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November 5, 2009 News 13 Comments

shands

From Ryan Nichols: “Re: CIO salaries. In 2004, you posted salary data for a number of CIOs, including some fairly high ones like Shands. How accurate was that data? Was there some other reason for some salaries to be off the scale, >$500K?” The salaries came directly from IRS reports, so they show exactly what a CIO was paid in one year, skewed only if that person quit and got lump sum benefits. Not true in most cases, including Shands — 2008 tax records show they paid Joan Hovhanesian $708K, more than everybody except the CFO (who made barely more) and the CEO, who got $1.26 million. Sweet, although not up there with what they pay Urban Meyer to coach football ($24 million over six years).

tampageneral

From Jerry Seinfeld: “Re: Tampa General. Heard a rumor that they will move to Epic from Siemens. Going to the board for final approval.” Unverified.

Listening: Travis, alternative rock from Scotland that sounds like an upbeat, pop-tinged Radiohead.

Eclipsys announces Q3 results: revenue down 5%, EPS $0.07 vs. $1.58, although most of the Q3 2008 earnings came from a one-time tax treatment. Without that, earnings were down 47%. The company also announced that North Mississippi Medical Center has chosen Sunrise.

QuadraMed announces its Q3 numbers: revenue down 7%, EPS $0.02 vs. $0.12.

metrohealth

Cleveland’s MetroHealth has had Epic for ten years, so Judy was there Thursday for the celebration.

An undercover journalist in England buys detailed medical records of British patients from two chat room “salesmen”, apparently provided by India-based transcription center employees. One said, “We can do really good business with these leads. These leads will give you diagnose, entire diagnose of all the customers, what the customer is facing … The floor managers, they are working as freelancers for me.” The records came from London Clinic, which doesn’t outsource transcription, but some of its doctors hired a local firm and may not have been aware that their information was being sent to India. In a quick marketing reaction, Atlanta-based Webmedx assures customers that all of its employees are US-based and therefore aren’t out of the reach of US laws.

HuffPo covers EMR stimulus money and the vendor marketing techniques being employed to go after it: “cash for clunker” rebates, interest-free loans, Walmart sales, and the Stimulus Tour. John Glaser is quoted as saying that ONCHIT will start tracking EMR prices and marketing claims, looking for any stimulus-related misstatements like the ones Siemens claimed Cerner user to steal its customers (and sued them over it, although it has settled, which I’m not sure I know until I read it in this story). HIMSS was invited to comment but, not surprisingly declined, knowing it might step on some diamond toes. I was amused that John Halamka was identifed as “John D. Halambra” in the article.

USA Mobility announces GA of I-LAND, a two-way emergency messaging system for hospital and government campuses that gets through in emergencies because it doesn’t use public networks.

Over 97% of healthcare organizations say they have behavior problems with doctors and nurses, according to an ACPE survey. Examples: yelling, cursing, insulting, refusing to work with each other, throwing objects, trying to get someone fired or disciplined unjustly, and harassing sexually. Many of the problems happen in public or in front of patients. Here’s an interesting one from the respondent comments: male surgeon says to female nurse, “You must be deliberately screwing up. No one could be so stupid as to be this incompetent.” Nurse replies, “If you don’t stop insulting me, I am going to drag you out into the parking lot and kick your ass.” Surgeon reports nurse to administration, nurse gets fired. Only 22% of respondents said doctors had been terminated over incidents, while 61% said nurses had.

Maybe this is related: a couple of readers Googling for the doctor road rage story may have uncovered an important trend — there are a lot of those stories in the news. Doctors have beaten motorists with Thermos bottles, punched women drivers in the face, and pinned a pregnant woman against a wall with an SUV. Do they teach anger management in medical school?

himssmidwest

Dann from RelWare says the Fall Technology Conference of Midwest HIMSS in Grand Rapids this week drew over 400 registrants. He took a picture of someone reading HIStalk during the sessions, which creeps me out the couple of times I’ve seen that at HIMSS (I write it entirely alone with only e-mail contact, so seeing someone read it in person makes me feel exposed).

I missed a couple of graphics from Mark Moffitt’s Web services article (you code geeks will love it because it shows a little bit of programming and some XML). I also ran across this video in which doctors talk about it and give a quick glimpse or two.

NHS is threatening its suppliers CSC and BT with termination if they don’t hit the November dates that were set earlier this year for bringing patient systems live. Sounds great, other than the previous suppliers it tried to hardball walked away. I tried to suppress the sophomoric cackling as I read the name of the hospital that went live this morning on Lorenzo, but I couldn’t — NHS Bury. 

My UCSF sources told me in August that it was stopping its Centricity project (finally verified by UCSF in mid-October). They also said that Epic would be brought in as soon as the lawyers killed the GE contract. Right again, apparently, as negotiations with Epic are underway and, if all goes well, implementation will start in the first quarter. I snooped around and found a copy of the e-mail online (warning: PDF). The GE experience must have been ugly: “I understand the frustration in our prior efforts over the past several years, and the concern that we are facing another two years of this work. However, because we are going with an established, proven system, we can have much greater confidence that in two years we will have the tools that our clinicians need to improve the quality and safety of the care they provide.” Wonder what that Strike 1 cost them?

Speaking of Epic, I got a nice note from Dr. Lucy, aka #1 Dinosaur, who was surprised to find that people assumed her EPIC FAIL line in her anti-EMR blog post that I mentioned referred to that Epic (she’s a fan of FailBlog and was riffing on that about EMRs in general). She does, however, stick to her guns in not buying an EMR for her practice, with her reasons listed in this post:

A man in the back spoke of the new EMR he had just purchased for $30,000. Once all the numbers were crunched, though, it turned out he was only going to see about $3,000 in P4P bonuses. The response, delivered somewhat more softly than the stentorian tones of the main presentation, was that his return was more likely to be in the areas of quality and lifestyle. I imagined presenting a proposal to an insurance company — actually to any kind of business — and saying, "Now, you’ll only make back about 10% of your initial investment, but you’re likely to see improvement the areas of quality and lifestyle."

And speaking of EMRs, cost is a big concern for doctors, but 58% of them know nothing about ARRA. 

Philips and the biggest insurance company in the Netherlands start a pilot project to develop home monitoring programs there.

This strikes me as bizarre: the MyMedicalRecords people engage a clinical trials company to help bring its monoclonal antibodies assets to market. An earlier announcement says it acquired the technology when it did a reverse merger with Favrille, Inc. in January 2009, although all the Phase III trials results I could find indicated that all of Favrille’s products were flops. The news didn’t seem to help the parent company’s share price, now down to less than eight cents, about a quarter of what it was worth in May.

medboard

Pharmacy OneSource acquires the MedBoard in-hospital drug delivery tracking system from MedKeeper.

Strange: a Phoenix doctor’s office gets 1,000 hang-up calls a day from a man angry at a former practice employee with whom he had a relationship. He’s done it for months and says he will keep it up for 25 years. They can’t block the calls because he’s in Jordan.

eHealth Ontario’s $236 million contract, signed quietly a few weeks after its CEO and board chair quit after a bidding scandal, will give 5,700 doctors a connected EMR – less than a fourth of those practicing in the province. The backlash over Ontario’s problems has stalled approval of a request from Canada Health Infoway for $500 million of what is basically stimulus money, although its audit was clean. That non-profit has spent $1.5 billion so far.

State government in India, annoyed that private hospitals obligated to treat poor patients are turning them away, directs them to post a count of empty beds daily on the Web page of the Director of Health Services. The newspaper article concludes that “If this works as planned, it will mean that patients will no longer have to share beds, limiting cases of infections.”

davidgrant

David Grant USAF Medical Center (CA) goes live in six weeks on ClinicComp Essentris CPOE, repository, and alerts.

Seton Family of Hospitals (TX) says its Sychron desktop virtualization saves caregivers 30 minutes each per day since the “roam button” allows them to save a session, leave, and then pick up where they left off on another PC without logging in again.

IMS, the big seller of patient and prescription data, sells itself for $5.2 billion, the largest buyout of the year. Thank them if you believe drugs are too expensive since they specialize in telling drug companies how to wring the most profit out of their products.

The SEC settles with imaging vendor Merge Healthcare and its former CEO and CFO for improper revenue recognition that overstated net income by 230% for three years, resulting in a $500 million hit in market cap when it was discovered. The former suits will pay a combined $870K. I read the original complaint and it said Merge did what an insider told me that HBOC did in the 90s — shipped empty boxes to customers when products weren’t ready so the revenue could be recognized anyway.

The whistleblower who turned in a Texas hospital group for paying doctors kickbacks for referrals gets a 20% share of the settlement amount — $5.5 million. Anybody know a really crooked hospital that’s hiring?

amicas

Q3 results for AMICAS: revenue up 121%, EPS $0.05 vs. -$0.02, handily beating estimates of $0.01 and guiding up. The one-year share price graph is above (they’ve nearly tripled).

Odd lawsuit you’ve already seen: the woman mauled by another woman’s pet chimpanzee has already sued its owner for $50 million, but now her family wants to sue the state of Connecticut for another $150 million because it didn’t prevent the attack.

E-mail me.

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Currently there are "13 comments" on this Article:

  1. That survey on health care workers’ behavior is so true…I often leave hospitals thinking there is no way I could keep my job if I exhibited the same behavior that they do. The cursing is frequently out of control and the way they have inappropriate conversations in front of the patient is unbelievable.

  2. “HIMSS was invited to comment but, not surprisingly declined, knowing it might step on some diamond toes. I was amused that John Halamka was identifed as “John D. Halambra” in the article.”

    Halambra has close ties to HIMSS. In effect, HIMSS did comment, through Halamka.

  3. I’m very sorry. When I look at the “n” in questions such as “In the last year at your health care organization, about how many DOCTORS have been disciplined about their behavior problems?” I am not very impressed.

    In my work for a municipal transit authority, there were “events” far worse than these in higher numbers on a *weekly* basis. And those folks held safety sensitive positions involving busloads and trainloads of people.

    Considering the abuses committed by hospital leadership against clinicians who speak out about anything untoward, I’m not sure I trust the meaning of these figures, either. (See “Tactics Characteristic of Sham Peer Review”, Lawrence R. Huntoon, M.D., Ph.D., http://www.jpands.org/vol14no3/huntoon.pdf for more on that illicit practice).

    It’s your healthcare that’s being affected. I serve as my family’s advocate against the travails of internecine warfare of hospital politics. Make sure you have yours.

    [From Mr. HIStalk] It also occurred to me that the disproportionate number of nurses fired to doctors fired (61% of responding organizations vs. 22%) is probably because most hospitals are community-based, so you can’t “terminate” a doctor who doesn’t work for you. The question probably should have included physician discipline in general, such as revocation of privileges, although the respondents would probably be less likely to hear about doctor discipline than nurse discipline. I suspect more hospitals than 22% have disciplined at least one doc in some way for behavior problems. Also, neither number indicates how many people were disciplined — did 61% of hospitals fire one nurse each or was it an ongoing problem?

  4. Regarding the comments from Dr. Lucy; it’s important for everyone to know that Blumenthal is not pushing HITECH or EHRs from the ROI angle AT ALL. Essentially, he is doing the opposite, calling for docs to implement based on their “professional responsibility” rather than profit motive. I would call this premise inauspicious at best.

  5. “2008 tax records show they paid Joan Hovhanesian $708K, more than everybody except the CFO ” miight explain why “Over 97% of healthcare organizations say they have behavior problems with doctors and nurses, according to an ACPE survey.”

    Doctors are angry. The anger and frustration is directly proportional to the poorly conceived schemes that hospital administrators have deployed to enrich themselves including HIT systems that create inefficiencies and risks in the care giving processes.

    There are HIT “experts” who know nothing about medical care putting in systems that the hospital purchased that are dangerous.

    I am glad that Senator Grassley is investigating for fraud in the industry.

  6. From the CEO’s email at UCSF: “I understand the frustration…”

    Sounds like a replication of the UK NHS experience.They need to cut the mustard and declare the incidence and description of the adverse events suffered by the patients who did not know theri care was being altered by HIT devices that had not yet been approved by the FDA. Knowing of these will help other hosptial and save lives.

  7. Regarding HuffPo covers EMR stimulus money: “HIMSS was invited to comment but, not surprisingly declined, knowing it might step on some diamond toes. ”

    CORRECTION: Gail Arnett is a Senior Director of Corporate Relations for members of the EHRVA within HIMSS.

  8. Doctors and nurses are angry. The executives earn 6 and 7 figures using floor nurses to carry out inferior care. The doctors are angry at the nurses but we are helpless when the nursing care has been limited by executive control. We get terminated for being patient advocates. To report that the computerization of nursing care has been particularly offensive causing many errors and SAEs is often met with termination. They always find something.

  9. Re: Maybe this is related: a couple of readers Googling for the doctor road rage story may have uncovered an important trend — there are a lot of those stories in the news. … Do they teach anger management in medical school?

    I’m surprised no one yet has commented on the tragedy at Ft. Hood regarding the psychiatrist/Major, so I will….

  10. Soooo nurses feel like they have lost their jobs because of HIT? No…it couldn’t be the change in economy, payor mix, and ever shrinking reimbursements. Nope…it must be HIT! Technology in the hospital has made is apparent where inefficiences are and how to help cut them off at the pass. Clearly from a revenue cycle and reimbursement standpoint, Hospitals would be sunk without automation & faster throughput of the mounds of paperwork that occur daily in a hospital.

    I just cannot see how staying on paper is efficient at all. If you are as you claim to be, clinicians, then bring ideas to fix the apparent IT problems instead of complaining. It’s not going to stop…change is happening. It has to…

  11. “Do they teach anger management in medical school?…I’m surprised no one yet has commented on the tragedy at Ft. Hood regarding the psychiatrist/Major, so I will….”

    This is a highly inappropriate comment about a deranged individual in the military in a time of war, the derangement clearly of multiple causes, the least likely which was medicine.

    Have you no decency, ma’am?

  12. To Fort Dix Loving Reader:

    Maybe you can’t read.

    If you scroll up to Mr. HISTalk’s 11/06/09 comments, right before the picture of “Midwest HIMSS”, you will notice that this comment you feel is “highly inappropriate” comes from Mr. HISTalk, not from me! And if you re-read my comment, you will notice that I copied Mr.HISTalk’s paragraph under the section RE:

    My comment was in reply to his, and was listed in the second paragraph, not the first.

    So, please direct your “Have you no decency, ma’am” comments to the appropriate person. Thank you.

  13. Dear Ms. Kohn,

    your comment appears as an attack on docs, in effect saying “doctors don’t learn anger management – and now look what this psychiatrist did.”

    If that was not your intent I’m sure others will be interested in knowin’ wha you really meant.







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