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June 15, 2010 News 32 Comments

From Maeby Fünke: “Re: Epic. I hear it’s telling new customers they don’t need to worry about staffing or hiring consultants — they are providing them with a test they can administer to college grads to determine if they have the aptitude for this type of work. Does anyone know if it’s something they created or bought commercially?” If anyone has a copy, I’d be interested in seeing it just for fun.

passavant

From Expert Witness: “Re: UPMC. Doctors and nurses do not speak to patients any more. All done by clicks, cut, and paste. If the computer says it’s right, it must be.” The family of a deceased UPMC Passavant patient files suit against the hospital and her doctors, claiming her home med methotrexate was incorrectly entered into her medical history as taken daily instead of weekly. Nobody caught the mistake when she was transferred to a specialty care center, so she was given the drug daily for 16 days until she died. If that’s found to be true, the hospital will learn a harsh lesson about the importance of medication reconciliation, not to mention that surely ample warnings were issued by its clinical systems (Cerner, I assume). It’s not a new problem.

artglasgow

From GenX’er: “Re: Ingenix. Former Misys VP Art Glasgow was named CTO of Ingenix. The announcement says he’s consolidating IT across the business. Big job.” Verified. He was promoted from SVP/GM of health information networks at Ingenix, where he’s worked since November 2008 after stepping down as Payerpath GM for Misys.

healthsmart

From Down Under Deepwater Horizon: “Re: Myki. Myki, my mates, is the failing, money-devouring ticketing system for public transport in Victoria, which has blown A$ Billion.” Hospitals in Victoria, Australia complain about the government’s $280 million (US) HealthSMART system, four years late and way over budget like the Myki system DUDH mentioned. Hospitals are being stuck with the tab for HealthSMART, which I mentioned in 2008 when they scrapped their first attempt after bring up zero hospitals on Cerner Millennium. It’s supposed to connect hospitals and provide e-prescribing capability. The government refuses to give a completion date or confirm the amounts that hospitals are being charged.

Listening: Broken Bells, new melodic indie rock from a couple of guys from Danger Mouse and The Shins. Also, my old favorites, The Vincent Black Shadow.

clonghurst

Chris Longhurst, MD is named CMIO of Lucile Packard Children’s Hospital at Stanford. 

An SIS survey finds that 92% of hospital executives rate the success of their perioperative departments as important or extremely important to overall hospital success, with quality and financial performance being their key concerns.

Vermont Information Technology Leaders names athenahealth as a Preferred EHR Partner.

da

Welcome to new HIStalk Gold Sponsor Diligence Analytics. Led by President and Chief Research Officer Wendy Shellhorn, PhD, MPH, MEd, the Tampa, FL-based company provides professionally conducted research and analysis services to healthcare and HIT. That includes surveys and data analysis to help clients make smart business decisions, bridging the gap between small businesses and their larger competitors. We thank Diligence Analytics for choosing to support HIStalk after what I’m pretty sure was a thorough analysis.

Inga’s taking a much-deserved break to bronze her loveliness and rest her creative mind in a tropical location, but she must be thinking about HIStalk since we’ve exchanged more e-mails today than when she’s on the job. She’s fussing, though: she’s trying to score an iPhone 4 online and can’t get through. It’s not just her, apparently.

Cooper University Hospital (NJ) goes live with iSirona’s software-based solution to integrate patient information from medical devices with its electronic medical record. Cooper VP/CIO Mike Sinno will talk about the project in a June 30 Webinar.

GE Healthcare announces Centricity Advance, an SaaS solution for small practices that includes PM, EMR, and a patient portal. It must be a pretty big deal: among the “thought leaders” discussing EMRs Tuesday night at the National Press Club with GE were Newt Gingrich and Peter Basch, MD.

Quality IT Partners releases a new white paper, What Every Healthcare Organization Should Know about Deploying IT when Planning and Designing a New Healthcare Facility.

CareTech Solutions, owned by Compuware, Oakwood Healthcare System, and Detroit Medical Center, names two DMC executives to its board: president and CEO Michael Duggan and EVP/CFO Jay Rising. DMC just signed an agreement to be purchased by for-profit Vanguard Health Systems, clearing the way for the required legal reviews.

marines

ahlta 
Photo: Cpl. Tyler J. Hlavac, USMC

Corpsmen with the 4th Marine Logistics Group are trained to use the AHLTA EMR on a Symbol MC70 mobile device in preparation for deployment to Afghanistan. They will use it to upload combat casualty information to AHLTA’s clinical data repository and to access treatment guidelines for biological, chemical, and radiation attacks.

eClinicalWorks buys 100,000 square feet of office space in Westborough, MA, making room for the 100-200 employees it will add to its current 1,100-employee headcount in the next year. The company’s revenue exceeded $100 million in 2009.

Roadside Medical, a health services company for truckers, will open three new clinics, all of which will feature iPads, telemedicine, and an EMR. Some snooping uncovered their technology partner: TeleMedExperts, which uses the TotusMedica.US PM/EMR.

carilion2 carilion1

Daniel Barchi, SVP/CIO of Carilion Health System (VA), e-mailed to let me know about its Epic go-live. “We have an incredible group of IT and clinical folks who just wrapped up one of the most aggressive simultaneous hospital and physician practice EMR implementation in the nation. Without hiring any external consulting company, this amazing group of folks simultaneously over two years converted eight hospitals and more than 100 physician practices to a single EMR for all clinical documentation, finances, and orders.” The photos above are from the last hospital go-live at Bedford Memorial Hospital, 23 months after the first big-bang go-live at 800-bed Carilion Medical Center. They trained 8,000 users, converted from nine EMRs plus paper, and hit 92% CPOE adoption. Nice work.

DIVURGENT Healthcare Advisors is offering a webinar this Friday called Meaningful Use Monitor and Gap Analysis Tool.

Nuance announces Enterprise Turbo Speech 8.1, the background speech recognition component of its Dictaphone Enterprise Speech System.

HHS will convene a Consumer Choice Technology Hearing at the Grand Hyatt Hotel in Washington, DC on June 29 from 8:00 a.m. until 5:00 p.m. I don’t have a link, but it’s a demonstration of several privacy technologies by the Privacy and Security Tiger Team of the HIT Policy Committee. Deborah Peel, MD and David Kibbe, MD are among the panelists who will discuss the demos.

Mass layoffs by hospitals are affecting more workers than at any time except right after Hurricane Katrina-induced closings.

isoft

iSoft reassures investors after its share price drops by half in the last couple of weeks, saying any inferences that its Northern Cluster NPfIT contract is in jeopardy are incorrect. That’s a three-month share price chart above.

Continua Health Alliance is creating a library of open source utilities that will help mobile health developers create applications for personal health devices and health records.

Varian Medical will move its employee applications from BlackBerry to the iPhone, saying iPhone OS 4.0’s security and management capabilities appear to be adequate.

A study finds that doctors will use even unproven technology as long as they get paid to do so. Mentioned specifically is computer-aided breast cancer detection, for which the manufacturer successfully lobbied Congress to mandate Medicare coverage despite lack of proven superiority and the large number of false positives it issues.

Greenway launches BlogEHR, which features the company’s executives writing about healthcare IT.

Cerner earns an award for encouraging healthy lifestyles for its employees. Except when Neal had the fitness center locked down during working hours, anyway.

E-mail me.

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Currently there are "32 comments" on this Article:

  1. Hey Mr. H…your slipping. You complain about ridiculous press releases, then go and repeat one.

    A Surgery system company (SIS) does a survey that says 92% of hospital execs say that the success of the surgery department is important. WOW! Who would have guessed?

    I trust you didn’t repeat that dribble because they have been a long time advertiser?

  2. I love the theory that EPIC has a test that will tell us if college graduates can help install their software – it’s either their software is so rudimentary or EPIC is just slamming it in – regardless of what the client wants. EPIC is starting to sound like POTUS – has an answer to everything and thinks they can walk on water. Maybe EPIC has the answer for mass unemployment or the oil spill in the gulf, there must be a test for it.

  3. I’m tired of readers who feel the need to add their own political leanings into comments made here. If you don’t like POTUS, fine. If you like him, fine. If you have problems with legislation coming out of DC then remember how our systems works. POTUS is one person. Legislatoin is discussed and voted upon by your Congressmen and Senators. POTUS does not have dictatorial powers in our country and his word is not law – it is opinion. And this is mine.

  4. From Maeby Fünke: “Re: Epic. I hear it’s telling new customers they don’t need to worry about staffing or hiring consultants — they are providing them with a test they can administer to college grads to determine if they have the aptitude for this type of work. Does anyone know if it’s something they created or bought commercially?” If anyone has a copy, I’d be interested in seeing it just for fun.

    REPLY:
    Had a friend apply for an application analyst position using Epic and the first step was a test referred to above. It had numerous math questions and then a section with questions like: You have $.35 and have two coins, one is not a quarter, what is the coins? You have a bouquet of flowers, all but 2 are roses, all but two are lillies, and all but two are daisies – how many flowers do you have? Etc.

  5. The strategy to avoid usability certification as you reported here, coming from Judy’s lips, is now clear. Those who pass the test are certified imbeciles and join the work force. Pity the patients.

  6. Re: Epic Training. I wonder if this test is a stop-gap measure until the new HIT Professionals in Health Care Program is in full swing at the community colleges. According to an interview I held recently, they’re pressed hard to get people trained in HIT in the numbers and at the speed that HITECH is requiring.

  7. The test given to college students thing from Epic is patently ridiculous from a sales standpoint. Epic will not be able to convince new customers to buy it’s product while at the same time insulting their intelligence.

    That said – I find this approach completely plausible. This is an understandable reaction to encountering change resistant silos of information too commonly present in healthcare. Individuals who are convinced that their opinion about how a thing works should trump the efforts of an entire installation project. I’ve seen it too many times. People with 15 or 20 years experience putting their feet down because they don’t feel appreciated and blowing past deadlines as a result.

    It’s a cost/benefit analysis. Sometimes an employee with 20 years experience really only has 2 years of experience – and 18 years of baggage.

  8. Congratulations to Chris Longhurst, MD.

    The promotion is suitable for an EPIC user and leader who published astounding results at the Stanford: First RRT (rapid response teams) reduced mortality by 18%, and then, EPIC’s CPOE reduced (during overlapping periods) mortality by an additional 20%.

    Funeral homes must be crying out for business.

    His explanation is here, followed by a rebuttal which happened to appear late on the WSJ Health blog:
    A
    8:28 pm May 7, 2010
    Chris Longhurst, MD wrote:
    Our statistical analysis did indeed account for the ongoing impact of the Rapid Response Team (RRT), which was associated with an 18% mortality decrease in 2005 (Sharek, JAMA, 2007). The CPOE implementation in 2007 was associated with an additional 20% effect after correcting for the RRT intervention (Longhurst, Pediatrics, 2010). We encourage readers to review the study details at http://pediatrics.aappublications.org/cgi/content/abstract/peds.2009-3271v1.

    9:37 am June 14, 2010
    S D, MD wrote:
    With an 18% reduction from RRT and an additional 20% reduction from CPOE, it must be that no babies are dying at your hospital. This report appears to have been written by the Vendor, EPIC. Stanford has equity in EPIC. How much did they pay you guys? Oh, that’s right, Paul Tang, MD has triad of roles: with Stanford and EPIC and ONCHIT. Who do you believe?

  9. Suzy, you don’t appear to be in a position to be calling anyone an imbecile. And I pity the patients every time I read your comments.

  10. When I started installing, I had a couple of unusually good years of hospital experience after college that led to an opportunity to install HBOC’s Star Financials (way back when…). I had a Bus. Admin degree with a biology minor, not a computer science degree. I thought I was prepared for the job, but “didn’t know what I didn’t know”! They mentored me (some so-so, some great!), but the important part was they were patient. When I made a mistake and embarrassed myself and them, they smoothed things over and got me some help.

    After two years of very hard work (nights in the hotel with the books and days sweating through meetings, training, conversions, and interface work), I finally felt competent and confident. I spent four more years there and had very happy customers. I wasn’t the smartest guy in the room, but I learned the old fashioned way and got very good at what I did.

    EXPERIENCE is the key. Tests only prove that someone will learn it faster; not whether they will be a better employee and representative of the company.

  11. What is the point of comments such as these at Carilion: “Daniel Barchi, SVP/CIO of Carilion Health System (VA), e-mailed to let me know about its Epic go-live. “We have an incredible group of IT and clinical folks who just wrapped up one of the most aggressive simultaneous hospital and physician practice EMR implementation in the nation. ”

    Are there computer records being kept as to who does it the fastest with the biggest bang and aggression? Is HIMSS going to give an award for another press release?

    I, personally, would rather see listings of the actual mistakes, near misses, adverse events and deaths. What are this hospital’s priorities, really now?

  12. First, my apologies for the horrific grammar on the original reply.

    Take the test for what it is – a filter to eliminate the chaf… the position in question had over 150 applicants – the test was a tool, and there appears to be a lot of good candidates looking.

    Could not agree with bkern more on the experience component, however, everyone has to start somewhere, hopefully with a mentor, and someone to shepherd under their wing as in bkern’s case. Too often however, new talent is just thrown to the wolves in my experience….for all the normal reasons, revenue recognition, shortage of existing staff, etc.

  13. Oh, Harvey. Hook line and?

    LPHC have Cerner. Not EPIC. Standford hav EPIC, LPHC don’t. It clearly says so in the text of the study, if you or “S D, MD” had bothered to read it.

    http://pediatrics.aappublications.org/cgi/reprint/peds.2009-3271v1
    “In 2004, the LPCH embarked on a multiyear EMR-implementation effort. The first implementation stage was focused on replacement of preexisting functionality for results-viewing and nonmedication unit-clerk– based order entry provided by a legacy hospital information system with software from a commercial vendor (Cerner Corporation, Kansas City, MO).”

    Here is the Cerner presentation of the build they did.

    http://www.cerner.com/public/filedownload.asp?LibraryID=51557

    More coverage for the people who cannot access the study.

    “From 2003 to 2007 LPCH, a 272-bed hospital, spent $70 million installing its system by Cerner Corp. of Kansas City, Mo. Cerner holds an estimated 80 percent of the CPOE pediatric market, Widen said”

    http://www.hcjnc.com/index.php/healthcare-quality/51-healthcare-quality/435-first-published-study-showing-cpoe-reduces-mortality.html

    Always bothers me when we have somebody with MD after his name willing to believe random, anonymous people on the internet rather than read the study he must have access to. Suzy must have something to say about that?

    Wasn’t there somebody around these parts who posted with the initials SD? He is clearly suggesting a fraudulent report and that EPIC had something to do with it, even though it was a competitors system.

    A new low from the detractors/resisters of EMR’s?

  14. they [Epic] are providing them with a test they can administer to college grads to determine if they have the aptitude for this type of work

    I detect a word missing: experience.

    Of course, this is not inconsistent with the views a few years ago of the HIT recruiters (“Who’s Growing CIO’s”, Healthcare Informatics):

    I don’t think a degree gets you anything,” says healthcare recruiter Lion Goodman, president of the Goodman Group in San Rafael, California about CIO’s and other healthcare MIS staffers. Healthcare MIS recruiter Betsy Hersher of Hersher Associates, Northbrook, Illinois, agreed, stating “There’s nothing like the school of hard knocks.” In seeking out CIO talent, recruiter Lion Goodman “doesn’t think clinical experience yields [hospital] IT people who have broad enough perspective. Physicians in particular make poor choices for CIOs. They don’t think of the business issues at hand because they’re consumed with patient care issues,” according to Goodman.

    IT’s culture is in the stone age compared to medicine’s.

  15. You have $.35 and have two coins, one is not a quarter, what is the coins?

    The coins “is” (sic) clearly a two-bits fragment cut from a Spanish Milled Dollar (a.k.a. Piece of Eight), and a Martha Washington Disme.

  16. Blah renders the point of corrective information that it was a Cerner instrument that was used in the Stanford CPOE study.

    It provides me understanding why Mark del Beccarro, MD was crowing about the study in Health IT News: “Mark Del Beccaro, MD, a pediatrics professor and vice chair for clinical affairs at Seattle Children’s Hospital, who was not involved in this study, said he welcomed the new findings. Seattle Children’s Hospital implemented CPOE in 2003. “Three years later a study of the effects showed mortality rates at our institution held steady,” Del Beccaro said.

    Mark del Beccarro came to Cerner’s rescue with a 2006 study published a few months after the Pitt study demonstrated marked mortality increase from CPOE. I now understand why he is a spokesman for the current study. This is a well oiled PR program.

    Thus, I would say that there should be an investigation of the role of “ghosts” writing both “favorable” papers. The earlier one appeared so quick after the Han paper. How is that possible?

    The recent paper’s conclusion is confounded despite the denial by the author.

  17. “IT’s culture is in the stone age compared to medicine’s.”

    Because stone age people got plenty of sleep, which is more than you can say for most medical residents and interns?

  18. Back away from the irony Says:

    Because stone age people got plenty of sleep, which is more than you can say for most medical residents and interns?

    Let me ask: would take your ill mother to a physician whose degree is from the “school of hard knocks” because “a degree doesn’t get you anything?”

    Can someone please explain to me why these HIT recruiters felt a degree (i.e., education) doesn’t “get you anything” in selecting healthcare CIO’s?

    I simply don’t understand this. In medicine, the lack of educationalr equirements ended with the Flexner Report of 1910.

  19. Experience without aptitude = Suzy, RN

    And by the way, no one ever came up with Judy saying that about usability.

    But alas, fact doesn’t seem to matter in your world.

    Suzy, I hope people don’t count on you to get doses right, times right or instructions right. You don’t seem to have a solid command of information or synthesis.

    Please make us all feel more at ease and post as Suzy, RN Retired.

  20. RE: Numismatist – Or…it could just be a quarter and a dime. But I like your style!

    And I have to agree with pretty much everyone’s comments regarding the test given to future EPIC employees. If it’s one thing EPIC has always had trouble doing, it is recruiting and maintaining top talent…even in this economy. Madison, WI isn’t the haven that Judy thinks it is…no matter how much she spends to make some resort with all the ridiculously overpriced software she is selling to hospitals struggling to keep a 3% profit (if not close their doors completely). How do clients react to the mountains of kids showing up to their sites learning on the job doing these implementations after forking over $30M (typically 15-25% more than any other vendor)? Let’s not kid ourselves here…EPIC is in no way perfect and has many of the same struggles that other vendors face.

  21. Epic’s installing clients are struggling right now because of lack of experience with their implementers. They are almost all in their early twenties with zero experience in health care. Their experienced folks are spread way too thin and they are too many new clients. They can’t all work with everyone.

    Consultants with experience have often been used to augment that hole in Epic staffing.

    Judy doesn’t like consultants because she can’t control them. But there is no way many of their installs would have been successful without the help of experienced consultants.

  22. re- the EPIC entrance exams:

    Seen on medical board exams:

    Patient is a 65 year old obese diabetic male who’s just shoveled snow and has crushing substernal chest pain radiating down left arm, diaphoresis, hypotension, irregular heart rhythm, and a history of three prior MI’s.

    What is the diagnosis?

    1. Carpal tunnels syndrome from computer overuse
    2. Diabetic coma
    3. Snail fever
    4. Dracunculiasis
    5. Heart Attack

  23. Pete wrote:

    It’s a cost/benefit analysis. Sometimes an employee with 20 years experience really only has 2 years of experience – and 18 years of baggage.

    Please provide peer reviewed data on just how often this is the situation. Thanks.

  24. I’d rather send her to a physician who isn’t sleep impaired and who has access to her latest medical records.

  25. Access to the latest records did not improve outcomes in the UK. You IT people have devices in need of a satisfactory use. Keep looking.

  26. “Access to the latest records did not improve outcomes in the UK”

    Hey, if you don’t mind sending your ill mother to a physician who doesn’t have access to her records, you go right ahead.

  27. Back away from the irony Says:

    I’d rather send her to a physician who isn’t sleep impaired and who has access to her latest medical records.

    This writer’s indirection seems that of a salesman, maybe one appointed a a blog monitor to deflect negative opinions of the HIT industry.

    Rather than commenting on the questions posed about careless attitudes about education in the IT industry, such as I raised in #18, we get some odd tit-for-tat comparing overwork of medical trainees and CIO’s.

    I disagree with long resident work hours and believe this practice must stop. (Attendings and physicians in non academic environments on the other hand need suffer no such problems.) Howeer, in my view anyone with an attitude that “a degree doesn’t get you anything” and “IT leadership should be from the school of hard knocks” as well known HIT recruiters are quoted above, belong nowhere near a hospital.

  28. There was absolutely no reason to block my last post.

    [From Mr. HIStalk] When comments turn into arguments among two readers who are addressing each other and nobody else, it’s time to take it offline. If you want to address all readers and not just one, then feel free to repost. Your sparring partner will receive the same treatment.







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