From Ruppert Breedlove: “Re: Meditech’s latest results. They are trending from high margin (product sales) to low margin (services) revenue that is bringing down profits. Maybe it’s a short struggle while they try to get 6.0 going, or maybe it’s the start of a slow, chronic decline. They are losing a few customers at both ends (Paragon and Epic) and the larger Magic hospitals see a long and winding road that leads to the 6.0 door. Service revenues lag product revenue, so if those flatten and then decline, that would be significant.”
From Cathy Halloran: “Re: Eclipsys Knowledge-Based Charting (KBC). The latest go-live of KBC occurred at North Shore Long Island Jewish Health System in the last three months. It incorporates CPMRC/Elsevier’s evidence-based content within Sunrise Clinical Manager to support the clinical workflow of the interdisciplinary (nursing and allied health) patient care team. This content and design was endorsed by enterprise-wide NSLIJ interdisciplinary teams including physicians with the goal to use KBC to advance practice at the point of care. NSLIJ teamed with the CPMRC for Transformational Services and with Eclipsys for implementation services. There are two hospitals live right now, the children’s hospital and a large academic/tertiary hospital. As we continue to implement KBC across NSLIJH, the tools and content will support evidence-based care and practice.” Cathy is VP of clinical systems at NSLIJ.
From Bulbs: “Re: GE. GE has a warranty on Meaningful Use and, unlike NextGen’s, it doesn’t specify ‘to use our BEST EFFORTS to keep a general released version of the Software in compliance’. It actually says it WILL meet compliance with certifying bodies, although they have carved out Enterprise stating they will use ‘diligent efforts’.” GE’s warranty text is here. The penalty, though, is only a credit (not refund) of six months’ of support fees, which isn’t much consolation if you’ve bought licenses, hardware, and implementation services (all from GE, the warranty specifies). My advice would be to forget the boilerplate and insist on your own contract language, backed up by more significant penalties. And, while customers are semi-guaranteed that GE’s product will be certified, most of the Meaningful Use obligations will fall on them, not their vendor (e-prescribing, getting quality results, keeping data in electronic form, etc.) I’ve got a UL-approved electric saw, but I’m still not prepared to build a house.
From Fed up with Zynx pricing: “Re: evidence-based nursing. With the recent acquisition of Provation, WoltersKluwer is now a reasonably priced alternative to Zynx for evidenced-based order sets and the recently released care plans. We were able to negotiate a substantial savings compared to Zynx when we bundled in the UpToDate product that Wolters also offers.”
Here’s what you thought about NPfIT in my previous poll: big success (3%); big failure (51%); somewhere in between (27%); don’t know and don’t care (19%). New poll to your right: will more EMR vendors promise their prospects future CCHIT certification or Meaningful Use compliance?
Allscripts will add 125 new jobs in Raleigh.
I couldn’t resist looking up Ken Kizer’s 11 acronyms: MD (medical doctor), MPH (master of public health), FACEP (Fellow of the American College of Emergency Physicians), FACPM (Fellow of the American College of Preventive Medicine), FACOEM (Fellow of the American College of Occupational and Environmental Medicine), FAMT (Fellow of the American College of Medical Toxicology), FAACT (Fellow of the American Academy of Clinical Toxicology), FAAMA (Fellow Academy of Medical Administrators), FACPE (Fellow of the American College of Physician Executives), FRPH (Fellow of the Royal Society for Promotion of Health), and FRSM (Fellow of the Royal Society of Medicine). He’s one busy “fellow”, apparently, since he’s also board certified in six medical specialties.
Listening: reader-suggested Silversun Pickups, LA indie with an all-too-rare female bass player.
The Seton Law people say that HITECH improves requirements for breach handling, holds business associates directly accountable to the government, increases enforcement of violations, strengthens “minimum necessary” restrictions, improves accounting of disclosures, and prohibits sale of PHI. On the other hand, personal health record vendors like Google and Microsoft are not specifically included, so they can still use, disclose, and possibly sell the health information of patients, leaving consumers no choice but to accept their privacy promises.
Speaking of Microsoft, it’s taking heat after a report found that 90% of the ads displayed when searching for prescription drug information on its Bing search engine led to unlicensed pharmacies, many of them providing illegal offshore counterfeit drugs.
Girish Kumar Navani, president of eClinicalWorks, is interviewed in The Journal of New England Technology and is asked excellent questions. He predicts the stimulus impact to eCW will be only 20-25% and will take 5-6 years to evidence itself. Asked if he wants to take the company public: “No. There is no question about it. There’s no way I would kill my freedom to be shackled by reporting to Wall Street every quarter … I think going public is like the hangover after a night out. You really feel good about it the day you go public, and then after that it feels like a hangover — and it never stops.”
A North Carolina business paper covers local companies that have added HITECH-inspired services (EMR hosting, order management, patient communication) to their physician product list.
The C. difficile bacterium killed 248 people in Scotland last year and was involved in the deaths of another 517, leading a public health official to urge use of an electronic bed management and infection tracking systems to combat the problem.
A new RFP tender from NHS: an order communications system.
Continua Health Alliance certifies three new personal health devices for connectivity and interoperability: a blood pressure cuff, scale, and glucometer.
Cleveland Clinic CEO Toby Cosgrove says healthcare reform “may end up making the problem substantially worse” if all it does is make insurance more widely available, adding that “the conversation has morphed from health-care reform to insurance reform.” Unfortunately, we’ve let those terms become synonymous.
Interesting results from the President’s Council of Advisors on Science and Technology this past Thursday and Friday in Washington. Attending were CTO Aneesh Chopra, ONCHIT head David Blumenthal, and our own John Glaser. According to the excellent recap by nextgov, Google CEO Eric Schmidt told them that the administration’s health IT system will keep hospitals using outdated databases in a Web-centric world, stifling innovation. He, of course, humbly suggested using Google Health and then snipped when Blumenthal told him the national system will share some information with PHRs. “Giving me a summary … is not the same thing as giving me the record." Microsoft’s Craig Mundie advised the administration to worry more about metadata and information lookup instead of specific EHR applications, but Blumenthal told him that’s not possible because stimulus funding was tied to EHR adoption (which seems more and more to have been a big mistake – you pay for a house, not for a pile of boards and a promise, to continue my construction analogy from above). He also admitted that we’re way behind Scandinavian countries in EMR usage (not to mention overall health and healthcare value).
South Florida HIE and Community Health Alliance, two dormant and broke RHIOs that never got much of anywhere, regroup to chase stimulus money. They’re arguing that it makes sense to give them the cash instead of using it to “reinvent the wheel”, which I almost buy given today’s prevalent bail-out mentality (crappy car makers, criminally greedy financial institutions, and market-failed EMR vendors and RHIOs … hey, it’s only taxpayer money).
GE paid $50 million in fines and $200 million in legal fees to make SEC book-cooking charges go away, but it was a corporate embarrassment nonetheless, “like a professional baseball player revealed to have been dabbling in steroids”, Forbes says (while also pointing out that the SEC is mighty blustery about going after GE considering they missed major scandals like Bernie Madoff’s). Other articles I’ve read said that Jeff Immelt panicked because he was about to break a long string of profits under Jack Welch as the new CEO and maybe created a culture of fudging the numbers. A former GE executive says he was told, when he advised another executive that results were coming in light, he was told he was “taking those accounting courses way too seriously” and to “just reverse a few journal entries.”
St. Vincent Indianapolis Hospital is experimenting with letting UPMC’s neuropathologists perform live biopsy readings via TeleNeuropathology, in which the Indianapolis neurosurgeons follow along as UPMC’s pathologists control a robotic microscope in the OR and inspect its images over an Internet connection.
Merge Healthcare will acquire Confirma, a Seattle-based MRI software developer, for $22 million in stock. I thought those Merrick people were obnoxious when they took Merge over a year ago, but they are doing everything right, including the eTrials acquisition last month and a stock price run-up of 16 times its 52-week low.
Kaiser Foundation Health Plan and Hospitals had a fair Q2: revenue was up a little, but net income was way up on lower non-operating losses (investments, I’d guess). It lost 36,000 members, but surely that’s related to higher unemployment. HealthConnect got a big mention in the announcement.
Winner of the Highest Potential Startup Idea at IPhoneDevCamp: Nurse Brain, a patient dashboard that nurses use to log their activities and then hand off to the oncoming nurse at shift change. Brilliant.
An HUC at St. Francis Hospital (WI) gets her job back after an arbitrator finds that termination was too severe a penalty for violating HIPAA laws in using the hospital’s medical records to locate her estranged son. The son filed a hospital complaint when he received a birthday card from her, claiming the only way she could have gotten his address was from hospital records.
The former director of interoperability and standards at HHS says the Nationwide Health Information Network needs to be scrapped because it’s obsolete, but there’s time because “I have not seen in the stimulus where the NHIN is being advanced.” David Blumenthal responded that HNIN is important and a work in progress.
HIMSS keynoter Dennis Quaid is on the big screen in GI Joe: The Rise of Cobra as General Hawk. How does a movie about a generations-old doll translate to the big screen? “Big, brainless action and bad acting,” said one critic. Others: “Whoever said Dennis Quaid was set dressing in this film was absolutely right … every line he delivers sounds as if he’s reading it right off the page” and “Dennis Quaid has apparently been assigned to look gruff and bark orders.” Roger Ebert gives it 1.5 stars and, in the biggest Dennis insult of all, doesn’t even find him worthy of mentioning. Despite the pans, it’s pulling in big box office, at least until word gets around.