Thanks, appreciate these insights. I've been contemplating VA's Oracle / Cerner implementation and wondered if implementing the same systems across…
News 12/16/09
From Edison Carter: “Re: another one bites the dust. Arizona Medical Information Exchange shuts down.” AMIE runs out of Medicaid Transformation Grant money and will set its sights on grabbing some ARRA cash by reinventing itself as a statewide HIE.
From Bob in Accounting: “Re: contest. If you can’t make people buy it, then give it away?” Inga mentioned this on HIStalk Practice: CDW and Cerner pair up to give one lucky (?) physician practice a Cerner EMR. The fine print is interesting: entrants must sign over the rights to use their image and biographies, agree to hold the sponsors harmless for everything in the world, and sign a liability release. Only Cerner would create a multi-page legal agreement requiring a team of lawyers to interpret just to enter a contest giving away an EMR that few want anyway. What are the odds that the winner’s implementation will never happen or will be so unimpressive that you’ll never hear anything more about them? My two-word analogy: free kittens.
From Bridget: “Re: Vigilance iPhone app. Is it FDA approved? It looks like a patient monitor to me. I looked at Acuitec’s Web site and couldn’t find any info on the FDA certification. As a clinical engineer, if it has waveforms and physiological info on it, it better be accurate, and as for alarms, you can’t call it an alarm unless it ‘alarms’ within 10 seconds of detection of physiological condition contributing to alarm status. Thanks for the excellent Web site — I work in the CE/IT interface arena.” Above is shot of Vigilance running on a different device, which I’m including because I think it’s cool. I e-mailed Acuitec and received a nice reply from Lionel Tehini, president and CEO:
Those products of ours for anesthesia charting that require FDA approval have this. In the case of Vigilance, it does not require FDA approval, provided the systems it is aggregating data from and the information being represented in the application have FDA approval. So for example displaying of the wave forms — if we render those ourselves, then it requires the FDA approval (and has it). If those use the rendering services of the vitals sign vendor (Philips, GE, etc.) then it does not, since those are already FDA approved. Yes, I know a complicated answer for such a simple question. But when it comes to the FDA, nothing is simple. My advice is always err on the side of caution and submit the for approval and let them make the judgment call.
From The PACS Designer: “Re: Windows 7 screens. InformationWeek has given use some useful information about what Windows 7 screens look like for us new users. TPD will be testing a Dell Wi-Fi netbook with Windows 7 Home Premium and will post a user perspective of the pluses and minuses for HIStalkers in the near future.”
From Lester Bangs: “Re: ARRA certification. Companies like this one (and they aren’t alone) get checked off on SOME of the ARRA criteria (which are changing) and get labeled as Pre-ARRA Certified by CCHIT. Amazing. And we wonder how folks are confused.” I found CCHIT’s disclaimer more interesting (click the above screen shot to enlarge) since it clarifies that the certification is preliminary, possibly irrelevant depending on the standards that are eventually approved, and possibly worthless since CCHIT may not even be a recognized certification body by them.
From Toadie: “Re: interviews. Some of the interviews read like a press release, while others are interesting. How do you choose who to interview?” Readers suggest some of the interviewees, PR firms sometimes e-mail to say they read HIStalk and can connect us to a CEO, and sometimes I just read about someone interesting and e-mail them. I get turned down sometimes (most recently by Atul Gawande, who was at least polite about it). Each interview is done by either Inga or me and we do our best to ask the right questions and steer the conversation away from self-promotion. It’s worked well, I think, since nearly every interview has redeeming aspects that makes it worth reading. No matter how an interview turns out, I’m always thankful that a busy person will take time to be interviewed by some idiot blogger who warns upfront that (a) the conversation will be published as transcribed; (b) I will not provide my questions beforehand for prep; and (c) I don’t allow proofing or changes afterward. What you read, good or bad, is a real conversation.
Now’s the time to add your event for free to the HIStalk Calendar (Webinars, conferences, etc.) I noticed that five items were listed for today alone, so everybody must be wrapping up before the holidays. Other housekeeping items: if you aren’t getting the e-mail blast when a new HIStalk article is posted, you really should take a few seconds to put your e-mail address in the Subscribe to Updates box to your upper right (you don’t want your competitors and co-workers to scoop you, after all). And, the best secret weapon there is for looking smart isn’t just Google, it’s the Google HIStalk search box to your right. Even industry noobs can sound like battle-weary HIT veterans when talking on the phone by quickly searching for HIStalk mentions of companies, products, and people, then uttering their newfound pearl at just the right moment to an unsuspecting colleague who doesn’t need to know that you used a lifeline.
KLAS announces the best healthcare IT software vendors, with Epic pulling even further away from the pack (I don’t have access to KLAS, so I’m going by the press release). I did learn from the announcement that Epic renamed some of its products, with its pharmacy system now called Willow and RIS renamed Radiant. Several sponsors of HIStalk and HIStalk Practice made the list: eClinical Works, Greenway, McKesson, Eclipsys, Wellsoft (coming soon), Nuance, CareTech Solutions, and Hayes Management Consulting, so congratulations to them.
Listening: The Oohlahs, reader-recommended, female-led punky pop. Reminds me a little of of Throwing Muses. I like it. Mrs. HIStalk is listening to (and watching) So You Think You Can Dance in the living room, which is obvious because I leap a foot out of my chair each time judge Mary Murphy elicits one of her incessant blood-curdling screams for no apparent reason.
My Health Direct, which sells a Web-based referral management system for EDs to send non-emergent patients to other providers, raises $4 million in Series A funding.
Regional Medical Center (SC) says they are happy with their $15 million Cerner go-live, despite significant clinical delays. “Patients have been quite patient,” a board member said without apparent irony.
Abbott Laboratories will acquire Starlims Technologies, an Israel-based lab systems company, for $123 million. It sells systems to hospitals, HMOs, reference labs, and pharma labs. All Web-based, zero client, and high tech, running the presentation code in a .NET control in the browser. Abbott mentions wanting to get into healthcare informatics, so perhaps this has more than the obvious significance.
Barnes-Jewish Hospital (MO) goes live with SIS surgical scheduling, charging, and the SIS Trax tissue management system BJH co-developed with SIS.
I’m on the EHR Scope e-mail list, so I see they’ve made some improvements to their site, fine-tuned their EMR matching system, and are now offering weekly Dragon Medical Webinars. Article submissions for the January issue are being accepted through December 30. I still think their EHRtv is brilliant and darned professional (check out the set in the interview with Evan Steele of SRS above).
The Senate’s health bill will likely not ban the use of prescription data for marketing purposes.
Pfizer’s sales reps will be required to use company-issued tablet PCs when requesting drug samples for doctors, choosing the doctor on the screen to then display a list of appropriate products for sampling. Pfizer has a mighty big meaningful use incentive: the company paid a $2.3 billion fine for illegally marketing its drugs to doctors, so Uncle Sam wants to keep an electronic eye on them.
Is it just me, or does this article about a Serbian EMR vendor have a distinctly AYBABTU quality? “Antamediamedical.com created an amazing software, which helps doctors in different ways. All the software are unique and has amazing results. Medical software is one of the most efficient and workable software, which has sorted a large number of tensions and problems of those people, who are working in medical centers and hospitals. With its installation, the doctors and other medical staff have taken a sigh of relief, for most of other issues have been resolved by it.”
Free (in some configurations) EMR vendor SynaMed announces its free HIPAA-compliant patient-doctor messaging application (the screenshot’s spelling of “Tylonal” suggests that a spell checker might prove useful). The app does look kind of cool, sort of an Instant Messenger tied into the application’s modules.
Hawaii Pacific Health launches its MyHealthAdvantage patient portal. Gee, I wonder who their unnamed vendor is?
The VA posts the raw data behind its 2008 Hospital Report Card on Data.gov, downloadable as .CSV files.
HERtalk by Inga
From Professor Higgins: “Re: you must talk funny. I love that new iPhone Dragon app and have been astounded by its accuracy. The main limitation is that one needs a good, high speed connection for anything more than a sentence. But for a quick response while driving — perfect! Maybe your voice is just so charming it got distracted? Also, they explained on their app site that while they do collect names only from your contact list, it is to improve accuracy, so when I say ‘John Vinkelgardenhorse,’ they know what I mean!”
With the release of the KLAS end-of-year reports, it’s time to start the annual discourse on whether or not the KLAS ratings are fair / objective / rigged / irrelevant, etc. I’m sure plenty of vendors lean on their happiest customers, asking them to (favorably) complete the KLAS surveys. Some likely extend honoraria for their clients’ time. That extra tweaking of the process may help move a vendor’s rankings a place or two, but, I think it’s safe to assume that if a vendor was not serving its client base, it would not have enough happy clients willing to provide a favorable report.
MED3OOO appoints Hillary Harlan, an attorney and RN, as its chief compliance and ethics officer.
PatientKeeper closes a $13 million round of funding comprised of equity and debt. The company says it will use the money to accelerate development of physician documentation and CPOE applications and extend its support operations. As part of the financing, Chip Hazard of Flybridge Capital Partners is joining PatientKeeper’s board of directors. Back in August 2008, I mentioned that PatientKeeper secured $7.5 million in Series F funding, which increased its total VC dollars to $75 million. Those funds were designated for R&D and to grow the company’s infrastructure.
3M Health Information Systems releases 3M Mobile Dictation software, a new option for its 3M Mobile Documentation System. The product is available Blackberry and Windows Mobile platforms and allows physicians to review patient detail on their smartphones.
Amcom Software also announces its new smartphone application, Amcom Mobile Connect. The app allows clinicians and staff to use a Blackberry device for messages and critical codes.
Halfpenny Technologies is also jumping on the smartphone bandwagon, introducing its ITF-Mobile application, which allows physicians to securely access test results.
Healthcare Information Xchange of New York selects InterSystems HealthShare software as its core HIE platform.
The Healthcare Authority for Baptist Health (AL) purchases McKesson Practice Complete to handle physician billing and claims management for its employed physicians. Physicians will also use the McKesson-hosted Horizon Practice Plus PM system.
Sounds like Ohio is seeing an economic turnaround, at least for healthcare workers. Cleveland Clinic says it’s planning to add 1,800 new jobs in 2010, a year after posting a $62 million loss. New positions include jobs for both staff and physicians. Meanwhile, University Hospitals (OH) plans to add 550 workers and MetroHealth (OH) has 270 full and part-time openings.
A new study concludes that EHRs often fail to achieve expected gains in healthcare efficiency. They often improve auditing and billing efficiencies, but decrease clinical efficiency.
ONC accelerates its timetable for rolling out health IT regional extension centers (HITRECs), planning to announce 30 grants on January 21 and another 40 or so in March. Sounds like a good move, given the amount of work that needs to be done in short order.
athenahealth names Dr. William Winkenwerder to its board of directors. He’s chairman of The Winkenwerder Company, a healthcare consulting company, and a former Assistant Secretary of Defense for Health Affairs.
The New York Post obtains 2008 tax records for several of the city’s biggest non-profit health systems and finds that at least a dozen CEOs received $1 million or more in compensation. Dr. Herbert Pardes of New York-Presbyterian took home a $1.67 million salary plus a $1 million bonus.
Anne Arundel Medical Center (MD) goes live on its $35 million Epic system, to which it gave the obligatory cute nickname (Alec), but at least based it on something more cerebral than a strained acronym (it means “protector of mankind” in several cultures, they claim). They even make pegged their super users as Smart Alecs, making the whole naming thing worth it.
Last year I wrote a little holiday poem for HIStalk, which I must say was very clever. I plan to update my prose this week and ask Mr. H to publish it a bit earlier, before the masses turn off their e-mail for the holidays. Stay tuned.
too funny…no, it’s not just you.
)(
Is it just me, or does this article about a Serbian EMR vendor have a distinctly AYBABTU quality? “Antamediamedical.com created an amazing software, which helps doctors in different ways. All the software are unique and has amazing results. Medical software is one of the most efficient and workable software, which has sorted a large number of tensions and problems of those people, who are working in medical centers and hospitals. With its installation, the doctors and other medical staff have taken a sigh of relief, for most of other issues have been resolved by it.”
)(
I’m disgusted by the pay earned by the New York Presby CEO… $2.67M for a poorly-run health system? Wall Street Fat Cats are clearly not the only overpaid New Yorkers. I visit a lot of health systems around the Country and the New York hospitals, including NY Presby, are all among the worst. HCA, please come to NYC.
Inga,
Please check: I recall Winkenwerder served in the last Bush administration and was the physician who OK’d the torture of prisoners at either Guantanamo or in Iraq prisons. And isn’t Athena health run by a member of the Bush dynasty? I differ with AthenaHealth’s press release stating” “Dr. Winkenwerder is one of the most influential and prominent leaders in American health care. ” He is neither influential nor prominent in my circles.
Thank you for listening.
re: Dragon’s iPhone app accessing your contacts
Tonight’s update to the app allows users to decline to upload their contacts, and to delete contacts that were uploaded by the original version. Kudos for Nuance’s quick response to very legitimate concerns
From Bob in Accounting: CDW and Cerner pair up to give one lucky (?) physician practice a Cerner EMR.
Couldn’t agree more. Allscripts is doing the same thing with their “free license exchange” for Misys EMR clients. By the time you add up all the implemenation, conversion, 3rd party licensing, etc. costs … “free” is not so free anymore. Often, free is the most expensive option!
The study published in the Milbank Quarterly confirms other scholarly reports about HIT not having the benefits that were advertised by the vendors and Daschle (as reported in the Huffington Post yesterday)
You depreciated its significance by burying it in a paragraph towards the end of your news. Those who are forced to use these systems should make this a must read report. The authors confirm that there is reason to be worried about your patients cared for with these systems. Your recourse is to report your concerns to the FDA and complain ferociously about the poor products.
[From Mr. HIStalk] You surely have noticed in your repetitive “report EMR vendors to the FDA” comments under multiple names that stories are not sorted by significance. And if they were, this one wouldn’t move up far … its a meta analysis, meaning a review of already-published articles (very few of them, some old) about EMR implementations. Most hospitals don’t publish such articles. And if the conclusion is that “EMRs never work”, then it would take only one positive article to refute that. I see a lot of stories in the newspaper about car accidents, but that doesn’t mean I blame Ford or the government … it’s generally the drivers that are the problem (and bad drivers, like bad EMR prospects, rarely identify themselves as such).
Nothing listed as far as submissions / approvals for Acuitec in the FDA 510(k) database:
http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm
Best in KLAS changes from last year:
Ambulatory EMR (26-100 Physicians)
2008: Allscripts Enterprise EHR
2009: eClinicalWorks EMR
Practice Management (26-100 Physicians)
2008: athenahealth
2009: McKesson Horizon Practice Plus
http://www.healthtechnica.com/blogsphere/2008/12/16/2008-best-in-klas/
RE SynaMed: Will vendors ever stop trying to sell me a HIPAA-compliant application? Show me in the Privacy or Security rules where an application is compliant. Only covered entities (and now business associates) can be compliant.
Re Winkenwerder and torture: Since I’m on a “show me” kick today. Show me the proof Winkenwerder approved torture. Look here: http://www.abc.net.au/news/newsitems/200502/s1300023.htm. Yes the accusations are out there that physicians participated in torture, but there was no conclusive evidence and Winkenwerder wasn’t implicated as giving the OK to torture prisoners. Please don’t make HISTalk a forum for bashing the admistration of either current or former presidential administrations.
Tell your wife to check out http://www.puresytycd.com for an added So You Think You Can Dance fix. Plus, since the season’s over it will start covering Australia so she can have year round So You Think You Can Dance fun. Plus, there’s no Mary Murphy in Australia.
And yes, don’t ask me how I became an EMR and So You Think You Can Dance blogger.