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September 9, 2010 News 23 Comments

9-9-2010 8-01-12 PM

From A. Nonnie Mouse: “Re: Kadlec Regional Medical Center (WA). Turfing McKesson inpatient and GE Centricity and moving to – surprise! – Epic. The number of Epic customers in Washington and Oregon make Epic CareEveryWhere something of a de facto HIE.” Unverified, but the hospital is running Epic recruitment ads, so your information may well be correct.

From FortWorthFan: “Re: JPS Health in Fort Worth, TX. I noticed they are hiring Epic Revenue Cycle analysts, but I don’t recall ever reading that they selected Epic as their replacement clinical system.” I’ll guess they’re going Epic since this position listing seeks Epic clinical analysts. From this job opening, it appears they are seeking a CIO as well.

From Tina LaBoeuf: “Re: HISsies. I miss your hilarious write-ups of the awards announcements that went away when you started the awards party :(” Tina’s comment sent me to the search function to find and relive those moments. I did find them amusing, especially since I mixed in actual winner quotes with my phony recap. You can read it here if you enjoy these snips from 2007, featuring as host my alter-ego, former HIT sales jock Billy “Biff” Jutjaw:

Imagination at Work? Must be talking about their Carecast guys porn-surfing at their desks! Zow! Rimshot! BA-DUM-PAH. GE guys … hey Jeff … we need one of your lightbulbs over here … yeah, a replacement for that faulty one that went off over your head when you bought IDX! Owwww! But I kid. What a great evening! What a constellation of industry stars! What a rack on that broad at Table 3! … Say, Chuck, let’s see who’s here. Hey, are we in the Ying or the Yang side of the house? Judy must have been having a Woodstock flashback when she laid this place out. Where did she get compost-powered PCs, anyway? That Kool-Aid they drink here must have been from Ken Kesey’s original recipe! … Yeah, it’s like a CHIME meeting – you can’t swing a golf club without hitting two CIOs and four sales VPs clinging to their underbellies like remoras on a shark. … Come on up here, Howard Messing. Nice suit! Must be nice to keep getting awards for doing nothing! But I kid, old friend. MEDITECH was an established company when some CEOs were still backdating options in Monopoly! Booyah! Boston community swimming pools always hate it when MEDITECH starts hiring because they take all their lifeguards! Kapow! You know the first thing a MEDITECH employee says after getting home from work? "Mom, is dinner ready?" BAD-DUM-PAH. I’m like butter, baby, I’m on a roll!

Listening: new from singer-songwriter Sara Bareilles, thoughtful pop-tinged heartbreak music if you’re in the mood for that sort of thing. Watching on Netflix streaming: Studio 60 on the Sunset Strip, a stupendous 2006 dramedy series about a Saturday Night Live-type program (think 30 Rock played mostly straight with an amazing cast).

9-9-2010 9-53-06 PM

An expert tells South Shore Hospital (MA) that 800,000 patient records that were on lost backup tapes of their Meditech system can’t be easily accessed, so they decide against sending out breach notices to individual patients. They’re just going to run newspaper ads, which given the state of American intellect and newspaper circulation these days, means about a hundred people will see them, especially if they ads don’t appear in the sports or entertainment sections. This is the incident where the hospital paid Iron Mountain to destroy the tapes, only to find out afterward that the company subbed the work out to another company and lost the tapes in shipping.

In England, the dismantling of NPfIT appears to be underway, as the government cuts its total cost by $2 billion to $17.5 billion and decentralizing the project. Said the co-director of the Royal College of Physicians Health Informatics Unit, “One of the dirty secrets of the NHS is the regrettable state of medical record keeping. Earlier reports have shown that this compromises patient safety and clinical care. If IT in the health service is going to regain the confidence of the medical profession, then more emphasis has to be placed by the Department of Health on making sure that the new systems accurately capture the dialogue between doctor and patient. Everything else flows from getting that right.”

Speaking of NPfIT, an NHS Foundation Trust invites bids for a new patient care and e-prescribing system, opting out of NPfIT’s iSoft Lorenzo option because of concerns it’s not ready for prime time.

The latest ISMP Medication Safety Alert (from Institute for Safe Medication Practices) has a fascinating article about why the CMS rule requiring hospitals to administer drugs within 30 minutes of their scheduled times endangers patients. ISMP only posts excerpts online, but it was truly revealing as real-life nurses (thousands of them, in fact) describe why it’s unreasonable to meet that goal. The IT-related gist: we’ve put in eMAR and bar-coding systems and written cool “overdue” functions for clinical documentation systems, but hospitals have done nothing to address the challenges of nurses trying to meet a staggering variety of patient needs without turning into medication-pushing robots. This is one of those areas where non-clinical IT people would struggle with the idea that it’s not just calculating a “med overdue” time and dinging the nurse on a report. Everybody in involved in any capacity with clinical systems should read the full text of this article – it is a tremendous eye-opener for folks who’ve never trodden the uncarpeted areas of the hospital where the real work gets done.

9-9-2010 9-54-33 PM

Athenahealth CEO Jonathan Bush tends to be a “love him or hate him” kind of guy, but he’s still eminently quotable either way. He was definitely wound up for The New York Times. On why the company was in the birthing center business in the early days: “You know, Bush family noblesse oblige. I wanted to take advantage of all this education and support I’ve had and do well by doing good, and health care seemed like a place that no one else in my family had been much. A new approach to health care seemed to me to be the oil fields of 1997.” On the company’s competitors: “We are the only cloud-based service in an industry segment full of sclerotic, enormous, personality-free corporations that have been in business making 90 percent margins doing nothing for decades and decades.” On the cost of healthcare reform: “Oh, it’s going to go through the roof! It’s widely accepted that this is not a cost-reform bill — it’s an access bill … Eventually, consumers will need to eat a big part of their health care cost, because health care will fundamentally consume the entire G.D.P. in the not-too-distant future.”

It’s interesting that WellStar Health (GA) apparently fired its CEO after it was fined for excessive Medicaid billing, but it named the CFO as the interim president. Wouldn’t the CFO be the person most accountable for billing mistakes? Mostly unnoticed: they fired their general counsel as well. And from an IT standpoint, the CEO blamed their billing system (McKesson Star, I think). Does it get the axe, too?

9-9-2010 9-57-51 PM

We like Encore Health Resources a lot since they threw one heck of an HIStalk bash in Atlanta this year (as many of you told Inga and me afterward and we saw first-hand ourselves – that’s Ross Martin in the pic). Dana and Ivo are fun at work too, apparently — the company is named as one of Modern Healthcare’s Best Places to work in Healthcare 2010. That’s pretty cool for a new, small consulting firm.

Jobs on the sponsor job page: Project Manager – Healthcare Implementation, Eclipsys Activation Consultants, Technology Account Executive. On Healthcare IT Jobs: Metadata Administrator, McKesson Horizon Consultants, IT Applications – VP. That reminds me to mention that I made a Google Gadget that you’ll see to your right that has tabs for the Events Calendar, Healthcare IT Jobs, news headlines, and posts from HIStalk Mobile. I did that for two reasons: first because the WordPress events widget wasn’t displaying the calendar entries correctly, and second because I was looking for an excuse to build something.

I always like to highlight badly written press releases, so it’s imperative that I recognize this gem from a home monitoring technology company, which leads off with: “Cytta Corp’s CEO Stephen Spalding is pleased to announce that, after a series of well received presentations and demonstrations, Cytta has been invited to provide its first major proposal to a major healthcare payor/provider to develop an individualized monitoring system.” It’s a penny stock, but the price would need to go up fivefold to actually reach a penny, closing today at $0.0018 for a market cap of $1.83 million, doubling in price since April.

The North Carolina sheriff’s association proposes that the state give its members access to its doctor shopper database of known drug seekers, saying they “can better go after those who are abusing the system.” Privacy advocates are less enthused by the idea.

9-9-2010 9-04-07 PM  

iMedicor launches its National Healthcare Communications Network, which offers practices secure messaging, peer collaboration, referrals, and CME. The company changed its name from Vemics last year, which seems like a good idea since that sounds like worm medicine. According to the site, it costs $24.95 per provider per month. It looks pretty cool to me. I can think of several business models that would work if they get enough subscribers.

Jim Bradley, former CEO of RXHub and Abaton.com, is named chairman of the board of e-health connectivity vendor VisionShare.

Let’s hope they aren’t big cloud computing or ASP users. Local hospitals (along with everybody else in four Tennessee counties) lose their Internet, cable TV, and telephone access for two days when some goober takes a shot at a bird sitting on the only cable line connecting that area to the rest of the world.

E-mail me.

HERtalk by Inga

Streamline Health Solutions releases its Q2 numbers: revenue of $4.7 million (15% better than last year) and a net loss of $76,000 (versus an $18,000 loss last year). The company attributes the higher loss to increased investments in marketing and hosting operations and the reinstatement of bonuses. Streamline also announced the promotion of Gary Winzenread from SVP of product development to COO.

c. martin harris deborah taylor tate

CIO C. Martin Harris, MD of the Cleveland Clinic and former FTC commissioner Deborah Taylor Tate join HealthStream’s board of directors.

Hard to believe, but registration for HIMSS11 is now open. If you are a HIMSS member and pay before December 7th, registration is only $695. Mr. H and I are already strategizing about all the fun HIStalk-related things we’ll be doing. If you have ideas, let us know.

hhs spanish

HHS unveils CuidadodeSalud.gov, a Spanish-language website to provide consumers with public and private health coverage options.

Mediware doubles its fiscal year profits to $3.24 million. Revenue for the year grew 17% to $47.6 million.

KLAS adds five new members to its advisory board, including HIStalk’s own Edward Marx, CIO at Texas Health Resources. Other new members include Alastair MacGregor, MD from Methodist Le Bonheur Healthcare, Kara Marx of Methodist Hospital of Southern California, Dan Morgan from Bay Medical Center, and HCA’s Noel Williams.

Forbes magazine profiles North Shore-Long Island Jewish Health System and its $400 million effort to help 9,000 employed and affiliated physicians move to Allscripts EHR. Though North Shore is taking advantage of relaxed Stark laws to subsidize up to 85% of system costs, so far only 175 of the system’s 7,500 community physicians have signed up. The health system’s chief executive admits there’s been resistance around “cultural stuff,” including concerns about North Shore’s hosting of the EMR data and discomfort with having to make work flow changes.

wayne state physician

Wayne State University Physician Group (MI) chooses Orion Health Rhapsody Integration Engine to help create patient data exchange between their offices and other providers and facilities.

McLeod Health (SC) contracts with Merge Healthcare to integrate Merge’s cardiology workflow solutions with McLeod’s existing radiology product.

picis perioperative staff

Perioperative employees at Southwestern Vermont Medical Center explain to the local press how their Picis system works, noting it “soothes some of that anxiety” felt by family members while loved ones are in the operating room.

Stamford Health System (NY) says its MedAssets Charge Capture Audit tool helped recapture $1.9 million in lost charges last year. It will also use group purchasing contracts, consulting services, and BI tools from MedAssets.

St. John’s Hospital (IL) selects Amelior Tracker from Patient Care Technology Systems for automated medical equipment tracking.

HHS awards a $980,000 grant to the University of Kansas Medical Center, University of Missouri, and University of Oklahoma to create the Heartland Telehealth Resource Center. The center will help physicians treat rural patients using telehealth technology. Almost 90% of the counties in those three states are considered rural with limited access to healthcare.

Sponsor Update:

  • The Massachusetts eHealth Institute (MeHI) REC releases a list of certified EHR vendors and Implementation and Optimization Organizations. EHR vendors include Allscripts, eClinicalWorks, eMDs, Greenway, MedPlus, NextGen, and Sage. Implementation organizations include Culbert Healthcare Solutions, eClinicalWorks, eMDs, and MedPlus.
  • San Juan Regional Medical Center (NM) will use the Universal Document Portal from Access to share information between its MetaVision ICU system and Meditech CIS. San Juan also uses the Access Portal to interface perinatal documents from its GE Centricity system into Meditech’s scanning and archiving product.
  • Bridgehead Software and Dell introduce an enterprise medical archiving solution that combines Dell hardware with Bridgehead’s healthcare data management software.
  • Nuance Communications introduces Dragon Medical Enterprise Network Edition for  large practices and hospitals. The new release includes a centralized management console and enhanced support for Citrix-based EHRs.

Medical office employees in Colorado smell a strong odor and discover the source is a dead animal stuffed into a filing cabinet. The clinic owner believes the incident was the result of a break-in, likely by a former employee. He does not indicate whether or not he suspects the prank was some sort of statement about the clinic’s need to move to an electronic filing system.

inga

E-mail Inga.

 

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Currently there are "23 comments" on this Article:

  1. Rats! I knew we should have bought an EMR sooner!

    Hopefully the animal was already dead when stuffed in the filing cabinet. It would be a HIPAA violation if it had access to patient charts while still alive.

  2. Regarding the story “The North Carolina sheriff’s association proposing that the state give its members access to its doctor shopper database of known drug seekers…” I encourage readers not to judge this request too quickly.

    This surfaces a significant abuse of our “current system” where individuals are “doctor-shopping” for drugs like OxyContin, going to the extent of using alias’s and family member’s in seeking access.

    There are physician offices that have gone to the extent of hiring PA’s and Nurse Practitioner’s to put this illegal practice in-check with little or no success. While there has been a recent DEA database put in place, it hasn’t proven beneficial. Reason being that if physician offices, et al aren’t entering the data, or the database isn’t being accessed to id potential abuser’s, it will remain a disfunctional system.

    In many cases these clinician’s fear for their own safety based on the anger & frustration displayed by some who are denied scripts or refills. I fully appreciate a patient’s right to privacy, but on the flip-side there comes a time when clinician’s deserve an added level of “security” for monitoring those who abuse the system.

  3. Unfortunately some physician offices have hired PA’s and NP’s to keep up with the volume of “pain management” cases that they churn huge amounts of oxycontin out to. For 60$ cash you can have any prescription you want.

    Releasing the “doctor shopper” list to the police would likely turn up some of those operations as well. Hard to find a clear moral and privacy ground on this one, but the destruction of lives from schedule II narcotics is an important issue that deserves some real discourse, not policy posturing.

    Mark

  4. Regarding WellStar Health; placing blame elsewhere is easy. I tend to agree that the CFO’s job is to make sure all things financial are addressed. The CEO’s primary job is to be visionary and make sure the other “Cs” execute the vision and the work.

    Being a STAR patient accounting installer from the early HBOC years (6 1/2 to be exact); I can tell you that the system does exactly as it’s told. It doesn’t decide what or how to bill by itself. It wasn’t perfect, but it was good. In my experience, the problems typically occurred when the personnel made poor decisions during implementation or, more likely, failed to make updates to the system as rules and laws changed. Few facilities want to spend money sending their staff back to class for training on software updates or even for a refresher. Nor do they think paying extra to have someone be the resident expert is a good investment. They think they are done with the project and never budget for follow-up training.

    When the system parameters are not correct, you bleed money, mostly unnoticed, through labor and delays that are required to make corrections to the bills after they get rejected, or worse, when the auditors come knocking and take away a portion of your Medicare and/or Medicaid reimbursement by deducting the percentages from future payments. Who can really put a price on that?

    A real-life example: I went back to do a consulting job at my former customer five years later and discovered they had quit billing 1500s two years before because they weren’t coming out right. The staff person guessed they had failed to bill thousands of professional fees for CRNAs. I fixed it in two hours and the claims started flowing that night. They had previously gotten similar recommendations from my coworkers and refused to make the changes. I DO NOT understand that mentality. OH, they threw the entire STAR system out a couple years later because it just didn’t work right. I’d already left the company but was no less disgusted.

    I guess you could say in the end, the CEO and the CFO are guilty as charged.

  5. North Shore doctors are to be commended for not taking the bait. Their CEO is clearly delusional with statements as you report here:

    “Though North Shore is taking advantage of relaxed Stark laws to subsidize up to 85% of system costs, so far only 175 of the system’s 7,500 community physicians have signed up. The health system’s chief executive admits there’s been resistance around “cultural stuff,” including concerns about North Shore’s hosting of the EMR data and discomfort with having to make work flow changes.

    “Cultural stuff”?? How about this culture?:

    the culture that the doctors recognize that they would be putting their patients at risk and jeopardizing the finances of their own practices by signing on to use devices that have no proof of safety and efficacy, and are down right unusable. Very few practices can afford scribes at 25 bucks per hour. They would also be beholden to this delusional hospital CEO, whoever he is.

    There are doctors out there doing primary care that would love to get paid $25 per hour for their 80 hour work weeks.

  6. Though I generally agree with your taste in music, I have to take exception with your taste in TV- Maybe you’ve only watched the first episode or 2 of Studio 60, but it was terrible. Way below Aaron Sorkin’s usual level of quality.

    [From Mr. HIStalk] You’re right, I’ve watched only the first two episodes. I’ve never watched West Wing or Sports Night, but they rate only a little higher than Studio 60 on IMDB.

  7. “There are doctors out there doing primary care that would love to get paid $25 per hour for their 80 hour work weeks.”

    This is $104k/year and even the lowest-paid PCP I have dealt with clears more than this annually although in some cases not by much. I get so sick and tired of hearing physicians (especially specialists) largely ‘cry wolf’ about their hours or take home pay.

    I would care to venture that not a single physician I work with is working 80 hours/week. 45-50 definitely. Maybe 55-60 on a bad week. Every physician recruiting firm survey I have seen in the past year or so put an overwhelming majority of physicians in th 45-55 hour work week. Busy – Yes. Extreme – No.

    The reason that the physicians don’t want to sign up for the North Shore deal even with the lucrative subsidization is that most providers overwhelmingly prefer the status quo (even if the status quo isn’t working that wel) and more importantly don’t want to share all ‘dirty lanundry’ in terms of financials with North Shore. If I were an independent physician, I would be reluctant to do that too because it could be used against me in a couple of ways.

  8. The implication that Wellstar’s software issue is related to McKesson Star is incorrect. The problem was not related to any McKesson product at all actually. Since Wellstar chose not to disclose the name of the vendor, neither will I. HIStalk has a stated bias against McKesson, but to imply without any facts that McKesson’s product was the cause of the problem is irresponsible.

    Regarding Epic and the VA, this makes no sense whatsoever. As a physician who uses both Epic and Vista on a regular basis in practice, I can say that, in my opinion, Vista is BETTER THAN Epic. Epic looks slicker, but the packaging is about the only advantage; Vista remains one of the most functional EHRs on the market. The VA is spending a significant amount of money to upgrade Vista, which is necessary. The program, somewhat like Meditech, was ahead of its time, but has been neglected and fell behind modern programming advances. If the VA chooses to dump its development program and go with an outside vendor, it makes no sense at all to go with Epic. The only reason to dump Vista would be to get away from MUMPS and move to a more modern platform like McKesson, Cerner, or Eclipsys. It still shocks me that hospitals are paying so much for Epic when it’s just Meditech with a better interface. It’s like a colleague of mine recently told me: “Every time I log into Epic, I have visions of John Stossel’s Fleecing of America.”

  9. Said the co-director of the Royal College of Physicians Health Informatics Unit, “One of the dirty secrets of the NHS is the regrettable state of [electronic] medical record keeping. Earlier reports have shown that this compromises patient safety and clinical care.

    I’m confused. I thought the expenditure of £ billions was to IMPROVE medical record keeping, partially using an American HIT vendor product whose name is synonymous with “a thousand years.”

    Am I missing something?

  10. Everybody in involved in any capacity with clinical systems should read the full text of this article – it is a tremendous eye-opener for folks who’ve never trodden the uncarpeted areas of the hospital where the real work gets done.

    These situations are predictable to those familiar with the (30+ year old) field of social informatics, whose main pillars include:

    – IT is not value neutral: its use creates winners and losers.
    – IT use leads to multiple, and often paradoxical, effects.
    – IT use has moral, and ethical aspects and these have social consequences.
    – IT is configurable – it is actually collections of distinct components (and mis-configurable as well)…
    – IT follows trajectories and these trajectories often favor the status quo
    IT co-evolves during design/development/use (functionally, or dysfunctionally)…

    Of course, it’s far easier to place the blame on “Luddite nurses” than to become educated in the true complexities of health IT, and medical and social informatics.

  11. JPS in Fort Worth is also implementing Epic’s EMR, EpicCare, as well. My friend was heavily recruited after earning her EpicCare AMB certification for a Ambulatory implementation job there. She ended up taking a job at Childrens… it’s nice to be an Epic resource in an area with such huge Epic saturation! THR/JPS/Childrens/UTSW/Parkland… am I missing any?

  12. FYI – your post on Vista – agree that it is a respectable app, but it isn’t nearly what Epic is under the covers or on the surface. I think both should be given kudos for real accomplishments in this industry.

    Your comments on dumping Vista for a modern platform seems odd though. Nothing really modern about any of those. Much less a real platform under anything but Cerner which although it qualifies as a real integrated platform has kludges that run deep and would make Cache look pretty impressive by comparison.

    And MIMD – 30+ years of “social informatics” – you might want to lay off the William Gibson novels.

    I’ve not heard vendors bash doctors or nurses – they have to figure out how to make them happy or at least ok to survive. So, ease up on the vendors. They’re not all bad people.

    If you really think that being treated at a hospital with no automation is better than being treated at one with reasonably good automation – I’m not sure you’d really make that choice if your life was on the line.

  13. Re: “FYI Says” The problem I have with your argument about WellStar is that these are tax payer dollars that have been misused. How many additional patients may have been denied treatment because the state has been incorrectly paying for these services and had to limit funds for other treatments? Why is there no transparency on this issue? How does WellStar, a non profit, get away with putting it under the rug as a “personnel” issue? If the state believes others may be doing the same, even if through no fault of their own, shouldn’t all hospitals be made aware of what the issue with the “billing system” is so it can be fixed? One article said WellStar had this problem for four years…isn’t it time we stop this from occuring? Has the vendor, whoever it may be, made the corrections to their system that are necessary to prevent this from happening again?

    And oh, just curious, since you apparently have a stated bias against Epic as you write, what “modern platform” do you think STAR is written in?

  14. On the North Shore situation, I am betting if they had chosen a different product than Allscripts enterprise they would have hope. The reality is Allscripts enterprise is a recipe for disaster in a situation like they describe. North Shore isn’t the only Allscripts enterprise client that has gone down in flames because MD buy-in was impossible. Allscripts took a product designed for 10 MD’s and tried to make into a 1000 MD solution. The product is built to be controlled at enterprise level so MD’s just don’t like it. It will not work at North Shore no matter how low the personal price tag for the MD. The only EHR products that can scale effectively for that size group are Cerner and Epic. I wish them luck but they need to reevaluate their situation before they spend any more money (btw for >100 MD groups Allscripts enterprise versus Epic Ambulatory often cost more than Epic when it is all said and done–you heard it hear first).

  15. Congratulations to C. Martin Harris and to HealthStream for selecting such a well connected former CCHIT Commissioner. This will pave a super highway between the Cleveland Clinic, its doctors, its patients, and the products of HealthStream. Go get em, Martin!

  16. How could I forget? C. Martin Harris, MD, CIO, is also a memeber of the ONCHIT Standards Committee, and its Clinical Operations Workgroup.

    I admire Dr. Harris’ multi tasking abilities.

  17. Lazio said:”I would care to venture that not a single physician I work with is working 80 hours/week. 45-50 definitely. Maybe 55-60 on a bad week. Every physician recruiting firm survey I have seen in the past year or so put an overwhelming majority of physicians in th 45-55 hour work week. ”

    As a PCP in private practice, ie not owned by a hospital, my income is more in line with the $100 k figure. Payments are going down, overhead is going up, Allscripts gets $550 per month for “maintenance”, patients are too sick and complicated for simplistic EHRs to expedite care, fees all around, health insurance going up. Lazio, with all due respect, doctors are no longer piggy banks for all.

  18. PICIS Perioperative in Vermont is notable. From the report: “Your perception is often different from reality so that gives the surgeon a sense of their accuracy in scheduling and it’s helpful to them,” Fairbanks said.” Helpful to the surgeon??

    Surgeons should be worried about their patient, no matter how long it takes. Every case is different. For big brother to scrutinize the surgeon’s time in the operating room is alarming. Will hospitals preferentially schedule their ORs with Fast Eddy the Seamstress?

    The report produced no data to support the use of this equipment for patients, families, or surgeons, but it would possibly improve the bottom line of the hospital’s finances.

  19. “As a PCP in private practice, ie not owned by a hospital, my income is more in line with the $100 k figure. Payments are going down, overhead is going up, Allscripts gets $550 per month for “maintenance”, patients are too sick and complicated for simplistic EHRs to expedite care, fees all around, health insurance going up. Lazio, with all due respect, doctors are no longer piggy banks for all.”

    More ‘woe is me’ and half-truths which is typical when I talk with physicians and their incomes. If payments are going down are across the board, then why does every survey including the MGMA 2010 survey which showed that PCP compensation increased an average of 2.9% in 2009 and other physician recruiting firms showed similitude increases? Figures aren’t available for the average US worker but I bet that it was nowhere near 2.9%. I would bet it would be under 2%.

    As for your ‘maintenance’ fee of $550 per month, I would be stunned at why you are paying such a ridiculously high fee. It should be the ballpark of $200 month give or take depending upon your hardware and a few other factors.

    I appreciate the complexities that physicians have to deal but I get so tired of hearing a physician who doesn’t have to worry about job security piss and moan about taking home $150k or quite more a year. I don’t hear nearly as many physicians complaining about guys who work in the finance sector after that industry bleed jobs last year (about a net of 50k in the U.S.) and is set to probably have more layoffs upcoming as some of the new regulations put a snag on revenues and profit margins.

  20. I am familiar w surveys to which Lazyo refers. They include doctors who are employed by the for profit non profit hospitals, who are paid excessively, sharing in the profits from keeping the scanners and operating rooms humming, and to not report the adverse events ciased by the ill deployed HIT systems and other flawed decisions of the corner suites.

    I agree with Lazyo, who would want to lose a job in which you are being over paid to increase the food going to the top of the chain?

  21. ODO: I refer you to the link below

    http://fcw.com/articles/2010/08/27/mumps-va-vista-system-roger-baker.aspx

    The VA has been going through its own internal discussions for quite a while regarding whether or not to dump MUMPS for a more modern language. They have chosen to stick with MUMPS, as mentioned in the article. In that same vein – if they’re good at MUMPS, why dump their own system for another MUMPS system like Epic. When they were considering an outside vendor, Gartner recommended Epic and Cerner. In my mind, this puts Cerner in the lead, not Epic; Cerner, McKesson, and Eclipsys all are written on more modern language and interoperability platforms, which is the primary concern with VistA.

    Really?:
    Note that McKesson has created their new revenue management program specifically because they recognize that Star, while a great product, needs to be updated. All great tech products become outdated at some point; it’s just a matter of whether a company has the foresight to do something about it sooner rather than later. This, in my opinion, is the reason for Meditech’s decline recently, and will soon become an issue for Epic. I am avowedly anti-Epic, as I feel their software is OK at best, and certainly not worth the cost. Free VistA v. multi-million dollar Epic…hmmm, what do I choose?

    The issue about Wellstar and its disclosure of the details of its billing problems is likely related to legal language in the settlement, and I certainly don’t want to upset that applecart.







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