s various medications or determining if your itchy skin is poison ivy (and not some sort of skin-eating strep.) Medpedia, the world’s largest collaborative online medical encyclopedia is launching at the end of the year. The Wikipedia-like project is a big collaborative effort between multiple healthcare institutions and all the contributors either PhD’s or MD’s.

The Illinois Primary Health Care Association is implementing NextGen products in five affiliated health centers and potentially 25 more in later phases.

If you are bound for Epicland, you’ll be happy to read about plans for a number of boutique-style hotels in Madison, Wisconsin. All are being designed with the tech-savvy traveler in mind and promise to be swank, hip, and priced in the mid-range.

Blue Ridge Medical Management (TN/VA) expands their investment in Misys products, adding 125 new Vision licenses. Blue Ridge bought an additional 250 Vision and 325 Misys EMR licenses to provide hosting for East TN State University College of Medicine.

Kudos to the 700 GE Healthcare employees from South Burlington (VT) who helped Habitat for Humanity build five homes for people in need.

HIMSS announces new officers and board members.  Charles E. Christian and Liz Johnson are the incoming chair and vice chair along with eight other board members who officially started July 1.

Thanks for all the encouraging notes, by the way. I know everyone is missing Mr. H’s expert commentary and amazing wit, so I am thankful you are sticking with the under-card in his absence.  I’m feeling the love, though I’m still waiting for those love sonnets to come my way.  Email me.