Eclipsys announced this morning that it will acquire patient flow systems vendor Premise of Farmington, CT for $38.5 million in cash. Closing is expected within 15 days.

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From The PACS Designer: "Re: 2008. TPD is blown away by the success in 2008 for HIStalk! Never did I expect the famous healthcare luminaries that agreed to be interviewed! Wishing HIStalk and everyone else a better and more prosperous 2009. Happy New Year!" Thanks to TPD for his regular-as-clockwork, bite-sized educational postings. Keep in mind that he and I have never met or spoken – he posts just to help educate HIStalk’s readers. Thanks, TPD!

This will be a little short since I’m just getting back in after a short trip to KCMO. The barbeque at the couple of places I tried was good, even if the sauce they bury it in is jaw-clenchingly sweet and heavy, more like ice cream sundae topping than anything you should put on meat (like KC Masterpiece or what they put on barbeque down south at the Sonny’s chain – mostly corn syrup, molasses, and fake liquid smoke). Once you scrape that off, it’s pretty good. By state, I’d rank the barbeque as TX, NC, MO, GA, and TN (OK, AL, and AR should be in there somewhere, but my experience is limited).

Andy sent a link to a story about struggling hospitals, with the focal point being Shands AGH in Gainesville, FL, the town’s first community hospital that will be shut down in 2009 to save money, 12 years after it was bought by Shands Healthcare. The CEO of Shands blames bad debt and reduced Medicaid payments.

I found Greg Hall’s analysis of the crippling effect of institutional debt in healthcare fascinating, the idea that industries that created phantom wealth in the form of leveraged debt and tax advantages. "Examine the notion of ‘capacity utilization.’ Without debt, excess capacity is not viewed as a problem. Consider the local fire department. Paid staff resides at stations 100% of the time, regardless of emergency conditions. 100% state of readiness. Imagine if the fire station had to pay a mortgage: it would then be forced to convert its unused (excess) capacity to a cost, and in turn focus on raising revenues to support its excess capacity. This is exactly the case with hospitals (and many other large U.S. businesses)." It’s dead-on for hospitals. Every one I’ve worked for, including those that showed a huge ’surplus’ (non-profitese for ‘profit’) still could not finance even predictable costs through operational profits; they were always going to the bond market. And, I’ll throw in my psychological theory that supports Greg’s concept: the hotshot MBA CEOs who now run many/most hospitals instead of the previous crop of MHA-trained ‘administrators’ aren’t satisfied with just keeping a hospital running efficiently and serving the community; they have to show their for-profit counterparts that they’re business sharpies, so the preferred outlet is community dominance and building massive Taj Mahospitals. That’s the coin of the realm when it comes to community hospitals: beating your competition and erecting awe-inspiring buildings that generate obvious community pride, but with highly questionable community value. One might postulate that much of today’s economic ills were caused by B-school grads, many of them who found their way into healthcare as their widget of choice, who were taught that growth is everything when it comes to businesses, stocks, and assets. Just making a nice profit is not sexy enough. As a result, the churn of leverage and acquisitions and vertical integration caused a mess that will not be easy to get out of, even with those $1 million and up hospital CEO salaries. Hospitals, unfortunately, were just as greedy, just less honest about it in claiming it was all for their communities, large chunks of which already couldn’t afford their services.

A reader sent over a BlueCross BlueShield of North Carolina memo that asks doctors to support elimination of "highly problematic privacy provisions" that it claims could be included in the economic stimulus package. I mentioned the Confidentiality Coalition’s similar demands last week (BCBS Association is a member of that group and that’s mentioned in the memo). Some items they don’t like: requiring patient authorization for disclosing PHI for treatment or payment purposes; requiring EMR users to keep records of non-verbal PHI disclosures; and allowing individuals to opt out of interoperability projects like HIEs and RHIOs (!!). That’s about as arrogant as the sham that BCBS is "non-profit" while sucking in huge chunks of healthcare expense for administrative functions that seem to more often hinder it rather than help it. All I know is that BCBS makes a ton of money (nearly $200 million profit in one year not too long ago in NC alone), pays its executives ridiculously handsomely, and occupies buildings that are decidedly non-Spartan.

Hollywood will surely make a movie about this: Cigna refuses to pay for a liver transplant for a 17-year-old leukemia patient, saying the procedure is experimental, even after the patient’s doctors report a six-month survival rate of 65%. Nurses and local citizens picket the insurance company, after which Cigna grudgingly agrees to pay for the procedure "out of its own pocket." Hours after Cigna relents, the patient dies before the transplant can be done. The family is suing. This is where our American cultural view of death kicks in: from what I’ve read, other countries accept death when it’s inevitable, while here, no expense is too great to prolong life even for a short time. A liver transplant costs several hundred thousand dollars and uses a donor liver that someone else won’t get. I don’t know the case, but to an objective (i.e. non-family) observer, would that patient have been the best use of the limited resource of dollars and livers? It would be nice not to have to make that choice, but insurance requires balancing unlimited demand with limited resources, with the result of doing that poorly what we have today — huge costs for heroic but ultimately often unsuccessful interventions, especially in the elderly in the last few weeks of life.

North Mississippi Medical Center will replace its EMR system at a cost of $28 million, approved this month by the state.

The New York Times covers the city’s subsidized rollout of eClinical Works and its pay-for-performance project. "As for Dr. Benovitz, he said that if the city had not recruited him, he would still be using paper charts, which had a comforting tangibility, a record of life that could be held in his hand and paged through like a book. But he was happy to invest the roughly $40,000 over three years to implement the project in exchange for the city’s expert advice, though it has temporarily slowed him down, with two patients filling the time in which he used to see three." Unless somebody convinces medical schools to drop their income-protecting student enrollment quotas, let’s hope the 33% reduction in capacity really is temporary since the EMR won’t do much for patients who can’t get an appointment.

I might be the only person left who remembers the Atlanta-based technology company Healthdyne. The company’s founder, Pete Petit, is named board chair of Georgia State University, where he earned his MBA. 

An interesting test case may set a precedent for the practice of telemedicine. A doctor prescribes generic Prozac for a 19-year-old without examining him after the Stanford student requested the drug via an Indian Web site (now gone, but I found an image in an archive above), which forwarded the request to the doctor as its contractor. The student killed himself. The doctor will go on trial for practicing medicine in California without a license, but the prosecution has to prove that the student was in California when he requested the drug and that it’s illegal for an out-of-state doctor to write and fill prescriptions across state lines. With all the talk about how to streamline and nationalize healthcare (not what it’s being called, but what it is), you would think that someone would suggest removing all the state-specific regulations relating to privacy, patient care, prescriptions, state billing, etc. and replace them with a national standard. Nobody talks about the inefficiency they create and the questionable benefits they provide.

OK, I’m beginning to think everyone involved in the would-be Emageon-HSS deal is nuts. The fighting lovers are embracing again, with HSS saying the consummation will happen in February 11, financed by Stanford International Bank after all. Why did Stanford bail out last week, then? According to the CEO of HSS, "This extension will also allow us additional time to complete our integration plan for our technologies." Maybe I’m clueless, but I don’t see that the integration plan has anything to do with the legally binding agreement HSS made to do the acquisition by an already-passed date. Plan whenever you want, but when you sign to do a deal with a given set of terms, the negotiation is over. Blaming the bank seems ridiculous since it has the same parent company as HSS. At least Emageon will supposedly get $9 million of HSS’s escrowed money if the deal falls through again. Is this saga really going to give prospects a good feeling?

Have a good New Year’s. Fun stuff coming! (HISsies, HIMSS stuff, and so on). Thanks for reading.

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From Blueware: "Re: promotion. Jyran Glucky was promoted from Lead Architect to Vice President of Application Development at BlueWare." I have to admit that I’ve never heard of the company and had to Google them. From its overly busy site, it’s hard to figure out exactly what they offer, but it has something to do with EMRs. And despite a press release about this promotion, there’s not a list of management anywhere I could find in the jumble, so I don’t know who else is involved.

From IntelliDOT: "Re: layoff. IntelliDOT in San Diego laid off 12 percent of its employees due to slow sales." Unverified. We’ll check it out.

Listening: Rachelle Ramm, a hard-rocking California beauty. Which reminded me of my old favorite, Swedish all-girl metal band Drain STH.

The New York Times writes up the Marshfield Clinic’s technology. A good quote from AHRQ’s Carolyn Clancy, who says the clinic "understands that it’s a system of improvement that technology makes possible that really matters, and the electronic health record itself is no silver bullet." That’s the positive, but the negative is this answer about the $50 million per year (!!) the clinic spends on systems: "People ask about return on investment, but that’s the wrong question. This requires the usual leap of faith that knowledge will yield good things — better care, doing things smarter and, yes, saving money in the long run." That’s a pretty big leap. Excellent article.

The Emageon saga continues, dragging the company’s name further in the mud. Would-be acquirer Health Systems Solutions, Inc. says its major shareholder, Antigua-based Stanford International Bank Ltd., won’t provide the funds for the acquisition to go through. Emageon CEO Charles Jett seems to be the outraged spokesperson, but he’s not a major player given that he was ousted from the board last summer after an ugly proxy fight with Oliver Press Partners. Now it could be that Stanford is just playing with the stock behind the scenes, safely tucked away in Antigua outside US jurisdiction, but it makes more sense that they’ve found something they don’t like about Emageon and their carefully created legal structure gives them an out that they’ve chosen to exercise. Or, that billionaire owner Allen Stanford and Oliver Press don’t get along, like Gordon Gekko and Sir Larry Wildman in Wall Street (Stanford really is a Sir, the first person knighted by Antigua, where he holds dual citizenship along with the USA).

Jobs: Cerner Millennium Senior Analyst (Healthcare Performance Group), Director of Clinical Information Systems (Snelling Executive Search), Director of Nursing Informatics (Johns Hopkins Medicine), PharmD (Parker Healthcare IT), CareVue Technical Specialist/Clinical Engineer (Cedars-Sinai Medical Center), C-Level Sales Executive (Company Confidential). Drop your e-mail address here and get a weekly jobs list.

West Virginia University Hospitals gets certificate of need approval from the state to spend $18 million on new hardware and a data center for its $90 million Epic project, although they’re short on capital and will delay the data center construction.

Odd: Mississippi lawmakers are considering increasing cigarette taxes to help support struggling hospitals, saying, ‘We have been leaving untold millions of dollars on the table." That’s what happens when politicians start seeing your money as theirs, although there’s no doubt smokers will cost the state a lot more than that.

The number of hospitals laying off in 2008 has already beaten the 2003 record, although the number of laid off employees is relatively modest at 9,700 who have filed for unemployment because of mass layoffs.

Kryptiq is awarded a patient on encryption of healthcare information in a way that prevents the servers it sits on from decrypting the data. Hopefully they’ll use it in products rather than as the subject line in nasty infringement lawyer letters.

Two employees of Samaritan North Health Center (OH) are indicted for identify theft and money laundering for getting names of the recently deceased from the newspaper obituaries, looking up their information in the hospital’s computer system, then taking out loans in their names.

The Bahrain Medical Journal will start publishing online with free access, even allowing readers to do whatever they want with the articles as long as they cite them properly. Leading the conversion to an open access journal was senior editor Dr. Mohammad Al-Ubaydli, author of the book Free Software for Busy People and author of an editorial (warning: PDF) in the current issue urging Bahrain to adopt open source instead of proprietary EMR systems.

UK patients, worried about NHS’s plan to store patient information in a national database, are choosing to instead carry their information on a smart card that doctors update via USB port after each visit. The card’s distributor pays doctors to download patient data, mention of which elicited this reader comment: "An other way for doctors to make a quick buck!! They are already been paid twice. Once by the taxpayer and the other by the drug companies. Its about time we patients had access to our own medical data."

The first 10 episodes of Children’s Hospital (inexplicably spelled Childrens’ Hospital) are now up on the WB, semi-entertaining in an Airplane kind of way. "A hospital is a place for smart people to take care of people who aren’t smart enough to keep themselves healthy."

Resident: You’re the attending physician and I need to get your permission. I need to cut this kid open.
Attending: Why? She’s got a broken arm.
Resident: Says who?
Attending: The X-ray.
Resident: Please. I don’t trust those – they’re not even in color.

Speaking of online series, Lisa Kudrow stars as an Internet-based psychologist who does three-minute Webcam sessions on the largely improvised Web Therapy.

Red Hat’s Q3 numbers: revenue up 22%, EPS $0.12 vs. $0.10.

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From Tom Tubow: "Re: blogs. I was thinking about why I read HIStalk instead of the other blogs and I realized: theirs feel like work, yours feels like fun." Thanks for noticing, but it’s by necessity. I have a short attention span, so you won’t get many long, weighty theoretical essays from the standard roster of self-anointed, frowning experts here. I’m more Howard Stern than William F. Buckley. If you leave here both informed and entertained after just a few minutes, Inga and I have done our jobs.

From Long-Time Reader: "Re: article. Here’s one from the Denver paper on local EMR integration." Link. It’s about the Colorado RHIO.

From Josh: "Re: McKinsey report. Puts 2/3 of what it believes is $650 billion excess cost on the backs of ’specialty outpatient care’ providers, noting that ‘current outpatient reimbursement methods reward providers for delivering more care, or care that is higher intensity.’" Link. The conclusion is so obvious that it’s often missed: professionals will perform whatever services they can get paid for. If you’re paying for diagnostic imaging, expect a lot of diagnostic imaging to be done. Don’t expect providers to cut their own income just because it might be beneficial to a particular insurance company or society in general ("first do no harm, but second, make sure to bill what’s paying well this month.")

From The PACS Designer: "Re: file sharing. Another cool online application TPD recently found is drop.io, which gives online file-sharing possibilities to those who work in teams to accomplish tasks and goals." Link.  I was annoyed that the only "how to" help is by video, which I generally refuse to watch online unless it’s something stupid on YouTube, but theirs is by DemoGirl, of whom I’ve been a fan for years. The service looks cool … you can password protect files, e-mail them in, and share them selectively. Not the cheapest, starting at $20 a month, but pretty slick.

From He Hate Me: "Re: Microsoft. I hear they’re putting a presentation together for Daschle’s team. Maybe Amalga HIS isn’t as far away as people are saying." I hope Daschle’s smart enough to recognize that Microsoft’s healthcare toe-dipping hardly makes the company an expert (its Azyxxi acquisition and Visio add-ins aside). Lots of folks, including those who have actually worked in healthcare as something other than a recent growth target, could give him the unbiased scoop if that’s what he wants.

From kb: "Re: Epic. You’ll be happy to know Epic will be contesting another frivolous lawsuit from Acacia. Doesn’t sound like Epic was the only one named in the lawsuit either." I assume that was the one by Document Generation Corp. that I mentioned last week. I said then I was surprised that Acacia, if it’s really behind the suit, would want to tangle with Epic again. I was reading something the other day about how many corporate infringement lawsuits are filed by shell companies with zero to five employees and a no assets other than a patent, using the high cost of mounting an infringement defense as leverage to extort money from big companies. No wonder other countries are eating us alive in everything from manufacturing to science — we’re too busy suing each other to actually produce anything.

From Darth Tater: "Re: HIMSS. The HIMSS staffers must be deluding themselves – probably being from Chicago, they think they have some special ‘in’ with the administration. They need to learn what happens once people move inside the beltway. More to the point, HIMSS is hardly the only source of information. John Halamka mentioned during a HITSP meeting last week that he was testifying earlier in the week. I am aware of other projects where they are personally working with specific Senators – more directly than ’staffers.’ And anyone that thinks IEEE, RSNA, AMA, etc. etc. aren’t in front of people also doesn’t know what they are talking about." I give credit to the incoming administration – they’ve got people believing that their vote and participation count, so thank goodness for that. The reality is, though, that not everybody will leave with a lollipop. Not everyone will be happy with the direction. Not all groups have the influence they think they do. Politicians are good at saying "maybe" when they really mean "no way." And despite the good work that a lot of people do in healthcare IT, HIMSS is, using its own words, a trade association of vendors, and those don’t typically carry a lot of weight. That’s where being vendor-heavy probably curtails their influence.

UPMC Presbyterian reaches Stage 6 of the HIMSS Analytics EMR adoption model, joining 23 others.

What do lobstermen, victims of ice storms, and potential users of electronic medical records have in common? Maine’s finance authority agrees to extend financial help to all three.

Motion Computing, maker of the C5 Mobile Clinical Assistant, gets $6 million in new funding. The press release says the C5 has been deployed to over 4,000 healthcare organizations, which is a lot more than I would have guessed. They must be selling lots of them in other countries since I’m pretty sure their hospital penetration is nowhere near 50% here and even that would only be 3,000.

Listening: Skarlet Blue, hard-rocking Aussies. Video here. Catchy and nicely done.

I had the HIStalk server upgraded again today, as I nearly forgot to mention. There were times, especially on weekday mornings between 9 and 11 Eastern, when you may have received a "page not found" error because the user load was redlining the Apache service, which means … well, that too many people beat you to HIStalk before the memory ran out. It’s hard to believe I could once get away with a little $4 a month shared Web hosting hosting account. Anyway, hopefully it will work better now.

EnovateIT partners with Metrologic to provide 800 bedside medication barcode scanners for Novant Health (NC).

AC/DC singer and local resident Brian Johnson dedicates a music room in his name at Sarasota Memorial Hospital (FL), paid for by the foundation of former Who bass player John Entwistle, who died of a cocaine-induced heart attack in 2002.

Deborah Peel’s Patient Privacy Rights is upset by a letter (warning: PDF) from Confidentiality Coalition to Congress. What it says (despite that group’s name): healthcare IT is so important to healthcare and the economy that principles like accounting of disclosures, consent for TPO, and "unnecessary" notification of a privacy breach should be scratched from any HIT plan the government undertakes. Don’t let patient privacy stand in the way of progress, in other words, kind of an eminent domain on PHI. The group behind it appears to be Healthcare Leadership Council, a self-described "business league" that spent $1.6 million on lobbying last year. Some of the members are predictable (drug and medical device companies, GPOs, and the Big Three drug distributors) but I don’t understand why a few non-profit hospitals have signed up (and Vanderbilt’s School of Nursing). Their main pitch seems to be that US healthcare is a great value because of all the "unparalleled improvements in the field" brought to you at high cost by the folks who would rather not have their gravy train derailed.

Forbes uses athenahealth’s payor ratings to determine The Worst Places to Be Sick and Poor. The bottom five states: Virginia, Florida, Georgia, Texas, and … drum roll … New York, which takes nearly 140 days to pay Medicaid claims despite billions spent on software. You know it’s going to get worse as states, especially those addicted to growth, find their coffers empty and, unlike Uncle Sam, they can’t just print more money.

RelayHealth wins a consumer engagement award for its connectivity offerings for consumers and providers, specifically its Results Distribution Service.

University Hospital in Dubai signs up with Epic. Judy is actually quoted. Come to think of it, that’s an opinion I’d like to hear: does Judy think the government should subsidize EMRs since she’s selling all she can without its help?

The Philadelphia paper debates the cost and benefit of electronic medical records, talking to Doylestown Hospital and Abington Memorial. It also invites the public to attend one of those local discussion groups that HIMSS is arranging to generate policy recommendations for the Obama administration. I would expect the lay people to suddenly be heavily in favor of healthcare IT investments they were unaware of previously since HIMSS is facilitating, but I’ll defer to anyone who was actually there.

A Kansas urologist develops cell phone software that protects highly unskilled and overconfident teen drivers from killing themselves and the rest of while yapping and texting while driving. It blocks the phone while the key is in the ignition. Ingenious.

A former Cedars-Sinai billing employee is charged with setting up a fake laboratory company and submitting patient bills that insurers paid via a post office box, using the identities of over 1,000 patients.

The British Medical Association fights a government plan to open up patient databases to researchers, including those from private companies. They say companies could harvest (or "hoover," as they say) patient names in order to market to them.

University of Wisconsin-Madison will put up signs warning patients that their doctors might be taking drug company money for research or consulting (without doing anything about it – kind of like those "unauthorized solicitors" signs in airports that let you know Moonies are around, but still leaving you on your own to deal with them. The medical school dean wants doctors to report the money they receive, with one example cited being an orthopedic surgeon who checked off the maximum amount — over $20,000 year — which in his case was actually $400,000 a year for eight days of work. Of course, patients still have to decide what to do even if they know Doc is pocketing drug company money, so it probably won’t amount to much.

Paul, an HIStalk reader in the UK, sent this message: "My current organisation is a New Zealand based Systems Integration Company, called Simpl, and they have been commissioned by 10 of the leading District Health Boards in NZ to procure a system which could potentially be a national standard across New Zealand. We would very much like to publicise the fact this procurement is underway and invite interest from any USA software providers that believes they have a solution that could fit. I suggested HIStalk may be a great way to alert the USA market to this potential. Up to 10 New Zealand District Health Boards are seeking to procure technology that will support the transformation of healthcare delivery by providing an individual-centric health management system that is health provider agnostic. Therefore the solution must address not only their hospital PAS requirements, but also enable seamless access to an individual’s health information by registered health practitioners / qualified health professionals wherever they work (hospitals, the community and primary care, rest homes etc) and even by the patients themselves. This procurement is being managed by Simpl, a New Zealand based Systems Integration company that specialises in Healthcare." The tender system is here and the reference number is 24585. I have the RFI, but I think you can get it there, or contact Paul.

The Nashville business paper reports that business is great at Brentwood-based 24-employee credentialing software vendor Sy.Med Development, on track for $3.2 million in sales this year. The piece has some interesting business pearls from the CEO, such as "You can change industries rather easily and hard work, belief and passion can make up for lack of knowledge."

A former Wachovia VP in the Miami area gets three years in jail for helping an accomplice with a $48 million Medicare fraud and money-laundering operation.

UnitedHealth Group launches its free public Web portal, myOptumHealth.com, run by its health and wellness subsidiary. The site run ads for United’s insurance products and will also sell advertising space (there’s already a Cymbalta ad running on the front page, I see). You can fill out a PHR online.

Oracle claims its DB Machine is the most successful launch in company history.

Emageon says its would-be acquirer, Health Systems Solutions, Inc., is taking too long to close the deal. Emageon says HSS is giving it the runaround by continuing to make due diligence requests despite a signed merger agreement, avoiding setting a closing date, and claiming Emageon misrepresentation. Emageon stock tanked on the news Monday, down $0.92 to $1.30. HSS is smaller than Emageon, so you never know if they’ve run into financing problems since that’s about the only valid excuse unless they’ve really found a skeleton in Emageon’s closet.

Enjoy your holiday(s), whatever they might be. I’ll be around if you want to e-mail me.

 

Twas the Night Before Christmas
By Inga

‘Twas the night before Christmas, when all through IT
Not a creature was stirring – not a single PC.
The charges were updated by users with care,
In hopes that more money would make its way there.

The doctors were finished, all smug in their heads,
While nurses were checking on every last bed.
And the CIO in his office, and I in my cube
Had cleaned up our e-mails (and watching YouTube).

When out from MS-Windows there ‘rose an odd chatter,
I switched off Minesweeper to check on the matter.
Away to the Internet I flew in a flash,
Launched open HIStalk and hoped nothing would crash.

The tune on Pandora was silenced at once
My laptop moved slowly – it seemed to take months.
When, what to my wondering eyes should appear
But a miniature Mr. H and Inga, that dear.

With my VGA driver, so lively and quick
I knew in a moment it must not be a trick.
More rapid than eagles, his rumors they came,
And he whistled, and grumbled, and called them by name.

“Now Neal! Now Vern! Now Hammergren and Judy!
Now Glen! Now JB! Now Pappalardo and Andy!
To the top of Web page! To the top of the crawl!
I know all your secrets! Yes I do know them all!”

With news and some gossip, those wild rumors fly
The leaders read closely, hoping they’ll not win The Pie.
So onto HIStalk the top dogs would click
To read Mr. H and his Inga, with all of their shtick.

And then, in a twinkling, I heard a new sound
My disk drive was churning and chugging around!
As I drew down my head to refresh the screen
Out popped Mr. H – an amazing sight to be seen!

He was dressed in polyester, from his head to his foot,
He had quite the old-fashioned programmer look.
A bundle of gadgets he had flung on his back,
As well as the Blackberry, still new from the pack.

His eyes – how they twinkled! His dimples how merry!
He looked ready to scribe a new fun commentary!
His droll little humor was clear from the start
This was man who made blogging an art!

The stump of a pipe he held tight in his teeth
And a light was encircled on his head like a wreath.
He had a kind face and pooch at his belly
So this was who turned vendors’ knees into jelly?

He was quiet and quick – the picture of stealth
As he checked out the tech things in our office of health.
A wink of his eye and a twist of his head
He noted our software and computers by beds.

He spoke not a thing as he took a keyboard,
I recalled how his words were stronger than swords.
Then touching his finger upon the word “send”
Today’s posting had clearly come to an end.

He sprang to my laptop and gave a short whistle
Then into cyberspace he went – as fast as a missile.
But I heard him exclaim as he slipped out of sight
“Happy Christmas to all, and to all a good-night!”

E-mail Inga.

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