From Bright Idea?: “Re: DC HIE. What would happen to regional HIEs if the government goes national with an HIE of its own?” That refers to this news: Washington, DC’s Medicaid agency chooses MedPlus for its Medicaid-focused health information exchange. The pilot will involve three hospitals and six clinics, with analytics that allow public health officials to track outcomes and look for care gaps.

Moffitt Cancer Center (FL) names Mark Hulse, formerly of North Shore Medical Center (MA), as CIO.

More on Canadian government agency eHealth Ontario: it paid a $300-an-hour consultant’s eight-hour invoice stating that she consulted herself. It was a typo, but the agency paid it without question. The consultant works for a company that got a $268,000 PR contract for the agency ($300 an hour for PR help? Seriously?) She also billed $7,000 for writing a speech for eHealth Ontario’s CEO. Her husband is the managing partner for Courtyard Group, which got $2 million worth of no-bid contracts. CBC throws another punch in its salvo: the 30% bonus paid to the CEO after four months on the job was double the 15% maximum allowed, which the CEO says was pre-negotiated because she left Cancer Care Ontario before earning her bonus there. eHealth Ontario let three highly paid consultants go Thursday after the unflattering articles appeared, one of them an executive assistant being paid $212 an hour.

Speaking of eHealth Ontario, it discloses all salaries of over $100K on this page (subtract 10% to convert Canadian to American dollars). It’s a long list and the salaries seem awfully generous for government-hired technical people

Orchestrate Healthcare is now a Platinum Sponsor of HIStalk. The Greenwood Village, CO offers healthcare integration and technical expertise (HIEs, transactions, service oriented architecture, and integration tools like eLink, Bridges, Cloverleaf, Ensemble, and DataGate). Consultant resumes are here. The company won Best in KLAS 2008 in the technical services category. I thank them for supporting HIStalk and the folks who read it.

I got a nice note from Natalie Hodge, the pediatrician I mentioned who started her own company to help doctors start pediatrics concierge practices. She’s looking forward to the iPhone 3.0 and doing some Web infrastructure setup to get things rolling, she says.

I bought the MacBook and wasn’t disappointed: the twenty-something young lady who sold it to me at the Apple Store had spiked hair, lots of tattoos, and a gruesomely fascinating piece of silver jewelry implanted squarely between her middle two top teeth. I was infused with hipness by just being there.

A news site criticizes an Australian hospital for not yet implementing oncology software that was bought in November following 11 chemo overdoses, none of which cause patient harm. The Australian Medical Association is demanding that it be brought live, while the hospital says it’s still working on setup and training (note to the AMA: you don’t want to rush them). The software appears to be made by Australian vendor CharmHealth.

David Brailer and his Health Evolution Partners seem to have disappeared, so I thought I’d check their site to see if anything was happening. They just made an investment in Optimal Reading Services Group, an Alabama-based radiology reading service. It doesn’t sound all that innovative to me, but Brailer claims it is highly cost-effective, a good idea when the market wants imaging costs lowered. HEP has a lot of expensive talent, but I’m not seeing much in the way of results. You would think they would be buying up everything in sight at a big discount with the market down.

I’ve closed the poll on CCHIT, where 88% of 193 respondents said CCHIT is still under the influence of HIMSS. New poll to your right, featuring an idea from Evan Steele. CCHIT was formed to certify interoperability, not functionality or vendor stability. To encourage EMR adoption, would you support a mandatory EMR “lemon law” that would give purchasing providers their money back if they found the product they purchased unsuitable?

MD Anderson joins other big-name hospitals on the service-oriented architecture advisory group of clinical trials system vendor Velos.

Concord Hospital (NH) had systems down all this week when a SAN upgrade took down their network. Recently hired clinical users had no idea how to go back to paper, so they struggled and say they’ll have to develop policies and procedures. That happens in every hospital with new clinical systems, of course: the first big downtime causes newbies to struggle because they don’t know how the old paper processes worked.

The federal government will upgrade its Connect NHIN gateway later this year, adding a master person index, a policy engine, and a document management system.

A few years ago, the cheerleading health IT rags couldn’t write enough about HealthSouth’s “digital hospital.” Says HealthSouth’s CEO: “It was a pipe dream and a figment of the imagination,” saying the company would have had to stop all investments in its other 93 hospitals for at least two years to pay for it. Siemens was supposed to supply all the gadgetry, including Soarian.

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From The PACS Designer: “Re: NASA’s Nebula. NASA has entered the cloud computing on ramp to apply the concept to its space travel activities. Their venture into cloud computing is called Nebula.” I took a look at the Nebula services chart ad didn’t understand anything on it other than MySQL, but I’m no rocket scientist.

From WhiteSoxFan: “Re: International MUSE. Has anyone heard anything about attendance, vendors, presentations?”

Carl Byers, CFO of athenahealth, will resign early next year to move overseas, the company announced today. Board member and former IDX CFO John Kane will lead a search committee to replace him. Finance VP Dawn Griffiths will be promoted to chief accounting officer and treasurer on July 1.

Debuting on the Healthcare Informatics 100: HIStalk Platinum sponsor Cumberland Consulting Group. The company was also named by Consulting Magazine as one of its “Seven Small Jewels 2009: The Hidden Gems of the Profession” of niche firms making a big impact. They interviewed managing partner Jim Lewis.

Herb Conaway, Jr., a private practice physician, attorney, and Democratic assemblyman from New Jersey, introduces a bill that would make it illegal to sell or use non-CCHIT certified systems in the state. He previously introduced the New Jersey Health Information Technology Promotion Act that appears to mandate EMR use. HIMSS loves him, of course, having given him a 2008 State Advocacy Award and put him on the podium at the annual conference in Chicago. I found it interesting that his own practice’s EMR vendor went belly-up, maybe leading him to favor the larger vendors that can afford CCHIT certification fees and who wouldn’t mind seeing a bunch of competitors knocked out of the arena for one reason or another. Thanks to HIStalk reader Chip for the tip.I thought I was getting used to well-intentioned government intrusion into private business, but this idea leaves me speechless.

Sensible Certification, on the other hand, is trying to rally support to scale back grand certification ideas. I was skeptical until I read its six suggestions, of which I agree with every one: (1) stop the rush to certification; (2) don’t define requirements until ‘meaningful use’ is defined; (3) certify only basic capabilities, such as data sharing; (4) use NIST’s Laika as the certification requirement; (5) don’t certify functionality because the market should decide that; and (6) certification CCHIT-style will stifle innovation. They’re petitioning David Blumenthal at ONCHIT. The site doesn’t say who’s responsible, but it’s registered to Gordon Moore, MD, a family doctor who left a salaried job and struck out in a low-overhead practice.

I’m not interested enough to sort this out, but two New Zealand medical systems vendors are threatening each other over something or other, one of them and EMR company with 90% market share who supposedly won’t make patient information available outside its systems without being paid.

TriZetto founder, chairman, and CEO Jeff Margolis publishes a book called The Information Cure: Solving the Healthcare Crisis Systematically Through Integrated Healthcare Management. It’s aimed at consumers willing to pay $25 to read about a technology vendor guy’s ideas on fixing healthcare, so I’m sure Jeff will be keeping that day job. Not that it isn’t interesting, but Americans don’t read books, especially non-fiction ones that require thinking. There’s just no time with all that reality TV to watch. If anyone wants to review it, jump right in. Amazon doesn’t have it yet, but Jeff was signing copies at AHIP this week.

CBC isn’t done with eHealth Ontario, following up its early article with reports that the CEO has connections to uncontested contract winners Courtyard Group and Accenture.

Want e-mail updates when I write something new? Join 4,317 folks who get the news first by putting your e-mail in the Subscribe to Updates box to your right. Below that is the Search function, courtesy of Google, that digs through six years (as of this week) of HIStalk to find whatever you’re looking for. The hideous green rectangle below that is the Rumor Report button, clicking of which allows you to directly and anonymously send stuff to me without fooling around with e-mail (even an attachment, if you like, with highly personal photos and revelations always appreciated). The calendar is getting some action, I see, and I should take a moment to thank the guest authors here and on HIStalk Practice for sharing with us all.

Jobs: Project Architect, Director of Marketing, Regional VP of Sales.

OK, you Apple zealots who are always e-mailing me finally convinced me. I’m buying a Macbook for a family member. The tipping point, beyond the obvious non-Microsoft hip appeal: Apple is offering a newly upgraded white Macbook for $949 (after an educational discount) and they’re throwing in a free $229 8 gB iPod Touch as a back-to-school special. Sold to the abrasive blogger for the equivalent of $720, not much more than I was figuring on spending for the usual generic HP or Dell laptop. All I need now is a black turtleneck and tattooed chick.

A Computer Weekly article says London NHS will pay BT more than $800 million in extra costs after the company renegotiated its contracts with the threat of pulling out like Accenture and Fujitsu did before it. In BT’s defense, however, it had already written down billions in losses, an unspecified amount of which was due to lowball NHS contracts. There’s probably a good lesson in there: Richard Granger did admirable work in stretching a dollar (pound, in his case) until the eagle squalled (as we country folk say on occasion), but having unhappy and money-losing vendors isn’t a formula for success. I thought he did a super job with some aggressive contracting, but the results don’t exactly bear that out.

Boston Medical center moves 67% of its accounts payable checks to electronic payments using software from Bank of America.

Nintendo announces the Wii Vitality Sensor, a finger-attached controller that measures stress. It won’t be out until next year. Nobody mandated its development, it isn’t certified, and you spend your own money on it, just in case you remember those days.

iMedicor announces a portal (it seems to be free) that it says will allow providers to exchange medical records. It has a doctor registry and utilities to export EHR documents and exchange Continuity of Care Record files.

Greek authorities put the wife and daughter of a former Siemens executive in jail, charging them with complicity in the money laundering and bribery case that sent the man fleeing as a wanted fugitive.

An Indonesian woman who complained about her hospital treatment is jailed on criminal defamation charges that could result in six years in prison. She e-mailed friends claiming the hospital falsified lab results to justify additional treatments. She already lost a civil suit that cost her $6,000 and a public apology. The Radio Australia news item calls Indonesia’s defamation laws “draconian”.

HHS cites a chemical dependency unit for HIPAA violations, saying the program director allowed her “significant other” to hang around patients and the nursing station. That means she’s in DePoo, which happens to be the name of the place.

Hospital lawsuit: a North Carolina hospital is sued by the Equal Opportunity Commission for not hiring people who are taking prescribed narcotics.

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HERtalk by Inga

From Bill Williams: “Re: The Pipe. I’ve long had a question in my mind that I’ll ask here: why would a doctor/healthcare provider be depicted smoking? Has anyone ever asked the question before?” As a matter of fact, the question has come up many times. Mr. H claims it is intentional irony since the doctor in the logo is in the 50s style (note the head mirror) when many doctors smoked. Check out this commercial for proof.

Duke University Health System selects SSI Group as its primary supplier of revenue cycle claims management products.

The national healthcare alliance VHA signs a multi-agreement with RemitDATA, Inc. for its Reimbursement PRO and WebScan PRO RCM products.

A power surge knocks out the computer system at Clarian Health (IN) Monday afternoon, forcing its hospitals to hand write records. By 1:00 a.m. Tuesday, Methodist Hospital and Indiana University Hospital were so backlogged with paperwork that they went on ED diversion. The computer system was fully restored by 7:00 a.m. As Kevin says, “If you want more of a smart-assed IT perspective, check out the comments on the Slashdot story here.”

Medsphere says it has raised almost $2 million of its targeted $15 million secondary venture round. Michael J. Doyle, Medsphere’s CEO and president, just received the Sister Fedde Award from Lutheran Healthcare (NY), recognizing his contribution to the health of area residents. You probably already guessed that Lutheran is currently installing OpenVista.

More hospital layoffs: 77 from Greenwich Hospital (CT) and 245 from The University of Alabama at Birmingham Health Systems, though 81 of the Alabama workers are being shifted into jobs now held by contractors. In addition, The University of Iowa Hospital must cut $45 million from its budget by June 30, 2010, which will likely result in an unspecified number of layoffs.

Walgreens teams up with HealthVault, allowing its pharmacy patients to access their prescription records through the online PHR. Patients will also be able to share the online information with their physicians.

According Harvard Business School researchers, male Twitter users have 15% more followers than women and the average man is twice more likely to follow another man than a woman. And, the average woman is 25% more likely to follow a man than a woman. Ergo, Twitter promotes sexism. (I was going to go into my detailed analysis of why Mr. H has more Twitter followers than me, even though I follow more people and Tweet more often. However, I think I’ll just blame society as a whole.)

MEDecision and Availity enter into a joint marketing agreement that includes integration between Availity’s web portal and MEDecision’s collaborative HIE service.

Longtime sponsor EnovateIT sent us this note: “Exciting times for us. What you see is short term, next week we unveil. You’re the first to know publicly.” We like getting the scoop, even if we don’t know what it means. What we do know is that Enovate, which specializes in wireless mobile computer systems integration, just rolled out this micro-site and promise to tell us more next week. Theories welcome.

The weather in San Diego is in the 60s as I type, which is surely more refreshing than most parts of the country. And if you are in San Diego at AHIP, fill us in on the buzz, including what happened during the protests scheduled for Thursday morning against the health insurance industry. Also take a moment to say hello to the HIStalk sponsors that are exhibiting, including Allscripts, 3M, and RelayHealth.

The Queen’s Medical Center pays $2.5 million to settle two whistleblower lawsuits. The suits allege that over a three-year period, the hospital overbilled and submitted false claims to Medicare, Medicaid, and TRICARE.

Sweden rolls out the first stage of its national EHR called National Patient Overview. Over 500 clinicians are now accessing patient records that are hosted by InterSystems Healthcare information exchange platform.

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Several weeks ago, I spent time talking to a class of IT managers. These managers, from a wide range of industries, were learning about IT management and leadership. I was there to talk about my career, my management style, my values, and why I made the choices that I made over the course of my career.

During our discussion, I suggested that they think about the following.

All of us are caught up in the busy-ness of our professional and personal lives. But let’s suppose that you were told that you had five minutes left in your life. As you looked back on your life, what would you want to be able to say?

And I gave them my answer. I would want to be able to say:

• That I was as madly in love with my wife then as I am today. I fell in love with Denise 34 years ago. And I am more in love today. She is my best friend, my lover, the mother of my kids, and my confidante. In ways that are unfathomable and indescribable, in many aspects of our lives and being, she and I have become one.
• That my three daughters have had lives as blessed as mine. Their paths will have been different and their choices will have been their own. But I hope that they know deep love, good fortune, success, and many fine moments that have become treasured memories. I would hope that we were always good friends and looked forward to each other’s company.
• That I will have been spared the agony and horror that can dominate a person’s life. I hope I never have to experience great hunger, deep and enduring physical pain, crushing hatred, or excruciating torment. If I was spared this, I would be grateful. If I was not spared this, I hope that I exhibited courage.
• That those people with whom I worked say that I inspired them, taught them, and led them well. Just as I have been inspired, taught, and led well by several people, I hope that I gave that gift to others. I would like to know that many people are different people, better people because they knew me.
• That the health care industry in which I work, and the provider organizations that I work for, have been changed, become more effective, have advanced because of the legacy that I have left. I would want to know that I showed these organizations and industries how to operate and think at a higher level; a level that significantly increases their ability to care for people, innovate and teach.

And if I can say all of this, I will die with a smile on my face. I will have had a good run.

 

John Glaser is vice president and CIO at Partners HealthCare System. He describes himself as an "irregular regular contributor" to HIStalk.

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From Blogger: “Re: Microsoft. Microsoft Health Solutions group blurs traditional relationship to media by building up inside relationship with bloggers. Should bloggers (not worried about HIStalk) disclose who pays them to attend conferences? What if companies like Microsoft give you early access to information and insider info — do you owe your allegiance to them?” I would say the blogger should disclose that fact, but you have no way of knowing anyway. Reader beware: if a blogger seems to have an unwaveringly positive opinion of a company or product, even in the face of negative news developments, then they may well have sold their soul intentionally or otherwise. I can only say that if I went to a conference or other trip at a company’s expense (which I’ve never done), I would say so when I wrote about it (and just to make sure, I’d probably rip them roundly just to err on the side of fairness, which means nobody will be inviting me anyway). I can’t speak for Microsoft except to say that they’ve never offered me anything.

From The PACS Designer: “Re: 2D/3D workstations for MDCT. There have been a lot of marketing claims by vendors that their MDCT workstations outperform their competitors. Well, now there’s been a 2D and 3D face-off conducted at the International Symposium on Multidetector-Row CT by Diagnostic Imaging Magazine. The result is they’re all quite similar in performance, thus no one can really claim to be the best.”  

Several folks have added events to the HIStalk calendar, so thanks for that. You can post your event here for free.

Microsoft buys Rosetta Biosoftware, a Seattle-based genomic software vendor owned by Merck. It will add gene analysis and clinical trials capabilities to Amalga Life Sciences.

Hospitalists Now, a hospitalist provider, gets a $3.5 million investment to help bring its administrative and patient care software to market. Its Web site says only “under construction” and “medical software solutions.”

A Connecticut doctor takes the concierge medicine route, taking on 250 patients for an annual retainer of $1,800 as a “country doctor with all the modern technology.” She says her practice prevents hospitalizations. “I have kept four or five patients out of the hospital in just this past year. I don’t let my patients go to the emergency room alone. I meet them there, and because I know them very well, I don’t have to practice defensive medicine. I can arrange for visiting nurse services or delivery of a hospital bed where necessary and have the patient home the same day. And when they do have to be admitted, I am in frequent communication with their specialists, and we care for them together.”

Ingenix acquires AIM Healthcare Services, a Nashville-based medical claims company.

One of the funniest things I’ve read lately: Joel Diamond’s take on abbreviations on HIStalk Practice.

An investigative report by The Arizona Republic says the lack of electronic medical records in Maricopa County’s jail system has cost taxpayers millions in lawsuit-related costs and contributed to its loss of accreditation. Strangely enough, if you read about the terribly backward paper and crude database systems they use, it sounds pretty much like the average hospital. They’ve passed on previous recommendations: “The software, the implementation, did not deliver the result that was promised. That was a business judgment. What’s the point of spending $5 million and buying nothing but trouble?” But, one late-breaking factor has led them to immediately change their tune and start EMR shopping: they will apply for $2 million in federal stimulus money to buy the system they declined to purchase with their own funds.

A Medicaid HMO privatization program started in five Florida counties in October 2006 isn’t drawing rave reviews: patients say they can’t get appointments, 25% of doctors in the two biggest counties have dropped out because of red tape, state officials can’t get even basic data about the program’s treatments and prescriptions, and the largest HMO company involved (which admitted stealing $35 million from another state program) opted out because profits were too low.

CFO Magazine runs a rebuttal by Al Borges, MD to its pro-EMR article.

Who knew it would be lobbyists who got stimulated? Big lobbying companies are creating new groups whose entire raison d’etre is to figure out how to lap at Farmer Obama’s trough. “Sinclair said he is awaiting clarity on the bidding process for electronic medical records systems, especially in terms of how the money would flow and to which agencies. Starting in 2010, the state will make grants available to hospitals, physicians and clinics for purchasing health information technology systems, according to its Web site, which tracks stimulus projects. With health information technology projects, Stanton also sees a change in the playing field. He said the challenge is in dealing with members of the executive branch, instead of ‘going down to Congress and begging a legislator to put an earmark,’ as both have different levels of complexity and difficulty.”

Speaking of lobbyists, GE Healthcare, anxious to ensure that healthcare reform doesn’t hurt its imaging revenue further, hires on a slew of former government officials as lobbyists, including the former chief of staff of Sen. Max Baucus, chair of the Senate Finance Committee. 

AHA mounts its own emergency lobbying campaign, hoping to derail the Senate Finance Committee’s deliberation of a reform issue that would require hospitals to provide charity care if they want to remain non-taxpaying. Meanwhile, the provider group that offered to reduce the growth of healthcare costs by 1.5% over ten years came up with this: prevent more infections, keep patients safer, use more technology, and simplify forms. One of the presenters was the CEO of a “non-profit” hospital who was paid $6.2 million in 2007, according to federal records, but absurd executive salaries weren’t on the list.

This hard-sell EMR Web site is courtesy of “America’s #1 EMR Medical Systems Expert,” who does not provide credentials to validate that claim (and who apparently caters only to one-patient medical practices, given the last line of the pitch).

Tasmania is looking for vendors of radiology and PACS systems, just in case any vendors are looking for prospects.

Software developer RxVantage gets $500K in VC money. Its systems let drug reps practically become a member of a doctor’s office staff, letting them book appointments, send samples, and “be able to to see office preferences for meal types and hours for sample drops.” The company claims it is “focused on developing smart technology to help improve patient care.” If you can overlook the flawed healthcare system it supports, it actually sounds pretty cool.

Stevens Institute of Technology (NJ) announces its IT graduate certificate for healthcare professionals.

Odd lawsuit: a man with a 30-year record of violent crime who took hostages at a campaign office of Sen. Hillary Clinton sues Frisbie Memorial Hospital (NY) and its psychiatric services provider, claiming they cause his actions by failing to treat a previous suicide attempt in which he ate antifreeze-laced soup.

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Picis announces new agreements with 18 hospital clients to use its integrated clinical and financial ED solution. Twelve of the hospitals have already gone live this year and six more are scheduled to go live within the next month.

Allscripts hires Eileen McPartland to serve as its COO, taking over for interim COO Lee Shapiro. Shapiro will continue in his role as President. McPartland has served as executive VP of global sales for Misys PLC and previously worked at Oracle. Allscripts also announces SYNNEX will distribute the MyWay product through its SYNNEX Healthcare Solutions Division.

The non-profit Vermont Information Technology Leaders names David Cocharan, MD as its president and CEO. Cochran is the former VP of strategic development at Harvard Pilgrim Health Care.

Sunquest president and CEO Richard Atkin accepts the role of president of the board of American Interfaith Camps (AIC). The North Carolina-based AIC provides an environment for children of different backgrounds to “eat, pray and grow together as friends both in body and spirit.” The camp looks like it is in a beautiful setting (lots of woods and water.) Good stuff.

The Premier healthcare alliance acquires Phase 2 Consulting (PC2), a division of RehabCare Group. PC2 provides consulting services to hospitals and health services and will complement Premier Consulting Solutions.

Amerinet and Perot Systems ink a deal that makes Perot’s revenue cycle solutions available to Amerinet’s acute and alternate care site members.

Former Vanguard Health System VP Orlando L. Alvarez, Jr. is named senior VP of physician strategy and business development for the Sisters of Charity Health System (OH).

All Children’s Hospital (FL) selects Mediware’s BloodSafe remote release blood system.

HealthGrades names the 340 winners of its Outstanding Patient Experience Award, which recognizes the top-ranking 15% of hospitals in terms of patient experience. The ratings are based on patient satisfaction results from the HCAHPS survey and included questions rated to clinician communication, staff responsiveness, cleanliness, and noise levels. In glancing at the list, I was somewhat surprised to see the absence of some institutions traditionally recognized for providing top medical care, including Cleveland Clinic, Mayo Clinic, MD Anderson, ULCA, and Johns Hopkins. Personally, if faced with a life-threatening illness, I’d choose the best care over noise levels and nice nurses.

The Canadian Sunnybrook Health Sciences Centre contracts for Eclipsys’ Sunrise Patient Flow solution.

Merge Healthcare reaches a definitive agreement to purchase Etrials for about $18.3 million in cash and stock. Last month Etrials rejected a $14.5 million bid from Bio-Imaging Technologies.

Healthcare Informatics releases its HCI 100 list, which ranks the top HIT companies by revenue. Not surprisingly, McKesson is number one (again), followed by Cerner and CSC. In the $3.5 billion consulting company category, CSC was the highest ranked, followed by Perot. HIStalk sponsors CareTech Solutions and Vitalize Consulting Solutions made the top 10. In the $22 billion HIS vendor category, the top three were McKesson, Cerner, and Siemens. In the $2 billion a year physician practice management category, Allscripts took the spot by a wide margin. I also noticed that on the overall list, both athenahealth and eClinicalWorks were ranked much higher than last year (now 31 and 39, respectively.) Here’s some interesting math (or mindless, depending on your point of view): the total industry represents about $27.5 billion a year in revenues and the 16 HIStalk sponsors on the list account for 21% of those revenues.

Dan Lemerand reports that the HIStalk Fan Club on LinkedIn now has 712 members. Also, I have 200 connections on LinkedIn (always happy to have more) and 360 followers on Twitter. I can only imagine how Susan Boyle feels.

CIO magazine lists its 2009 CIO award winners, which includes companies shown to create “new business value by innovating with technology.” The list includes plenty of corporate giants, including IBM, Dell, and FedEx. Also recognized: tiny Midland Memorial Hospital (TX), with reported revenues of $155 million, and 261-bed Chester County Hospital (PA), with revenues of $190 million.

The Northern Californian IPA Hill Physicians Medical Group discloses it had a net loss of $4.4 million last year, due to unrealized investment losses of $7.4 million. Hill’s 2008 HMO revenue was $420 million; operating operating was $3 million.

Cerner launches a Smart Room to be on display at the company’s Dubai office. Cerner says this is the first-of-its kind high-tech hospital room created in the Middle East.

Here is one of Mr. H’s favorite kind of stories. A Michigan woman is suing Starbucks, claiming that an employee improperly secured a lid of her coffee, causing it to spill on her lap, inner thighs, and legs. The incident occurred three years ago when Irene Bruno purchased the coffee through a drive-through window. Bruno now seeks a minimum of $75,000 in damages, alleging she has suffered “extreme humiliation and embarrassment” due to the coffee spill scars still visible on her body.

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The views and opinions expressed in this blog are mine personally, and are not necessarily representative of Texas Health Resources or its subsidiaries.

It’s Not About You
By Ed Marx

I dreaded visits from Battalion HQ. Bravo Company operated fine without big brother coming down and creating more work. As a twenty-year-old platoon leader, I had to gauge what level of involvement was beneficial versus what was busywork. I understood the need and benefit of our association with well-intentioned HQ, but at times, enough was enough before they only caused agitation. I made every effort to keep standard operation policies from becoming the frontlines. HQ existed to help my troops complete their mission, not create diversion and roadblocks.

I then recall with trepidation my promotion to Captain with orders to HQ. As the Battalion Motor and Movement Officer, I was responsible for the readiness and mobility of the 40M dollars worth of vehicles in our five line companies. Operating my unit and making sure our companies were prepared to deploy at a moment’s notice while contending with the inherent HQ bureaucracy of my position was tough.

Over time, I became…one of them. I found myself so focused on my HQ efforts that I lost site of the reason for my position. I was building a world-class organization and process but inadvertently choking our line companies agility required for mission execution.

Those Army leadership experiences shaped my belief that corporate exists to serve those who did frontline work.

As our country emerged out of the American Revolution, similar conflicts took place. Our young republic was deeply concerned about the national government growing too large and powerful to the point of snuffing out state rights. Conversely, federalists were worried that too much state independence and freedom would unravel the fragile democracy. Perhaps the greatest balance was brought forth not by the constitution itself, but in the principles espoused in the Federalist Papers. Two hundred years later, these papers still carry important lessons and ideas for corporate America. They help bring perspective and balance to the relationship of corporate HQ versus line company relationships.

It’s easy for those of us who hold HQ positions to forget that we exist to serve line companies. In healthcare, the frontline is anywhere care is delivered. In a single hospital, clinics and departments see patients. In multi-hospital systems, the hospitals themselves interface with patients. I continually struggle with this reality. In and of themselves, the strategies, structure, and process I create are important. At the same time, they become hurdles too high for frontlines to jump, therefore impeding progress. When HQ is physically separated from the frontline, the challenge is exasperated. In such cases, be extra vigilant.

Here are some actionable ideas to help us remember our appropriate HQ role:

· Frontlines is where care is delivered and what drives revenue:

Beyond government/accreditation/safety mandates, are your requirements perversely impacting clinical care?

Beyond government/accreditation/safety mandates, are your requirements perversely impacting revenue?

· HQ by definition is overhead, a “tax” burden on the frontline:

Keep costs low as possible

Keep demands on frontlines to a minimum

Regularly question your own demands and those of your peers

· Seek to understand before striving to be understood:

Leaders, spend equal amounts of time on the frontlines as you do in your safe, remote office

Send staff routinely to the frontlines to gain customer perspective and understanding

· Engage frontlines in all aspects of your area and avoid mandates:

Include them in strategic planning

Be extremely transparent with costs

Provide options with well thought out pros and cons

Discuss and gain perspective before making mandates

Ask them the tough question “am I helpful?” and then listen

· Policy & procedures:

Eliminate as many policies as possible

Stop creating new policies unless absolutely necessary

Develop common operating principles

Say “yes” more than you say “no”

Many governments, armies, and companies grow the complexity of HQ at the expense of frontlines and eventually lose their sense of purpose. Their pride turns into arrogance as HQ shines brightly, yet the dull of the frontlines quickly tarnishes any fleeting glory. I plead guilty on all counts! Balance is a must. Once you become more concerned with your area performance than with frontline success, you have lost your reason for existence.

Ed Marx is senior vice president and CIO at Texas Health Resources in Dallas-Fort Worth, TX. Ed encourages your interaction through this blog. (Use the “add a comment” function at the bottom of each post.) You can also connect with him directly through his profile pages on social networking sites LinkedIn and Facebook, and you can follow him via Twitter – User Name “marxists.”

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