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The Problem with Publicly Traded Companies
By Mike Quinto
The problem with publicly traded companies is they serve the spreadsheet, not the customer.
In the last year, I have heard:
- the VP of implementation of an HIS vendor said that she does not have the personnel to devote to our implementation because she needs to hit a certain metric and this would blow her numbers.
- a sales VP at a major ambulatory EMR vendor tell me that because of their end of year, they needed me to commit to buying six more licenses (to true up a five-year-old old problem THEY created) within 24 hours or they would “turn us off”.
- the SVP at a major ERP vendor, admitting that the sales team “made a mistake,” said they can’t fix it because they have to hit a certain profit margin (FYI, your company hitting a certain double-digit growth or profit margin is not a large concern of my non-profit health system struggling to break even — know your audience, people).
Whatever happened to partnerships? It is clear that the ‘partnership’ with the shareholder is far greater than the ‘partnership’ with the client.
I have been fortunate enough to work for privately held software vendors and unfortunate enough to work for publicly traded software vendors. I have worked at a privately held software vendor that was purchased by a publicly traded company. I have seen the difference from both sides. I know that the customer is not at the center of decisions in a publicly traded company; spreadsheets are at the center of decisions.
As a client of both publicly traded and privately held vendors, I am experiencing both sides of the equation. Without question, the privately held vendors make better ‘partners’.
I would not imagine the 14K that caused such a barrier to customer service at a major healthcare ERP vendor is worth the damage it has done to this two million dollar ‘partner’. The 20K that created a competitive environment was not worth putting the client at risk. The confidence lost at the executive level was not worth the implementation team hitting a certain metric for the quarter.
We all have to hit certain metrics. We all have our own challenges. Publicly traded software vendors often keep the short term revenue recognition or expense metric in focus when the big picture should be on customer satisfaction and retention. This quarter’s financial statement will not keep you going in the long run. Your ability to attract and retain happy customers that buy from you again will keep you going.
Mike Quinto is CIO of Appalachian Regional Healthcare System of Boone, NC.
Is Data In Your CDR Accurate? Are You Sure?
By Unfrozen Caveman CIO
I’ve always wondered about the accuracy of the process of duplicating data in ancillary systems, such as a laboratory information system (LIS) or radiology information system (RIS) to a clinical data repository (CDR). The most common process consists of parsing HL-7 messages and storing the data in a CDR. Sounds simple and straightforward. What could go wrong?
It turns out it’s not so simple and things do go wrong:
- HL-7 is not simple or straightforward to work with. Parsing data can cause random discrepancies.
- Changes, such as revising clinical data, e.g. change a lab value, revising a finalized report, etc., can cause discrepancies.
- Software updates in the ancillary system can cause discrepancies between data in the ancillary system and CDR.
My organization is moving away from the CDR-centric framework to a web services framework (aka service-oriented architecture). In this framework, clinical data is not reproduced in a CDR unless absolutely necessary and data is retrieved from ancillary systems using web services when needed. However, for reasons related to response time, we needed to duplicated lab data in a lab data repository outside the LIS.
During this process we discovered that a vendor-supplied CDR and a second, smaller CDR, purchased as a package from a vendor to provide mobile access to clinical data, store lab data that does not match data in the LIS. These systems are no longer used for clinical operations for reasons unrelated to the discrepancies noted.
As part of our effort to build a lab data store, we also built a program that validates lab data by comparing data in the ancillary system with data in the CDR for a specific date. We are experimenting with the best strategy for running this program. For example, run the program every morning for dates equal to yesterday, last week, and last month.
How significant were the discrepancies? That question misses the point. The question should be what do you do about it? Ignore it and pretend it doesn’t exist? Or have in place a data validation process that identifies, reports, and fixes discrepancies. Did your CDR come with one? If not, what are you going to do about it?
Forget eHealth Ontario
By Justen Deal
Forget eHealth Ontario! Take a look at the federally-sponsored not-for-profit entity, Canada Health Infoway, which actually appears to be accomplishing even less. Plus, because it is not actually part of the federal government, it gets to be much less transparent to boot!
So far, since 2001, it has received $2.1 billion in funding, including $500 million for 2009 it just got in January.
Their longstanding goal has been to ensure 50% of Canadians are covered by electronic health records by 2010. According to a recent survey by the Commonwealth Fund, only 23% of primary care physicians in Canada are using electronic health records (compared to 28% for the United States). Sounds like they’ve got a long way to go in the next seven months, eh?
That might be why they’re now focusing on a new (and improved!) goal of covering 100% of Canadians by 2016. They estimate more funding will be required… 😉
Justen Deal is venture director at QuarrierWade of Charleston, WV.
By John Holton
This is a belated update on the NAHAM (National Association of Healthcare Access Managers) convention a week ago. The most exciting aspect of the convention was the formation of the Healthcare Access Management Coalition which is comprised of NAHAM, hospitals, other healthcare providers and industry vendors.
Everyone acknowledges administrative waste in our healthcare system and yet access to care and the arcane reimbursement environment created by the insurance companies is missing from the current debate. The new coalition is focusing on educating policymakers on the importance of efficient and quality management processes from a patient’s point of entry through the continuum of care. Hopefully through this education, new policies streamlining the administrative end of healthcare will result in more dollars being spent on the actual delivery of patient care.
The goals of the coalition are:
- Improve access to care and reduce healthcare costs through dynamic healthcare management
- Ensure healthcare reform includes entry point and patient management processes
- Educate policymakers about technologies that improve service delivery models
- Support technology solutions that make healthcare more affordable and efficient
Anyone interested in these topics can get more information by contacting John Richardson, NAHAM Director of Government Relations at (202) 367-1175 or email@example.com.
John Holton is president and CEO of SCI Solutions of Los Gatos, CA.