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March 12, 2009 News 6 Comments

From Six Sigma: "Re: HIMSS keynote speakers. You failed to mention 2004 when HIMSS had hiker Aron Ralston, who cut off his own arm with a pocket knife to escape a fall in a rocky canyon. Now this was classic poor HIMSS programming. And let’s not forget co-keynoter, Tom Wolfe, the noted author and White House fellow for not going home again." I actually was trying to remember the arm-cutting guy but couldn’t think of his name, so I fell back to Dana Carvey as the "why is he keynoting?" example. But, HIMSS likes affordable C-list celebrities (Ben Vereen, for example) who seem hot until you think about when you saw them last in something important. Hold for Mr. Piscopo, please.

From The PACS Designer: "Re: Windows 7 beta. TPD has been watching for Microsoft to offer in its pending operating system Windows 7 Beta more solutions that will be usable by both Windows XP and Windows Vista users. With the addition of the system owner being able to shut off applications, the Windows 7 solution can win more advocates in the business world where having extra bandwidth available for business use is a valuable asset. Also being able to turn off Internet Explorer 7 can allow other Internet solutions to be employed." Link. I still hate using Office 2007 since I can never find Page Setup, Zoom, or Paste because of that damned ribbon, but Vista is OK.

From Andy: "Re: you said you liked weird stuff, right? What exactly is the procedure code for this?" A woman is airlifted to a Maryland hospital after being injured during a romantic escapade involving an electric saber saw. Hospital ED people can tell some bizarre stories (say, they would be great keynote speakers). At least this one’s not on YouTube yet.

From Kiwi Pete: "Re: movement. Or, is it more haste, less speed?" HHS is looking for people to serve on the HIT Standards Committee and HIT Policy Committee, with nominations for both due by March 16.

From Taxpayer: "Re: stimulus bill. Any thoughts on this? I’m a worker bee that sees so much squandering of good $ in HIT that I’m convinced the same thing will happen to stimulus $. Happy for never-ending employment, though." Link. The article by open source supporters says proprietary systems will turn into "poorly performing, opaque national Health IT at a high price." Maybe, but I don’t see that open source solutions are ready to step in as replacements (except maybe for VistA in specific circumstances), at least unless someone starts up the equivalent of a Red Hat to reduce the risk (real or perceived). On the ambulatory side, free/cheap EMRs exist, but are not dominating the market, which means upfront money isn’t the only problem. Hospitals waste a lot of capital on expensive applications that are woefully underused and fail to deliver ROI, but that’s usually the fault of the hospital and not the vendor (they bought it, superficially installed it, didn’t like it, and stopped using it, all without any serious effort or commitment). I doubt results will be any better now that the goal has changed to a quick selection, a subsidized purchase, and rapid go-live. I’m more in favor of getting the national infrastructure in place and then plugging in whatever appliance you want to exchange information with it. The value is in the network, not market-differentiating bells and whistles running on a local PC (I say that with great hopes for clinical decision support, but I’ve worked with it and it’s not really supporting many clinical decisions except to ignore the constant, unhelpful cookie cutter warnings). On the other hand, products and support aren’t fully commodotized, so as it stands today, there may be strong, valid reasons for choosing one commercial product or vendor over another. If there was a perfect system, we would need only one and that’s not the case.

Speaking of which, I like this quote by Mark Smith of CHCF on the stimulus bill: "It’s the land rush and the gold rush and the GI Bill of Rights all rolled into one."

Inga and I will be taking some possibly overlapping breaks over the next few days. We need to rest up for HIMSS, although I’m not sure that coming back to an inbox full of hundreds or thousands of messages will do it for me.

Riding on some Oprah quotes from Dennis Quaid (which were wrong, since he still thinks bedside barcoding will fix IV compounding errors like the one that affected his twins), Detroit Medical Center puts out a press release touting its own system. It’s actually Cerner’s, which would not have prevented the Quaid error either since it’s not used inside the pharmacy for IV prep, at least not as far as I know. There are hardly any systems that will detect mislabeled products when the barcode doesn’t match the contents of what it’s attached to. The hospital is awfully proud of the pro sports teams it takes care of, rattling them off at the end as though people who wield balls and pucks are more important that regular Joes.

Some folks who missed the HIStalk reception cutoff asked me to post that they’d like to meet similarly situated people at the Trump’s lobby bar during the same hours, a kind of Overflow Reception of the buy-your-own-drinks variety. I may swing by incognito just to see what’s happening there, so be rowdy.

FBI agents raid the offices of Washington, DC’s CTO (the previous job of Obama’s newly named US CIO), reportedly arresting an employee and a contract worker for bribery.

huntzinger

Just about everybody who’s been in the industry for more than a few years knows who George Huntzinger is, but here’s a refresher: he was president of CSC Healthcare for many years and also COO for the gone but not forgotten Superior Consultant, one of the class acts of HIT consulting. He’s now at The Huntzinger Management Group of Plains, PA, which in a remarkable non-coincidence, shares his name. A couple of HMG’s partners are also former SUPC folks who have decades of experience in running businesses, doing M&A work, etc. HMG offers consulting services to both providers and vendors, such as business assessments and planning, marketing strategy services, operations effectiveness, IT effectiveness, and full program management and PMO services. The Huntzinger Management Group is a new HIStalk Platinum Sponsor and I am delighted to have their support.

Listening: Pink Floyd’s Wish You Were Here, an incredible, moving tribute to LSD-fried (and now deceased) founder Syd Barrett. I rediscovered them after watching the Which One’s Pink documentary recently.

McKesson is the latest HIT vendor to pony up to make a patent troll go away. The troll’s strategy: find companies using technologies vaguely similar to a patent it bought with lawsuits in mind, sue everybody and his brother for infringement in a friendly court’s jurisdiction, then generously offer to settle if the target company agrees to buy a license that costs just a little bit less than mounting a legal defense. Everybody caves in every time except Epic, which happily offered to trade legal punches until the weaker fighter hit the canvas.

It’s nine years in jail for the New Zealand health district CIO accused of defrauding his employer of $11 million US by submitting phony IT maintenance invoices paid to himself.

esd

Enterprise Software Development is a new and appreciated HIStalk Platinum Sponsor. The company offers management consulting, supplemental staffing, software services, implementations, integration, and infrastructure support (among other services). Solutions expertise includes Cerner, Eclipsys, Epic, Siemens, MEDITECH, and McKesson. Some familiar client names are here. Thanks to the folks there for supporting HIStalk.

Massachusetts Senators Kennedy and Kerry bring home the pork, getting $143K of federal taxpayer dollars for the South Shore RHIO, among other spending items like sewer repairs and a bus. I guess that passes for cheap stimulus spending these days.

Perot Systems will spend up to $60 million on a new campus, stimulating India’s economy instead of ours. It’s also talking to five Indian hospital chains about implementing "hospital software that is available in the US and UK," which sounds like Cerner.

A report says Connecting for Health will lose its standards-setting role to a new group under the Department of Health, opening the door for more NHS organizations to choose their own systems as long as they can interoperate via a common infrastructure. Some have argued that stimulus money will encourage healthcare IT like the UK’s, which aren’t fairing so well, but it sounds like they are actually gravitating more toward our model, with certified commercial products being chosen locally but exchanging information on a common network.

E-mail me.

HERtalk by Inga

From Code Red: “EMRs, ROI, and physician adoption. I think if the market actually realized the savings and efficiencies, there would not be a need for government forced market demand to move these products. I think the reality is that the current generation products do not provide these things, or why would a doctor not adopt them? The current generation of products have low adoption and high abandonment because they force the wrong workflow into the clinic and the doctor. Many EMR products ignore the doctor’s need to enter original thoughts and observations which do not appear on a pull down list. My fear is that the HITECH spending is going to freeze spending and investment on next generation products that would be adopted, and create artificial market demand on old school products certified based on the rules from the old school vendors. So, no better mouse trap for the next few years, just ‘bridges to nowhere’ in HIT.” Hasn’t the industry spent the last 15 years or so trying to come up with the better mouse trap? Maybe it’s time to try something new. Plus doesn’t new business provide vendors increased revenues for product reinvestment?

Thank you for all that sent over the great footwear suggestions. Did I forget to mention that in addition to gorgeous and comfortable, they need to be affordable enough for someone on a blogger’s salary?

UTMB (TX) remains on life support after regents approve a proposal to keep the Galveston hospital and school open. Now the organization needs to find $1 billion from philanthropic and government sources to fund the rebuilding of the hospital, which was heavily damaged in Hurricane Ike.

The FDA clears Sunquest Information Systems’ latest Blood Bank software application.

The HHS creates a new Office of Recovery Act Coordinator to manage the distribution of the $137 billion in ARRA funds. HHS veteran Dennis Williams will lead the office and serve as Deputy Assistance Secretary for Recovery Act Coordinator. That really rolls off the tongue.

PatientKeeper is mentioned in this article about Caritas Christi Health Care (MA) and its $70 million technology project. At first glance, it sounds as if the Caritas IT staff actually created the PatientKeeper technology, which is not the case. I asked for clarification from Susan Worthy, PatientKeeper’s director of marketing. Her reply: “PT Barnum says any publicity is good publicity. Not sure that’s true. I sent a note to the editor regarding the inaccuracy.” I’m with PT.

Greenway Medical Technologies celebrates its 1,000th connection of PrimeExchange, Greenway’s interoperability engine.

Poor communication at US hospitals costs $12 billion per year, according to business school researchers at the University of Maryland. Communication failures result in unnecessarily long hospital stays and account for 54% of total losses. The $12 billion figure is equal to about 2% of hospital revenues nationwide and definitely cuts into the average hospital’s 3.6% margin. Leaders at the school’s Center for Health Information and Decision Systems believe that improved IT would streamline communication among caregivers and reduce inefficiencies.

OSU Pathology Services (OH) selects McKesson’s Revenue Management Solutions.

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Some Congressmen take a closer look at the healthy salaries earned by many hospital CEOs. The IRS says the average CEO salary is almost $500,000, with a small group averaging $1.4 million. Republican Senator Charles Grassley would like to introduce legislation that puts more pressure on hospital boards to keep salaries in check.

Beth Israel Medical Center implements Meta’s Electronic Physician Query software to improve clinical documentation.

Availity promotes (warning: PDF) Russ Thomas to the role of President and COO. Thomas joined Availity in 2008 as an executive VP and COO and was previously president of Gold Standard.

PHR provider HealthTrio will leverage Dossia’s technology platform to advance the clinical data integration within HealthTrio’s PHR and EHR products and increase online record access.

The Rochester RHIO goes live with eHealthConnect Image Exchange, a service by eHealth Global Technologies to automate access to patient images. The service ingrates with Rochester’s Axolotl Elysium system and connects to the PACS imaging services at eight radiology providers.

As Mr. H mentions, I once again have the opportunity to take charge of the blog while he taking a break in some Internet-less location. Feel free to drop me a note. It makes me feel important.

E-mail Inga.

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Currently there are "6 comments" on this Article:

  1. Re: Taxpayer’s comments on stimulus and open source…

    I’ve used Red Hat and Ubuntu Linux, Open Office, etc. The only thing that seemed to stick for me was FireFox and Skype. Both of which I still run on the Mac and Windows.

    I think the main problem with Open Source is that in this world it takes a bunch of investment to make something really good. Although I’d agree VistA is pretty good, I keep hoping no one tells me how much money the gvt spent on that.

    Although working for free sounds noble and all, I’m not sure that’s enough to do the trick in an industry that keeps writing papers on how we need to increase the sophistication of the systems that already exist by an order of magnitude. … if only the computer could “think” like each indiidual doctor …

    You may consider the 14% EBITDA “vendor excess”, but when you compare it to government contractor inefficiency and cost overruns, I’m not sure this argument is really material.

    I’d like to see everyone who champions the open source idea delete their Mac and Windows Operating Systems, delete their MS Office, and help lead by example.

  2. Perhaps this comment may appear naïve to bombastic but meant to be more sarcastic than ultraistic or is that altruistic. The $timulus Bill “Entitlement” for HIT may move the commodity of individual health record through an indifference curve thereby establishing a utility need for personal health repository.

    Electricity is a utility that magically appears at the flip of the switch on the wall. We as consumers don’t get involved with the power grids, transmission lines, maintenance, etc. In other words, we are indifferent to the cost, vendor or economy of scales of electricity provided by the local monopolized power company.

    You get where I’m going with this IT Guy. I have been picking winners & losers of medical instrumentation and information systems for over thirty years and determined by the nature of marketing and commercialism, “you win some and lose some.” EMR? They are all over priced, limited to gluttonous in features, intuitive to difficult to use and unfortunately must fall back on my gut intuition, “you get what you pay for” and this have been proven more and more to be inaccurate.

    eClinicalWorks, almost sound like a utility looks more enticing as a utility item than as a true commercial product. You buy one; you use it; you throw it away as a disposable except for the priceless data elements. Maybe we should all be investing in thumb drive stock. Look at the sale of light bulbs. You use electricity by the minute as a utility and must buy the light bulb in order to receive some of the benefits of electricity. And then there are toasters, blenders, power equipment, computers, solar panels…

    You still following me IT Guy?

  3. RE: HITObserver

    “I’ve used Red Hat and Ubuntu Linux, Open Office, etc. The only thing that seemed to stick for me was FireFox and Skype” I think dismissing the millions of open source Unix installs by saying you don’t use them isn’t much of an argument. FYI, Skype is free-to-use but not open source.

    “I’d like to see everyone who champions the open source idea delete their Mac and Windows Operating Systems, delete their MS Office, and help lead by example.” I don’t see how supporting open source requires abstaining from all proprietary software. Where open source make sense, use it. Where proprietary software makes sense, use that instead.

  4. RE: Congress looking at hospital CEO salaries. Inga, this looks like a case of salary envy since each takes home a puny $174K. Regardless of who is “in power”, you have to love the theatrics involved year in and year out to come up with a script as to why Congress will not bring up a discussion to elimnate their own automatic cost of living increases mandated since 1989 (this January a tidy $4,700 bump).
    http://news.yahoo.com/s/ap/20090312/ap_on_go_co/congress_pay;_ylt=AtPQMkSPTrC4REfq8vv73gUDW7oF
    With Mr. H.’s mention of Pink Floyd, he would understand we’re all just bricks in the wall for Congress.

  5. Classic Office 2003 menu in Office 2007: http://lifehacker.com/5166887/ubitmenu-brings-the-microsoft-office-2003-menu-back-to-office-2007 – I haven’t used it so don’t vouch for it, but LifeHacker is generally reliable, so you can assume it works.

    Alternately, someone added a search bar to the ribbon, which searches commands in the ribbon itself, to help you find the ‘new spot’ for doing things.

    Also, if you remember the exact keystrokes, Office 2007 does support the Office 2003 keystrokes.

    And to be clear, you’re perfectly in the right to complain. I’m just raising awareness of the workarounds, which may or may not work for you.


    Meanwhile, on the Open Source front, we can demand all funded development be open source, meanwhile the vendors don’t have to completely convert. Once funding stops, they can take the source and make all further changes proprietary.

    Believe it or not there’s a benefit to having source available, even if the ultimate goal (open source product w/ critical mass) isn’t realized. It’s still good to have source available, even to reuse for common tasks.

  6. There is good news here. Medsphere has taken what is certainly one of the most reliable and proven EHR’s available today, the VA’s Vista solution, and created OpenVista. Think of Medsphere as Red Hat meets HIT. As an Open Source healthcare information solution provider, we’ve enhanced Vista to efficiently function in non-governmental hospitals. Our initial client, Midland Memorial Hospital, is one of the initial 13 HIMSS Analytics Stage 6 EMR hospitals in the US. Medsphere achieved this in conjunction with Midland for 1/3 the time and 1/3 the price of the proprietary vendors. Hospitals that want to take advantage of the stimulus money have begun to form a line outside of our offices because, as an Open Source company, we do not charge anything for the software and can quickly make clinical improvements through the use of best practice templates and care guidelines. We make our money by charging subscription fees that almost every hospital can afford in their operating budget. Our subscriptions help defray costs for support, maintenance, upgrades and inclusion in the Healthcare Open Source Ecosystem (www.medsphere.org). There is an alternative to proprietary systems with Medsphere and OpenVista.







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