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December 1, 2009 News 25 Comments

From Ex-Cerner Guy: “Re: FirstNet. I am loath to come to the defense of my ex-employer, but ED/ER applications feeding an EMR are notoriously difficult to successfully rollout. It’s the nature of the ED physician. He does not care about generating a record for the floor or medical records — he cares about triage / diagnosis / treatment / discharge-or-admit-floor, with those words quickly strung together. It’s about treatment and discharge. And cost does not enter the picture. Ever. We NEVER won a deal with FirstNet as the ‘entry’ product — it was an add-on or check-the-box application. Did they not look at any of the other vendors? There are so many good small shops making great product. $1M for a report writer for about 200 facilities seems like a pretty good deal, so that number might be off a bit.  If they really received Report Writer for all users and facilities for $1M, they need to ease up.”

healthcentral

From Clint Gristwood: “Re: HIPAA firings. What do you think the over/under is on HIPAA-related firings or reprimands at Health Central Hospital in Ocoee for unauthorized access to Tiger Woods’ medical records?” I think the odds that employees have already peeked are 100%. The odds they will be caught and/or disciplined is 20%, even though the hospital will be watching. It’s a 141-bed facility and I have slight familiarity with IT there, so I don’t know how sophisticated their systems are with regard to role-based security and access monitoring. The tabloids would pay big bucks for copies. The Florida Highway Patrol was considering asking Health Central for the records, but it sounds like they’ll just write Woods a $164 reckless driving ticket and be done with it (I’m pretty sure he can afford it). Imagine the eBay price for the golf club his wife was supposedly beating him and his car with.

From LE: “Re: Siemens. I applied for a job there six weeks ago and there were many US jobs listed, over 100 I’m sure. Now, mysteriously, there are only nine internships listed.”

maillive

From The PACS Designer: “Re: Windows Live Mail. With the release of Windows 7 comes a new way to access multiple e-mail accounts. Microsoft has announced the availability of Windows Live Mail, which can make you more productive while online.”

From Inside Outsider: “Re: two doors. I agree, but only because this is radiology we’re talking about. Now, if this practice ever gets pushed through to more emergency healthcare — the extreme example being the ER — then I might begin to disagree. Those that come in the common man’s door are not sacrificing their healthcare; they are sacrificing time and amenities. Let’s hope it doesn’t get to the point where Mr. Bigbucks gets priority in the ER and Mr. Littlepennies suffers grave consequences because of it.”

From Certifiable: “Re: stolen identity. Patient at St. Anthony Hospital (IN) had identity stolen. Got bills in the mail for phones shipped overseas, ordered via Sprint. Patient suspected hospital system, hospital would not talk to her until Sprint got involved.”

Thanks to Barbara, a former Sarasota Memorial Hospital employee who set me straight on the Eclipsys announcement that the 50 millionth order had been entered in Sunrise there. It’s true: SMH was not a TDS user and all 50 million orders were entered into Sunrise, which is pretty darned amazing (that’s around 12,500 orders per day for 11 years). I don’t know what made me agree with the reader’s TDS comment since I remember when SMH signed on originally.

HHS Secretary Sebelius and National Coordinator Blumenthal will announce some kind of new grant program (Beacon Community Cooperative Agreement Program) on Wednesday.

elmhurst

Weird News Andy likes this picture, the result of burned out light bulbs at a New York hospital’s ED. He also noticed this sad ED story, in which a school counselor waiting in a hospital ED’s waiting room was robbed by three homeless addicts there, dying of a heart attack immediately afterward without ever getting to see the triage nurse despite having waited for 80 minutes. Aria Health had no comment, but the whole event was captured on surveillance video. It seems like every horrifically negligent patient care issue in EDs and nursing homes is recorded on security cameras, making you wonder if maybe they shouldn’t pay someone to watch the monitor in real time.

How could this happen? A toddler in South Africa being treated for hand burns has her legs amputated by surgeons in the 1,100-bed academic medical center.

Andrew Watt, MD is named VP at Southern New Hampshire Medical Center. He was already CMIO, CIO, and an ED doctor and formerly worked on ED systems for Meditech.

Reminders: the HIStalk events calendar is here and you can add yours for free. Put your e-mail address in the Subscribe to Updates box at your right to join 4,924 people who have already done so and maybe become the five thousandth subscriber (signing up makes you eligible to vote in the HISsies awards, which I’m doing differently this year). Click the crude Rumor Report box in the right column to send me juicy news anonymously (it even takes attachments). Use the Search HIStalk box to the right to dig through 6.5 years worth of HIStalk (maybe I’ve mentioned you or your employer). That is all.

Wisconsin will spend federal stimulus money to create the an HIE, to be dragged from the womb sporting the obligatory painfully contrived acronym WIRED (Wisconsin Relay of Electronic Data) for Health. The governor is looking for nominations (warning: DOC) for its board and committees.

ontomed

OntoMed, an Ann Arbor, MI startup, is talking to University of Michigan Health System about helping it validate its COSMOS PC-based bedside monitoring and alerting system for the ICU. Their conveniently cutesy product acronym is even lamer than WIRED – COmplexity-based Stability MOnitoring System.

It was fun running pictures of the SMS reunion. In fact, I really like using any pictures that people (rarely) send me: department pictures, data center shots, IT people in their natural habitat, doctors using computers (those are hard to get), and anything related to healthcare IT. Send them my way, please.

Newsweek runs an article extolling Cleveland Clinic’s methods, declaring it “The Hospital That Could Cure Health Care”. Epic is prominently mentioned, although not by name (except for MyChart). CEO Toby Cosgrove is lauded for not hiring smokers to work there and declaring he’d do the same for overweight candidates if federal discrimination laws allowed it. He doesn’t think healthcare reform will do much to reign in costs. Technologies mentioned: clinical decision support, a smart IV system being developed there, MyChart, home monitoring, and powerful data capabilities.

sage

Welcome to Sage, a new Platinum Sponsor of both HIStalk Practice and HIStalk. The Tampa, FL company offers a variety of physician systems, including the Sage Intergy EHR, practice management solutions, Sage Intergy RIS and PACS, community health applications, analytics tools, and EDI services. The Sage Intergy EHR Kit includes ARRA information, access to an online demo of Sage Intergy EHR and Sage Intergy, a presentation covering EHR benefits, and a practice case study. Thanks to Sage for their much-appreciated support of HIStalk Practice and HIStalk.

AMI is looking for a CIO for a 200-bed hospital in Kuwait.

Nuance announces Version 4.0 of its Veriphy critical result management system.

An e-mail about H1N1 claiming to be from the CDC is actually the carrier for a different kind of virus, a PC Trojan. The e-mail urges the recipient to create a profile on the CDC’s Web site, which is actually a phishing site that downloads the Kryptik Trojan.

E-mail me.

HERtalk by Inga

CCHIT certifies four new products under the newest programs announced in October. ABELMed EHR-EMR/PM, Version 11 received certification under the CCHIT 2011 Comprehensive program, while eHealth Made EASY, KIS Track, and Medios earned Preliminary ARRA 2011 certification.

Here’s the difference between the two certifications: the Comprehensive certification program “provides a more rigorous inspection of integrated EHR functionality, interoperability, and security in addition to full compliance with Federal standards.” CCHIT also includes an inspection process in the Comprehensive program that considers successful use at live sites and good usability. Additional certification announcements are pending, per CCHIT. And OK, I admit it — I’ve never heard of any practices using any of these products.

driscoll

Driscoll Children’s Hospital (TX) selects CAREt System by PatientSafe Solutions (IntelliDOT) for beside medication administration.

KLAS reports there is a “huge gap” in provider satisfaction scores for PACS software. In acute care, GE Centricity PACS-IW scored 23 points higher than the lowest performer, Cerner. Infinitt was the best-performing community PACS vendor and Intelerad led the ambulatory PACS vendors. At the top end of the market, almost nine percent of large hospitals plan to replace their PACS. KLAS predicts the vendors most likely to be replaced include Merge, Siemens, eRAD, and Emageon.

eClinical Works adds a couple of healthcare systems to its client list. Portage Health (MI) is providing the eCW software to its 31 employed physicians and will interface the application with the hospital’s Meditech system. Also, Johnson Memorial Hospital (IN) will offer eCW to its employed physicians and use eCW’s Electronic Health eXchange to allow access for other physicians and hospitals.

In yesterday’s HIStalkPractice, a reader shared that eCW was the “clear-cut winner” in Health Industry Insights’ recent review of the ambulatory EMR market.

MedQuist signs an agreement to license Nuance’s SpeechMagic speech recognition engine and processing software. MedQuist will use SpeechMagic in its SpeechQ for General Medicine, a front-end speech application for all medical specialties. MedQuist, which seems to be churning out press releases in conjunction with the RSNA meeting, also introduces SpeechQ VTB for Radiology, which integrates speech recognition, automated coding technology, and Web-based billing services. MedQuist has also integrated a radiology search tool from Primordial Design into its SpeechQ for Radiology application.

meditech

The architects that designed Meditech’s Fall River facilities win an award for their work. The New England chapter of the American Institute of Architects and the Boston Society of Architects said the building shows “excellent site organization” that capitalizes on “great views”. Now I am curious what exactly the “great views” are from all those windows.

The Chatham County Safety Net Planning Council (GA) picks Orion Health to build the Chatham County HIE pilot, which will serve over 250,000 people.

Meanwhile, the Pennsylvania HIE (PHIX) issues a draft strategic plan for a 30-day public comment period. The plan is the same as everybody else’s – get stimulus money.

Continuum Health Partners is replacing multiple imaging systems with Horizon Medical Imaging.

General Leonard Wood Army Community Hospital implements ClinicComp Essentris inpatient clinical documentation, part of a 36-facility contract with the DoD.

The 18-physician Naugatuck Valley Radiology Associates (CT) claims its use of MedInformatix RIS, along with DR Systems PACS and Nuance PowerScribe voice recognition, has allowed the practice to achieve a 100% paperless environment.

Picis announces that several medical centers have selected Picis ED PulseCheck, including Scottsdale Healthcare, Antelope Valley Hospital, and Bayonne Hospital Center.

caretech1

The CareTech Solutions folks informed us of their revamped corporate Web site, built with its CareWorks CMS content management tool. I can’t say I fully understand what makes a particular CMS tool robust or weak, but I can say the new site is easy to navigate, has a clean look with nice graphics, and contains a nice mix of written and multi-media content. I also see they are hiring in Ohio and Michigan, in case you are looking.

e-Prescribing in Delaware is up 150% one year after the state began funding e-rx start-up costs for the top 50 Medicaid providers.

shot

The Champaign-Urbana Public Health District (IL) sets up a drive-through H1N1 vaccine clinic that allows patients to stay in their cars. Wait times averaged 45 minutes and 2,000 people received shots at the first clinic. Not as much fun as a drive-through Starbucks, but pretty handy nonetheless.

Despite Mr. H’s prediction that Twitter is a passing fad, Global Language Monitor proclaims “Twitter” the top word in the English language for 2009. In fact, it beat out Obama, H1N1, stimulus, vampire, and 2.0. Healthcare was ranked ninth.

inga

E-mail Inga.

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Currently there are "25 comments" on this Article:

  1. Ex Cerner slave: “FirstNet. I am loath to come to the defense of my ex-employer, but ED/ER applications feeding an EMR are notoriously difficult to successfully rollout. It’s the nature of the ED physician. He does not care about generating a record for the floor or medical records — he cares about triage / diagnosis / treatment / discharge-or-admit-floor, with those words quickly strung together. It’s about treatment and discharge. And cost does not enter the picture. Ever.”

    You do not know what you are talking about. We care about efficient and safe medical care and taking care of the pastient rather than screwing around with a user unfriendly untrustworthy computer with outdated softare. Perhaps you go back to Cerner and tell that to Neal: and tell him to stop trying to suppress the truth about his HIT.

  2. Hello. A couple of minor annoyances which would save you space… please drop the ‘RE:’ which starts off readers comments. Superfluous as they are all blue anyway (I think).
    Also, I for one find the ‘Warning:PDF’ annoying & unnecessary. Good to see the flash ads are being slowly squeezed out! Keep up the great work

  3. “It’s the nature of the ED physician. He does not care about generating a record for the floor or medical records — he cares about triage / diagnosis / treatment / discharge-or-admit-floor, with those words quickly strung together.”

    Thank God someone focuses primarily on taking care of often extremely ill patients instead of focusing on the needs of the bureaucracy.

    If God forbid a person is ever brought in after a traffic accident or trauma, they will be thankful for that.

  4. RE: Cleveland Clinic…seriously? They won’t hire smokers and wouldn’t hire people if they are “overweight” if they had the choice? I didn’t realize that nicotine was the new crack and not being physically perfect meant someone wasn’t qualified.

    Is smoking bad for a person’s physical health? YES!
    Is being overweight bad for a person’s physical health? YES!
    Is being a pompus, self-righteous ass something bad for a person’s mental health and the health of those subjected to them? YES!

    It is also something bad for society as a whole.

    Do they test for mental state or alcohol addition? Are their applicant’s required to take a Rorschach or MMPI? I think I’d rather have a smoker review my vitals and suggest treatment vs. a potential Munchausen candidate or a raging (in cognito) alcoholic.

    Wow…

    Sign me: Disgusted and Horrified.

  5. “CEO Toby Cosgrove is lauded for not hiring smokers to work there and declaring he’d do the same for overweight candidates if federal discrimination laws allowed it.”

    Unbelievable to this former hiring manager.

    I believe this MD-CEO will not be “curing healthcare” any time soon, since a primary consideration is *compassion*. He seems somewhat deficient in that attribute.

    He also seems deficient in the characteristic known as business wisdom in an era of trigger-finger llitigation. His statements could very likely be used to support discrimination lawsuits against the Cleveland Clinic, which can be very expensive and damaging to an organization’s reputation.

    See my post at http://hcrenewal.blogspot.com/2009/12/why-we-have-federal-antidiscrimiation.html for more thoughts on this issue.

  6. Twitter may be a passing fad, but I saw 4 of todays stories on Twitter earlier today (the toddler amputation, the imhurt photo, the Newsweek story on Cleveland Clinic, the Blumenthal announcement)–so MrH is either reading his tweets or eventually the business model will take over us all. (After all I’m reading this soon after MrH hits “print”

    The good news for Mr H is that dismissive snarkiness is tough to get over in 160 characters, so we’ll all keep coming back for that!

    [From Mr. HIStalk] I don’t read Tweets. I tried it for about one day several months ago, but Twitter has the same content supply problem as any form of publishing technology for the masses — 99% of Tweeters don’t really have anything consistently interesting to say, which is probably why they weren’t saying much until Twitter lowered the bar (although at least Twitter forces them to keep it short and hides marginal writing skills). Still, I’m pretty sure I could be equally dismissively snarky in 160 characters!

  7. Mr. Ex Cerner.

    ER physicians are largely reimbursed at least in part on productivity. The documents they create are the billing documents that for better or for worse represent their productivity.

    If a product decreases the productivity of the ER physician, they see it directly in their paycheck. No better way to alienate the user than to provide them with software that cuts their pay, I don’t care what industry you are in. I don’t think you’d find even one ER doctor that likes that situation, but it is a CMS thing, and therefore not really up for negotiation.

    Failure of a company to provide software that provides benefits to all of the users is one thing, blaming the users themselves for not using your software is astonishing, and it explains a lot about FirstNet.

  8. How could this happen? A toddler in South Africa being treated for hand burns has her legs amputated by surgeons in the 1,100-bed academic medical center;
    As a South African I am a bit sensitive to these reports. I have checked all SouthAfrican newspapers this morning, and I cannot find any report. Looks like a hoax, and if it is, nasty for South Africa’s reputation.
    Can anyone find proof of this?

    [From Inga] A quick Google search found this story was published in numerous outlets, thus it appears true. Sadly. http://www.timeslive.co.za/news/article216453.ece

  9. Siemens website is always full of oudated jobs; even internally you can look at the jobs, and when you apply for them, you never get a response, and if you do, the job has been filled long ago. My position was filled and 8 months later, the job was still posted internally, simply because my director forgot to take out the request for the job. Maybe 2 months ago they did an update of the current job needs and maybe thats when they cleaned up all those outdated jobs on the site.

  10. Re: Tiger Woods
    I was a little disappointed that you decided to jump on the tabloid reporting. Followed your link and nowhere did the FHP indicate that they were considering going after the health records. To say it is an “option” is not the same as “considering.”

    [From Mr. HIStalk] Of course it’s tabloid (or at least tabloid-style) reporting – who else is going to run endless stories on a celebrity’s minor, one-vehicle traffic accident? FHP said it had “insufficient evidence” to get his medical records, according to a Washington Post article, so that sounds like they would have gone after them otherwise. All moot now that he gets off with a minor ticket.

  11. “Siemens website is always full of oudated jobs; even internally you can look at the jobs, and when you apply for them, you never get a response, and if you do, the job has been filled long ago.”

    Incompetent HR departments directly injure a company, through errors of commission and omission. This damages chances of geting and retaining the best talent, and the personnel in incompetent HR departments need to be the first to be laid off if a company desires economic health.

    Siemens Healthcare should consider firing the HR staff responsible for an “outdated” recruiting website.

  12. “CEO Toby Cosgrove is lauded for not hiring smokers to work there and declaring he’d do the same for overweight candidates if federal discrimination laws allowed it.”

    Good for him. If we’d focus less on PC and more on reality, we could perhaps start improving things. Yes, smoking and eating junk food are both limited personal “rights”. But so is hiring. Being overweight is not a protected class, nor should it be. As long as employers are responsible for paying for employees’ healthcare (which they shouldn’t be, but that’s a whole other topic), they should have the “right” to minimize their cost.

  13. CCHIT_”Here’s the difference between the two certifications: the Comprehensive certification program “provides a more rigorous inspection of integrated EHR functionality, interoperability, and security in addition to full compliance with Federal standards.””

    It remains a travesty that safety is ignored. The CCHIT certified (whatever that means) equipment may be usable while simultaneously causing adverse events in patients. CCHIT has failed the medical community by not caring about what happens in the after market. This is not surprising since it is a front for HIMSS and the HIT vendors.

    If any one out there puts patients’ safety at a premium, it behooves you to issue reports to the FDA and encourage law suits against the vendors.

  14. Dead in Philly_”Rivera’s cruel end was captured on security videotape, much like the June 2008 death of Esmin Green, who died on a hospital floor as staffers at Kings County Hospital Center in Brooklyn ignored her.”

    Was the ER care directed by an HIT sytem like that described in Sydney? High tech cameras, high tech records? U tube anyone? If you know, please send a comment here.

  15. RE: How could this happen?
    As a mom of a recent burn patient, I can see how something like that could happen. For whatever reason, my toddler was not required to wear an identification band – when I questioned that I was told that it was due to the fact that many burn patients do not have the skin surface to tolerate a band. (Only her hand was burned.) We had a few near misses with medications that were caught before they were administered, but the last straw occurred when the surgeon wanted me to sign a consent form to graft her left arm and hand. When I refused to sign, he told me that I was not the medical professional and did not know what I was talking about until I showed him that her left hand was intact. He continued to cross things off the consent form and then presented it again to me to sign. Turns out that he had the wrong patient all along, he never confirmed her identity up front. Procedures are in place and should be followed for a reason.

  16. Dear Seriously,

    Keeping track of patients is something I do in my ER work all of the time. We have a computer tracking system that enables a view of the records and census. I was just curious as to what system they have. As a researcher of safety methods, I would never come to any preconceived notion that HIT caused death.

  17. Re: “CCHIT certifies four new products”. Of the four products, CCHIT evaluated two of the EHRs against only two of the 28 Meaningful Use objectives (as understood today), and granted “preliminary” certification status. The other 26 objectives were “NOT inspected of certified”, according to the CCHIT website. Doing the math, the EHRs were evaluated against only 7% of the Meaningful Use objectives, but were given a specious certification status, albeit a “preliminary” one.

  18. Rumor has it Sage Healthcare is in final negotiations with Ex Misys(fired) CEO Tom Skelton for the President position. As a recent ex-Sage Healthcare employee and former Misys employee, this has to be the last bullet in the gun set by Sage northamerica to destroy the business. Does anyone think that the leadership at Sage northamerica has bothered to google Skelton to undertand why he was fired from Misys?

  19. OK, I read the article (thanks for the link Inga) and this is NOT a case of surgeon malpractice. The girl developed gangrene in both legs and that’s why they were amputated. The way the incident was first described, it seemed like a horrible physician error of a hand burn being treated via leg amputation.

    The gangrene was supposedly caused by the administration of an IV through a leg by the hospital, so the hospital may not be off the hook, but it’s not nearly what the headline suggests. I think South Africe deserves a clarification in the next HISTalk — they’re not nearly as bad as Rhode Island hospital.

    [From Mr. HIStalk] Gangrene is just a theory, according to the stories I saw. They’re doing an investigation, so something must be suspect and miscommunication was mentioned more than once. From one of the articles:

    ‘‘It is possible the girl was suffering from some form of gangrene in her lower limbs and that is why the operation was performed. ‘However, it could be that there was a miscommunication or mistake. This is what will be established.’

  20. Last I heard Tom Skelton was heading up the InteGreat division at MED3000 and was being groomed to take over as MED3000 president (leaving Pat Hampson as CEO.) I’d be shocked if was seriously considering leaving MED3000 for Sage.

  21. To doubter,

    Does that make you feel more comfortable about Med3000’s future? I can’t imagine that being a good hire for either company.







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