From Rick Weinhaus MD: “Re: Cheezborger and usability. I agree completely. I also found Dr. Bradford’s special article in January on usability, as well as the comments, right on the mark. The promise of EHRs to improve patient care, reduce costs, and minimize errors will never be fulfilled until the software becomes more usable. As a physician, I have had first-hand experience with several EHRs. On the basis of these experiences and my sense of what mental models I actually use in taking care of patients, I have proposed two EHR design idioms to improve work flow and reduce cognitive load. If any readers would like to see detailed descriptions including graphics, they are posted as threads on the EMR Update website.” Link 1, Link 2, Link 3. Jim Bradford’s excellent article is here.
From Pete Potamus: “Re: war game EMR predictions. How about making EMRs easier to use? This includes personalization by physician or nurse, select versus enter, dictate complex orders in ‘human’ terms; use voice recognition and personalization to present the order for review and approval. Physicians and nurses are busy people. Make it easy and they will use it. Design it so they do more work and they will resist using it. But who wouldn’t respond the same way?” I like the idea, but everybody says the same thing and the products are still never really retooled. Apple creates its own market every time it adds its considerable design expertise to otherwise pedestrian and commoditized products. Why hasn’t it happened with healthcare software? I see only two possible answers: (a) customers are buying anyway, so the redesign isn’t necessary to make sales; or (b) vendors don’t expect to get ROI from doing it even though prospects say they want it.
From Val Kelly: “Re: Epic layoffs. The last number I heard was about 400 people who were asked to resign in January and February. It’s hard to say for sure since they were told not to talk about it.”
El Camino Hospital gets a second campus and CMIO Eric Pifer gets a hospital president’s job. Interesting financial tidbits: ECH has $400 million in cash and $1.1 billion on the books (note to self: recheck the definition of “not for profit”). Not to worry though – projections are that the new place needs a daily census of only 42 patients to throw off $11 million in annual profits … sorry, margin contribution … starting the third year.
Hedge fund Tremblant Capital discloses that it has taken a 6% stake in Eclipsys.
Listening: The Cliks, an outstanding hard-rocking Canadian band (which happens to be all-LGBT). I’m desk-drumming to Oh Yeah (seventh song down in the player). And I admit I don’t watch much TV, but I’m liking 30 Rock (smart women like Tina Fey are hot, yes?) and I’m enthralled with Brit talent show singer Susan Boyle (while the cynic in me says it could be a stunt since she surely had to audition in front of someone to get there, but watching the sniggering, superficial audience and judges reduced to slack-jawed awe and near tears is still priceless). I could get pop culture if I had more time.
The son of British TV magician Paul Daniels, an IT support manager with an NHS trust, is charged with fraud for allegedly engaging a company to perform phony IT work and skimming a fee in return for approving the invoice.
JPS Health Network (TX) mulls over a potential $150 million project to implement electronic medical records, hoping to suck up some stimulus money but still worried about the upfront cost. Nobody wins those deals except Epic, so you know they’ll be calling Judy if they get their nerve up.
South Nassau Communities Hospital (NY) goes live on the Forerun ED dashboard application commercialized from BIDMC.
It’s reader survey time! It’s a quick, non-annoying way for you to let me know how to make HIStalk better for you. Here’s the link. Thank you.
A reader asked if the HIMSS presentations can be downloaded yet. They were giving a link at the conference, but the member pages don’t show the 2009 files yet.
TeraMedica will partner with Compressus Inc. to create a workflow and data management tool that will make all of an enterprise’s imaging systems and databases available from a single worklist and will support data exchange.
Natividad Medical Center (CA) hires Kirk Larson from Cerner as CIO, intriguing the local paper because he stands to make more than previous CEO ($185K and up to a 30% bonus). Seems kind of rich for a 172-bed county hospital to pay up to $240K for a CIO to run what must be a fairly small IT shop.
Two companies selling MUMPS-to-Java conversion try to convince the DoD and VA to give them a big contract to turn VistA into a semi-new system that will run on something newer than aging DEC Alphas. The estimate to develop a new system: $15 billion (!). The estimate to convert VistA to Java: $125 million over 2-5 years, including replacement servers. The problem with that kind of porting is that all the internal expertise has to start over with a new language and database (and the fact that the resulting source code is next to unreadable and free of comments to provide documentation, at least in my limited experience). And I miss the Alphas, personally.
The local health district is trying to figure out who will help Petaluma Valley Hospital (CA) pay to replace its retired A4 hospital system with Meditech. Perot told them Meditech was a logical fit, which seems kind of self-serving since it owns the former JJWILD and needs work for those people. The hospital’s parent company has Meditech and PVH can jump on for $2.8 million, but they’re worried about parting ways when the hospital lease is up.
Bad Philips numbers have investors worried about GE’s, to be reported Friday. I’m not sure how anyone could expect good GE numbers given their big exposure to bad markets (construction, manufacturing, big-ticket healthcare equipment, aviation, and of course albatross GE Capital), but maybe they will surprise positively. The stock price is at 1995 levels, but then again the Dow itself is at 1997 levels.
Backup tapes from Penisula Orthopaedic Associates (MD) containing information on 100,000 patients are stolen from a courier’s vehicle.
This is an excellent first-person story by a technologist about how bad healthcare data models nearly killed him in facilities with supposedly state-of-the-art EMRs, leading him to conclude that any kind of nationwide health network will never work. HIT people should read every word since it dashes the notion that having an EMR means improving care. “Medical personnel at urgent care and the hospital who interacted with me all used a version of the same electronic health information system (the ‘system’). It became clear that everyone was fighting that system. Indeed, they wasted between 40% and 60% of their time making the system do something useful for them … I was in ER for 20 hours before being admitted to the intensive care unit (ICU) where I spent another 28 hours. Throughout my stay, I was hooked to network attached monitors that incessantly sounded alarms to which no one responded. I was asked 11 times to repeat my medical history, medication, and allergies to as many different medical professionals. I was seen by seven doctors each of whom asked me similar questions. Five doctors were never to be seen again. All doctors mumbled something about putting their findings into the hospital’s electronic records system – most did not according to ICU nurses. No one read my allergist’s detailed report about my condition and health history.”
Groups line up against the Australian government’s plan to use patient medical records to detect Medicare fraud. "The patient record will be completely exposed, extracts obtained, copied, retained and potentially submitted in court for all to see.”
Tech Mahindra acquires Satyam for $578 million, giving it 425 acres of land, 48,000 employees, and a big footprint (not to mention a reputation sorely in need of repair, but not unsalvageable). It’s hard to believe IBM didn’t beat that bid.
Odd lawsuit: a woman microwaving hair removal wax and apparently not following instructions overheats it, then spills it as she tries to take it out of the microwave. She was burned on the thigh and chest. She’s suing the wax manufacturer for $160 million.
HERtalk by Inga
From Deborah Peel: "Re: stolen laptop at Moses Cone. The new security protections for health IT in the stimulus package require encryption of data, which will help prevent thieves from being able to use personal data in the future. But that is not enough to prevent future privacy violations like at Moses Cone. Strong state laws and medical ethics that require patient consent before medical records are disclosed were violated, but victims will have to go out and hire their own lawyers to sue hospitals and vendors to enforce these rights and protections. The stimulus package empowers state AGs to defend citizens’ privacy rights in HIPAA, but in 2002, HIPAA granted rights to hospitals like Moses Cone and over 4 million other ‘covered entities’ to disclose YOUR personal health information to outside vendors like VHA for any ‘healthcare operations’ or business use like ‘improving care’ or ‘reducing costs’ without your informed consent. Congress should have closed this giant privacy loophole in HIPAA, too."
From Large and In Charge "Re: EMR consultants. My large practice in the Midwest is looking at EHR options. Can you recommend any consultants?" If you are a consultant and/or have any names to recommend, let me know and I will forward to Large and In Charge.
The County of Los Angeles signs a contract for iMedConsent, an informed consent and patient education system by Dialog Medical. The product includes thousands of consent forms and patient education documents, plus provides digital capture of signatures and other annotations.
Allina Hospitals & Clinics settles a lawsuit with the state of Minnesota over high interest rates charged on medical debt. The not-for-profit Allina will pay patients $1.1 million to settle a dispute over whether the health system broke state law by charging patients double-digit rates on certain outstanding medical bills. Allina maintains its actions were legal.
Utah implements a new task force to stop the state’s pharmaceutical drug problem. The Utah Pharmaceutical Drug Crime Project will work to eradicate the selling, buying, stealing of prescription drugs. Utah, by the way, has the country’s highest rate of non-medical painkiller abuse. (Who’d a thunk it?)
The for-profit HCA expects its Q1 profits to much better than last year’s, in part due to higher inpatient volume and better controlled expenses. Pre-tax income is projected to be $600-$650 million for the quarter compared to $344 million last year.
I am wondering if Twittering is going too far? Do we really need our doctors Twittering during surgery?
Regardless of the answer to that question, I am loving Twitter and have decided there are really two types of users: The Tweeterers (those who use Twitter to send out information) and Tweetees (those who primarily follow others to glean information.) I suppose there are also in-be-Tweeters who do a bit of both. I am primarily a Tweetee, though I do send out the occasional pearl of wisdom. IngaHIStalk if you want to follow.
IASIS Healthcare (TN) contracts with McKesson for the Horizon Medical Imaging PACS solution. IASIS is a 16-hospital system with approximately 2700 beds.
QuadraMed announces an agreement with e-MDs to provide QuadraMed’s hospital clients with the eMDs EHR/PM software for its affiliated physician groups. Sounds like e-MD is looking for a way to compete head-on with ECW for the hospital-supported physician EHR deals.
Gateway to Care, a large FQHC system in greater Houston, selects Sevocity EHR as the system’s only funded EHR solution. Five of the organization’s health centers will implement Sevocity by August for over 200 physicians and other users.
So far this month, it looks like five new ambulatory products have achieved CCHIT 2008 certification.
I nominated Mr. H for this award, though its doubtful they would accept an anonymous blogger. But they should, don’t you think?