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October 15, 2009 News 19 Comments

From Nash Rasty: “Re: HIT Regional Extension Centers. Is there a list of sites that are on the preliminary approval list? Is it your understanding that for-profit vendors can provide technical expertise? I’m foggy on how companies can get involved.” I haven’t seen a list. I believe the original announcement indicated that the non-profit organization that is awarded an Extension Center contract (up to 70 of them will be created using stimulus money) can farm some of the work out to a for-profit company. In fact, Perot has already thrown in with AMGA and MGMA to offer services to them. I assume but don’t know for sure that each Extension Center is free to choose its own partners. That’s an interesting point: there’s going to be a ton of spending by these organizations, so if my assumptions are correct, consulting and other firms should be watching developments there carefully.

From Midwest CIO: “Re: Siemens. Siemens IT is reorganizing. Hospitals here say experienced associates are no longer with the company.” Unverified.

mstag

From The PACS Designer: “Re: Microsoft Tag. Using your iPhone to navigate the web will be easier if you use Microsoft Tag. The application is designed to read a color-coded 2D pattern called a High Capacity Color Barcode (HCCB) that is similar to the black and white checkerboard ones your find on packages which are called Portable Data File 417 (DF417). The PDF417 is a stacked linear bar code symbol used in a variety of applications, primarily transport, identification cards, and inventory management.”

I’m looking for a really good writer, preferably with a clinical background, who is on top of the mobile computing market, especially smart phones and caregiver apps that run on them. Let me know if you know of someone.

Patent troll Acacia Research Corporation extracts cash from Sage in return for dropping its nuisance suit against Sage over PACS, which Acacia claims to have invented. Despite having “research” in its name, even the company itself admits that its business is pretty much suing companies who quickly realize that it’s cheaper to buy ridiculous licenses than mount a legal defense. “The subsidiaries of Acacia Research buy patents as well as represent patent owners on contingency basis to generate revenue from licensing and enforcement.”

More hospital IT employees get the axe courtesy of a Cerner outsourcing deal, this time at Naples Community Hospital (FL). Thirty of the IT department’s 75 employees are turfed off to Cerner, nine stay on as NCH employees, and 36 are screwed.

Former ONCHIT head Rob Kolodner joins Open Health Tools, a North Carolina-based non-profit trade association of open source developers working on interoperable health records, as CIO.

skmc

A couple of readers e-mailed to say that former Baylor CIO and Cleveland Clinic IT executive Bob Pickton has been named CIO of SEHA, the health authority of Abu Dhabi. I know Cleveland Clinic has a management contract for one of its hospitals (Johns Hopkins has a couple, too), so maybe there’s a connection. Bob starts work Sunday. The high there today: 96 degrees.

A New York Times article says that time pressures, mandatory multitasking, and real-time attention demands (including EMRs) are burning out doctors who no longer have any contemplative time.

Surescripts will adopt the NCPDP SCRIPT 10.6 standard to connect EMRs to pharmacies for prescription information. 

coastal

Coastal Communities Hospital is the first site to go live on CalRHIO’s statewide HIE.

Now I won’t be able to enjoy my pork barbeque, thanks to a YouTube-prowling reader: pigs whose foodd is automatically dispensed in controlled portions by their RFID collars are smart enough to look for discarded collars on the ground and carry them in their mouths back to the feeding station, earning a second meal for the effort. I’ll refrain from making witty comparisons to healthcare scanning.

In the UK, the CEO of the Colchester Hospital trust blames poor service numbers on “data issues”, implying that the CIO was fired as a result. According to the article, “a new chief information officer had been appointed to address this.”

Stock publications have a terrible track record of being able to predict the future, so take this for what it’s worth: someone lists the five companies Dell should take over, all of them in healthcare IT. They are Allscripts, Quality Systems (NextGen), CSC, Cognizant, and Citrix Systems. Citrix isn’t technically a healthcare IT vendor, but it’s probably their biggest vertical since the industry is dominated by 1970s time capsule applications that won’t run efficiently and securely without it (my war horse Citrix joke: Citrix is like a Denny’s restaurant – chosen often, but only out of desperation). Actually I use Citrix a fair amount at work and it’s pretty cool – poorly architected fat client apps run a heck of a lot better over wireless or VPN when you’re only painting screens and not slinging massive data packets back and forth.

mdell

Michael Dell hints that the services business he’d like to get into is practice EMR hosting. I’d say that boosts the credibility of the Allscripts part of the rumor above. I bet he would love to get his hands on eClinicalWorks if the founders would sell.

Speaking of Quality Systems, it gets the #3 spot on the Top 10 Small Companies list by Forbes.

Senator Mike Enzi (WY) wins the HIMSS Federal Leadership Award. He’s HIT-friendly, of course.

Caritas Christi Health Care will use the Azyxxi part of Amalga and HealthVault, both from Microsoft.

Virginia Governer Timothy M. Kaine creates the Health Information Technology Advisory Commission, charged with spending a lot of federal taxpayer ARRA money. I don’t think I know anyone on the long list of commission members.

Five hospitals and health systems go live on MEDSEEK’s consumer portal: Advocate Healthcare (IL), Connecticut Children’s, EMN Regional (OH), Forrest General (MS), and St. Joseph (WI).

orchard

Cardinal Health signs a deal to distribute Orchard Software’s LIS and anatomic pathology systems.

Recombinant Data Corp. and Sun Microsystems sign a $4 million deal to create a translational research and quality improvement data warehouse for Health Sciences South Carolina, made up of the state’s big hospitals.

I don’t know why this popped into my head, but you aren’t a newbie if you know which popular software once had competitors named Quattro, Symphony, and Lucid.

Informatics Corporation of America wins the Best New Technology award at the HealthIT Insight Conference.

Centegra Health (IL) chooses GE Centricity Enterprise.

Everybody wants to get their snout into the ARRA trough. Medical equipment and monitoring manufacturer Welch Allyn launches an EHR preparation and selection consulting program.

Health plan software vendor HealthTrio spins off an independent company, Monument Systems LLC. The same guy owns both companies, so I’m not sure this is really big news, especially since the only thing I know about HealthTrio is that HIT industry pioneer Ralph Korpman used to work there.

The LA Times covers the Cedars-Sinai radiation overdoses, citing “the blind trust of medical machinery” as a key cause since the incorrect dose came up on the screen every time and nobody noticed for 18 months. I’m sure Cedars is doubly thrilled that the Times reminded its readers that the hospital also nearly killed the Quaid twins with massive heparin overdoses.

Interesting: 80% of Taiwan’s citizens are happy with the country’s national health insurance, they have lower infant mortality than we do, and the country spends 6% of GDP on healthcare compared to 15.3% here. Technology is credited, including a nearly universal smart card containing medical data that uploads to central systems (not separate insurance company databases) to provide a real-time view of healthcare. As a result, administrative costs there are 1.5% of the total vs. over 30% here.

Hoboken University Medical Center will implement Medsphere’s OpenVista.

New England Baptist Hospital bans social networking sites, fearing that employees could be posting confidential patient information.

Bizarre: the Minnesota Board of Nursing revokes the LPN license of a man who allegedly encouraged people in suicide chat rooms to hang themselves while he watched via webcam. At least two people did, the board said; the person who alerted police claims there were actually at least eight victims.

ACS gets a $4.5 million, three-year contact to develop the Kentucky HIE. All of us are paying for it: CMS covered the initial amount and the state wants ARRA money to take it statewide.

The Senate’s healthcare reform bill would create Internet-based health insurance exchanges with standard enrollment and make EHR incentives from the stimulus bill and make them permanent. That second item is interesting.

pittcounty

Pitt County Memorial Hospital (NC) says a missing Flash drive contains information on 1,700 former patients. And in Florida, a laptop stolen from the car of an employee of Halifax Health contains billing information for 33,000 patients.

The Health IT Standards Committee will assemble a panel later this month to share best information management practices, bringing in experts from other industries.

Hospital systems vendor Healthcare Management Systems will start selling an ambulatory EMR this month.

umkc

This sounds like a good job for you MD or PhD types: University of Missouri-Kansas City’s school of medicine is recruiting to fill a new position to lead a newly created department — Chair, Department of Informatic Medicine and Personalized Health.

E-mail me.

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Currently there are "19 comments" on this Article:

  1. Re: Competitors, “Alex, What is Microsoft Excel?” I ruled-out Lotus 1-2-3 as Symphony was to be the “next generation” spreadsheet from Lotus.

  2. In response to Rash Nasty’s question, it is my understanding that each state is to designate who within that state will accept the funds from the Feds for both HIE and Extension Centers, and they, in turn, will determine where those funds get assigned. In NC, the State has designated the Health & Wellness Trust Fund to perform that task, and it is anticipated that the lion’s share of those extension center funds will go to the AHECs (Area Health Education Centers) currently in place. But every State has the option to allocate their funds (for both HIE and Extenstion Centers) in the manner it chooses. It’s not determined by the Feds, nor is it something that organizatons can apply to the Feds to get.

  3. Re: Taiwan’s healthcare System

    So I thought we could use some perspective here in dollar figures:
    GDPs : Taiwain: $699B US: $13.94T
    Healthcare % of GDP: Taiwain: 6% US: 17.6%
    % Administration Costs: Taiwan: 1.5% US: 30%
    Population: Taiwan: 2,920,946 US: 304,059,724

    Therefore, the average cost per person for administration is:
    Taiwan – $27.87
    US – $2420

    So that makes me wonder a few things:
    1) What’s their physician to patient ratio?
    2) What exactly is the cost of privacy?

  4. “time pressures, mandatory multitasking, and real-time attention demands (including EMRs) are burning out doctors who no longer have any contemplative time.” and “The LA Times covers the Cedars-Sinai radiation overdoses, citing “the blind trust of medical machinery” as a key cause since the incorrect dose came up on the screen every time and nobody noticed for 18 months.”

    We have been discovering mistakes caused by blind trust of these devices. That is why the benefits of the HIT products are trumoped up and are nothing but pie in the sky dreams.

  5. Re: Siemens…. Siemens “reorganizes” every September and lays off a ton of people. Its a running joke internally to see who makes it through the next round. This is nothing new.

  6. Re: Happy Tiawanese

    Key statistics missing from your list: Obesity/Overweight prevalence 10.6% vs 25% in US (BMI >30kg/m^2). Tobacco use 17.6% vs 19.6% in US. Alcohol Abusers 3.0% vs 5.5% in US. (Stats from WHO and CDC data for similar periods. Also note that Tiawan is not separate from China in this data, so there is some increased margin of error.) Ratio of a certain high-fat, high-carb, high-sodium fast food chain restaurants to people 1:68K in Taiwan vs. 1:22k in US. Also I would bet that elective procedures, such as some plastic surgeries, are included in %GDP data. I would expect to see a higher consumption in the US than Taiwan.

    Clearly, there are other issues in the US that contribute to the higher GDP% of healthcare costs, but I rarely see them mentioned when discussing how “bad” our healthcare system is.

    I’m not arguing that we shouldn’t address the issues in US Healthcare. We definitely should. There are things that are terribly broken and wasteful. I’m just saying that we need to also address the contributors to our higher consumption of dollars for healthcare.

    Excellent food for thought! Thanks for the dialogue!

  7. The first Regional Extension Center applications just went in about 3-4 weeks ago, and they haven’t announced anything on the “winners”.

    The structure of them, as I understood it, is that there should be a non-profit organization that acts as the main organization, and they can sub-contract out the actual day-to-day implementation work to for-profit companies. In the grant application, it had some statement to the effect that they expect that most of the money should be spent “in the field” and gave a high %, like 70-80%, of what they expect that to be, so it’s reasonable to assume that the for-profit sub-contractors could make a good pile of money off of this. That’s assuming, of course, that the Center can achieve financial sustainability within the 2 yrs they have to do so before the grant runs out.

  8. Regarding the note: “80% of Taiwan’s citizens are happy with the country’s national health insurance”. My question would be whether they ever had the medical care options that US citizens have. It seems to me that a lot of people come in from other countries for specialized treatments they can’t find anywhere else because we have better medical technology available than anywhere else. Don’t get me wrong, we can certainly do a lot better with interoperability, insurance portability and availability, and a safety net (oh yeah, isn’t that what we call Medicaid?) for those who REALLY can’t afford it, not just won’t buy it. But much of our cost problem is due to onerous billing requirements (particularly Medicare and Medicaid – entire departments exist in hospitals just to comply) and defensive medicine due to the fear of being sued because of an unexpected/unpredictable complication shows up. Just sayin’…

  9. RE: Suzie…Anyone else find it ironic that there is someone so adamantly against IT and automation in the healthcare industry and she uses a PC to keep up with a blog daily and writes ridiculously uninformed and infinitely small minority opinions on the use of HIT? Honestly, how is staying in an extremely outdated, slow, wrought with mistakes & workarounds with redundancies in a paper environment better than anything automated through IT? If you really believe what you say on this blog daily, then I will gladly take your PC from you and any technology in your house and/or all of your convenience items (i.e. dishwasher, refrigerator, convection oven, microwave, TV, washer/dryer, etc.). Obviously you couldn’t use those as they have to be worse than the workflows those items replace.

  10. Anyone else find it ironic that there is someone so adamantly against IT and automation in the healthcare industry and she uses a PC to keep up with a blog daily and writes ridiculously uninformed and infinitely small minority opinions on the use of HIT?

    I hope everyone reading those comments sees the irony.

  11. Not to mention that Suzie’s most recent rant implies that she also opposes tbe use of CT scanners. Bring back bloodletting!

  12. Congratulations: “HIMSS Federal Leadership Award: The Ranking Member of the U.S. Senate Health Education Labor and Pensions Committee, U.S. Senator Michael Enzi of Wyoming was a co-sponsor of the Wired for Healthcare Quality act in the 110th Congress. Senator Enzi has advanced health IT principles and health IT issues; he has been an important supporter of the health IT provisions in the American Recovery and Reinvestment Act. ”

    These programs, while well intentioned, are ill conceived. As recently reported, the cost overruns will be astonomical. Interesting that Sen. Enzi accepted the gift. I guess the lobbying efforts of the HIMSS trade groups were successful.

  13. Compliments to Mr. HIStalk for excellent coverage

    “The Health IT Standards Committee will assemble a panel later this month to share best information management practices, bringing in experts from other industries. ”

    The problem is that these experts are all yes men and women. There are not any skeptics on the panel. Any who may be skepttics are intimidated by the likes pf programmes and pisman.

  14. That LA Times article (which usually is one of the better major newspapers on health care issues) was pretty poor for several reasons.

    “time pressures, mandatory multitasking, and real-time attention demands (including EMRs) are burning out doctors who no longer have any contemplative time.”

    In comparison to what exactly? How is “burning out” doctors and “contemplative time” conceptualized and defined? How do you measure these things to show even a basic change over time?

    I hate when anecdotal junk like this makes it into a newspaper article but I generally find it is par standard for the course. Not looking for anything “academic” but there should be a little more than just people complaining about their jobs and earning for the “good olde days.”

    “citing “the blind trust of medical machinery” as a key cause since the incorrect dose came up on the screen every time and nobody noticed for 18 months.”

    This is a notable design flaw in the software but it is still a process error in the end. Should be a redundancy in the program that clearly highlights incorrect ranges that are out of the norm.

    I am sure that there were and are errors that occur for prolonged periods of time on paper too. Drug delivery instructions on paper come immediately to mind.

    You are still going to have plenty of process errors with HIT (including whole new classes of errors) but taking isolated incidents and using them as a representative of HIT in general is a pretty flawed way to go about proving it.

  15. There are not any skeptics on the panel.

    What kind of skeptics? People who think that computers have no place in hospitals? That’s like putting witch doctors on a panel discussing medical standards.

  16. “Anyone else find it ironic that there is someone so adamantly against IT and automation in the healthcare industry and she uses a PC to keep up with a blog daily”

    Wonderful logic there, programmer.

    And paying $100 for a toaster is a good deal compared to buying a Ferrari.

  17. Wonderful logic there, programmer.

    I didn’t post that comment.

    In any case, PezMan’s logic makes a lot more sense than the gibberish you just posted.







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Reader Comments

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