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Monday Morning Update 6/1/09

May 30, 2009 News 9 Comments

From Tired of it: “Re: quality. If I hear one more consultant say ‘quality is the new battleground’, I am going to fire every single one of them. We are right now in four-year process to get paid for implementing an EHR. Last I checked, that makes quality last at this point, economically. Consultants love to sell quality ideas and analytic solutions.”

From Frank Pulver: “Re: NAHAM. Attendance is down 25-30% this year, but lots of hospital representation and some outstanding presentations.”

From Pedro Fumar: “Re: Top Ten American Healthcare Myths (warning: PDF). It is over 100 pages, is kinda pithy, but nonetheless contains a lot in interesting stuff, particularly when looking at European solutions. There is a chapter on IT.” It’s from Pacific Research Institute, a think tank that seems to be somewhere between conservative and Libertarian (right in my sweet spot, in other words). Some pretty good insights: “The sad reality is that as much as we’d like for politicians to be able to create technological revolutions, they just aren’t very good at it … Private businesses are quite good at adopting the right technology at the right time—and finding innovative solutions to improve productivity. When government tries to grease that process, it often gums up the gears. You end up with something resembling a classroom in a D.C. public high school. There are plenty of computers, but not enough textbooks, or even kids who can read … Politicians love to talk about HIT as though it will automatically save costs … A 2005 study by the RAND Corporation concluded that HIT could save our health care system around $77 billion a year … Americans spend $2.3 trillion a year on health care. So potential savings as a result of HIT are only 3.3 percent of our total medical spending. That’s like a family cutting its housing costs by moving from a house with 21 rooms to a house with 20.”

Participation in the “Is CCHIT free of HIMSS influence” poll to your right is high, with 91% saying “no” so far. 

Thanks for the couple of folks who posted events to the brand spankin’ new HIStalk calendar. Feel free to click the Submit Event link on that page.

g1

Speaking of the calendar, I Googled to find events I might want to put on it. Big mistake: there are for-profit companies everywhere (many of them associated with the rags) that are shilling conferences. They all feature big-name speakers, who I assume are paid (since it’s a for-profit conference, why not?) and don’t mind missing work. There’s an $800 conference on HIT stimulus money (run by a magazine). There’s an EMR one run by a conference company that urges immediate registration, despite having no posted agenda and a registration form (including asking for credit card info) that nowhere mentions what it costs. There’s a $1,600 version run by a magazine that features the latest in buzzwords: deep dive, galvanize, futurist, and symbiosis. Here’s a radical thought for folks who work for cash-strapped providers (is that redundant?): stay home instead of going to conferences. Radical, I know, but when hospital employees are losing their benefits and even their jobs, I could not sleep fitfully in a $300 a night hotel room and sit in swanky ballrooms listening to peers from places highly unlike mine give their standard stump speech, bracketed by wide swaths of time left open for receptions, recreation, and schmoozing with vendors. More importantly, if the place those speakers work is so darned smart, why are they struggling like everyone else? Encouragingly, a couple of the conferences offered an online version that eliminates all the time and money wasted on travel, so that’s better. But, I’ll stick with the premise that conferences occasionally give you safe, mildly useful information that passes for change, but real innovation is something you have to sweat out on your own.

MedAssets will promote the Web-based, front-end patient access tools (including scheduling, orders and self-service) of SCI Solutions as part of its offerings to improve net revenue.

TeraMedica and its partner Sun Microsystems announce the availability a pre-configured image viewing and management solution that presents images from multiple modalities and providers as a single view.

The Verden Group releases its Q1 Insurer Ranking Report (warning: PDF). Spoiler alert: Aetna drops a few spots, while small market LifeWise Health Plan takes #1.

A VP of the Cox cable company describes (by audio) his company’s interest in healthcare technology, which comprises 10% of its overall business. He talks about telemedicine in rural areas. My short attention span kicked in at the three-minute mark, so there’s 12 more minutes that, like Nixon, I can’t account for. I don’t get the whole podcast thing, which takes 15 minutes to absorb what would be a 30-second read, but it has fans, I guess.

Hospital operator Tenet and physician practice systems/services vendor MED3OOO form a joint venture that will offer services to doctors in Tenet’s service area, including those Tenet employs. The new MED3OOO Practice Resources will offer management services and technology. Tenet owns 20% of MED3OOO. Correction: Tenet owns 20% of the newly created entity, not of MED3OOO itself.

Old news I missed: Emdeon will acquire fraud management company The Sentinel Group.

Elected to the board of medical exam and actuary company Hooper Holmes: Larry Ferguson, former CEO of First Consulting Group and Daou; and Ron Aprahamian, former CEO of Compucare and chairman of Superior Consultant. The announcement didn’t mention that the company did not support their election, which occurred only after Aprahamian led a proxy fight. He’s a big shareholder with 3 million shares, which sounds fantastic until you learn that the share price is $0.49 and market cap is only $34 million.

albertachildrens

Microsoft asks Alberta Children’s Hospital for its technology wish list for hospitalized children through its program that provides PCs, software, Xbox consoles, and wireless connectivity. I had a smart alecky comment about asking for Macs, but it felt Scroogish since they’re doing an undeniably good thing.

A doctor in Australia uses his EMR to successfully defend a medical board’s claim that he mismanaged a patient. A family member claimed his exam lasted only one minute, but the medical record showed it took more than seven minutes. His conclusion: “His mother gave evidence to the board of what she thought, but I gave evidence from the computer.”

IT saves the career of another doctor. A hospital ED director accused of sexual assaulting a co-worker as she replaced the printer toner in his office is cleared after IT staff verified that he didn’t have a printer there.

A Harvard Business blog discusses the declining trend of virtualized company management, using Eclipsys as its focal point. On replacing Andy Eckert as CEO, primarily because he didn’t want to leave California to be where the company is (Atlanta), “Pead said this week in an address to customers, ‘You can’t deny how effective it is to be able to sit down and have lunch with another leader and resolve an issue quickly.’ My sense is that he’s right and we all know it. However, many companies seem not to want to acknowledge it.”

hodge

I’ve mentioned Natalie Hodge before – she’s the pediatrician who started Personal Pediatrics, a concierge practice that does house calls. Some interesting nuggets from this interview: (a) she says there is no need for an actual office since everything fits in the trunk of her car; (b) she plans to affiliate with other physicians (“a fleet of iPhone Doctors,” the article says) and to offer them iPhone access to company tools once Version 3.0 comes out, and (c) the “old model” of running an office cost her office $200K, while the new one provides the same revenue with only $50K in costs. She’s gone all dot-com: moved to San Francisco, hired PR people (thus the artsy black and white pic above, which I like), and is looking for a startup CEO.

The local paper profiles Geonetric of Cedar Rapids, IA, which is moving from designing Web sites to creating a personal health record or consumer portal type of product. I played around with their Backpack Tool for kids, which is pretty cool.

A huge Northern California IPA announces that it took a surprise loss last year, mostly because of investment losses, but also discloses that it spent $7 million on EHR implementation last year.

A reader called out a typo in Inga’s mention of BIDMC’s cost savings using Nuance eScription. The savings cited was $5 million since 2003.

Amy Rees Anderson, CEO of MediConnect Global, is named to the Utah Technology Council’s board. MediConnect’s site lists several services, but its bread and butter is retrieving medical records for lawyers and insurance companies. “MediConnect specializes in providing medical record retrieval services to the organizations that need them most-law firms involved in mass tort, medical malpractice and personal injury cases and insurance brokers and underwriters … turn soft medical record retrieval costs into concrete billable expenses.” As best I can tell, they simply call up hospitals or doctors, ask to have paper medical records sent to them, and then scan and send them on. That’s an interesting business, especially since she started out selling Web-based physician systems. Smart.

The CBS Evening News runs a piece on BIDMC, whose employees sacrificed to save jobs that would have otherwise been eliminated due to a $20 million budget shortfall.

Fresh off the “most e-mailed” list of articles from the Orlando newspaper is one detailing salaries of the folks who run the non-profit hospitals there, including the CEO of Florida Hospital ($1.1 million) and its parent, Adventist Health ($3.5 million), which the author dryly notes is “not bad for a faith-based nonprofit” since that paycheck is bigger than those for the folks who run Mayo and Hopkins … combined.

Medical diagnostics vendor Hologic will use products from Loftware in deploying Oracle’s supply chain applications. If you’re involved with healthcare labeling or the GS1 standards for global supply chain, they’ve got resources, including a GS1 white paper (warning: PDF), which I had to look at since I’m not very familiar with GS1. I was more comfortable with their Hopkins case study involving lab sample labeling.

inquicker

I mentioned InQuickER a few months back, an online ED appointment scheduling application that I could find next to nothing about. The Atlanta profile does a short writeup on it. Patients pay $24.99 to scheduled an ED slot online and are guaranteed be seen within 15 minutes of the scheduled time. I’m skeptical, of course: if you can make an advance appointment, why are you going to the ED? Are EDs like restaurants, where reservations trump walk-ins? If EDs are already overburdened, why are they making the experience more pleasant only for those who pay extra? Come on, people, use those retail clinics that are everywhere unless you truly need ED services.

On that theme: if you’re a highly paid executive and don’t want to hang around the sick and underfunded people that hospitals attract, Adventist Bolingbrook Hospital will treat you better for a price, offering executive health coordinators and an “executive health lounge.”

A fire that requiring shutting off power at St. Vincent’s Medical Center and St. Luke’s Hospital in Jacksonville, FL took computer systems down Thursday. They were back up that same evening. I always like this quote: “Patient care has been unaffected,” which seems to imply that those systems weren’t doing much for patients anyway.

iSoft sells to its first hospitals in Italy.

Ralph Webb, who designed LDS Hospital’s lab system and developed the first patient wristband ID, died this week in Utah at 80.

E-mail me.

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Currently there are "9 comments" on this Article:

  1. RE: Adventist Health System CEO Salary. In the spirit of AIG disclosures, Mr. William G. Robinson is the President & CEO of Adventist Healthcare obtained his master in business administration with no healthcare concentration. http://www.wittkieffer.com/cmfiles/reports/RobertsonLeaders1.pdf (Warning PDF)

    It appears the MHA degree in modern times has been relegated to the lower echelon of service line management and no longer represents the spirit of a true calling as humble hospital administrator when salaries paid are over a million dollars for serving the health needs of the community. If you remember, hospital governance starts at the top, Board of Directors and the Hospital Administrator aka President CEO reports to the BOD.

    What’s my beef? Why are these MBA “superstars” driving U.S. healthcare deeper into the World Health Organization’s table for Health system attainment and performance for 191 Member States, ranked by eight measures? Apparently there is much confusion into the validity that the WHO will be performing the 2010 Health Performance ranking. As the U.S. stands in 2000, and this was the healthcare performance data from the 90s decade, the United States health system was 72nd (N = 191 nations) “On the level of health performance” in relationship to “health expenditures per capita in international dollars”. Let’s look at the cluster ranking for the United States “on the level of health performance” and the politician are crying circa 2009 that the U.S. Healthcare is broken:

    70 – Bosnia Herzegovina
    71 – Argentina
    72 – United States
    73 – Bhutan
    74 – Nicaragua
    75 – Iraq

    And I’m supposed to be a concerned citizen that the U.S. Healthcare is becoming socialistic? Look at the company U.S. Health keeps on the level of health performance and don’t even get me started on the Overall health system performance. I understand why the World Health Organization will not perform the 2010 Member States Ranking by eight measures; all the statisticians are nowhere to be found.

  2. Absolutely agree re all these “conferences”. Just the latest shills trying to jump on what seems to be a lucrative HIT bandwagon. We know where to go for real insights. Check the agenda and speakers. Spend your travel dollars wisely.

  3. To Tired of It. RE your comment: “Re: quality. If I hear one more consultant say ‘quality is the new battleground’, I am going to fire every single one of them. We are right now in four-year process to get paid for implementing an EHR. Last I checked, that makes quality last at this point, economically.”

    Consultants aside, quality is and should be a huge priority for us. I’m a CIO of a system in a mid-market and we’ve lost entire service lines to competitors due to our lack of ability to produce analysis and reports for the health insurance/managed care companies. This isn’t a future problem – it’s a now problem. And it’s a current economic problem that my EMR vendor is not solving for me.

    I agreed with most of the comments made in the article I think you’re referencing. My take-away was that we need to think beyond the EMR, even if we are buried in it right now. I know I’m changing my board presentation.

  4. Concerning tired of it…

    I agree with your sentiments and description of the “quality battleground.” It’s consulting b/s from those that have never lived it (but make profits rambling about it)

    I look for comments from “certified” healthcare experts, and people with deep clinical training and experience…otherwise they are mostly consultant profiteers blowing smoke.

  5. Latest in buzzwords: “deep dive, galvanize, futurist, and symbiosis.”

    I prefer simple, straightforward words like: “provide detail, inspire, a person who doesn’t “do” anything and instead “speculates” about the future (BTW, much easier than work), combined effort.”

    But what do I know, I’m just a caveman?

  6. Hi unfrozen caveman…

    Great translations, I think pretty spot on…and, pretty funny…

    Too many “deep dives” and the lack of oxygen could cause brain death;)

  7. Just for the sake of being snarky – any idea why your Peds doc moved from where she was to San Francisco? There might be a story there all in itself.

  8. RE: Tired of it…. I guess there are some consultants that go to college, join a big consulting firm and never really see projects through to completion due to the short term nature of consulting projects. Most of the consultants I’ve worked with over the years (including myself) have experience in the “real world” and have chosen to do something different for a while.

    Consulting provides a good change of pace, not necessarily easier, but different. I’ve moved in and out of consulting twice now. You can agree or disagree with a consultant’s opinion, but the fact is that they tend to have a breadth of knowledge because they can view a common problem across multiple organizations. Not as much depth, I agree.

    Stick to the small boutique firms and you’ll get the deeper, operational experience. The big consulting firms tend to have smart, but not necessarily experienced people. And if you don’t like either one, don’t hire them. That’s your choice.

  9. Thanks for pointing out all of these silly conferences with a focus on ARRA. I can (and have) read the HITECH portion of the ARRA. I don’t need anyone to dumb it down to a PowerPoint for me. I am not attending any conferences unless ONCHIT has organized it and is leading it.







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