The Department of Veterans Affairs will pay $20 million to settle a class action lawsuit involving a privacy breach caused by a laptop stolen from a VA employee in 2006, according to a proposed settlement.

The laptop and its external drive contained names, dates of birth, and Social Security number of over 26 million military members and veterans. The equipment, stolen in a routine burglary of a data analyst’s home in Maryland who had taken it home without permission, was recovered by authorities, who concluded that its information had not been accessed.

The settlement will be paid to veterans who can show they were harmed or incurred credit monitoring expenses.

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From The PACS Designer: "Re: best hospital workplaces. Fortune Magazine has just published its 2009 list of top 100 places to work, which includes 13 hospitals. The highest ranked is Methodist Hospital System (Houston) at #8; followed by #19 – Ohio Health; #45 – King’s Daughters Medical Center (KY); #62 – Griffin Hospital (CT); #63 – Mayo Clinic; #67 – Children’s Healthcare (Atlanta); #68 – Southern Ohio Medical Center; #75 – Atlantic Health (NJ); #76 – Lehigh Valley Hospital and Health Network (PA); #77 – Northwest Community  Hospital (IL); #79 – Baptist Health South Florida; #85 – Arkansas Children’s Hospital; #98 – Vanderbilt University. TPD congratulates those selected as being top notch in their treatment of employees." Link.

From FIT003: "Re: McKesson. They have started laying off staff. Long-term employees are the first to have been laid off. Initial numbers, placed at 50-75 people within the Alpharetta operations." Unverified.

From Songbird: "Re: Perot’s MEDITECH solutions group, formerly JJWILD. Planning a third round layoff this Friday, January 30." Unverified.

From KFC: "Re: Keane Healthcare. About 10% or 30-35 employees from the Keane Healthcare division over the last two weeks. With the sunsetting of the old First Coast Systems patient billing application and the merging of the Unix product, I wonder how this will impact the always-delayed timeline?" Unverified. For all these unverified layoff rumors, by the way, I will run a brief company response if one is provided, whether confirming or denying. That’s fair.

From Ken Kercheval: "Re: physician practice EMRs. It is going to be an interesting year. Lots of companies will go away. Like they say, ‘When the tide goes down, you find out who isn’t wearing a swimsuit’. Indeed."

From Jackie Martling: "Re: sponsor ads. Just a suggestion. The animation is annoying to the point I copy and paste your great content to avoid the distraction. Seems unfair to the non-annoying ads." Noted and dutifully passed along to the sponsors for their future consideration.

HISsies voting will be winding down shortly, so cast your vote now.

Listening: The Gaslight Anthem, a reader suggestion. Good Jersey Shore bowling alley ballads with a soupcon of punk. Should be on an indie film’s soundrack. They’re on Letterman Friday night and touring everywhere.

The Raymond James folks sent over a couple of briefs about the healthcare IT stimulus proposals on the table. They predict that HIT adoption incentives will be around $32 billion over ten years, with the biggest adoption jump happening in 2011-2014 and with the biggest potential beneficiaries being physician practices and hospitals in the 300-499 bed size. They question, as I did yesterday in HIStalk Practice, whether prospects may actually hold off on purchasing clinical systems until the federal involvement shakes out. With that in mind, I’ve put two new polls to your right — one for vendors, one for providers — asking about any purchase delays your employer has been involved with. Your comments are welcome, too, so feel free to e-mail me. The stimulus could actually be detrimental in the short term if potential customers become indecisive.

A Fort Bragg military team is the first to use the AHLTA-Theater battlefield EMR to document patient encounters stateside.

A former Kaiser Permanente employee in Los Angeles kills himself, his wife, and five children ages 8 and under (including two sets of twins), apparently after being fired in a dispute with an administrator. His suicide note claims that the administrator told him on coming to work one day that "you should have blown your brains out." His wife had also previously worked for Kaiser. Update: according to CNN, both parents had been fired from Kaiser for cause.

A reader says Ivo Nelson, formerly of Healthlink/IBM, will launch his new business next week. It’s called Encore Health Resources. The domain is registered to a PR firm’s contact and address.

IBA’s iSoft gets a deal to install its software at 38 Healthscope hospitals in Australia.

New on HIStech Report: an interview with Steve Ura, CTO of MED3OOO, including questions about its InteGreat acquisition.

Capsule (they seem to have dropped the "Technologie" part of their name except when referring to their Paris headquarters) announces the addition of 80 more medical device drivers to its library of 400.

Consumer Watchdog demands that Google "cease a rumored lobbying effort" related to stimulus bill discussions that would allow the company to sell patient information to Google Health advertisers.

Members of Parliament want individual trusts to be able to buy their own systems if NPfIT can’t get its Cerner and iSoft software problems fixed within six months. Also reported: one trust that’s merging with another may be planning to drop Cerner and go with the other hospital’s 20-year-old Atos Origin legacy system. All of this, of course, is a warning to anyone who thinks huge healthcare IT projects can work fine if given the proper money and oversight, neither of which is in short supply in the UK as NPfIT disintegrates.

This may sound off topic, but I’ve been involved with similar solutions that made IT a hero: an Indiana Web 2.0 startup announces that its WiFi digital sign technology has been installed at several hospitals. It’s a terrible press release (as any would be that references rotten teeth) but maybe interesting.

Hospital layoff: Hennepin County Medical Center (MN), 100.

The Wisconsin paper investigates a touchy topic: do hospitals provide enough free care to be worth all the tax breaks they get, especially when governments are strapped?

A rumor site reports that Apple CEO Steve Jobs will undergo surgery at Stanford Hospital, citing as a source "a secondhand account passed along from an employee at Stanford." I’m sure the HIPAA-violating source will provide updates throughout the day if the story is true (he was rumored to have been thinking about a liver transplant).

A phony doctor is arrested at his fake doctor, nurse, and dentist school in India. Graduates of the "Medical Diploma Training Agency" are actively practicing, it’s believed. The doctor was printing his own diplomas, but later outsourced it to a computer company. He was turned in by a night guard who paid for his dentist’s diploma, was told he had to ante up more money, and then was allegedly beaten by the fake doctor for complaining.

Siemens says its healthcare business isn’t so great, but it still sucks less than GE’s.

An Australian hospital is in such dire financial straits that employees, feeling sorry for patients, are spending their own money to buy groceries, bandages, light bulbs, and computer paper.

Venture investing declined in 2008 for the first time since 2003. Green tech companies are hot; software vendors and Web start-ups are ice cold.

Archives of Internal Medicine Article
Clinical Information Technologies and Inpatient Outcomes

"Health info technology saves lives, costs" screams the Yahoo News article. Modern Healthcare fires out an e-mail news blast, claiming that "when computers replace paper, patient mortality rates drop 15% during hospitalization."

The headlines are misleading (as they often are to lure in readers). You need to interpret the article yourself.  It’s available online.

Here’s the conclusion, verbatim from the article: "Hospitals with automated notes and records, order entry, and clinical decision support had fewer complications, lower mortality rates, and lower costs."

Sounds promising. Even more so when the article talks about the researcher’s use of a survey tool that actually measures how much technology is being, not just how much has been bought (although that CITAT survey instrument itself isn’t available in this or the predecessor articles that I could find, which is odd since that’s a key part of interpreting the findings).

However, the study had compromises:

• It covered only patients >50 years old and only four medical conditions.
• It randomly surveyed physicians using an AMA file, asking them to respond and to include the hospital in which they provided most of their inpatient care, but it wasn’t clear whether they provided all that much inpatient care at all or whether they were the most prolific doctors at the hospitals being reviewed.
• Since the doctors who responded drove the choice of hospitals, those hospitals studied were not typical: they were much larger and more of them were academic medical centers.
• Outcomes were determined from claims data.
• Some results were predictably erratic, such as the lack of correlation to length of stay and the conclusion that use of electronic notes and records increases the odds of heart failure complication.

Compared to studies that preceded it, this one’s pretty good, but it suffers from Most Wired-like conclusion-leaping (not in the article, but by those who try to turn it into a sound bite). Nothing suggests that technology use caused the improvement, only that it seemed to coincide with it. So, we know what we already knew or presumed: good hospitals are more likely to do many things (including deploy IT) better than bad ones.

Nothing in the article suggests that a given hospital will see its quality improve just because its starts using technology (in fact, that might have been an even more interesting study: take those same hospitals studied, identify those that recently implemented clinical systems, and compare their before-and-after numbers to see if anything changed).

The bottom line: it’s a pretty good study that has encouraging conclusions, even if they are iffy. IT won’t make bad hospitals good, but it can help make good ones a little better if it’s used right and along with other improvement measures. The article does not, however, suggest that IT is the can’t-miss answer to quality and cost problems.

E-mail me.

HERtalk by Inga

Consultants warn that as the economy worsens, more hospitals will lay off employed doctors or slash their pay. The US Department of Labor reports that 107 hospitals had mass layoffs (50+ employees) for the first 11 months of 2008.

Despite all the bad news of layoffs, many believe that healthcare still offers more stability than other sectors. In fact, the US Bureau of Labor Statistic predicts 3 million new wage and salary jobs between 2006 and 2016, more than any other industry. In nursing, older students, men, and second career newcomers are joining the ranks.

In a paper entitled “Hospitals as Hotels,” researchers conclude that amenities such as good food, attentive staff, and pleasant surroundings may play an important role in hospital demand. “From the patient perspective, hospital quality therefore embodies amenities as well as clinical quality. We also find that a one-standard-deviation increase in amenities raises a hospital’s demand by 38.4 percent on average, whereas demand is substantially less responsive to clinical quality as measured by pneumonia mortality.” Sounds like the message is to buy nice furniture instead of improving care if you want to keep the beds full.

Turmoil at Tri-City Medical Center (CA) has employees wondering about the facility’s long-term stability. Last month, a new board majority placed the hospital’s top eight administrators on paid leave and brought in a temporary management team that opponents claim have no hospital experience.

An Ohio man sues a nightclub for $25,000 after a stripper’s shoe flies off during a tricky dance move, chipping a bone in his nose that will require surgery to fix. No word on whether her shoe was damaged, but I say shame on that stripper for risking her shoes.

HealthGrades releases (warning: PDF) its seventh annual Hospital Quality and Clinical Excellence study. Medicare patients treated at top-rated hospitals are 27% less likely to die there, on average, than at other hospitals.

The Association of Academic Health Centers calls for a revision of the HIPAA privacy rule following a study in which HIPAA was found to impede study recruitment and study diversity.

McKesson reports mixed financial results for its fiscal third quarter, losing $20 million because of the $493 million paid to settle AWP price fixing charges. Without that, EPS would have been $1.05 vs. $0.68 last year on slightly higher revenues. Technology Solutions grew but missed expectations due to contract signing delays in hospitals and physician practices. Cost cutting was the key to a pretty good quarter. The company raised its earnings outlook, running the stock up 12% on Tuesday.

MedAvant Healthcare Solutions appoints Troy Burns as CTO. He previously worked at Misys and Payerpath. MedAvant’s president Andrew Lawson is also a former Misys guy.

Philips Healthcare reports 9% sales growth in Q4, driven by sales in imaging systems, healthcare informatics, and customer services. Royal Philips as a whole ended the year with a $1.9 billion loss and will lay off 6,000 employees.

Scott Perra, the new president and CEO of Faxton-St. Luke’s Healthcare and Mohawk Valley Network (NY) claims the implementation of an EMR is his first priority. The health system is about 18 months into installing its $15 million clinical system (I believe Cerner).

In what the company calls a planned transition, Virtual Radiologic Corporation promotes President Rob Kill to CEO. Company co-founder Dr. Sean Casey will remain chairman of the board. The announcement coincides with the release of the company’s Q4 and full-year financials, which include a 24% jump in revenue for the year. Adjusted net income grew from $7.0 million to $9.7 million. The company also just signed its third internal client, this one in Saudi Arabia.

Griffin Hospital (CT) implements the Logical Ink electronic charting system in its new Center for Cancer Care.

Madonna Rehabilitation Hospital (NE) plans to adopt (hopefully they’ve signed a contract) Eclipsys clinical solutions.

The Outpatient Rehabilitation Center of Margaret Mary Community Hospital (IN) implements Chart Links therapy documentation and scheduling system for its 19 physical, occupational, and speech therapists.

PHR vendor MediKeeper announces the appointment of David Ashworth as CEO.

The Queen’s Health System (HI) renews its IT outsourcing contract with ACS. The new contract is valued at $26 million over three years and includes Queen’s Medical Center and its affiliates. ACS has been providing IT services to Queen’s since 2001.

BJC HealthCare (MO) signs a five-year agreement with CareTech Solutions. CareTech will provide BJC and its 11 affiliated hospitals a suite of Web products and services including CareWorks content management system and BoardNet communications portal.

I was amazed to learn there are now over 10,000 applications available for the iPhone. A cool new HIT tool just announced: Safe OR, which includes a 19-item surgical safety checklist A Surgical Safety Checklist to Reduce Morbidity and Mortality in a Global Population.

Picis CEO and Vice Chairman Todd Cozzens will chair the Business Office Improvement educational track at TEPR+ next week. I’m envious of anyone who gets to spend a few days in Palm Springs right now. If you’re attending, send us updates and impressions.

Medsphere announces the successful implementation of BCMA at all eight of West Virginia’s state network of acute, psychiatric, and long-term care hospitals.

athenahealth and the Illinois State Medical Society announce an agreement to offer special pricing on athenahealth’s PM solution to its 12,000 members. I also saw that athenahealth hit a 52-week high Monday, following Jonathan Bush’s appearance on CNBC’s “Mad Money” with Jim Kramer.

E-mail Inga.

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Ministry Health Care Will Implement CattailsMD

Ministry Health Care has chosen to implement CattailsMD electronic health record. For over 20, Marshfield Clinic has developed a comprehensive electronic health record, now available as a CCHIT-certified ambulatory EHR product known as CattailsMD. The EHR is also available with a data warehouse to actively drive decision support and population management.

Conventional Wisdom

Conventional wisdom speaks against the use of an internally developed product. While conventional wisdom is often used as a rule of thumb, tunnel thinking can limit your options. Every software decision is the result of a complex analysis of objectives, risks, benefits, values, and mitigation strategy. The purpose of this post is not an exhaustive explanation of our decision, but rather a review of several factors influencing our thoughts.

EHRs Are Becoming a Utility

Within a few years, EHRs will be more of a utility than a unique product. Increasing CCHIT certification and government incentives are driving standardization of function. Many organizations are turning to SureScripts to satisfy the CMS E-prescribing incentive. SureScripts standards will be just one of many leading to an ever-increasing identical functioning of EHRs. Simply having an EHR will not lead to process improvement nor increase clinical quality.

EHRs Do Not Improve Quality

Most EHRs have not improved quality of care. Simply automating our traditional process should not be expected to fundamentally improve quality. Improvement occurs when we redesign our care systems and standardize our processes (often enabled by use of an EHR). It is not the EHR that magically improves care; it is the people and processes utilizing the EHR that improves care. If you are both vendor and end user, then you can first vision how care should be provided and then deliver the necessary software to support it.

Marshfield Clinic has effectively demonstrated the value of this approach by achieving improved quality of care resulting in decreased health care costs in an ongoing CMS Demonstration Project.

The Status Quo Will Not Meet Future Needs

Our health care system is broken, we simply are not meeting the prevention, wellness, and primary care needs of our patients. We do not have enough primary clinicians to meet our current needs and we are not producing enough primary clinicians to meet our future needs. In Wisconsin (warning: PDF), the demand for primary care clinicians in the next 10 years is projected to increase by as much as 33% with only a 5% increase in clinicians. We will need to redesign our health care delivery system if we hope to meet future needs.

Our use of CattailsMD maximizes our opportunity to influence the design of an EHR to meet the needs of our patients. Although our vendor is interested in the commercial success of the product, as a provider of health care, their prime objective is the same as ours: caring for patients.

It Is All About the Data

Ministry Health Care and the Marshfield Clinic have a large number of common patients and will share the same EHR. While a shared EHR with a single source of truth for medication lists, allergies, labs, and documents is appealing, the real value is an extensive data warehouse ten years in the making. The data warehouse currently contributes to a number of activities including population management, disease management, maintenance of numerous registries, formal research, and increasingly, decision support.

As our business intelligence tools become more robust, I expect increasing emphasis will be placed on activities such as searching the database for trends of best care, identifying potential drug interactions, post-marketing surveillance of medications, and identifying care opportunities that will improve the health of the communities we serve.

A Decision Without Risk?

Is our decision to use CattailsMD without risk? Nope. But then again, no decision is. During the 20 years I have been interested in health care IT, I have seen numerous vendors (both large and small) come and go. I have also been through the agony of “upgrades” in hardware, operating systems and entire new versions of software forced on us by our vendors.

What has not changed is our need for information to improve health care. We are on the threshold of having EHRs and data warehouses that do not just present information, but actively support the practice of medicine.

A Future Post

Ministry Health Care and the Marshfield Clinic have been actively working to build the infrastructure necessary to support a joint EHR. In a future post, Dr. Carlson (Marshfield’s CIO) and I will discuss some of the issues we have dealt with that will have national significance if government seeks to foster greater sharing of patient data.

While you are waiting for a joint post, please take some time to read Will Weider’s (Ministry’s CIO) advice for President Obama.

Peter Sanderson, MD, MBA is a family physician and Director of Medical Informatics and Operations and Executive Sponsor, EHR Program, at Ministry Health Care. He can be reached at pete.sanderson@ministryhealth.org. He also blogs at MD Leader.

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An HIT Moment with ... is a quick interview with someone we find interesting. Michael O’Neil is founder and CEO of GetWellNetwork, Inc.

People may think of GetWellNetwork as an TV entertainment service for hospital patients. How do you describe your company?

GetWellNetwork was founded on the principal that patient engagement is a core strategy for performance improvement and a critical puzzle piece in the elusive search for service, quality and safety improvement in healthcare. GetWellNetwork provides technology, as well as process and skills training, to effectively actively engage patients in the care process. 

Today, we are leading this emerging HIS segment called Interactive Patient Care (IPC). Every day, we are humbled to work alongside leaders at the Adventist Health System, Catholic Health West, Children’s National Medical Center, Christiana Care, Henry Ford, Thomas Jefferson University, and Poudre Valley Health System, the 2008 Malcolm Baldrige National Quality Award Winner. Their commitment to patient-centered care energizes and inspires our work. It matters, and it works.

We developed a patent-pending workflow engine called Patient Pathways. Patient Pathways leverage existing clinical workflow and HL7 interfaces as triggers to directly engage patients in the care process via their in-room television.

For example, a physician entering a Coumadin order via CPOE triggers a Medication Teaching & Pain Assessment Pathway via GetWellNetwork. Consequently, the system prompts a patient while watching the Oprah Winfrey Show, provides critical education on this high-alert medication through an interactive video, and then tests the patient on comprehension through a series of on-screen questions. The Pathway concludes by documenting the education results back into the EMR and alerts clinicians in real-time if the patient fails to complete the education. In another example, a Discharge Pathway guides patients through a series of activities, including a patient checklist and the ability to order discharge medications from their bed.

In summary, GetWellNetwork is a patient care tool, automating and hard-wiring critical service and quality tasks for nurses and providing an exceptional, personalized care experience for patients and families.

And yes, GetWetNetwork patients can also watch movies, send instant messages, surf the Internet, and play video games until they break every record imaginable. So we do entertain patients as well. Entertainment can be quite a powerful healing tool for patients and families.

Hospitals are struggling with reduced utilization and lower payments. How can you help them?

Alongside our hospital partners, we are measuring the application’s impact on HCAPHS scores, Core Measures, and preventing "Never Events" such as falls and hospital-acquired infections via patient engagement. As the transparency of service and quality data increasing rapidly, pay-for-performance systems and value-based benefit design are gaining significant traction. Top performing hospitals will continue to attract the best physicians, best nurses, best staff, and best patients. 

Over the past 18 months in particular, our hospitals are seeing exciting movement in their HCAPHS and Core Measures where we have implemented a focused Patient Pathway. In addition, we are also seeing encouraging indications regarding patient engagement on reducing cost per case. In 2009, we are investing quite significantly in research regarding the efficacy of patient engagement on outcomes, with heavy participation from our client community. It’s an exciting time.

Early in-room applications had facilities challenges, such as replacement of TVs, concerns about suitability of keyboards or other peripherals, and the need to rewire patient rooms. What’s required to install your products?

As one of the first companies in the Interactive Patient Care market (since 1999), we were among those applications the facing  the facilities challenges you mention. Through significant blood, sweat, tears (READ: lots of mistakes, frustrated early clients, and significant R&D expense), our engineers and supplier partners have created proprietary and cost-effective ways to implement Interactive Patient Care. Today, we are relatively infrastructure (wiring) agnostic and can run the system in old buildings on coaxial cable alone and, of course, on Ethernet where available. In both cases, digital video streaming and full Internet browsing has been integrated into the application. 

As for peripherals, today we offer a pillow speaker device that interfaces with all major nurse call systems and a fully-sealed keyboard for under $40/unit. This year, we will be launching a next generation keyboard that will finally make Internet through a patient room television as elegant as being on your laptop or desktop at home or work.

You’re working with Florida Hospital on their "Hospital of the Future." What elements of that do you think are important?

Late in 2008, we were chosen by the Adventist Health System as the exclusive provider of Interactive Patient Care throughout their organization. Since then, several facilities have contracted for GetWellNetwork, with one of them being Florida Hospital, where projects including their new Ginsburg tower as well as the Disney Hospital for Children @ Florida Hospital. 

The top three elements of success with Interactive Patient Care are 1) executive sponsorship to provide strategic outcomes priorities; 2) integration with EMR (they use Cerner, which we successfully interfaced with at Christiana in ’08) to provide triggers for our Patient Pathways and a place to document patient activity for compliance automation; and 3) nursing engagement. 

When nursing leadership embraces Interactive Patient Care as a tool vs. a task, the impact is powerful on their service, quality and safety initiatives on the floors. Florida Hospital is highly engaged and committed to setting a new standard in patient-centered care. We of course are thrilled to contribute to their vision for patient care.

Are hospitals getting better at involving patients and family members in their care?

Yes, they are. But, it’s hard work, takes a genuine commitment and accountability, and does not happen without strong leadership. On November 17, 2008, the National Quality Forum published their National Health Priorities and the first one listed was patient and family engagement: ‘PRIORITY STATEMENT: ENGAGE PATIENTS AND THEIR FAMILIES IN MANAGING THEIR HEALTH AND MAKING DECISIONS ABOUT THEIR CARE.’ So, hospital leaders are listening and they are acting. 

Of course, this does not happen overnight, and the technology, applications and interfaces are perhaps the easy part of the equation. Interactive Patient Care is a commitment, and when hospital leaders make the commitment, their patients and families are winning. Hospitals are experiencing fairly spectacular improvements in satisfaction, quality, and operations measures that have been difficult to move the needle on in the past.

Lastly, keep up the great work on HIStalk … it’s simply terrific! Thanks for having me.

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From RSNA Body: "Re: RSNA. Don’t believe this RSNA whitewash about attendance. These were pre-attendance numbers — wait for the audited RFID traffic numbers. I was there and, for the first time, there were hardly any lines for anything. I spoke to cabbies, bus drivers, restaurateurs, vendors, etc. who all reported thin crowds. One cabbie asked me on Wednesday if the radiology show was over because he said the traffic was so light. Several vendors told me that a number of hospital customer contingents had cancelled their RSNA trip or only sent a few rather than the scheduled dozen or so staff. With IT vendor layoffs since November and a worsening economy, I predict a huge decrease in HIMSS attendance." You’re probably right. Conferences, like sports venues, have been known to report big attendance despite obviously empty seats.

From Eclipsys on the Ropes?: "Re: Eclipsys. I understand that McKesson just took another revenue cycle customer away from Eclipsys: ‘Baptist Healthcare System Selects McKesson to Optimize Physician Revenue.’ Can you verify this for your readers?  If so, it seems like Eclipsys is in a certain death spiral. Also, the client that represents 10% of the ECLP revenue is probably North Shore Long Island Jewish since they have both outsourcing and software." I’ll have to call in a lifeline on that because I have no idea. It’s the Baptist group in Kentucky that contracted with McKesson for physician revenue cycle management. I don’t recall hearing anything about Eclipsys there, but it may well be. Update: the group is not an Eclipsys customer, so the reader’s understanding is incorrect (to the other reader who said my facts are incorrect, they aren’t my facts: the blue text is a reader’s question; my answer in black text was "don’t know, never heard of ECLP being there.")

From I’m Just Saying: "Re: Eclipsys. The 10% of revenues client may be Baylor. Also, expect more layoffs this week in Services. One VP resigned in December (J. Bell) and two others were termed last week (B. Pille & D. Tom). J&J could be a good answer."

HIMSS is not too many weeks away. I haven’t come up with any HIStalk-related activities yet since I’ve been swamped, but we’ll have some HIStech Report interviews coming very soon. The conference was awash last year in Fake Ingas, HIStalk shoeshines, badge ribbons, the big bash, and probably stuff I’ve forgotten (like that $1,000 worth of tote bags I bought – is anyone still using theirs or did I waste my money?) I’m open to ideas from vendors on anything that would be cool for readers.

A Georgia family puts everything they own except their house up for auction on eBay to pay the medical bills of their children, a 7-year-old with an autoimmune disease and another with autism.

HHS announces acceptance of HITSP interoperability standards (warning: PDF) that took effect January 16. Complete list here.

Jobs: Sales Account Executive, Northeast, Director of Channel Sales, Epic Clinical Reports Writer, MEDITECH Consultant – Advanced Clinicals. Sign up here for a weekly jobs blast.

Speaking of jobs, several folks at Eclipsys lost theirs this week, which I reported as a rumor on Wednesday. At least 100 have been shown the door, a couple of folks say, and the purge may not be over yet.

And speaking of layoffs, Children’s Hospital of the King’s Daughters (VA) laid off 28 employees on Friday and also cut 90 unfilled positions. It’s also shutting down its child care center. Mike e-mailed about Alegent Health (NE – Immanuel Medical Center pictured above), which laid off seven VPs this week and will eliminate 285 more positions by March. It also forced 20 senior managers to take a 10% pay cut.

And more layoffs: GE Healthcare dumps an unnamed number of employees in Burlington, somewhere between 8 and 39 given their sketchy announced percentage range. The staggering giant has never been forthright about its cutbacks in the old IDX office, probably due more to smothering bureaucracy rather than intentional obfuscation. Kind of like when Jeff Immelt put on his happy face about GE Capital while the rest of the world (me, anyway) proclaimed loudly that the company could not possibly avoid fallout from the financial sector meltdown. Let the record show that Jeff was way wrong: GE’s Q4 numbers announced Friday after the market close showed revenue down 5%, EPS $0.35 vs. $0.66. GE Healthcare’s profits were down 9%. The stock dropped nearly 11% during Friday trading and is down another 11% after hours.

And even more layoffs: NorthShore Skokie Hospital (IL), 150; Frankford Health System (PA), 100; Hamilton Health Sciences (Canada), 250; Irvine Regional Hospital and Medical Center (CA), 510.

Intel’s chairman Craig Barrett will retire in May. He’s been loud about healthcare and technology (I quoted him in July 2007), so maybe we’ve not seen the last of him.

Two PricewaterhouseCoopers executives in India are arrested and charged with conspiracy for the company’s role in signing off as auditor on the books of Satyam Computer Services, whose chairman admitted that $1 billion of claimed cash didn’t exist. I mostly associate PWC with dumb names: its own and the one it announced for its consulting organization in 2002, "Monday," which thankfully never happened because the company sold the whole organization to IBM just five months later.

The State of Massachusetts signed a big mandatory EMR law in August with $25 million a year in funding to get doctors online by 2015. The state cut the budget to $15 million two months later, which everybody agrees is far short of what’s needed to get the job done. Also agreed, judging from the comments, is that not much benefit has been derived so far.

Another victim of Bernie Madoff’s Ponzi scheme: Charleston Area Medical Center (WV), whose foundation lost $800K and the hospital $200K.

McKesson CEO John Hammergren gets his name and picture in The Wall Street Journal, although it’s hardly a flattering mention. The article addresses the methods companies use to calculate executive pension value into a single lump sum payment, with some using an obsolete federal formula that boosts the number as "a sneaky way to give executives larger pay." McKesson tweaked the formula for Hammergren last March, jumping his parting gift’s value to $85 million (everybody’s outraged about healthcare costs, so you might think that would raise an eyebrow or two).

Former QuadraMed CEO Larry English gets a new job as CEO of CIFG Holding, Ltd., a Bermuda-based holding company running a French bond insurer recently bailed out after getting burned on derivatives.

Think we’ve got healthcare challenges? Malawi has 14 million people, of which 1 million are HIV positive, and only 280 doctors. Their answer: treatment protocols managed by non-physicians using touch screen clinical workstations (developed in Ruby on Rails) at the point of care. Scroll down for several YouTube demos. It would never work here, of course, because vendors couldn’t load it down with proprietary bells and whistles to boost the price. Still, you have to like this quote extolling the virtues of designing systems to take the use through a consistent, guided function (which I always argue in saying that charting a med should be as easy as the import wizard in Excel): "If the system is useful, then other people want to use the system. This is a nice problem that gets solved with…training! But soon, the developer notices that users keep using the system in a way that was totally unexpected. Time for another training session… But there is another approach that doesn’t rely on training. They are called constraints … The amount of training required is usually inversely proportional to the number of constraints in the system.."

Two sides of a Connecticut hospital’s proposed health information exchange. Pro: the hospital is raising money for the $8 million project and hopes the federal government will pay for it while it’s slinging money around. Con: the president of the state medical society says the government shouldn’t pay because mandated physician usage would just make the state’s doctor shortage worse because they’d steer clear of Connecticut.

Debbie Turpin, clinical systems manager at Alton Memorial Hospital (IL), is named chief nurse executive.

Odd lawsuit: a mentally disturbed female prisoner is taken by corrections officers to a hospital for psychiatric treatment, where she "went berserk" and bit the nurse’s hand. The officers watched and did nothing, later saying they believed it was outside their jurisdiction. The nurse is suing the city.

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