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News 3/27/09

March 26, 2009 News 8 Comments

From Skippy Van Oakes: "Re: Keith Hagen. Was the personal reason that he thought that QuadraMed shouldn’t be put up for sale? Chatter on the Yahoo! Finance boards would indicate a distinct possibility." The press release quote from interim CEO Jim Peebles made me wonder: "I am eager to focus on the ways in which the Company can further unlock its potential and increase shareholder value." His additional comments suggested more R&D and positioning for HITECH money rather than a change in ownership, but I understand those who assume quotes referring to shareholder value mean that all options are on the table. I like the company, QCPR is an excellent product, and they are a franchise when it comes to HIM technologies. Their only disadvantage is size compared to the competition. Some of the Yahoo posters took Oracle’s announced acquisition of Relsys this week as a signal of more healthcare interest, but clinical trials software offers a vastly different vertical sales opportunity than the average mid-sized hospital.

From ILoveLA: "Re: Cedars. I heard a rumor that the clinical project at Cedars-Sinai has been halted." I didn’t hear that, but I did hear they got rid of a bunch of Perot people and replaced them with Deloitterers. That’s not verified, but the source who told me should know.

 realage

From New York Cynic: "Re: RealAge. They just set back PHRs and online health information technology about a year." No doubt. Over 27 million people have taken the 150-question RealAge test on the Internet, which purports to calculate your biological age based on personal characteristics rather than date of birth, but was actually collecting targets for drug company advertising, including specific quiz answers and e-mail addresses. RealAge says it discloses everything and doesn’t let the advertisers have the data. Scumbags or not? I’m leaning toward no (the communication came directly from them and users should have expected the worst given the vague privacy agreement), but I bet smoke is coming out of Deb Peel’s ears for their using patient information to kick off personalized marketing blitzes. If we’re ever going to control healthcare costs, can we afford to let wiley drug companies hard sell to often clueless consumers and their customer-friendly doctors willing to oblige? Also gone unnoticed by most: RealAge is owned by Hearst (which paid $100 million for it in 2007), which also owns First DataBank, Zynx Health, and Medscape. This guy saw it coming: "I would think that the 8 million submitters of private medical information would feel a little uncomfortable when their data got acquired by a major publisher, but I haven’t seen any real journalists exploring that angle yet. Oh well, at least it wasn’t a life insurance company."

From Victor Franko: "Re: Emergisoft. Joe DeSilva was probably the best thing to happen to Emergisoft in its history. The company’s bottom line was better, the product was significantly improved, employees were motivated, and customers were happier than before he started. I’m disappointed that the company didn’t have the class to recognize his contributions."

From Bobby Orr: "Re: Eclipsys SCM. Look for announcement of a major SCM win at prestigious teaching and research organization in the Northeast."

From Cleon Jones: "Re: Sutter. A major obstacle in its implementation was organizational and process (making decisions upfront, defining realistic charters, establishing governance, and managing user expectations). They are prime time for a Federalist champion or a good organizational management consultant looking for a challenge. Their IT budget is allocation to individual affiliates and there is not tight corporate governance, so there is little corporate funding available. Consider the first implementation a prototype evaluation."

From Home Provider: "Re: medical homes. A report says their savings will be less than or equal to the monthly fees paid since they will be serving too broad-based a population." Link.

I’m hearing that Orlando Portale, CTO of Palomar Pomerado Health, may be under consideration by House Speaker Pelosi as her appointee to the government’s new HIT advisory board.

A UK hospital chooses MEDITECH v6.0 EPR, a big win given the hospital’s huge project budget and planned scope.

I’m hearing a little buzz that economic pressures are causing some vendors to claim they can’t integrate with third-party systems or, when that doesn’t discourage the customer, charging them a high interface fee plus annual maintenance. Apparently they would rather not share the sandbox play-time, so they are taking their ball and going home. The government and customers want interoperability, but it’s not in the best interest of vendors to allow too much customer independence. That will be interesting to watch. 

Bankrupt Nortel Networks, praying desperately for stimulus crumbs, will demonstrate some new IVR applications at HIMSS.

A UK hospital is chastised for scrapping PCs still containing patient medical records.

Health Robotics announces the early release of its ivStation Profile at a Dubai conference, a biometrically secured IV dispensing system similar to profile-secured dispensing cabinets like Pyxis. Gaspar DeViedma, formerly of Eclipsys, works for them.

HIStalk odds that Rob Kolodner will cash in on his ONCHIT stint by taking a high-level, mostly ceremonial vendor or lobbying job instead of heading back to the VA: eight to one.

McKesson is testing the UK HIT waters for a return following its failure to win NPfIT contracts in 2003, but also after project stumbles opened the field back up again.

Part 4 of our HITECH vendor question series is up on HIStalk Practice.

It’s hard to believe this survey’s conclusion, even though it does appear in JAMA. Only 1.5% of US hospitals have comprehensive clinical systems running in all units, with the number increasing to only 7.6% if you count just one or more units. CPOE for meds is at an embarrassing 17%, with 45% of respondents saying they have no plans to implement it at all. The decision support survey elements are skewed, obviously allowing respondents to count them as implemented even if not for physicians (example: only 17% do meds in CPOE, but 46% say they have drug-allergy alerts, obviously in the pharmacy system). You might argue whether some of the requirements to be considered "comprehensive" are really practical the way vendors have designed them (physician notes, drug-lab interactions, and nursing assessments), but those are not unreasonable criteria. The EHR-less hospitals blamed upfront cost nearly 3/4 of the the time, while a third questioned ROI and the abilities of their IT shops. So, smug hospital types snarking on poor physician EMR adoption have little to brag on since penetration may be higher in practices even though the excuses are the same. So, assuming Santa Obama defuses the major argument by using our money to buy EMRs, where will hospitals get all the IT and informatics resources? (not to mention that the ROI gets better when someone else pays, but the overall benefit doesn’t change). And if you thought the 1.5% number was appalling, consider this: having it running doesn’t mean using it to improve care or reduce cost, it just means it’s available.

nyp

New York Presbyterian gets a CNBC mention for using CPOE to reduce adverse drug events by 80%. Watch closely and you’ll see Eclipsys SCM on the screen.

At least this data breach involves paper: a Mass General billing manager leaves a stack of charge slips on the Red Line T, including treatment information (for an HIV-positive patient, in the newspaper’s example). That patient’s anger is the opposite of what we IT people usually hear: "I was really angry at first because I thought everything in the hospital was supposed to be electronic and things wouldn’t get lost, and to find out someone took their work home, private information wasn’t supposed to be taken home, … to find out it was left on the subway, that wasn’t cool. It wasn’t secure. It wasn’t in a briefcase. It was secured in a rubber band."

CareTech Solutions, ranked #1 in KLAS for extensive IT outsourcing, announces the launch of its US-based technical and clinical information system support for hospitals, including proactive system monitoring. Continuum Health Partners (NY) has already signed up.

An interesting quote on Wal-Mart’s selling of eClinicalWorks: "I often state that Wal-Mart is not a store, it is an Information Technology company. Their servers in Arkansas have the capacity to store everything on the internet two times over. It is in the area of electronic health records where they may have the most impact, through EHR software sales and applying EHR standards to millions of future customers in their health clinics. If it were king of Wal-Mart, I’d go ahead and store a patient’s records on their Wal-Mart Money Card. Why not? Wal-Mart may also become the largest referrer of medical care in the nation, by sending patients in their clinics to physicians when those patients have more serious healthcare needs. Ask a doctor, referrals are the lifeblood of a medical practice."

The rumors were apparently correct: IBM will fire 5,000 Americans and ship most of their jobs off to India, increasing the number of foreign workers it employs to even more than the current 71%. I guess that’s where the "I" comes from, leaving just a lot of BM to save healthcare now that Uncle Sam’s money has made it worth their time. So buying a US-made Toyota is not buying American but hiring IBM and its mostly offshore workers is? Rumor is Big Blue is smelling the pheromones of Satyam, too.

I had a good personal EMR encounter today. My doctor’s clinic uses them (Centricity, I think) and has integrated them nicely into the practice. I checked out the screens and they were very logical and easy to use. All my info was in there, easy to find, and even though the monitor was badly placed (on the desk, meaning his back would be to the exam table), he didn’t really focus on it until we were nearly finished. He would have use eRX on my prescription except I had no idea where we get them filled (that’s a Mrs. HIStalk task) so he printed off a quite nicely formatted copy. I don’t know how much work he has to do after hours (forgot to ask), but as a patient, it was definitely no worse than a paper chart and probably better. The assistant was pretty comfortable logging my vitals in there, too. Best of all, I left there better than I went in, always a crapshoot in our expensive but inconsistent healthcare system.

An interesting NEJM editorial by new ONCHIT David Blumenthal states his opinion that CCHIT’s certification is fine for covering basic capabilities, but doesn’t address user-friendliness or their suitability to meet HITECH’s quality and cost goals. Also, an interesting disclosure: GE’s paying him.

Sheldon Razin, chair of Quality Systems, Inc. (parent of NextGen), is awarded the 2009 Excellence in Entrepreneurship award from the Orange County Business Journal.

St. Mary’s Medical Center (WV) is lauded by the local paper for its use of APACHE in managing ICU patients. They credited it with saving 21 patients. I’m too lazy to look it up, but I seem to remember that Cerner bought it awhile back.

E-mail me.

HERtalk by Inga

From LTC: "Re: Twitter.Take a look at my page. I’ll shamelessly admit that I thought of your sexy LinkedIn & Twitter pic when I posted mine!" LTC includes the following in her bio: Driven hospital software seller by day, pastry chef wannabe with a shoe fetish nights & weekends. Obviously she’s now my new BFF.

beth israel

Beth Israel Deaconess Medical Center (MA) reduces the number of planned layoffs from 600 to 150, following $350,000 worth of donations from department heads and various cost-cutting measures.The 13 medical department leaders pledged enough money to save about 10 jobs (very nice.) Beth Israel is also delaying raises, temporarily reducing benefits, and offer some employees early retirement.

Capario (the company whose name I still haven’t figured out, but I’m careful to include only one ‘R’) announces three new contracts with provider groups to help members reduce claims processing costs and improve RCM. In case you missed it, Capario was formerly know as MedAvant.

Mr. H just bought me some cool new software that improves my ability to post photos. I have it just in time for HIMSS, so please pack your camera and share your pics with us. We’d particularly love some shots from the HIStalk/Ingenix soiree, as well as any other parties you attend (since Mr. H and I haven’t been invited to many and we want to see what we are missing.) If the exhibit police don’t stop you, send us photos of your picks for best and worst booths. Of course, shots of fancy shoes are always exhilarating.

PinnacleHealth (PA) selects MobileMD to provide its HIE and Enterprise Access technologies and services.

Spectrum Health commits to a three-year contract with MEDSEEK to create an "interoperable eHealth ecoSystem." I think that is a fancy way of saying Spectrum is going to use MEDSEEK’s products to connect its hospitals, providers, consumers, and patients.

Grad student Valerie McCleary wins the 2009 Beacon Partners Scholarship, worth $7,000 and an all-expense-paid trip to HIMSS. She’s working on a Masters in Arts in Health Informatics and Information Management at the College of St. Scholastica.

The Louisville HIE picks 3M Health Information Systems to provide its EHR banking system and interoperability solution. InterComponentWare (ICW) will design and build the HIE network to provide free health record banking services to the greater Louisville area.

Faculty members from Wake Forest and Duke University collaborate on a commentary that stresses the need to clarify the legal ownership of patient records. In order to make use of potentially valuable clinical data for medical research or improving patient outcomes, regulators must create a new system of patient-initiated control of health records.

Pharmacy OneSource, a SAS solution-provider for pharmacy applications, announces two new hospital system clients. Lehigh Valley Health Network (PA) has implemented the Sentri7 and Quantifi systems and Bethesda Memorial Hospital (FL) is now using  ScheduleRx.

Allviant, a division of Medicity, joins the Arizona State University Center for Services Leadership. Allviant’s president Lilian Myers has also been named to the center’s advisory board.

The bankrupt BearingPoint consulting practice plans to sell substantially all of its businesses as part of a restructuring agreement with its senior creditors. No word on who’d like to buy the healthcare consulting segment.

phil fasano 

FusionCIO interviews Kaiser Permanente CIO Phil Fasano and asks him about KP’s decision to outsource IT services to IBM. Says Fasano, "We spent an awful lot of time and energy looking at our operations and looking at organizations around the world that had capabilities that could partner with us and help us to really accelerate the high performing IT function that we have at Kaiser." Does that mean KP believed they weren’t getting it done on its own?

A CDW survey of HIT professionals finds that hospitals that spend 40% or more of their IT budgets on infrastructure have more providers reporting "outstanding" performance from their clinical applications. Hospitals spending less money had only 29% of their providers report outstanding performance.The survey also found found that 67% of respondents described applications as "critical" to patient care compared to 50% who believed infrastructure was critical to patient care. CDW sells infrastructure, as you might have inferred.

A NEJM article  concludes that putting more money into existing HIT may be the wrong approach for delivering long-term benefits. Instead, the authors recommend that HHS mandate development of a new platform that will support a variety of individual applications, making the data "liquid" and providing an easy way for providers to change systems. Good authors: Kenneth Mandl and Isaac Kohane, both MD/PhDs from Children’s Hospital Boston’s informatics program.

AARP publishes a list of top hospitals, based on surveys of physicians and various hospital ratings.The magazine also created an interactive map that lists the top-ranked hospitals by geographic area.

E-mail Inga.

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Currently there are "8 comments" on this Article:

  1. Deloitte has already signed an asset purchase agreement of BearingPoint’s Public Sector. Lock, stock and barrel.

    The big 4 giant, just got bigger. When it comes to health care and especially health IT, Booz who?

  2. Yes, Cerner does own Apache now. My favorite piece of that integration was when the vendor confessed that they weren’t used to hospitals actually “transferring” their patients out of the units to procedural areas. “Most of our customers leave the patient in the ICU bed (in the HIS) while they are having their procedure.” We transfer those pts to the procedural areas because we are electronically charting in procedural areas and we need those patients in those computers. That shows up as a readmission in Apache — not good for your critical care numbers. Sigh.

  3. Can’t see all the fuss around REalAge and certainly disagree that RealAge puts PHRs back.

    First, RealAge, which I did try for kicks, is very transparent in what they may do with the info you enter. If you do not see this while going through the process/ques, you are either blind or illiterate. Along the way, RealAge provides plenty of opportunity to the consumer to “opt-out”. Honestly, this kind of fuss is stirred up by those who like to drag-out the privacy boogeyman for ulterior purposes.

    Secondly, RealAge does not even come close to being anything like a PHR so how can one draw a relationship between one and the other. Comes across as a certain level of ignorance, or again, from some faction of the healthcare sector with an ulterior motive.

  4. So Kaiser is outsourcing their IT to IBM which in turn is increasing its foreign staff to greater than their current 71% after firing 5,000 Americans? Anyone ever have their help desk operations contracted out, especially overseas? Ponder that service level experience but on a much greater scale.

  5. “I’m hearing a little buzz that economic pressures are causing some vendors to claim they can’t integrate with third-party systems or, when that doesn’t discourage the customer, charging them a high interface fee plus annual maintenance.”

    EHR vendors claiming they’re not interoperable? In the era of CCHIT certifications? Say it ain’t so. Maybe the new Interoperability workgroup can borrow a strategy from Congress and tax vendors that overcharge for interfaces.

  6. RE: How late your doctors works after office?
    My current doctor uses Centricity EMR in his practice. He is 67 years old and has been practicing for 30years. He says he goes home earlier now with the system than he ever did when he used paper.

  7. “It’s hard to believe this survey’s conclusion, even though it does appear in JAMA.”

    Remember that almost 50% of the hospitals in the US are under 100 beds, many of which are capital challenged.







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