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August 6, 2009 News 20 Comments

From Wade Welles: “Re: evidence-based nursing. Do you know of any product in the market similar to Zynx Care, Milliman Guidelines, or McKesson InterQual?” I’ve heard of MCAP, which might be worth a look. Sunrise Knowledge-Based Charting from Eclipsys looked pretty good last time I checked quite some time ago. The floor is now open for suggestions.

From Sally Apizza: “Re: Todd Park. Todd’s appointment as CTO for HHS makes perfect sense. He is one of the most sincere, honorable people in the industry and, while the money he made building athena is nice, he is clearly focused on fixing the healthcare system. Besides, he has way too much energy to stay retired at 35.”

From Wes Jeeter: “Re: magazines. They are doing blogs and interviews. Like yours, only way not good.” I’m flattered in that imitation sort of way, especially since I’m a toiling-after-work amateur competing against companies and full-timers.

From The PACS Designer: “Re: cloud basics. Smaller institutions can benefit from good content on the Web. InformationWeek has a Plug into the Cloud blog that continually posts the latest in trends when it comes to cloud computing concepts.”

From The Queen: “Re: TPD. Would it be possible for TPD to please, please stop referring to himself in the third person?” It’s possible, but of unknown likelihood. Mr. HIStalk will leave that up to him since it’s his brand.

QuadraMed announces Q2 numbers: revenue down a little, EPS -$0.04 vs. $0.05. Severance payouts for two departed executives were largely responsible for the loss.

Eclipsys also moved into the red in Q2: revenue was down slightly, EPS -$0.07 vs. $0.15, missing revenue estimates by a large margin and guiding lower for the fiscal year. CEO severance was part of that loss, too.

Listening: reader-suggested Muse, pop-progressive that sounds kind of like the best parts of Queen. They’re doing a big stadium tour starting next month as the opening act for U2.

jp 

Streamline Health Solutions names board member Jonathan Phillips as board chair, replacing Brian Patsy, who will continue in his CEO role. Jon is founder of Healthcare Growth Partners and has supported HIStalk as a sponsor nearly from the beginning, also sharing his expertise in some interviews that turned out to be eerily accurate about the HIT vendor marketplace.

merge

Merge Healthcare, seemingly back on the right track after some long and ugly struggles, announces that its PACS product has been integrated with Epic at HealthPartners. Shares have nearly tripled in three months, with market cap back to a respectable $235 million.

Speaking of Merge, it says it will “unlock the vault” on its internal imaging software tools, making them available to the commercial market as toolkits.

Salesforce.com takes a minority equity position in free EMR vendor Practice Fusion, also announcing the use of Salesforce.com’s cloud infrastructure for Practice Fusion’s new PHR, due out in November.

The military releases an independent report (warning: PDF) reviewing the design plans for the “world-class medical facility” that will replace Walter Reed. On the IT side, it worries about infrastructure planning (fiber and wireless) and EHR issues such as interoperability and usability. Most interesting is the highly practical definition of “world-class medical facility” in Appendix B, which calls for Stage 6 of the HIMSS Analytics EMRAM and state-of-the-art technology for knowledge management and unified communication. A fine job, but no surprise given those involved, including Ken Kizer of Medsphere (with a record-breaking 11 credential acronyms after his name) and Orlando Portale of Palomar Pomerado Health.

A reader is looking for technical experts who have experience with the Touchworks data model. E-mail me if you are interested.

AHRQ will provide a Web site generating application that allows organizations to publish hospital quality and utilization data.

Mississippi Medicaid will offer beneficiaries an EHR and e-prescribing system from HIE provider Shared Health.

ehrtv

EHRtv filmed last week at the Orlando Allscripts ACE09 meeting.

Speaking of Allscripts, several more uncreative law firms have filed suits against the company that are identical to the ones already filed by their legal competitors, i.e. the same “material misrepresentation” charges that don’t stand a chance at lining legal pockets unless certified as class action. The stock went down and is climbing back nicely, but naturally anyone who lost money must have been a victim of something other than market conditions or their own bad decisions. At least we still lead the world in something: resource-wasting lawsuits.

Epocrates gets a nice plug from US CTO Aneesh Chopra: “There is not a doctor I know who hasn’t downloaded a copy of Epocrates. It’s accessible and they use it on their Treos and iPhones."

China’s Ministry of Health is getting expert opinions on EMR standards, hoping to use electronic records to save money.

Jobs: Account Executive, Practice Partner Consultant, Lead Pharmacy Informaticist, Project Office Manager, CFO/VP Finance, Director of Marketing. Lots of winners here. I might apply.

Memphis startup Provider Health Services, which puts doctors and nurse practitioners in nursing homes, is using EMRs as a core strategy to manage costs and reduce provider paperwork.

Local police are mad at Rhode Island Hospital for refusing to give them details about a suspected homicide victim’s injuries, citing state privacy laws. Disclosure to police is allowed only in cases involving gunshots and abuse of children and the elderly, the hospital says. Police called out an exception that allows it if the information could help law enforcement.

Massachusetts, which has most expensive health care in the country, wants to replace the fee-for-service model for all providers with a capitated payment (although they avoid calling it that to prevent memories of bad HMOs).

chop

Children’s Hospital of Philadelphia gets recognition for its Pediatric Knowledgebase, which provides dosing guidance, therapeutic drug monitoring, and medication usage research. It can be customized to work with EMRs.

IT solutions vendor PC Mall announces the formation of a dedicated healthcare division. 

This gripes me too: a husband and wife get their annual physicals, taking care to get blood work at an in-network hospital. They got a bill for $1,700 after the fact — the in-network hospital had sent their blood off to an out-of-network lab. The hospital told them it was their job to figure out which lab the hospital uses, later sending collectors after them. I had the same problem with my own hospital’s ED doc – the hospital’s insurance didn’t cover their own ED doctor services because they contracted ED coverage out to another company. How the heck are hospital patients supposed to figure that out in an emergency? And what alternative do they have anyway?

AMICAS reports Q2 numbers: revenue up 73%, EPS -$0.19 vs. $0.00, and guides revenue up. The stock jumped 15%, now having nearly tripled since December.

Somehow hearing Fannie Mae say this while asking for another $10.7 billion in taxpayer bailout money because of their bad mortgage investments makes me nauseous: “We are dependent on the continued support of Treasury in order to continue operating our business.”

quicken

UnitedHealthcare will make Quicken’s health expense tracking tool available to 700,000 of its enrollees, with plans to roll it out to 20 million people by the end of the year. Or, you could just download it here.

E-mail me.

HERtalk by Inga

From Worried:Re: healthcare reform. Consider this: over the next three months, more than 700 post offices will be reviewed for possible closure. Don’t know about you, but the last time I had to go to the post office, I stood in line forever. Rates continue to rise and the quality of service doesn’t come close to Fedex. Hmm … does anyone seriously want this same government to run our healthcare system?”

From Robe 411: “Re: ARRA vendor guarantees. With all the talk about how IT vendors can get hospitals to Meaningful Use, is anyone aware of any guarantees vendors are stating should they be selected? For instance, are they promising in writing to be CCHIT certified by a particular date or promising to have a capability gap filled by a certain date?” Robe 411 posted this now on the HIStalk Discussion Forum, in case you missed it. I’d be interested in hearing what companies are doing. I do know that NextGen has a money-back guarantee program that includes a promise that the “solution that will always evolve to meet the standards and certifications for federal stimulus reimbursement programs of interest to physicians using NextGen Healthcare products.”

Eclipsys names former Trinity Health CEO Judith C. Pelham to its board of directors.

barrett

Cardinal Health elects current executive George Barrett chair and CEO, just in time for its August 31st spinoff of CareFusion. The company also announced a $500 million stock buyback plan and appointed Glenn Britt, chairman and CEO of Time Warner Cable, to its board.

Twitter suffers a denial of service attack Thursday, making the service unavailable and leaving users like me confused about alternate ways to waste time. Meanwhile, Facebook was suffering its own performance issues, possibly also due to an attack or maybe because of extra traffic from all those Twitter-deprived folks.

 ginos

SRS announces that the 12-provider Chestnut Hill Cardiology (PA) has selected the SRS hybrid EMR for its practice. We mentioned this on HIStalkPractice and included a photo of the office. EMR_guy sent us this note: “I saw the building and immediately recognized it even though I haven’t lived in Chestnut Hill in 12 years. When I was a kid (a long long time ago) the building was originally a fast food burger place (fitting that it is now a cardiology practice). The place was call Gino’s and they had great burgers and shakes.” We are happy to inspire trips down memory lane. Mr. H, being a sucker for nostalgia and reader happiness, tracked down the photo above that should really take you back.

Maryland state officials agree to fund up to $10 million over the next five years to build a statewide HIE, getting the money by adjusting hospital reimbursement.

Picis enhances its ED PulseCheck solution with the embedding of First DataBank Drug Data File Plus. Picis has long supported access to Cerner Multum Vantage Rx Database, but with the addition of FDB, now covers 95% of what hospitals use.

Perot reports a 3% increase in profit for the second quarter despite an 11% decline in revenues. Perot says tighter cost controls helped earnings to rise to $31 million, compared to $30 million last year. New contract signings decreased 48% to $135 million, but have totaled $1 billion over the last year.

peace

PeaceHealth (OR) selects ProVation MD software for procedure documentation and coding. Meanwhile Provation vendor Wolters Kluwer Health introduces its ProVation Care Plans solution, which allows interdisciplinary care teams to customize care plans and create education programs and guidelines.

AT&T agrees to extend special pricing to VHA member hospitals and non-acute care organizations. The contract allows VHA members to obtain “competitive” rates on AT&T wire line services, including local, long-distance, and toll-free services, plus audio and video conferencing.

Consumer Reports, the granddaddy of rating services, offers patient satisfaction ratings on more than 3,400 hospitals. The Consumer Reports Health Ratings Center rates the overall patient experience, including doctor and nurse communication, room cleanliness, and hospital staff attentiveness.

Healthcare Management Systems launches a new online bill pay service, providing hospitals the alternative to send electronic bills and receive payments online.

athenahealth reports its second quarter results, which included a 9% increase in profit compared to a year ago. The company reported $3 million in profit ($.03/share) and revenue of $46.7 million (a 42% increase.) athenahealth attributes the positive results to better sales, including an increase in athenaClinicals EMR users from 498 to 1,034 providers. Results were in line with analyst expectations, yet the stock price has fallen the last two days. Go figure.

A British GP receives a formal warning for downloading pornography at his surgery computer. The General Medical Council said the actions don’t meet the standards required of a doctor, but “are not so serious as to require any restriction on his registration.” Got to love those Brits and their sense of humor. I know people who have been fired for far more frivolous dalliances.

AMICAS second quarter results: revenue of $23.5 million compared to $13.6 million last year; net loss of $6.6 million compared to last year’s $97,000 loss.

runpee

Darn. Why didn’t I think of this?

inga

E-mail Inga.

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Currently there are "20 comments" on this Article:

  1. “Don’t know about you, but the last time I had to go to the post office, I stood in line forever. Rates continue to rise and the quality of service doesn’t come close to Fedex. Hmm … does anyone seriously want this same government to run our healthcare system?”

    What a pea-brain question. The gov’t runs the finest military IN THE WORLD. Medicare is so beloved by elder Americans that no one dare mess with it. I’m not saying the gov’t can do everything right. But your question is simply childish in it’s oversimplification of a complex issue.

    Turn off the TV, read up on the issue, and come back and post when you have a view of your own, unblemished by the talking idiots on the boob-tube.

  2. The “Look How Bad The Postal Service” analogy is unfortunately both clichéd and, with a little knowledge, embarrassing for poster. The USPS makes the best comparison to the US healthcare system, perhaps, by pointing out how spoiled we Americans are.

    We, and every other country in the world, would be extremely fortunate to have a health care system that delivers like the USPS. Consider some of the facts:

    – Universal coverage from Hawaii to Maine. Guaranteed. No discrimination, no rationing. Everyone has access both at their personal mailboxes as well as the public. If it weren’t for the USPS, many (most) rural parts of the country would not have service.

    – The USPS delivers more mail than perhaps the next 5 national services combined…yet it does so at a fraction of the cost. Look at the rates for countries like Japan and Germany (or anywhere else). You can spend $2-3, easily, mailing a simple letter within a European country the size of New England. France? About 2x our cost. Switzerland? You know, the model of efficiency and effectiveness? More than a $1.00 to send a letter. Etc.

    Explain to me again how expensive and inefficient our postal system is.

    – Does anyone think that the alternatives to the USPS (FedEx, UPS, etc.) perform any better? My little company uses all of these services and we have waaaaaay more trouble with the (much more expensive) special companies. Yes, they exist because they offer some services the USPS doesn’t (morning delivery, for example), but I’ve had more stuff lost, stolen, or broken by “Brown” than the USPS.

    – Interestingly, the USPS has had a privacy component built into it that the healthcare industry continues to struggle with. Reading someone else’s mail and interfering with the delivery, etc., carry some serious penalties. Many felonies.

    – Finally, to the specific point of the original poster. The USPS is the third largest employer in the US (behind DoD and Walmart). They have over 32,000 locations. With the demand for first class mail dropping heavily as email services expand…what would you advocate that they do? Keep those money-losing locations? We’re talking about, what, 2% of their locations? I don’t see how the USPS actually acting as a bottom-line oriented business suddenly makes them the poster children for gov’t mismanagement. You can’t have it both ways – they either have to balance their budget or we have to subsidize some of their business. Seems like no matter which they choose, people complain.

    The USPS isn’t perfect, but it’s remarkably good. If you don’t believe me, go mail a letter in another country.

    OK, so I used to live next to the Postmaster General.

  3. I had to laugh at this statement…
    “The gov’t runs the finest military IN THE WORLD”
    Really? Is that why they still haven’t foudn Osama Bin Laden and is that why they are still stuck in Afghanistan and Iraq?

    Ill give you your same advice:
    ” Turn off the TV, read up on the issue, and come back and post when you have a view of your own, unblemished by the talking idiots on the boob-tube.”

  4. Robe411- Vendors guaranteeing CCHIT, Meaningful Use, etc. Everyone is guaranteeing it, is there a choice? It is required to be a player in the ambulatory EHR market. Down the line, we’ll see who actually does it. NextGen just did a press release first, that’s all.

  5. The last time I was in a Walmart I had to wait in a really, really long line to pay for the cheap piece of foreign made trash I needed. I was in a long line because there were not enough registers open, and the poorly paid staff did not seem very motivated. Does anyone really want our government to leave these people in charge of our healthcare system?

  6. Can Sally Apizza make mine a white clam?

    [From Mr. HIStalk] I never know if anyone gets my occasional phony name references. I’m glad you did!

  7. I agree the USPS analogy wasn’t a very good one, but to “Enough Already”; your comment that “Medicare is so beloved by elder Americans that no one dare mess with it.” is no better.

    I’ve been in the patient accounting, registration, and medical records areas for over 20 years both with hospitals and vendors, not to mention being the designated “interpreter” of Medicare bills for all my retired family members.

    Medicare is not “healthy” and there are few, if any, doctors who are willing or able to accept only Medicare or Medicaid patients because the reimbursement levels are too low to support their costs, particularly malpractice insurance. In fact, many have chosen not to accept new Medicare patients. My OB/GYN buddies pays over $100,000/yr.

    I also agree that most of the talking heads on TV have their own agenda, instead of just reporting the news. But there are a few good talk radio hosts who are reporting what I’ve observed over the years and that makes me feel that they ARE doing their homework and that instills trust in me.

    My opinion: Everyone in the US can be treated in an emergency; insurance, cash, or not – that is a fact. Many working people choose to waive their company medical benefits because they choose to spend their money on other things. What a gamble.

    The government has no business trying to run a new, comprehensive health care plan. They have the right (and duty) to make sure insurance companies are consistent and fair with their customers. They also have the ability to address tort reform so those doctors’ malpractice insurance isn’t so expensive and they aren’t tempted to turn away those whose insurance doesn’t pay enough. Every other type of business has to make those decisions. They can also compel citizens to accept their company insurance (rather onerous), and make sure COBRA benefits don’t cost double what they did (employer and employee total) when you were employed by the company (that’s my experience).

    Medicare recipients without a supplemental plan get eaten up by the deductible and copays. When they have Medicare and Medicaid fixed, then government can come back and tell me how they can effectively run a single-payer system. Then they can offer their advice to all the other broken single-payor systems around the world. None of them off the kind of care we have in the US, period!

  8. RE: Uber-CDS. If you are looking for economic relief from the “usual suspects” for clinical decision support, then investigate a striving doppelganger CDS alternative DiagnosisONE. http://diagnosisone.com/

    If D1 can integrate a National Health Information Network in Pakistan (PHIN) between Taliban raids and regime changes, and do a respectable partnership with the Massachusetts’s NHIN, then quite possible this alternative might be worth your due diligence. My experience in techno-haggling demonstrates that being number #2 in the market is always a benefit to the consumer because it assumes they try harder to delight their customers.

  9. “Is that why they still haven’t foudn Osama Bin Laden and is that why they are still stuck in Afghanistan and Iraq?”

    We haven’t found Bin Laden because most of our military is looking for him in Iraq. It isn’t the fault of the military that they’re looking for him in the wrong place, it’s the fault of the idiot who sent them to Iraq.

  10. Re: Medicare

    Obviously you made the comment because you have no first hand knowledge. Let me tell you how great it is form the viewpoint of one who recently when on Medicare: I applied for Part B three months before I was eligible (this is the recommended lead time) when the three months came and went with no coverage, I contacted Medicare and was told that had no record (surprised?) and to fill out a new application and it would be expedited with no penalty (if you don’t take Part B when you are first eligible they dock you for the payments back to when you were eligible).
    I received a card saying that my Part B would be effective in July (note the original request was for March) and deductions would begin then.
    A month later, June, I received another official notice that I was in Part B effective last March and they would retroactively take out the payments in a lump sum. I could also use the letter as proof if I wanted to back in time and receive my annual physical.

    The proposed plan will reduce healthcare costs by pumping billions into healthcare. How do you do that?, you may ask. (drum roll) How about we take rationing and wrap it in newspeak; see “comparative effectiveness”.

    Even the CBO, which is conservative in its prognostications states that healthcare costs will rise.
    After almost 40 years in healthcare management; I have found these problems to much more convoluted than can be decided in a summer rush.

  11. Worried’s post office analogy is illuminating to the healthcare reform discussion. Do you really want to pay 2 to 4 times more for FedEx compared to USPS? Package shippers often buy the expensive but often unnecessary FedEx level of service when the cheaper USPS service would suffice. This is due in no small part to the lack of direct financial impact to the service purchaser e.g. company employee selecting the shipping method. Sounds familiar to the disconnect between purchaser, provider and payer in healthcare, right?

  12. RE: US Military

    I have twelve reasons why the USA Millitary is the best in the world:
    USS Abraham Lincoln (CVN-72); USS Carl Vinson (CVN-70); USS Dwight D. Eisenhower (CVN-69); USS Enterprise (CVN-65); USS George H.W. Bush (CVN-77); USS George Washington (CVN-73); USS Harry S. Truman (CVN-75); USS John C. Stennis (CVN-74); USS Kitty Hawk (CV-63); USS Nimitz (CVN-68); USS Ronald Reagan (CVN-76); USS Theodore Roosevelt (CVN-71)

    There is nothing that converts a supporter of the current healthcare model to an advocate for change than when they lose their employer-based coverage due to job loss or other reasons. The pool of those in the safety bubble gets smaller and smaller every year. That is why healthcare is going to change.

  13. Closing/reducing postoffice locations (sales/intake facilities) seems like the reverse of what needs to done. If more, albeit smaller and less expensive (possibley contracted or non-union) locations were made available would that not offer the potential for increased utilization (sales)?

  14. Plenty of completely empty rhetoric and dumb comments on this thread. It would just be easier if clearly baited comments like by Worrier simply didn’t get posted unless they were clearly HIT-specific.

  15. Universal coverage without rationing? Really??? You have to be kidding!! Hope you enjoy paying 80% of income in taxes to pay for it all!

    @Enough Already: I spent years on several of the boats you mentioned. Flush out your head gear, new guy!

    Let’s take stock on why what you say is true and how it applies to health care:

    1) DOD’s buget is 574.5 BILLION dollars. Put that money into health care and you won’t HAVE a problem.

    2) DOD has vast resources to develop cutting edge technology. Most of which never reached the battlefield, but that doesn’t stop them from trying.

    3) Most of the patients are ragingly healthy.

    3) They have a single uni-lateral infrastructure command and control. Each provider works for the military and conscripted to the chain of command. Admiral Robinson and every Zero down the line is in that chain of command.

    So…to transform health care we’ll need:

    1) a half a Trillion dollars a year.
    2) abolish insurance.
    3) Universal access. All providers work for the government and agree to see every patient in the system.
    4) create a research arm.
    5) Mandate quality and performance measures on every provider.
    6) put everyone on a diet and sign them up for PT twice a day.

    Sounds good…when do we start??? Oh wait…we can’t do any of that?? Oh well… time for Plan B.

  16. Ladies and gentlemen:

    I regret to inform you we have driven into the swamp. We are not sure exactly how we got here but one thing is certain – we are far from rational dialog and clear thinking; indicative of the current state of the national discourse on healthcare reform.

    Anyone want to go with me to yell and scream at a town hall meeting? United Healthcare is sponsoring vocal participants through grants of $250 for qualifying individuals. 🙂

  17. Re: Lazlo “Plenty of completely empty rhetoric and dumb comments on this thread.”

    Inspired by the empty rhetoric beginning HERTalk. Can’t say it wasn’t foreseen. How about leaving the Fox News comments off this website to begin with?

    Now HITECH, there’s some fun flamewars to get everyone started. 🙂

    Anywho, as long as were on the topic, how about we start a universal health plan that only covers preventative care AND gives ridiculous amounts of money for primary care doctor’s scholarship funds? The lack of preventative care is appalling when you look at how cheap it is compared to EDs…

  18. Re:
    “1) DOD’s buget is 574.5 BILLION dollars. Put that money into health care and you won’t HAVE a problem.”

    That’s right – there’d be no healthcare problem because we’ll all be under the thumb of Osama, Kim, the Ayotolah, etc. Or dead, and I can assure that after that you will not need one iota of healthcare.







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Reader Comments

  • HIT Girl: And this is how it propagates all the way up to the Executive branch of our government -- nobody says "no". Nobody puts...
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  • Chris Grover: My opinion. Good read. Let's all please remember that the VA can negotiate price with Pharma and pay 2/3rds of what the ...
  • JustaGuy: You should attach Ed's post from today to the termination letter.......

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