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News 12/23/09

December 22, 2009 News 11 Comments

bb

From BlackBerry Bramble: “Re: BlackBerry. Tonight, for hours, a widespread BlackBerry service outage has occurred and spread to Messenger. Does anyone depend on it for patient care and can I sign up for a backup system?” Sounds like a Messenger upgrade cause the problem like it did last week.

From HC Biker: “Re: Cerner’s IMC acquisition. I know IMC pretty well. They recently decided to use eClinical Works for the primary care side of their business and had some custom software written to link eCW with the occupational medicine software that they were using. Not sure what Cerner plans on doing with this business, but they had a couple of failed bids to provide employer-based primary care and perhaps this is their way to finally get some success in the business. On the surface, it does not appear to be a good fit.”

From RaleighObserver: “Re: my 2010 prediction. Dell acquires Allscripts for their footprint. Tullman pockets a ton of money before Dell realizes the house of cards that it inherited and he runs for public office.”

liveedu

From The PACS Designer: “Re: Microsoft live@edu. Microsoft is trying to attract new students to its e-mail application called live@edu. So, if you are a student reading HIStalk, let your school administration know about their service. One of the key features is each user is granted 25GB of storage space for their e-mail address, plus they also have some other nice features at low cost to the institution.” It doesn’t work with Chrome, I see.

From Weird News Andy: “Re: no longer a member of the 3-H club.” Harlem Hospital gives a 54-year-old woman an advertised $15 mammogram, throwing in a blood test for free. She claims the hospital told her the blood test revealed that she had terminal HIV, hepatitis, and herpes. She suffers for weeks, then gets a call from the hospital saying it was a mistake and she’s fine after all. No apology, though. She thanked God for her new lease on life, then got herself a malpractice lawyer because “we don’t want anyone else to go through what we’ve been through.” People always say that when suing, but they always just keep the money.

From Marvin Gartner: “Re: Why nothing on the AM J Med article by Himmelstein et al entitled ‘Hospital Computing and the Costs and Quality of Care: A National Study?’ No savings – limited outcomes improvement in only one of four measures. This article needs to be discussed.” OK, allow me to rant: I get e-mails fairly often from someone who indignantly claims I missed or intentionally ignored some big story, when in fact it was prominently featured and mentioned more than once. I pretty much never miss a story, but casual readers much less rarely skim blissfully right by them. I mentioned that article twice in November, one writeup coming in uncharacteristically long at four paragraphs, 555 words, and even a picture of one of the authors (that was exactly one month ago today). So, it has been discussed amply right here, with my conclusion being that the article is not surprising, but not definitive, either. I bought a guitar once, but I’m not blaming the manufacturer for my inability to play the guitar parts of Rush’s The Trees since I’m pretty sure Alex Lifeson could pick up my old six-string and knock it out flawlessly, so mileage most definitely varies with both guitars and EMRs, mostly because of who’s playing. This article matched up a few databases and then blamed the guitar, written by folks who have a definite political agenda and who profess that “idiot hospital administrators” buy EMRs “to extract more money” and “jack up the charges.” I don’t disagree with the concept that providers haven’t historically shown impressive IT results (I preach that myself all the time), but I question the takeaway that nobody should be implementing software systems because they universally don’t work. The problem isn’t that 80% of providers are too weak in change management and reproducible processes to implement software successfully — it’s that they think they are in the 20%.

From Big Wayne: “Re: Flower. You might want to take a look at a sorta grassroots movement to get patients informed about interoperability issues and asking their providers to ‘talk’ to each other.” Flower is some kind of interoperability manifesto. I have a short attention span, so I couldn’t really figure out if it’s a movement, a technology, or a business.

I made a couple of tweaks to speed up page loads: I cut the number of front-page stories from five to three (click the Archives link at the top of the page to see the last 200) and I took pictures out of the View/Print Text Only page. In case you were wondering.

 clearview

API Healthcare acquires Clearview Staffing Software of Addison. TX, a vendor of SaaS scheduling systems for healthcare temps. API is offering a January 20 Webinar to explain how its system can help hospitals manage their agency staff.

IBM Global Financing makes a pitch for the credit business of providers who buy EMR systems from companies like Siemens, HMS, and SCC Soft Computer (and bunches of others). It’s like a payday loan until the iffy ARRA windfall comes through, and I’m betting that quite a few of those customers (especially those on the physician practice side) will be grudgingly sending in checks years after their clunker is up on wheels in the front yard. Next you’ll be seeing reps from the other companies with the hoods up on their PCs, offering “Buy Here, Pay Here” weekly payments at larcenous interest rates. Free financing advice: if you are assured of making money from ARRA (do your math carefully), then borrow the money to make sure you are implemented in time. If not, pass — Americans go broke regularly by financing items that have negative ROI (cars, TVs, and vacations) instead of paying cash and treating them as an unbudgeted splurge. 

Craneware shares pop a little in Europe after the company signs a deal with Intermountain for its charge master product.

The Singapore government is soliciting bids for an interoperable EMR system for general practice doctors, with the proposal due by January 23 after being delayed for a few weeks.

In the least-shocking New York Times news of the day, John Halamka has been a nerd since birth. The article pitches the idea that we don’t have enough nerds to innovate in computing, which isn’t surprising either since students and their parents seem amused that little Johnny doesn’t get math and instead sets unrealistic sights on being a rock star or supermodel like those obnoxious Disney Channel children, thus ensuring ongoing technical domination by those from India, China, Vietnam, and elsewhere where parents don’t pander to their children.

emram

Children’s Pittsburgh meets (warning: PDF) EMRAM Stage 7 from HIMSS Analytics. There are a bunch of others, but all are owned by Kaiser or NorthShore. The HIMSS Analytics criteria are above. If he Harvard people need a new study, it would be fun to compare their outcomes, both pre- and post-implementation as well as overall mortality rates, especially since Children’s famously saw theirs skyrocket after their badly managed original Cerner implementation (but the study they did wasn’t much better designed than the implementation – my 2005 comments are here).

medhub

MedHub, a five-employee University of Michigan spinoff that sells residency management software, says it has bagged some big hospital clients and will expand if it can find qualified people. Maybe the problem, according to their jobs page, is that they want people who are proficient in PHP and mySQL who have “good personal and phone skills.” That rules out most of the people I know.

This sounds like pork to me: two small Pennsylvania hospitals get a $1.6 million Defense Department grant to help them in their fight against bioterrorism. What that means: they get federal taxpayer cash to buy software written by a local doctor. I tried to figure out what the software does from the company’s Web site, but it never actually says, other than throwing out terms like “process arbitrage” and “process adaptation.” It doesn’t sound like anything related to bioterrorism, but I wasn’t all that motivated to figure it out. Unfortunately, federal handouts need a lot more zeroes to be worth serious scrutiny these days.

GE Healthcare, unhappy about negative statements a Danish radiologist made about its Omniscan drug in a professional presentation two years ago, unleashes the lawyers on him, suing him for libel. GE says he accused them of suppressing information.

IBM and the government of Taiwan sign a research agreement to “pioneer smarter solutions, technologies and services that would be validated in Taiwan and then exported to the rest of the world by IBM and Taiwan companies.” On the list: mobile devices, analytics, and cloud computing.

This probably has application in healthcare: Raytheon develops an iPhone app that shows a real-time map of friendlies on the battlefield, allowing coordinated movements and reduced chance of friendly fire. The company admits it would probably work better on Palm and Google smartphones, which can run concurrent applications (the iPhone can’t, apparently).

Stan Opstad, formerly product management director at Ingenix, is named SVP of product management and development of Healthland.

Sad: the big-ego leaders of two competing, big-money, celebrity-touting cleft palate repair charities run competing ads against each other, try to buy each other out, and accuse each other of poor outcomes.

Newsweek predicts that Microsoft will fire Steve Ballmer in 2010 after the company’s string of financial and product woes.

Mike Thomsett, founder of practice EMR vendor Thera Manager of Murray Hill, NJ, says he was robbed of a Canadian Nobel Prize for his imaging work at Bell Labs. He designed and patented CCD cameras, but the Nobel for imaging devices went to a former Bell Lab colleague who was looking at a similar technology but for entirely different purposes, he says, blaming the awards committee for faulty research.

Odd lawsuit: a woman visiting a corn maze claims to have a severe allergic reaction that her attorney says was caused by “some kind of pesticide or herbicide” used by the family orchard. She’s suing for $2 million.

Have yourself a merry little Christmas. I’ll probably not post until the Monday morning update since news will be sparse, but let’s get together then.

E-mail me.

‘Twas the Night Before Christmas
By Inga

santa

‘Twas the night before Christmas, when all through IT
Not a creature was stirring – not a single PC.
The charges were updated by users with care,
In hopes that more money would make its way there.

The doctors were finished, all smug in their heads,
While nurses were checking on every last bed.
And the CIO in his office, and I in my cube
He cleaned out his email while I watched YouTube.

When out from Windows 7 there ‘rose an odd clatter,
I switched off The Who to check on the matter.
Then away across the ‘Net I flew – launching Flash,
I opened up HIStalk, hoping nothing would crash.

My tunes on Pandora were silenced at once
Yet my laptop moved slowly – it seemed to take months.
When, what to my wondering eyes should appear
But a miniature Mr. H and Inga, that dear.

As my GeForce driver became lively and quick
I knew in a moment it must not be a trick.
More rapid than eagles, his rumors quickly came,
And he whistled, and grumbled, and called them by name.

“Now Neal! Now Glenn! Now Girish and JB!
Now Philip! Now Judy! Now Pappalardo and Sunny!
To the top of web page! To the top of the crawl!
I know all your secrets! Yes I do know them all!”

With news and some gossip, the wild rumors fly
The leaders read closely, hoping they will not win pie.
Daily to HIStalk – those the top dogs do click
To read Mr. H and his Inga, with all of their shtick.

And then, in a twinkling, I heard a new sound
My disk drive was churning and chugging around!
As I drew down my head to refresh the screen
Out popped Mr. H – an amazing sight to be seen!

He was dressed in polyester, from his head to his foot,
He had quite the old-fashioned programmer look.
A bundle of gadgets he had flung on his back,
As well as a Blackberry, still new from its pack.

His eyes – how they twinkled! His dimples how merry!
He looked ready to scribe a new fun commentary!
His droll little humor was clear from the start
This was the man who made blogging an art!

The stump of a pipe he held tight in his teeth
And a light was encircled on his head like a wreath.
He had a kind face and pooch at his belly
So this the man who turned vendors to jelly?

He was quiet and quick – the picture of stealth
As he checked out the tech things in our office of health.
A wink of his eye and a twist of his head
He noted our software and computers by beds.

He spoke not a thing as he took a keyboard,
I recalled how his words were stronger than swords.
Then touching his finger upon the word “send”
Today’s posting had clearly come to an end.

He sprang to my laptop and gave a short whistle
Then into cyberspace he left – as fast as a missile.
But I heard him exclaim as he slipped out of sight
“Happy Christmas to all, and to all a good-night!”

E-mail Inga.

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Currently there are "11 comments" on this Article:

  1. Children’s Pittsburgh meets (warning: PDF) EMRAM Stage 7 from HIMSS Analytics. There are a bunch of others, but all are owned by Kaiser or NorthShore. The HIMSS Analytics criteria are above.

    don’t mean to be parochial or thin skinned about this but why the “but” in the your statement above?

    [From Mr. HIStalk] To distinguish unaffiliated, un-corporately funded and un-centrally IT managed Stage 7 hospitals (of which there are none) from two big multi-hospital organizations (which owned all the Stage 7 hospitals until Children’s came along). Children’s will get the same “but” if other UPMC facilities get added to the list. It would be misleading in my opinion to observe that 27 hospitals have made Stage 7 without also noting that they represent only two organizations and two sets of applications.

  2. re:AJM article- bravo for your response, especially the Rush reference! When you think about what a consulting company would charge for “insights” comparable to what we get for free 3 times a week, it takes a lot of chutzpah to complain. Thanks to both of you for the great work, and take some time off already!

  3. “The problem isn’t that 80% of providers are too weak in change management and reproducible processes to implement software successfully — it’s that they think they are in the 20%”

    This comment deserves to be in some sort of HISTalk hall of fame.

    As far as the study goes, it may come as a surprise for some people resisting change, that after a go live a large administration cost is to do with scanning in old paper documents. It may also come as a surprise that immediately after go live auditing costs go up. They then start to come down over time. The academic literature is clear, after I.T is implemented there is a lag in time between the cost and the benefits. There are multiple papers that show this that have stood the test of time in the peer review process.

    Let the peer review process take its place. Check the citations in 9 months, the papers methodology will be trashed.

    People who jump on studies that fit their world view almost always have an agenda.

  4. Merry Christmas! Thanks for another great year.

    On a side note my PHP, MYSQL,LINUX programming co-worker just laughed when I informed him he’d need people skills to work for that startup. Still in this economy I’m sure your post will help somebody connect with the company.

  5. Why bother with a Lorem Ipsum generator? I’m just going to cut and paste text from that Process Proxy site! How can you get better than this:

    “Measuring and managing the usage, identifying the best value with greater precision, and guiding the resources of healthcare toward maximum impact are all part of the fundamental purpose of ProcessProxy’s unique Healthcare SmartGrid™ overlay for all of healthcare’s stakeholders, ranging from providers to payers to the U.S. Federal Government as well as governments worldwide.”

    Or:

    “Pioneers of the only global Healthcare SmartGrid™ subscription service created by trusted global health quality advisors, physician executives, and machine learning engineers.

    * Benefits clinicians, researchers, payers, and governments.
    * Identifies with greater precision the best value in healthcare.
    * Guides the resources of healthcare toward maximum impact.
    * Overlays on any existing systems of healthcare’s stakeholders.

    What?!

    I love it when people trademark little phrases throughout their materials. Lord knows “Healthcare Smartgrid” was in danger of being used by someone.

  6. I’m interested in the CCD requirement for stage 7. Do any of the apps that UPMC and Kaiser have really send them natively yet at this point, ie, Cerner and Epic? Or did those organizations jury rig something to create one? And are they really sending them to anyone at all? Or even within their own organizations? Really?

  7. “Raytheon develops an iPhone app that shows a real-time map of friendlies on the battlefield, allowing coordinated movements and reduced chance of friendly fire.”

    I can only hope it’s all encryted, otherwise…!

  8. Has the death rate at Pittsburgh’s Children’s decreased since the Han study?

    The hospital recently received a warning from the Pa DOH for unsigned electronic charts and orders generated by the computer and not the doctors

  9. re Winston’s CCD questions- not sure all of what he is asking but Kaiser did just electronically share useful patient information with the VA’s system for patients who are servred by both institutions…is that what he means?

  10. ONC has now defined the taxonomy of health IT leadership. Seems they’ve heard my message about the importance of cross-disciplinary formal education:

    http://healthit.hhs.gov/portal/server.pt?open=512&objID=1428&mode=2

    1. Targeted Information Technology Professionals in Healthcare Roles

    The six types of roles targeted by this FOA are:

    (i) Clinician/Public Health Leader: By combining formal clinical or public health training with training in health IT, individuals in this role will be able to lead the successful deployment and use of health IT to achieve transformational improvement in the quality, safety, outcomes, and thus in the value, of health services in the United States. In the health care provider settings, this role may be currently expressed through job titles such as Chief Medical Information Officer (CMIO), Chief Nursing Informatics Officer (CNIO). In public health agencies, this role may be currently expressed through job titles such as Chief Information or Chief Informatics Officer. Training appropriate to this role will require at least one year of study leading to a university-issued certificate or master’s degree in health informatics or health IT, as a complement to the individual’s prior clinical or public health academic training. For this role, the entering trainees may be physicians or other clinical professionals (e.g. advanced-practice nurses, physician assistants) or hold a master’s or doctoral degree(s) in public health or related health field. Individuals could also enter this training while enrolled in programs leading directly to degrees qualifying them to practice as physicians or other clinical professionals, or to master’s or doctoral degrees in public health or related fields (such as epidemiology). Thus, individuals could be supported for training if they already hold or if they are currently enrolled in courses of study leading to physician, other clinical professional, or public-health professional degrees.

    (ii) Health Information Management and Exchange Specialist: Individuals in these roles support the collection, management, retrieval, exchange, and/or analysis of information in electronic form, in health care and public health organizations. We anticipate that graduates of this training would typically not enter directly into leadership or management roles. We would expect that training appropriate to this role would require specialization within baccalaureate-level studies or a certificate of advanced studies or post-baccalaureate-level training in Health Information Management, health informatics, or related fields, leading to a university-issued certificate or master’s degree.

    (iii) Health Information Privacy and Security Specialist: Maintaining trust by ensuring the privacy and security of health information is an essential component of any successful health IT deployment. Individuals in this role would be qualified to serve as institutional/organizational information privacy or security officers. We anticipate that training appropriate to this role would require specialization within baccalaureate-level studies or a certificate of advanced studies or post-baccalaureate-level training in health information management, health informatics, or related fields, leading to a university-issued certificate or master’s degree.

    (iv) Research and Development Scientist: These individuals will support efforts to create innovative models and solutions that advance the capabilities of health IT, and conduct studies on the effectiveness of health IT and its effect on health care quality. Individuals trained for these positions would also be expected to take positions as teachers in institutions of higher education including community colleges, building health IT training capacity across the nation. We anticipate that training appropriate to this role will require a doctoral degree in informatics or related fields for individuals not holding an advanced degree in one of the health professions, or a master’s degree for physicians or other individuals holding a doctoral degree in any health professions for which a doctoral degree is the minimum degree required to enter professional practice.

    (v) Programmers and Software Engineer: We anticipate that these individuals will be the architects and developers of advanced health IT solutions. These individuals will be cross-trained in IT and health domains, thereby possessing a high level of familiarity with health domains to complement their technical skills in computer and information science. As such, the solutions they develop would be expected to reflect a sophisticated understanding of the problems being addressed and the special problems created by the culture, organizational context, and workflow of health care. We would expect that training appropriate to this role would generally require specialization within baccalaureate-level studies or a certificate of advanced studies or post-baccalaureate-level training in health informatics or related field, but a university-issued certificate of advanced training in a health-related topic area would as also seem appropriate for individuals with IT backgrounds.

    (vi) Health IT Sub-specialist: The ultimate success of health IT will require, as part of the workforce, a relatively small number of individuals whose training combines health care or public health generalist knowledge, knowledge of IT, and deep knowledge drawn from disciplines that inform health IT policy or technology. Such disciplines include ethics, economics, business, policy and planning, cognitive psychology, and industrial/systems engineering. The deep understanding of an external discipline, as it applies to health IT, will enable these individuals to complement the work of the research and development scientists described above. These individuals would be expected to find employment in research and development settings, and could serve important roles as teachers. We would expect that training appropriate to this type of role would require successful completion of at least a master’s degree in an appropriate discipline other than health informatics, but with a course of study that closely aligns with health IT. We would further expect that such individuals’ original research (e.g. master’s thesis) work would be on a topic directly related to health IT.







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