From Specialty EHRland: “Re: ONC FAQ regarding Core and Menu Set items. I sent this question to ONC in September and they punted to CMS, which hasn’t answered. The rule is unclear as to whether vendors must require their clients to pay for and use all components of the certified complete EHR even if the client chooses not to qualify using those menu set measures. Why should a vendor of specialty systems where diagnostic lab results and growth charts are outside the scope of provider practice be forced to develop those features knowing that the providers will be given an exception by ONC and CMS anyway?” This was in response to a confusing ONC FAQ that I tried to interpret. I think the intended guidance, despite some misinterpretation by some publications, is that vendors must demonstrate capability for all Menu Set items to earn certification even if all of their customers plan to pass on those items in meeting their required five of 10 Menu Set items. The impact is on vendors, in other words, not customers (other than having to pay for features they know they won’t use).

From Frank Drebin: “Re: Black Book Rankings. Have you heard anything about the quality of their market research? I’m not wealthy enough to purchase the results of their recent HIT vendor surveys and I’m not an expert in statistical analysis, sadly, although it does not sound dissimilar to what KLAS already does. As a side note, I have three co-workers and a few nurses still quoting, ‘There is a fracture. I need to fix it.’ whenever we run into pedantic problems.” I don’t have a clue – the company seems to popped up out of nowhere with press releases blazing. It’s a recently acquired subsidiary of Datamonitor and one of the principals was Doug Brown, formerly of Avega and McKesson. Their site lists the vendors by category in order – alphabetical, that is (seeing them in score order costs from $799 to $4,995 per report). They sell the reports only through Amazon, oddly enough. Here’s the excellent “Orthopaedics vs. Anaesthesia” cartoon that won me over.

From Wildcat Well: “Re: Black Book Rankings. They rank top EMR vendors, which includes … everyone. Next they can rank the top 32 NFL teams. Morons.”

From Truth Seeker: “Re: news postings. A group says it’s posting stories on KevinMD and The Health Care Blog, saying they are the two most widely read healthcare blogs in the United States. What about HIStalk?” I don’t follow KevinMD, but HIStalk gets more readers than The Health Care Blog. October numbers: THCB, 67,534 visits, 110,191 page views; HIStalk, 95,366 visits, 134,141 page views. Maybe they’re talking only general healthcare sites.

From Mr. Excitement: “Re: Cerner. How ironic it is that they’re being snake-bitten after all those years of selling snake oil.” Cerner’s $400 million office building and soccer stadium project (of which $232 million is being paid by Kansas taxpayers) is jeopardized when two endangered snake species are found on the site.

From Charles De Mar: “Re: CEO salaries. Sturdy Memorial Hospital pales in comparison to its New England counterpart Lifespan, where the non-profit CEO took home a $9 million payday and employees had no raises that year.” I’d like to say that shocks me, but hospital executive salaries are so ridiculous that it doesn’t. Tiny hospitals paying million-dollar salaries is just absurd.

From RFIDebaser: “Re: HIMSS RFID technology. You wrote about HIMSS using RFID to track attendees on the exhibit floor and in educational sessions. You should ask them to talk about what exactly they are doing here and how they will use/sell the data. You can opt out at registration, which I will.” A few folks got worked up when I wrote that HIMSS will use attendee-tracking RFID chips embedded in the conference badges, but most didn’t seem to care. The idea is that your chip feeds leads to vendors in real time and allows them to deploy salespeople when someone of lofty provider rank enters their perimeter. The opt-out wording says that vendors won’t see your e-mail, phone, or address if you allow them to track you like a stray dog, but only the dimmest of vendors won’t figure out how to Google that since they’ll have your name, title, and employer. Needless to say, I’d recommend checking the opt-out box (or disabling the chip).

From The PACS Designer: “Re: Swype. Inga mentioned ShapeWriter this past June, which is now a division of Nuance Communications. ShapeWriter’s Swype application is now becoming a quite popular choice for replacing keyboard touching to speed up data entry in mobile apps and could help win over physicians who shun typing into medical records while treating patients.”

Weird News Andy concludes that “It’s good to to be the King,” at least if your kingdom sits on a lot of oil. King Abdullah, monarch of our supposed democracy-loving ally Saudi Arabia, has everybody else booted from the entire VIP wing of New York Presbyterian / Weill Cornell Medical Center so he can recover from back surgery in private. Relocated, lower-ranking VIP patients are whining that he’s getting special treatment, apparently missing the irony completely. I guess the hospital runs itself like any other business, taking the highest bidder’s cash in return for hanging out a “closed for private function” sign that keeps the tax-paying citizens away from its not-tax-paying doors.

Allscripts VP Rich Elmore, who the Communications Workgroup leader for ONC’s Direct Project (formerly NHIN Direct) offers this clarification of Direct vs. CONNECT:

The Direct Project (formerly NHIN Direct) is a project to create secure transport specifications for point to point messaging of protected health information using the Internet. While the Direct Project does make it easier for providers to communicate directly with one another, this is in comparison to the fax machine, not CONNECT. CONNECT is a software stack that implements health exchange specifications. The CONNECT roadmap includes support for the Direct Project specifications, which will allow any organization running the CONNECT stack to implement the Direct Project specifications.

I: Global Intelligence for the CIO will be running a version of Ed Marx’s July HIStalk post called The Authentic Leader (Death to the Cliche).

The Economist is running an Oxford-style debate and poll on privacy, pitting Microsoft’s Peter Neupert against Patient Privacy Rights’ Deborah Peel. Two-thirds of voters are siding with Peel so far.

Athenahealth CEO Jonathan Bush compares data-sharing among providers to friending someone on Facebook, describing an athena service that will allow providers to share and update patient information. That’s an alternative to “financial integration”, which he describes as the Kaiser-like model where hospitals buy other providers just to assemble their data into a single, proprietary repository.

Indian IT services vendor MphasiS, whose majority owner is HP, says it’s testing a new HIM product for small- to medium-sized hospitals in emerging markets as its entry into healthcare.

Internet image-sharing vendor lifeIMAGE integrates its product with Microsoft HealthVault, allowing physicians to send images to a patient’s account.

An iSoft press release touts the huge reduction in prescribing errors enabled by its medication management system. My critical review based on the abstract of the original work (since I don’t feel like paying for the article itself): (a) the study involved only 72 patients in four weeks as the “before” group and 58 patients in five weeks as the “after”, all of them patients in a psych unit where medication usage is about as different as it can be from the usual med-surg unit; (b) the rate of the most significant errors, such as wrong dose or wrong drug, didn’t change; (c) system-related errors averaged nearly one per patient. In other words, patients didn’t really benefit since the errors prevented were minor or almost certain to have been caught anyway. That’s usually the conclusion of studies involving CPOE, mostly because they focus on error reduction instead of improved ordering practices (putting the best choices first on the selection list, giving only reasonable choices, calling attention to duplicate orders, improving the timeliness and accuracy of order delivery and response, etc.)

Speaking of iSoft, acting CEO Andrea Fiumicelli is announced as CEO at the company’s annual meeting in Sydney. He was previously COO. The call transcript is here. Most of it involves reduced revenue because of the fall of NPfIT, cost-cutting measures, the hope of selling systems outside of the UK, and the usual streamlining efforts (reduced locations, discretionary spending freeze, sunsetted products). They’re still confident in Lorenzo given its relative youth and sales prospects outside of NPfIT, including in the UK itself as more NHS trusts get to make their own decisions.

Australia’s government says its $380 million (US) telehealth program may install service centers in drug stores and could be staffed by non-physicians for online consultations of low-acuity medical problems.

A hospital in China loses telephone service and Internet connectivity for the second time in a month when someone steals a section of telecom cable running through an apartment complex. Doctors wrote bills by hand and patients had to pay in cash.

University of Iowa Hospitals and Clinics says the MyChart part of its $60 million Epic system is a hit with patients, with 35% of them activating their account, 48% of those checking lab results online, 12% looking up appointments, and 11% sending an electronic message to a provider.

Piper Jaffray is holding its healthcare conference in New York right now (November 30 – December 1).

The odd campaign promise by an incumbent Australian politician to buy every doctor an iPad with government money is apparently history after he loses the election.

In England, NHS lists a few abuses of its emergency services: a woman who wanted her toenails clipped, a drunk man brought by ambulance because his wife locked him out of the house, and a child brought in because she had stepped in dog droppings and her mother was too squeamish to clean her up herself.

E-mail me.

HERtalk by Inga

From Hercules: “Re: Cerner fun fact. There’s a full gym right on the Cerner campus with trainers. Most associates don’t use it unless they are trying to get promoted quicker, but this does eliminate the need for them to leave the parking lot.” I figured that Neal Patterson was a pro-fitness kind of guy, given his strong support for soccer. Funny that fitness helps those on the fast track.

KLAS recognizes DR Systems as the leading PACS vendor for large hospitals with Infinitt ranking first for community PACS. In the same report, 92% of KLAS respondents say they don’t plan to replace their PACS in the next few years.

MedLink completes an aggregate of $2.25 million in financing, including $1 million in private placement. It will use the money to increase sales and marketing efforts, for working capital needs, and for the acquisition of MedAppz.

Hill-Rom hires Brian Lawrence as SVP and CTO. He was CTO of Life Support Solutions for GE Healthcare.

M*Modal and Virtual Radiologic announce a strategic partnership to integrate M*Modal’s Speech Understanding technology into the vRad Enterprise Connect 3.0 Technology Suite.

Genesis HealthCare System (OH) deploys BIO-key’s biometric identification solution, enabling clinicians to establish their identity when ordering or administering meds in Genesis’s Epic system. In its next phase, Genesis will implement fingerprint biometric user logon with the Sentillion Vergence SSO product.

Bill Sterling, the former director of healthcare systems for Vocera, joins clinical workflows company EXTENSION as VP of channel and business development. Maybe he can convince them to ditch the all-caps name.

The CFO for Cincinnati Children’s Hospital Medical Center says the health system plans to add 500 new employees over the next year, in addition to the 480 who were hired over the last year.

Advocate Good Samaritan Hospital (IL) wins the 2010 Malcolm Baldridge National Quality Award in healthcare, which honors performance excellence through innovation, improvement, and visionary leadership. Other healthcare-related winners included MEDRAD(medical devices) and Studer Group (healthcare coaching and consulting). 

A subsidiary of Wolters Kluwers Health enters into an agreement to acquire Pharmacy OneSource, a provider of clinical decision support tools for the hospital pharmacy market.

The Leapfrog Group names the University of Maryland Medical Center and Virginia Mason Medical Center (WA) as its Top Hospitals of the Decade. The recognition was based on their public commitment and patient safety and quality innovations.

I don’t recall if I had mentioned this before, but Mr. H generously bought me a new laptop over the summer. The 30-day trial version of antivirus software ran out a few months ago and I have been “too busy” to load new antivirus. I am now realizing that was a pretty stupid excuse since I have now picked up a nasty virus which is preventing me from getting on the Internet. After spending an hour cursing and trying to fix it myself, I took it to a local computer nerd for repair. Now I’m working on the old laptop, which is missing four keys and runs slowly. I only mention this as a reminder, just in case you are also one of those really busy people that has failed to keep your antivirus current. It’s best to take care of these matters as soon as possible in order to reduce the number of expletives you utter.

The CIO of Northern Hospital of Surry County (NC) says the hospital’s implementation of EMC and VMware virtualization solutions has allowed them to eliminate 20 physical servers, decrease power usage, and reduce network congestion. Northern Hospital claims it has saved hundreds of thousands of dollars despite a 30-40% growth in data and the addition of a couple thousand medical devices.

Tensions appeared high at a recent Regional Medical Center (SC) trustee meeting. Trustees were informed that for a one-month period, charges from the pharmacy system were not passing to the billing system. The hospital is working with their HIT vendor (Cerner) to resolve the problem , but had to reissue 3,600 bills. The situation did not please trustees, who had just approved  an additional $2 million for the hospital’s Cerner project, including $628,000 for Meaningful Use upgrades. Now here is where things get a bit testy. One trustee, Danny Covington, says that if the hospital had used Meditech, it could have met the Meaningful Use objectives for less money. Here is the play-by-play in the local paper:

"That is not so," trustee Milton Dufford said.

"I know you want to believe …" Covington said.

"Don’t tell me what I am going to believe now," Dufford said.

"You wanted to believe that we had everything for ‘meaningful use,’" Covington said. "What you think and what you believe are contrary to the end result here."

Why can’t we all just get along?

The 70-provider Riverside Radiology and Interventional Associates (OH) adds ZixGateway Inbound to scan incoming e-mail for unsecured PHI.

CHRISTUS Health and United Regional Health (TX) are some of the dozens of healthcare customers who recently signed up with Catapult Systems for Microsoft IT consulting services.

A study published in the Archives of Internal Medicine concludes that lower-income families with out-of-pocket medical expenditures are more likely than higher-income families to delay or forego medical care. They are also more likely to question services requiring out-of-pocket expenditures.

Sponsor Updates

• ICA wins Best of Show honors in the provider and insurance categories at the recent Everything Channel’s 2010 healthcare IT summit.
• Wellsoft ties for first place in the best of breed category in KLAS’s recent EDIS report.
• The 13-physician Apple Valley Medical Clinic (MN) selects e-MDs for its EHR and PM system.
• Indiana Hand to Shoulder Center (IN) will implement SRS Unified Desktop (PM, EMR, PACS) for its 35 providers.
• Springs Memorial Hospital (SC) chooses the check printing solution of the Access Enterprise Forms Management suite.
• Orion Health announces that its HIE solution has been enhanced to include a modular suite of components to match specific needs of individual healthcare organizations and allow them to scale out projects over time.
• Nuance Communications introduces PowerScribe 360, a radiology and communications platform that combines capabilities of PowerScribe and RadWhere. The solution also works with Dragon Medical to provide core radiology reporting.

E-mail Inga.

 View/Print Text Only

The views and opinions expressed in this blog are mine personally and are not necessarily representative of current or former employers.

Go to Grow

In 2007, I dropped off my oldest child at Biola University in LA. We arrived a few days early so Brandon and I could attend the student-parent orientations. In the name of father/son tradition, we also squeezed in some workouts and ate bad but tasty food.

After we got his belongings organized in his dorm, we huddled for a final prayer and blessing. We embraced, shed a man-tear or two, and then I left. Sitting in my car in the parking lot, I watched him walk to the final student orientation.

Leading up to this point, I had planted seeds: encouragement to grow, encouragement to test his personal boundaries, and warnings against complacency. Brandon was officially beginning his journey into the future and to independence. The results of my optimistic seed planting were soon to blossom.

What happened next surprised me. As I drove down the Pacific Coast Highway, I began to wail. From the depths of my soul, I cried so hard my stomach convulsed. Wheezing in breaths, I mourned my treasured son’s rite of passage. Then mourning turned to dancing, and I rejoiced for Brandon and his future. I can only imagine what the drivers in the cars next to me must have been thinking of my spectacle. I pretended to be singing.

Three years later, Brandon graduated. We’ve seen amazing growth in our son — growth that could not have occurred had he stayed home. Despite an enriching and loving environment, his potential would not have been fully realized without a dramatic change and challenge. Part of us would have loved to have him stay, but we knew and accepted the truth that he needed to go to grow.

My career has been much the same. I can’t think of a single employer that I have ever wanted to leave. Yet with each one, I knew at some point I’d need to go to grow. Indisputably, my former employers offered ample career growth and challenges. But to gain exponential growth, I had to enroll myself on a journey of sorts. I had to break out of my comfort zones and push the envelope of security.

Each successive move has pushed me out of man’s natural bent toward complacency. They’ve shaped and sharpened my abilities. The breadth and depth of divergent experiences have broadened my skill set in an extraordinary fashion. My talents have gained a sharper focus and my leadership quotient has multiplied. I have become a better servant. I attribute my personal and professional growth to pushing my boundaries and circumventing the traditional career path.

Naturally, we need to create internal opportunities and have career ladders — something for every kind of employee. Yet at some point, the best thing for some will be a new environment, a place that challenges them to accelerate to the next level. I believe it is a leader’s imperative to fight complacency in the workplace and encourage others to go to grow. If it benefits our children and ourselves, then we must be willing to encourage subordinates and peers to do the same.

Sound inconceivable? Untraditional? Scary? An exceptional leader is not afraid or insecure to give away their best.

I have helped some of my best go. I have brought them opportunities for external advancements and served as their reference. At each departure, I felt the loss of their daily presence, skills, and talents. I cried in secret, yet I never regretted a single endorsement. I’ve stayed in touch, and what a thrill it is to see how they’ve grown in ways far more enriching than the opportunities I or my employer could have given them. They had to go to grow, to reach their fullest potential.

I recall a sunny afternoon run along the San Diego harbor with one of my colleagues, the president of a well-known hospital. We spoke about “go to grow” and the fruit we have seen in careers as a result. He resigned a short time later, citing this conversation as the catalyst for him to leave a secure position and take on a new growth opportunity leading a health system on an opposite coast. Catching up recently, he shared that it was the best career decision he had made. His growth has proved exponential.

Are there people in your life and work who need to go to grow? Does complacency have a hold on your organization? Are you selfishly clinging, or do you have a heart to see the best opportunities made available? (Picture the able-bodied forty year old still living at home).

If one of your staff has significant potential but circumstances are such that you can’t fully exploit that, do you give that person the freedom to advance elsewhere? Are there other staff members who need you to encourage them to leave for these same reasons but who won’t on their own out of fear?

We only have one year left with our teenage daughter. We will cherish every minute. But we’ll also do our best to prepare her mind to take on challenges and enriching opportunities. In love, we will push her to learn from the past and fail forward, to maximize the present in preparation for the future. Ultimately, the time will come when she will go to grow, just like her brother.

Now it’s your turn. Go to grow!

Ed Marx is a CIO currently working for a large integrated health system. Ed encourages your interaction through this blog. Add a comment by clicking the link at the bottom of this post. You can also connect with him directly through his profile pages on social networking sites LinkedIn and Facebook and you can follow him via Twitter — user name marxists.

 View/Print Text Only

From Bit Byter: “Re: Samsung Galaxy Tab. I’m interested in it.” The new $600 iPad tablet competitor (discounted by carriers selling data plans) runs on Android, has a 7-inch touchscreen (the iPad is 9.7”), two cameras, integrated GPS, Flash support, the cool Swype typing system, Wireless-N, Bluetooth, and seven-hour batteries. It’s too early to say (or buy, probably), but it looks like a reasonable alternative to the iPad for anyone who wants one (just like there are many smart phones better than the iPhone in some ways, but that most people don’t want because they aren’t iPhones).

From Train Wreck in Progress: “Re: CONNECT. ONC can shuffle paper, but they are screwing up real software and progress in treating the CONNECT team like unloved stepchildren despite multiple awards and demonstrated progress in connecting VA, DoD, and Kaiser. It’s a sad day when initiatives like CONNECT are not celebrated, embraced, and supported. Doug Fridsma’s framework was attacked at the HIT standards meetings as not practical, yet he marches on.” The top two CONNECT consultant managers quit as the program stalls while GAO investigates a complaint from Harris, the incumbent contractor, over a new contract awarded to CGI. The open source CONNECT platform, which won WSJ’s technology innovation award for HIT this year, was developed by a group of more than 20 federal agencies to support secure healthcare information exchange among providers, insurers, government, and consumers. ONC standards director Doug Fridsma says ONC wants to make it easier for providers to exchange information directly through NHIN Direct.

From Capiche: “Re: ONC clarification. Any thoughts on hospitals and practices being required to implement all Core and Menu items?” It’s a ONC FAQ that seems to mix vendor and provider requirements in a confusing way, but I’m interpreting it as being applicable only to providers with self-certified, homegrown EHRs. To do that requires implementing all of the Menu set items even though as providers, they could qualify for MU by using a vendor-certified EHR to meet only five of the 10 menu set items. But another interpretation is that all providers must meet all 10 Menu items even though CMS requires reporting only five. Click the above image to enlarge and let me know what you think it means. Or maybe someone from ONC can clarify their clarification since it’s a pretty big deal if that latter interpretation is correct.

Hospitals may lock down their internal e-mail systems with malware protection and tools to prevent PHI transmission, but docs can just go to their Web-based e-mail on those same PCs and do whatever they want, so say 80% of respondents to my poll. New poll to your right, rekindling an old argument — who should be calling themselves “informaticists”? As usual, click the Comments link in the poll to support your position.

Listening: reader-recommended Ry Cooder’s I, Flathead. I haven’t warmed up to all the music yet, but I like that he’s a non-conformist roots music songwriter who doesn’t really care what the masses think. This one’s a third of a three-part concept album series dealing with the Southern California culture in the first half of the 20th century. The alternative to auto-tuned, air-headed, ad-packaged Barbies and Kens singing about lust. And Watching – one more thing I hadn’t thought of that you can do on an iPod Touch: stream your Netflix movies over WiFi, which I did this morning in watching MST3K while brushing my teeth in the bathroom, just because I could.

A five-year study using trigger tools (instead of unreliable self-reported errors) finds that hospitals have made no progress in reducing incidents that cause patient harm. Nearly one in five hospitalized patients were harmed by the care they were given; nearly two-thirds of their injuries should have been prevented; and those injuries contributed to their deaths in 2.4% of the cases. The article concludes that preventing mistakes isn’t rocket science since every hospital knows that they should be doing. The problem is that they aren’t doing those things consistently: handwashing, medication reconciliation, decubitus prevention, etc.

A good article with the great title of The Doctor-Patient-Laptop Relationship looks at how doctors typing into computers changes the doctor-patient dynamic. A past president of the Connecticut State Medical Society says medical schools in her day taught doctors not to see patients from behind a desk since it served as a barrier, but they aren’t teaching today’s medical students ways to keep computers from becoming an equally disruptive barrier. It makes an excellent point: writing makes no sound and people can do it while they’re talking, while keyboarding makes noise and requires most people to look at the keyboard and monitor. I was thinking about that and I agree: when someone’s typing, I usually stop talking because they won’t hear what I say anyway.

Politicians get involved in the plans by two Canadian hospitals outsource IT to Cerner. They don’t like losing local jobs and they also don’t like the fact that Cerner sells de-identified patient data from this side of the border. Meanwhile, the IT department’s “whistleblower” who heard rumors of the discussions and quit in protest says the hospitals are making a mistake in turning over system knowledge to contractors who will have the hospital over a barrel. Anything related to HIT is a touchy subject in Ontario after audits last year found that eHealth Ontario was wildly overpaying no-bid consultants who were filing padded expense accounts, kicking off a political scandal in which heads rolled. The papers are making a big deal about the fact that IT staffers weren’t consulted in advance of the outsourcing discussions, which is ludicrous – in what world does management seek the input of those who would be negatively impacted by one of the two potential courses of action?

Inga interviewed David Delaney MD, CMO of MedAptus, about revenue cycle management tools.

NEJM runs the case study of the Mass General surgeon who performed the wrong surgical procedure on a patient and went public afterward to help prevent errors elsewhere. The Swiss Cheese Effect was in full force, with several potentially minor problems adding up to one big one in which the surgeon performed a carpal tunnel release instead of a trigger-finger release. Contributing factors: (a) the patient did not speak English and the hospital had no interpreter available; (b) the surgeon did several hand cases the same day; (c) the nurse had not marked the planned incision site; (d) the OR suite was changed because other cases were behind; (e) the change in room also involved a changed in staff, including the nurse who did the pre-op assessment; (f) the change in rooms delayed the surgery, so the surgeon saw another patient while waiting; (g) the circulating nurse fell behind in her documentation to go find a missing supply item; (h) the patient’s site marking was washed off when the area was cleaned; (i) the surgeon spoke to the patient in her native Spanish, so the circulating nurse assumed that was the mandatory time-out and didn’t call for one; (j) the nursing team changed mid-procedure; (k) computer monitor placement in the OR forced the nurses to look away from the patient. The best takeaway came from another physician in the case review:

Surgeons need to take ownership of these policies. When the airline industry evaluates a crash, the pilot is not considered responsible except in two circumstances: the pilot was under the influence of drugs or alcohol, or the pilot did not follow protocol. All hospitals need to have a culture in which surgeons feel responsible for making sure the protocol is followed.

Another HIMMS sighting, as even trade show supply companies can’t spell it right.

Funny: Steve Wozniak, the goofball half of the founding team of Apple Steves, mistakenly says in an interview that Apple has acquired speech recognition vendor Nuance, sending that company’s stock on a tear. The Woz says he must have read something wrong.

A court rules that the Iranian government owes McKesson $44 million for illegally seizing its dairy there in the 1979 revolution. The company was Foremost-McKesson back then.

Here’s why you probably don’t want to buy penny stocks of companies more competent at selling shares than product. Shares in would-be HIT vendor Healthmed Services, which I mentioned last week along with pictures of its “headquarters”, go down just as quickly as they’d gone up when pumped earlier in the week. Share price was less than four cents on Monday, up to over 12 cents on Tuesday, now back to under four cents and dropping. Considering the company has zero revenue and prospects for earning any, even the current $7 million valuation is ridiculous. Penny stocks aren’t usually worth even a penny.

IT application coordinators and analysts working for Kaiser Foundation Hospitals get a $2.91 million settlement from Kaiser for being misclassified as salaried instead of hourly. The employees were part of the HealthConnect go-live team, which required uncompensated travel, overtime, and on-call support responsibilities.

In the UK, a hacker gets 18 months in prison for send spam-infected e-mails that allowed him to take control of the PCs of anyone who clicked a link. He bragged on being able to turn on the webcams of infected PCs and to browse their files without the knowledge of their owners. One of his targets was a hospital. About one in 250 of the spam recipients clicked the link. The man is a father of five, runs a computer security firm and did his hacking from his mother’s living room.

The founder of India-based Apollo Hospital Group judges healthcare ideas for a reality TV show about entrepreneurship, choosing Medsynaptic. The Pune company offers imaging solutions, including PACS, low-bandwidth teleradiology, and image workstations.

The South Asia president and CEO of GE Healthcare says the company’s “de-featured” (up to 40% less expensive) medical devices will improve healthcare efficiency, adding that “India will teach the world healthcare innovation.” GE’s healthcare business there is growing 25% a year and they’re planning to hit annual revenue of a billion dollars within five years.

Strange: a UK nurse who accidentally killed a premature baby by giving 50 ml of sodium chloride injection instead of the ordered 5 ml gets in more trouble when the dead baby’s parents find that she posted a Facebook picture of herself asleep beside the baby’s bed a week before the mistake. Afterward, she posted messages asking for friends to “wish her luck” in the inquiry, and when allowed to return to work after her suspension, posted a message saying, “Has had a fantastic day! Is goin 2 treat herself 2 bottle wine!” The hospitals says they knew about the posts.

The Australian government issues $55 million in grants for interoperability projects, or at least that’s what I assume the article is referring to with the term “personal e-health records.” The government is looking for vendor bidders, just in case you’re interested.

A patient sues Halifax Health (FL), claiming his ex-wife, a former hospital employee, provided information from his electronic records to a hearing officer in their divorce and child custody trial. The hospital had already fired her for accessing the records of another plaintiff, which one might assume is hubby’s new love interest.

Nuance will collaborate with Montage Healthcare Solutions to offer radiology users the ability to search their Powerscribe 360 reporting database using voice commands or keystrokes. They’re demoing at RSNA if you want to drop by for a peek.

Surely we can agree this is excessive: the CEO of 128-bed Sturdy Memorial Hospital (MA) is paid $1.18 million per year. You know the excuses: they have to dig deep to prevent her from leaving, the not-for-profit hit its performance targets that enabled it to bank a big surplus, etc.

E-mail me.

 View/Print Text Only

This will be one of those really rare times where I get all reflective and maudlin, it being a holiday and all. I was moved by Inga’s Thanksgiving post. I might have sniffled a little, but I did cook Indian food for dinner, so it could be that the oils from the chili peppers I was chopping for the aloo matar found their way from my fingers to my nose. That’s my story, anyway.

What I’m most thankful for is that I don’t have to think hard to come up with a “what I’m thankful for” list every day of the year. That’s the great thing about having low expectations and a cynical outlook. Any day above ground is a good day.

I love my day job and the hospital that pays me OK for doing it. It’s the best place I’ve ever worked. I’m just as happy when the alarm goes off Monday morning as when it doesn’t on Saturday.

I am thankful for my family and that I found a woman early who not only tolerates my eccentricities and insecurities, but appreciates them. We ought to be sick of each other after all these years, but the first thing Mrs. HIStalk said when she came home tonight, instead of complaining about the paint-peeling stench of my simmering chana masala that she detests, was that I looked sexy. That’s doubtful (especially since I had just sneezed violently from accidentally inhaling sinus-searing masala vapors) but characteristically commendable of her to say. She’s as cute to me as the day we met in college.

I’m happy that I’m healthy, protected by those in military service, and still moved by good music. I’m glad I don’t care much about money, power, and fame since I’d be worrying all the time about losing them even if I managed to get them in the first place.

I’m glad I started writing HIStalk way, way back in the dark ages of 2003. Nobody was reading and I didn’t care, but somehow it has improbably allowed me to meet some pretty amazing people who are trying to make a difference. Sure, and a few douchebags too, but that’s a small minority. We have our differences and our debates in healthcare, but we always end up on good terms.

I’m thankful for everybody who spends their valuable time reading what I write (even the music recommendations, especially the weird ones). I’m grateful that companies support HIStalk just because they appreciate my work and knowing that I’m still going to rag on them when they deserve it.

I appreciate everyone who takes the time to e-mail me, write guest articles, submit thoughtful comments, be interviewed, and tip me off to news and rumors. You make me look smart and your efforts benefit many.

I’m really thankful for whatever cosmic forces sent Inga my way. She keeps me sane and amused, balancing my negativity with cheery optimism and funny e-mails. The insecurity oozed from her early writing as she struggled to keep inside her tiny industry comfort zone. Now she’s confident, insightful, and eagerly read by her many fans (and just as insecure). You’d like her even more if you knew her in person.

I’m thankful that Mrs. HIStalk knows her culinary limits without me having to remind her, so I’ll be doing the cooking Thursday (after popping Zantac all night because the chutney for the samosas was a little too hot). She does make a mean pumpkin pie, though. I’ll just need to crank up the iPod while she’s watching those idiotic televised parades she likes so much.

Have a fabulous Thanksgiving, Black Friday, and the long weekend. And, in my final “what I’m grateful for” item, thanks for reading.

 View/Print Text Only

ONC invites the public to weigh in on personal health records as long as they do it by December 10.

A just-in report from Canada says that two hospitals there are talking to Cerner about outsourcing IT.

Central DuPage Hospital (IL), a long-time Lawson customer, says it has implemented Lawson Contract Management in less than four months.

Listening: new from My Chemical Romance, high-energy, defiant punk/pop with some nice hooks that provide a needed break from auto-tune singers and phony country warblers. Driving music.

St. Joseph Medical Center (TX) develops a 10-physician hospitalist program with Intercede Health, which includes the use of the company’s Order Optimizer software. It provides SaaS-based diagnosis-specific order sets and order set management tools, medication alerts, physician favorites, and a nine-week implementation time. That product is also available separately from a subsidiary.

In Ontario, Sunnybrook Health Sciences Centre partners with Telus Health Solutions to roll out a consumer health portal / PHR that will allow Telus employees to upload and enter medical information that providers can review. Its underlying technology is Microsoft HealthVault.

Happy birthday to Ed Marx, whose special day was Tuesday. You can post belated best wishes on Facebook.

Jobs on the HIStalk sponsor-only job page: Implementation Consultants and Project Managers, Director of Technical Readiness, Implementation Consultant. On Healthcare IT Jobs: Health Information Technology Support Manager, IS Senior Project Manager, Ambulatory EMR Implementation Specialist.

I received a nice response from AMIA President and CEO Ted Shortliffe about a reader’s question as to whether the organization will decline financial support from vendors who won’t go on record as not using “hold harmless” clauses in their customer contracts. He says AMIA’s vendor contracting task force received redacted contract copies and have no knowledge of how specific vendors are writing contracts. He mentioned that Senator Chuck Grassley had sent letters to vendors asking that very question, but he has not made whatever responses he received public. Ted says AMIA’s role is as an educator, not an enforcer, so it made strong recommendations. I can see that point of view: other than Epic, most vendors aren’t going to walk away from business if the prospect insists on removing clause like that one. Nobody makes customers sign on the line which is dotted.

Speaking of that, I’m amazed that hospitals allow vendors to provide the first draft of a contract, loading it with vendor-friendly boilerplate and making sure to look astonished and hurt at any suggestion from their “partner” that it be changed before they hand over their large check. Job #1 is to create your own contract draft and give it to the vendor as the starting point for negotiation. I’m thinking of starting a telenegotiating service where I whisper electronically in the ear of hospital and practice IT people, telling them what to say and how to use classic negotiating techniques to their advantage. Customers are always complaining about the bad deals they got without accepting blame for taking what was offered without a whimper. In negotiation, 80% of the money on the table is going to be split equally between the two parties. When you’re negotiating, you’re fighting for a bigger share of the remaining 20%.

Investment bank TripleTree will host a Webcast about cloud computing in healthcare on December 1. The panel includes top executives from Castlight Health, SCI Solutions, MedVentive, and Connextions. Two of those four are HIStalk sponsors (SCI and MedVentive), so tune in and support them if you’re so inclined.

Nuance announces Q4 numbers: revenue up 17.7% to $310 million, EPS $0.01 vs. $0.02 after some accounting adjustments. 

British company Cambridge Consultants announces the Minder smart device, which transmits medical data in real time to EMRs. It can also receive checklist information from providers to instruct patients. Technologies used: Bluetooth, Wearable Mobile device hardware, accelerometer, the Continua-compliant Vena platform, and input devices that include a blood pressure cuff and scale.

iSoft’s former auditors face misconduct charges over – what else – allowing questionable recognition practices.

Odd: Healthmed Services, which has staked its fortune on some kind of iPad-to-desktop communication tool for healthcare use, floats a bunch of press releases touting its vaguely described agreements with Facebook and Google. Its also-vague Web site features a video of President Obama and a lot of generic information about the vast healthcare IT market it plans to conquer. The company today announced a development agreement with Veritas Software Systems, which might sound like the big backup system vendor unless you recall that Veritas was acquired by Symantec in 2005 (and its name was actually Veritas Software Corp. – this particular company has no Web presence that I could find). It also announced this week a new Web-based practice management system called HealthTrac, with no details whatsoever. What’s really newsworthy about the company: (a) it just filed an 8-K disclosure that it paid a company $600K to develop its flagship product, armed only with an oral agreement, but that company is holding them up for more money; (b) the company’s stock was being pumped and dumped by cocaine-smuggling New York longshoremen (note this “monster pick” that ran up the price 93% on Monday, with 42 million shares changing hands); and (c) its SEC filings from August indicates that the company had zero revenue, had no expectations of any revenue, and was down to its last $52 in the bank. I Googled its listed address and came up with the Las Vegas building above from Google Maps, which I assume is a mail drop. The address it uses for its SEC filings is a one-person virtual office in California that’s currently for rent for a minimum period of one night (that photo is above, too). The CEO quit in August and the CFO was replaced. Shares are at $0.08, with a market cap of $14 million. Maybe I’ve finally found that HIT vendor who’ll have me on their board, enjoying the corporate headquarters any time I can come up with the daily rent.

Odd: Spirit Airlines refuses to give a surgeon’s pregnant wife water while their overheated plane is sitting on the tarmac, offering instead drinks for sale. He makes a scene and makes vague references to terrorism, his son kicks a flight attendant in the groin, the flight crew kicks the family off, the surgeon is suing for $11 million.

Attachmate acquires Novell for $2.2 billion, if there’s anyone left who cares. A Microsoft subsidiary chips in $450 million to get a bunch of Novell patents, leading to speculation that their interest is either in suing other companies or perhaps porting .NET to Linux.

I think we probably won’t have enough news to be worth posting new issues of HIStalk, HIStalk Practice, and HIStalk Mobile through the holiday, but I’ll have the usual Monday Morning Update. Inga has written a sweet Thanksgiving piece that I’ll run on HIStalk Practice and I may write one myself for HIStalk since we are both sentimental, dreamy-eyed romantics anxious to give our BFF readers a clingy holiday hug, just like the watch-those-hands Uncle Bill on the porch after a little too much spiked eggnog and cheap Thanksgiving wine. We’ve been ultra-busy with new sponsors, interviews, and party planning, so we will enjoy the short break. if you’re headed off to RSNA this weekend, travel safely and make sure to crack up your fellow airline passengers in the security line by loudly delivering a few carefully rehearsed jokes about TSA’s full-body scanners. Have a wonderful Thanksgiving.

E-mail me.

HERtalk by Inga

Fun fact: at Cerner’s on-site cafeteria in  Kansas City, color-coded serving tools prompt employees to notice good food choices. Green handles indicate a great choice (think broccoli), yellow handles suggest you might want to limit your portion (pimento-stuffed olives), and red handles (burgers and fries) mean you might want to make time for a workout after work (that is, if you can sneak out of the parking lot without Neal noticing).

Austin Regional Clinic (TX) implements Webmedx’s Enterprise5 platform for its outsourced transcription and speech recognition services.

CMS will give providers online tracking capabilities to check the status of their Meaningful Use incentive payments. The payment information will be available online once a provider is notified that they have met Meaningful Use requirements.

In an article profiling Epic, the story’s author notes that the company rarely advertises and doesn’t encourage media articles. Apparently the reporter had difficulty getting answers to some basic questions. After several phone and e-mail attempts, she was basically told no one was available to assist. Finally an Epic spokesperson told her that the company’s “managers and leaders were too busy to speak with newspaper reporters, even if the reporter in question was writing a major feature story about them.” I bet lots of companies wish they were that busy.

Meanwhile, another local publication points out that Epic makes financial contributions to over 100 nonprofits. The company also donates older computers to local school districts, supports the local public library, and hosts area high school graduations in its auditorium.

The US Bid Committee announces  that Cerner is now an official partner in efforts to bring the FIFA World Cup to the US in the 2022. The committee chair says that Cerner has “clearly demonstrated” its commitment to the sport “in their innovative web-based health surveillance system for professional soccer players in the United States.” I was aware of the Cerner / Kansas City Wizards connection but didn’t realize Cerner also has an “athlete-focused” solution that was launched earlier this year and is now used by all 16 Major League Soccer teams.

Microsoft’s Peter Neupert says the company is abandoning efforts to make HealthVault profitable because of the complexity of the country’s health system. Neuport told  the Financial Times that HealthValult’s benefit to Microsoft was simply to increase the brand relationship” by raising Microsoft’s image with customers as “important, critical and trusted.” Compare those thoughts to what Neupert had to say at HealthVault’s unveiling three years ago:

The way we make money is by encouraging online activity, and through our search application.We know that search is a big business, it’s an important tool, it’s where consumers are today. And by growing the overall search market and delivering more value to consumers, and delivering a better end-to-end search experience, that’s where we can make our money to support this effort.

Florida doctor Arturo Carvajal sues a restaurant after injuring himself while consuming an artichoke. The doctor claims the restaurant failed to “explain the proper method of consuming an artichoke.” Carvajal, a brain surgeon, ending up eating the entire outside of the vegetable, which caused him "severe abdominal pain and discomfort," ultimately resulting in "disability, disfigurement, mental anguish," and "loss of capacity for the enjoyment of life".  OK, Carvajal really isn’t a brain surgeon, but I thought that sounded funnier than family practice, which is his real specialty. Regardless, I hope he has better luck eating his turkey and that someone advises him not to eat the wishbone.

Sponsor updates:

• NextGen Healthcare partners with Scimage to release a jointly develop the NextGen Medical Image Integration Module. The new module will give NextGen EHR ambulatory users the ability to view images produced by any imaging modality or PACS from within the NextGen EHR.
• Eight MEDSEEK healthcare clients win a total of 14 awards at the Strategic Communications eHealthcare Leadership competition. The program recognizes outstanding health web sites.
• Consulting firm North Highland hires Rebecca Whitehead Munn and Brent Holman as account managers. Munn was formerly the SVP of sales and marketing for Consensus Point. Holman comes from a large for-profit healthcare system (which I assume is HCA since both Munn and Holman are based in Nashville).
• North Sunflower Medical Center (MS) will deploy a suite of McKesson products, including Paragon HIS, Practice Partner EHR, and RelayHealth claims and eligibility  processing solutions.
• Surgical Information Systems says its SIS Version 5 is the first perioperative system to be certified as a modular EHR.

E-mail Inga.

 View/Print Text Only