From Healthcare Idiot Savant: “Re: Allscripts. They are supposedly near to announcing their acquisition of the Centricity software, the old IDX suite, from GE. Timing?” I’ll guess June 1.

From Lady of Spain: “Re: editorial. Tell me what you think about this editorial. Incredibly uninformed, right?” Too many wordsmiths claim to be HIT pundits just because they’ve churned out a few articles or interviewed people from the sidelines instead of actually working in healthcare or IT. All in all, this one isn’t the worst I’ve seen, though, just not very insightful.

 
I’m running an old (legal) copy of Office XP at home since I don’t use it much, but I figured it was time to upgrade. I’ve been running the Office 2010 beta and I like it just fine, so I’ve been watching for deals on the licensed version, due out this summer. Here’s one that I just bought this morning: Amazon has Office Home and Student 2007 for $99.99, free shipping, and a free upgrade to Office 2010 when it comes out. Plus, that package includes three licenses that can be used by members of the same immediate family, so you’re down to as little as $33 per user. If you don’t need Access or Outlook, this is a great way to get the 2010 versions of Word, Excel, PowerPoint, and the underappreciated OneNote cheap. It’s a strong clue as to why Microsoft is struggling — remember when Office cost something like $400?

Speaking of Microsoft, who can resist watching an overweight, red-faced Steve Ballmer nearly stroking out on stage as he hysterically professes his undying love for everything Microsoft? I feel cheated that he didn’t freak out equally at HIMSS a couple of years ago.

According to my last poll, around 58% of HIStalk readers think a single-vendor strategy is a good idea for hospitals, primarily because integration and support are theoretically better. Those who like a best-of-breed strategy instead most often cite weaknesses in individual applications as a good reason not to give one vendor all the business. New poll to your right: if you were diagnosed with a psychiatric illness and your doctor or hospital shared your electronic information with other providers, would you be comfortable that it would remain private or would you worry about that?

Dell spent $760K lobbying the federal government in Q1, with an unnamed but apparently significant part of that amount going toward influencing decisions about HITECH money. Microsoft spent $1.72 million during the same period, also hitting HITECH.  

Flush with taxpayer cash, ONCHIT is hiring.

A retired Cincinnati cardiologist will get $23.5 million for his role as whistleblower in a DOJ lawsuit against the Health Alliance of Greater Cincinnati and Christ Hospital, accused of preferentially scheduling cardiologists based on the number of referrals they generated.

Doctors at a Minnesota hospital are beta testing technology from American Well that allows them to communicate with patients via videoconferencing, IM, and VoIP. I think I’d love that, either as a patient or a doctor. The problem has always been that few people using desktop PCs had webcams or microphones, but now that most PC sales involve laptops, those are usually standard. That’s a significant yet seldom observed development when it comes to online collaboration.

I ran a reader’s question about whether Jefferson Regional Medical Center of Pine Bluff, AR could really have upgraded Eclipsys Sunrise to 5.5 in 30 days. JRMC CIO Patrick Neece was nice to provide this summary:

JRMC and Eclipsys finalized the implementation plans at the end of March 2010. The upgrade steps began the first of April 2010 and took approximately 30 days. The implementation encompassed all of the Sunrise Clinical Manager components we have implemented in the hospital including house-wide clinical documentation and core functionality for med/surg and sub-acute areas, critical care, 12 ambulatory clinics, emergency department, labor and delivery, Sunrise Pharmacy, Knowledge-Based Medication Administration, Device Integration and other related components. It also included installation of additional hardware, Microsoft software upgrades, configuration changes, report changes, testing, and training for the technical staff and end users. As with any upgrade, there were problems that had to be worked through, but we were highly confident in the JRMC and Eclipsys team who preformed the upgrade and that we would have a successful implementation.

Former HIMSS Analytics CEO Dave Garets, now with The Advisory Board Company, joins the board of Health Care Data Works, a Ohio State spinoff led by former OSUMC CIO Herb Smaltz that sells a data warehouse solution. The company offers a pre-built Meaningful Use dashboard (above). 

A Hawaii clinic’s inconsistent and time-consuming EMR data reporting process is improved after a local technology company’s change. The article doesn’t name the EMR vendor or describe the change that was made, but it says one report that took 55 hours to run now takes less than a minute. It sounds to me like they added database indexes.

Listening: brand new (actually not even released yet) Stone Temple Pilots. Billboard has the entire album up for free streaming. Sounds pretty good. Also, The Rural Alberta Advantage, Canadian indie-electrofolk.

Some Indiana hospitals divulge what their electronic medical records projects will cost: Community Health of Munster, $40 million for three hospitals and doctors. Porter Health System, $11 million for upgrades. Methodist Hospitals, $30 million for Epic. Sisters of St. Francis Health Services, $125 million.

The University of Florida Health Science Center and Shands HealthCare announce a $580 million, five-year collaboration that includes implementing Epic across the system.

Now that I’ve got a Facebook page, I see that I should wish my new FB friend John Halamka a happy birthday this Sunday, with John Glaser’s coming up on June 2. Thanks to all who have friended me and who have clicked “like” on the HIStalk widget to your right. Social networking is exactly like high school, including the competitive aspects, so public displays of even virtual-only camaraderie are important to one’s standing.

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From Skinny Little B: “Re: Advance for Health Information Executives. It’s officially dead, even though the staff were told not to tell readers or advertisers that the May issue was the last one.” Former editor Bob Mitchell is a good guy; his last day there was a couple of weeks ago. Maybe not admitting defeat is like hanging a “remodeling” sign on an obviously closed restaurant — a Hail Mary that somebody will buy it before word gets around that it’s defunct (like among the advertisers). They may try to salvage the non-print parts of the business like they did for the HIM magazine. I can only imagine what a disaster it would have been if I’d been running it, considering that I use a $5 invoicing program, I refuse to do anything to encourage prospective sponsors except e-mail a crude information sheet if they ask, and I keep turning down all kinds of brilliant money-making ideas because I don’t really care about money all that much and I’m lazy. So I give them credit for hanging in there for what must be at least a dozen years. I used to read it and like it.

From Hans Solo: “Re: Colorado RHIO. A big win for Medicity, beating out incumbent Axolotl.” Colorado RHIO chooses Medicity’s platform for its statewide HIE. The organization plans to cover 85% of the state’s providers and hospitals within five years.

From Nancy: “Re: Jefferson Regional Medical Center. The press release on Eclipsys 5.5 says they did the upgrade in 30 days. Is that really possible?” The headline also claims that unnamed users declared it “blazing fast and fun to use,” but doesn’t provide details anywhere in the actual writeup. Maybe a reader from JRMC will chime in with details.

From Limber Lob: “Re: MUMPS and Cache’. MUMPS takes hits because it’s still around after 30 years and many of the ancient MUMPSters are coding the way they did 30 years ago. Old COBOL, RPG, and Pascal programmers have all passed on instead.” I like that analysis and will extend it: companies like Epic and Meditech hire trainloads of noobs and train them on a language they’ve surely never heard of even if they majored in computer science. Since it’s more of an apprenticeship, they can also train them to follow their own internal programming standards and utilities, which are arguably more important than the choice of programming language anyway. It may be true that only in healthcare would a robust market still exist for applications written in something that quirky and old (or “industry-specific” and “time-tested” if you’re a glass-half-full type). Bottom line: it works, the vendors can support it, and customers shouldn’t (and apparently don’t) care about the invisible underpinnings.

From Epic Cleans Up: “Re: Atlanta. Epic will own the Atlanta market, having won the business at CHOA, Grady, and Emory (soon to be announced). It’s not surprising given the superior software, services, and support of Judy and her team. However, it should be a wake-up call to local companies that failed, including Eclipsys, McKesson, and Philips.” Unverified, but I will say that being local isn’t really much of an advantage. And, that those companies you mentioned are surely wide awake and well aware of exactly what they’re up against. I’ve been a customer of all three of those local outfits (well, Philips is from the Netherlands, but I’ll allow it). One of them was excellent, one was very good, and one I wouldn’t wish on my worst enemy.

Jobs from the sponsor job board, where sponsors post free just because we are really nice: Implementation Consultant, Cerner Ambulatory Consultant, Regional Solutions Consultant, Healthcare Market Research Manager. On Healthcare IT Jobs: EMR Project Manager, Ambulatory Technology Trainer, Cerner Orders Consultant, Clinical Director of Field Marketing.

The health minister of Saudi Arabia is visiting Children’s Hospital of Michigan to check out its Cerner electronic medical records system. I’m not sure why since they’re already running Cerner in Saudi Arabia, but maybe they need fresh ideas.

Dell’s Q1 numbers: revenue up 21%, EPS $0.22 vs. $0.15. The former Perot was a bright spot, while PC margins weren’t.

I decided I needed a Facebook page so I won’t have to keep using Inga’s login to add to the HIStalk page (man, that’s confusing). Anyway, if you want to friend me, just search for HIStalk and I’ll pop up in all my smoking doc glory. I’m helping that obnoxious kid who started Facebook add to his several billion dollars so he doesn’t have to lifeguard this summer.

Weird News Andy and I agree: this story is sad. An admittedly inebriated woman in England falls in a bathroom, embedding a six-inch toilet brush handle in her pelvis. She tells doctors what happened, she shows them the bleeding wound, they take an x-ray, and they still can’t find the problem, so they send her home on pain meds. After two years of constant pain, she finally convinces them, but dies of massive blood loss in a 10-hour surgery to remove it, the hospital’s third attempt. Her husband summarizes, “I think it was probably down to the hospitals trying to save money and doing things as cheaply as possible … I’m sure she would have got better treatment in foreign countries.”

Miss Russia 1998, who was a physician back in the Motherland, is charged in New York with forging a Vicodin prescription using a prescription pad stolen from her psychiatrist’s office. She was already on trial for a nearly identical case. I will make a flimsy argument about illustrating the benefits of e-prescribing in order to justify running her picture.

Listening: reader-recommended Jonathan Tyler and the Northern Lights, bluesy straight-ahead rock. From the look and sound, I thought I’d traveled back in time to see Grand Funk Railroad, which isn’t necessarily a bad thing.

Inga and I appreciate our new HIStalk Platinum Sponsor, Navicure of Duluth, GA. They’re a medical claims clearinghouse, meaning they help their 20,000 physician customers get paid (eligibility, claims, remittance, recovery, productivity). The company is on several “fastest growing” lists and – get this – they GUARANTEE that every call is picked up in three rings or fewer, which as they say, is because their client services area is “purposefully overstaffed.” They also have a 90%-plus “would recommend” rating from clients (video testimonials are here). Check out their blog, The Daily Practice. You may also remember that CEO Jim Denny wrote a Readers Write piece in October the value of clearinghouses. Thanks much to the folks at Navicure for supporting HIStalk.

Nurses in Australia picket a local hospital over incorrect pay caused by a new payroll system, a problem still unresolved after five pay cycles.

The CEO of Bend Medical Clinic (OR) writes a good blog post that explains to patients what an electronic medical record is and why they use them.

A group of Florida hospitals is using a BCBS grant to track employee reports related to infections and and surgical outcomes, rather than the usual billing data. They hope to convince CMS that billing data is worthless in trying to monitor clinical results.

Greenway’s PrimeSuite EHR is now available for the iPhone and iPad.

Baptist Health cranks up Philips VISICU eICU in its five San Antonio hospitals, where a critical care team monitors their 134 ICU beds from an office building.

Yet another sobering malpractice verdict: a six months pregnant woman is turned away by the local trauma center, whose NICU doc says his facility can’t handle a preemie that small. They call an ambulance to take her to another hospital an hour away. She delivers in the ambulance, but the baby suffers brain damage and cerebral palsy. The malpractice jury returns a $10 million verdict against the county’s non-profit ambulance service. The hospitals had already settled for $1.4 million.

North Adams Regional Hospital (MA) fights with its nursing union, with ergonomics being a key union bargaining issue. Said a union rep, “We’ve had two instances where a computer station on wheels has fallen on a nurse.”

E-mail me.

HERtalk by Inga

maxIT Healthcare and Ingenuity Solutions Group enter into an agreement to combine as maxIT Healthcare. The merger expands maxIT’s expertise with Lawson ERP solutions. Ingenuity President and CEO Phil Summer will now be maxIT’s National Practice Director.

PatientKeeper announces the availability of Mobile Clinical Results on the iPad.

Hoag Memorial Hospital Presbyterian selects Patient Care Technology Systems’ Amelior EDTracker solution for its new emergency department opening in Irving, CA later this year.

DigitalPersona, the provider of U.are.U fingerprint biometrics, will integrate its product into ScriptRX’s products. ScriptRX provides touchscreen EMR and discharge systems for ERs and urgent care centers.

For all our readers who are 7th grade boys (or 7th grade boys at heart), here’s an opportunity to come up with all sorts of tasteless jokes. HP Labs calculates that a hypothetical farm of 10,000 dairy cows could produce enough energy to power 1,000 servers.

Greenville Hospital Systems (SC) selects MedAssets for revenue cycle software and services.

RCM provider Accretive Health offers 10 million shares in an IPO that raised $120 million. The $12 per share price was well below the proposed $14 to $16/share.

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From Epic Watcher: “Re: USF. Heard that GE did not go well, Epic has been chosen, and the docs are signed. Just what I heard and I am looking to triangulate. Kinda what you do sometimes, Mr. H, if that IS your real name!” Unverified on both counts, but I’ll always answer to Mr. H since Inga started calling me that way back when and I’ve warmed up to it.

From MaxPayneUK: “Re: value probe. Is iSoft/CSC the prime target after missing ‘must meet’ delivery targets? Or BT/Cerner CCN3 because of value?” The British government will review all spending commitments made since January 1, with IT contracts a key focus of cost-saving initiatives.

From The PACS Designer: “Re: Office Live Workspace. Since Windows Office 2010 is now released for businesses, the next step is the release next month for consumers. TPD has been testing Office Live Workspace for use with Windows Office 2010 to compare it to Google Documents. Also, Microsoft just announced that Office Live Workspace is becoming Windows Live SkyDrive soon.” Sounds a lot like Google Docs except you need a licensed copy of Office on your desktop (Microsoft will imitate Google in nearly every way except when it comes to giving stuff away).

Government healthcare IT contractor Quality Software Services will hire up to 70 people for its new South Carolina office.

Physician Michael Westcott, CMIO of Alegent Health, and pharmacist Jeannell Mansur, medication safety practice leader for Joint Commission Resources, will present a Webinar on medication reconciliation next Thursday, May 27 at 2:00 p.m. Eastern. Design Clinicals is sponsoring.

Strange: up to 55 people getting free blood glucose screenings offered by physician assistant students are exposed to blood-borne diseases when the students fail to change out the glucometer’s lancets between patients.

Indiana appoints Andrew VanZee, a former Logansport Memorial Hospital VP, as the state’s healthcare IT coordinator.

Cleveland Clinic grants Carefx an exclusive license to sell its business intelligence dashboard, developed by the clinic’s startup subsidiary IntellisEPM.

Listening: I’m still enjoying old and new stuff from Hole, but a reader recommended Neon Trees, a Provo, Utah pop/rock band that sounds to me like Muse meets The Cure. I like it.

Weird News Andy notices a blog’s rant against a MEDSEEK ad campaign in which a Facebook page was created for a mythical patient named Sara Baker who updates her wall with chatty descriptions of her healthcare interactions that often involve electronic services like those offered by MEDSEEK. Perhaps the page has been changed, but from what’s there now, it’s hard to believe someone would mistake Sara for a real patient, although obviously the folks leaving heartfelt congratulations for Sara’s new twins must have been gullible (or maybe they were enlisted to help add realism). My opinion: it’s brilliant! The only thing worse than bad publicity is no publicity. Whoever wrote Sara’s postings (probably a young marketing intern somewhere) did a nice job in making it realistic. It’s giving me all kinds of ideas for various stunts a la Fake Steve Jobs (check out the Ballmer Reviews iPad video – “No Flash, no Farmville, no porn, no sports – now I know why Steve calls it Safari – ‘cause it’s a hunt to find a Web site that works on this thing.”)

The Care Collaborative (Ascension Health, Adventist Health System, and Catholic Healthcare West) licenses its collective order sets to Zynx Health. HCA has already signed up.

Doctor Dalai describes big PACS problems in all hospitals in Western Australia, where a new version of Agfa IMPAX is apparently behaving so erratically that one hospital called a Code Yellow (a disaster that prevents accepting new patients). Dalai also says that previous versions were so flaky that radiologists were bringing in their own non-Agfa image reading software on USB sticks so they could continue to provide patient care, only to have the IT department delete the software and threaten them with disciplinary action. Another article confirms the problems with a hospital source, adding a fun tidbit in which the Department of Health apparently has blocked internet Web access to Dalai’s site.

A Texas hospital runs Doc Shop, a speed dating type event that connects doctors looking for patients with patients looking for doctors.

United Arab Emirates hospitals are using government-issued ID cards to check patients in faster.

E-mail me.

HERtalk by Inga

PEPID announces the availability of its medical and drug content tools for Google Android devices.

Demand for skilled consultants is high, according to a new KLAS survey of healthcare providers. Thirteen firms enjoy significant mindshare, up from just five in 2007. CSC tops the list, followed by Vitalize, Dell, and maxIT Healthcare. Providers striving to achieve Meaningful Use guidelines are leading the demand for skilled consultants, though another key driver is the migration of Meditech clients to the 6.0 platform.

Health Management Associates (FL) will add enterprise-wide CPOE functionality to its PatientKeeper solution.

The federal government won back or negotiated approximately $1.63 billion of your money last year and sent 77 people to prison for Medicare fraud.

Lest the government hold onto your money too long, the HHS says it will conduct two surveys to learn more about patient perceptions and preferences related to HIT. ONC will collect data on patients’ opinions of EHRs, while the HHS Office’s Assistant Secretary for Planning and Evaluation will determine user satisfaction with personal health record programs.

Thirty-six hospitals conducted mass layoffs in the first three months of 2010, just one fewer than the same period last year. The number of affected employees, however, dropped from 3,003 to 2,516. The figures do not include a couple of key layoffs in April, including 1,000 from St. Vincent Catholic Medical Centers (NY) and 511 from Jackson Health System (FL).

CMS selects Northrop Grumman to develop a National Level Repository to process HITECH payments to providers meeting Meaningful Use objectives. The order is valued at $34 million over one year with five and one–half year option periods.

Providence Equity Partners pays $17.25 per share to buy Virtual Radiologic Corp. That’s about $294 million, which represents a 42% premium of the three-month average stock price.

A widow sues her husband’s doctors after he dies of uterine cancer. No, he never had a uterus, but he did receive a transplanted kidney from a woman who died of uterine cancer. His NYU doctors said that even though the transplanted kidney was covered in tumors, they felt he had a less than 1% chance of contracting uterine cancer. Sadly, the 37-year-old died just seven months after the transplant.

I finally made it to the Apple store this weekend and checked out the iPad. It was love at first touch. Must. Have. One. Don’t exactly know why, but I’m sure that I can’t live without one.

Centegra Health System (IL) is partnering with Dell to launch Centegra Physician Network, a newly created HIE. The HIE will be built on Axolotl’s Elysium Exchange platform.

The 471-bed Jefferson Regional Medical Center (AR) becomes the first hospital to activate Eclipsys Sunrise Enterprise 5.5.

Kudos to United Health Foundation for extending a three-year, $3.3 million grant to Daughters of Charity Services of New Orleans. The funds will be used to support and expand the new Daughters of Charity Health Center-St. Cecilia in the city’s 9th Ward.

Universal Health Services (PA) will purchase behavioral health provider Psychiatric Solutions in a $3.1 billion deal. Together the companies will have 196 behavioral health facilities and over 19,000 licensed beds, plus 25 acute care facilities with 5,500 beds. UHS expects to realize $35-$45 million in annual cost synergies; 35-40% of those synergies will come from the elimination of PSI’s senior management.

Mount Auburn Cambridge IPA (MA) extends its 10-year relationship with MedVentive.

The Dallas Morning News takes a look at the region’s larger health systems and how they (and their EHR vendors) may be putting patient privacy at risk. Cerner, used by Tenet Healthcare, is mentioned for its practice of sharing patient data with drug companies. athenahealth, which provides Cook Children’s Health Care System its physician EHR, is cited for its plan to offer discounts to providers willing to share patient data. The announcement by three other large health systems that they will share patient information between their separate Epic systems also raises privacy concerns. Patient privacy advocate Dr. Deborah Peel is quoted in the piece, using an analogy that Paris Hilton surely appreciates and that likely makes Mr. H chuckle:

“Once your information is released, it’s like a sex tape that lives in perpetuity in cyberspace. You can never get it back.”

E-mail Inga.

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Submit your article of up to 500 words in length, subject to editing for clarity and brevity (please note: I run only original articles that have not appeared on any Web site or in any publication and I can’t use anything that looks like a commercial pitch). I’ll use a phony name for you unless you tell me otherwise. Thanks for sharing!

Medical Image Sharing: The Future is In the Cloud
By Eric Maki

Is the world coming to an end — the healthcare IT world of proprietary silos, that is? When it comes to the sharing of radiology images and report files, the answer appears to be an emphatic YES.

My facility, the Great Falls Clinic in Great Falls, Montana is just one of dozens I know about that now share full-resolution images and reports via cloud-based technology.

The approach works seamlessly. Both uploading and downloading aren’t much more complicated than sending an e-mail with an attachment. No one needs to babysit the process, which at a leanly staffed rural clinic like ours, is a big advantage. And there are no requirements to establish and maintain the link, unlike the VPNs that were our workaround until recently.

There are advantages to proprietary healthcare IT technology. But when it comes to sharing images, proprietary IT has posed challenges throughout my entire state. Because nearly all of Montana’s medical facilities are less than full-service, we often have to transport patients with major issues to a large hospital in the nearest big city. The docs there, of course, want to see whatever imaging studies and accompanying info we generated at our facility. Proprietary IT forced us to use VPNs or other workarounds like burning and sending CDs.

There was also a major expense involved in all the time we spent to maintain our VPNs every time we installed an IT upgrade such as a beefier firewall. Some of my colleagues in Montana who relied on CDs for file sharing were having other frustrations. Sometimes the CDs couldn’t be read on the recipient hospital’s computers. Sometimes the CDs were damaged, couldn’t be read anywhere, or worse, were lost and never found.

We were fed up with this situation in our state, so 30 of our facilities formed an organization to search for a better solution. We called it Image Movement of Montana, or IMOM. We asked several PACs vendors for ideas and, fortunately, one had just developed a cloud-based service that met our needs. It required no new capital acquisition of hardware or software and bypassed all the proprietary hurdles that had plagued us to this point.

The Great Falls Clinic was one of the six facilities that tested the system on behalf of all 30 IMOM members. It worked pretty much without a hitch. A problem that vexed us for many years was suddenly solved, just like that.

The system we use is called eMix, but there are other players in this game — LifeImage and SeeMyRadiology, for example. From what I’m reading, there may soon be more cloud-based image-sharing services available. It’s clear to me that the medical image sharing’s future is in the clouds.

Eric Maki is manager of information technology at the Great Falls Clinic, Great Falls, MT.

NHIN CONNECT Code-a-thon
By iReporter

ONC sponsored what it called an NHIN CONNECT code<a>thon held in Miami a few weeks back. Like the IHE Connect-a-thon held earlier this year in Chicago, this forum’s attendees were primarily hands-on senior software architects and engineers who are refreshingly working together to tackle our industry connectivity woes. 

This meeting had three components. The main one was two days of in-depth collaborative sessions to discuss a variety of technical topics regarding the current CONNECT version as well as group planning for future version features. The second was the CCD template competition won by Georgia Tech that you highlighted here.

The third and most important component in terms of potential long-term impact on the industry was the creation of the Electronic Health Record Interoperability Special Interest Group (EHRI-SIG). To a standing room only audience (and 60 online participants), the CONNECT team presented their ideas and reached out to the private sector for help in establishing a group committed to advancing the state of practice involving medical record interoperability. 

One unique idea presented involved the use of XMPP, a protocol underneath applications like Skype and instant messaging. The idea presented was to exploit this protocol for implementing new communication and exchanges between doctors, patients, personal health records, laboratories, and pharmacies. Another interesting discussion revolved around the CONNECT teams’ desire to implement no-click solutions and to stop the phone from ringing in the doctor’s office.

The meeting video/audio and presentation and audio can be found here.

This modest event could very well signal the beginning of how health information exchange will fundamentally be changed and accelerated in this country. By combining the best of the NHIN CONNECT industrial strength “trust fabric” with the some of the same concepts being considered within NHIN Direct, this effort is positioned to provide a “sweet spot” that likely will appeal broadly to health care industry stakeholders as they tackle meaningful use under Stages 2 & 3.

EHRI-SIG will be making specific decisions on how to move forward at its second meeting in DC on June 2.  As a true working meeting, attendees are required to submit short use case descriptions and be representatives of EHR, lab, pharmacy, PHR, etc. vendors so that the outcome of the discussion can potentially translate into enhancing their own product capabilities. Information can be found here.

This initiative is an open challenge to the healthcare industry vendor community to demonstrate true leadership at a critical time in order to improve outcomes by getting the right information to the right person at the right time. It will be interesting indeed to see who steps up and who does not.

Creating Efficiencies through Enhanced Communications: Alerts and Notifications
By Jenny Kakasuleff

With the recent passage of health care reform and the 30 million newly insured individuals estimated to enter the marketplace, providers are under increasing pressure to improve productivity and efficiencies to meet increasing demand. These challenges must be met while simultaneously improving the quality of care patients receive.

Historically, providers of health care services have taken a piecemeal approach to implementing health information technologies. This has resulted in a number of disparate systems that do not communicate with one another, and contribute to a growing army of devices that health care providers must haul around with them, or have at their disposal in a largely mobile environment.

The alerting and notification systems still in use at many hospitals today are a conglomeration of proprietary systems and devices utilized to perform one particular function — a bedside monitor that sends an alert to the central nursing station to report a change in a patient’s vitals; a tracking system that allows any provider with computer access to locate a device; or a lab information system that sends an e-mail to indicate an abnormal lab result.

While this approach provides many individual solutions to overcome past inefficiencies, it has been uncoordinated, and as a result, creates its own set of problems. The responding provider is saddled with a number of different communication devices to perform a range of non-standardized tasks.

Most professionals today have the ability to perform all of their business-related (and personal) activities via a single mobile device. We make phone calls, check our e-mail, manage our calendar, pay our bills, locate people and places using GPS, listen to music, connect with friends and family through SMS text and instant messaging, or through social media networking — all through one multi-functional device. It is amazing that the same demand is not pervasive in the medical sector.

Health IT solutions now exist that not only address the problems of the past, but work to streamline the disparate systems currently in use into a single, standardized messaging system that delivers a range of alerts and notifications of varying importance to the appropriate recipient. Also, with the integration of an enterprise-class communication solution, providers now have the ability to receive alerts from each proprietary system — electronic medical record (EMR), hospital information system (HIS), nurse assignment, lab information system, etc. — via a single device powered through a unified communications system.

Different messages are delivered based upon their level of importance and escalated until its receipt is acknowledged. The HIS is then updated and auditing trails create a measure of quality tracking and control. The recipient can then respond to the relevant options generated without locating a phone, computer, or other staff member.

As the American Recovery and Reinvestment Act (ARRA) forces health care professionals to evaluate how best to implement and utilize their EMR systems to qualify for meaningful use incentives, their approach should be holistic; cognizant of current and future challenges; and focused on gaining as much mileage as possible from the investment.

Jenny Kakasuleff is government liaison with Extension, Inc. of Fort Wayne, IN.

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From Skyline Pollution: “Re: non-profit UPMC. They may be paperless, but can’t do without their $1.7 million skyscraper signs, according to the spokesperson for the multi-million dollar CEO. More help desk support and nurses could be had for that chump change.” CEO Jeffrey Romoff, who took a 25% pay cut this year to $3.6 million, admits that UPMC is being sued by a local sign company for an unpaid balance, but says the company’s work was substandard because high winds delayed hanging the 20-foot-tall “M” in “UPMC” atop the 64-story US Steel Tower.

From Larry’s Pizza Guy: “Re: Oracle. With the buyout of Sun completed, Oracle is reworking the contracts for EGATE/JCAPS Integration Engine clients to be based on the number of cores of a system instead of the actual number of interfaces being used. The clients’ only option is to invest time and money to replace the engine(1+ year process) or paying the outrageous increased fees (200,000+ more) to continue using the EGATE/JCAPS.” I hadn’t heard that, but I’m not a bit surprised since a lot of CEO Larry Ellison’s $30 billion in net worth came from charging licensees for theoretical usage capability rather than usage itself. Or, perish the thought, just selling the product for a fixed price. Imagine how much more money Bill Gates would have been worth if Word was licensed by CPU power or by the number of words typed. I’m still a market forces guy, so if Oracle is taking advantage of customers, those customers should bolt for a better option.

From Better Late: “Who do I call when my Monday Morning Update isn’t delivered on time?” Funny. I usually publish Saturday evening, but a pretty wonderful getaway with Mrs. HIStalk took me offline until Sunday afternoon. If it’s any consolation, you’ll get that late-breaking Sunday morning HIT news that you would have missed otherwise (irony meets irony). Thanks to those who expressed concern, best wishes, or consternation – it’s nice to be noticed.

A Wall Street Journal article called Smart Money: Is Your Favorite Charity Spying on You? highlights Sharp HealthCare, which uses data mining software to identify patients who might be financially capable of becoming hospital donors. The article points out that hospitals are even training doctors to identify prospects, and once a VIP has been tagged, hospitals may give them perks such as free visitor parking passes, direct access to staff, and priority appointments with specialists. The president of a philanthropy group admits that such targeting is kept quiet by nonprofits because it “creeps a lot of people out.”

I’ve been involved in a couple of CPOE implementations and they went well, so I’m a little surprised that 33% of respondents to my poll believe that CPOE makes outcomes worse. Maybe theirs didn’t go so well, or maybe CPOE sounds more dangerous theoretically than it really is to those without first-hand experience. Anyway, in the new poll to your right: is a best-of-breed application strategy a good or a bad idea? The poll accepts comments, so feel free to add yours along with your vote. Ed Marx stirred up a lot of commentary from his post that touched on that topic, so let’s see the consensus.

Speaking of Ed, thanks to him again for his inaugural HIStalk post, which drew a lot of thoughtful discussion. I posted his response at the end of the original article, so it’s worth a re-read.

The 150-bed Robinson Memorial Hospital (OH) recently chose Eclipsys Sunrise. The local paper discloses the overall cost of its EMR project: $39 million, or what seems to be $260K per bed.

A rare Weird News Andy weekend factoid, which he calls “Oh, the irony”. Financial organizations consider bailing out Greece’s debt-ridden economy want it to privatize its expensive government-run healthcare system, a leftover from the country’s previous Socialist Party rule.

A group of Baltimore hospitals, including Johns Hopkins, donates technology to the city’s fire department that allows EKGs to be transmitted from ambulances to hospitals, allowing faster diagnosis and treatment of heart attacks in progress.

In Ireland, a hospital requests an urgent review of its 20-year-old IT system because it poses “consequential risks to patient safety.”

Ohio State University Medical Center will operate retail clinics inside Giant Eagle grocery stores.

A local newspaper article covers the use of AirStrip OB monitoring software at Somerset Hospital (PA), paid for by us federal taxpayers.

Alpharetta-based healthcare data solutions vendor MDdatacor raises $2.6 million in funding.

Meditech says it will add 300 employees this year to its current 3,000 to keep up with customer demand.

A night shift security guard at a Texas clinic who spent his last scheduled night on the job hacking into 14 of his employer’s computer systems pleads guilty to two charges of “transmitting a malicious code” and faces 10 years in prison for each count. He hacked the clinic’s HVAC system (apparently feeling a need to mess up the air conditioning) and another that contained patient data. He’s not the brightest bulb in the circuit: the self-styled “GhostExodus” posted a dry run of his adventure on YouTube (above – some language is PG13) which led to his arrest. This isn’t an entirely original observation on my part, but the line between known criminals and security guards (especially those of the rent-a-cop variety, which GhostExodus was) is often blurry.

Vidyo introduces its telepresence system for healthcare that uses a standard broadband connection instead of a dedicated network. The system, which the company says costs around $1,000 per user or 85% less than competitive offerings, is being used by North Region Health Alliance in Minnesota and North Dakota.

A Delaware state congressman, chair of an “obscure” committee that recommends which government programs to end, subpoenas a state auditor for information on the Delaware Health Information Network. He says he wants to know where DHIN has spent $20 million in taxpayer money. The auditor calls the subpoena “a joke”, adding that “All you need to know is they sent out the subpoena and a press release at the same” and that the audit would have been completed earlier without having to deal with the surprise subpoena.

Anyone who likes to make fun of healthcare’s reliance on MUMPS and the Cache’ database: the European Space Agency chooses Cache’ to support the Gaia space mission that will map the Milky Way. Now who’s the rocket scientist?

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