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November 30, 2010 News 12 Comments

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.

11-30-2010 8-14-56 PM

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).

11-30-2010 9-26-59 PM

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.)

11-30-2010 8-53-55 PM

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.

11-30-2010 9-29-00 PM

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

11-30-2010 6-32-49 PM

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.

cincinnati childrens

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). 

11-30-2010 6-34-58 PM

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.

11-30-2010 6-35-50 PM

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.

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  • 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.

 

inga

E-mail Inga.

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Currently there are "12 comments" on this Article:

  1. Re: Hercules and Cerner Fun Fact:

    I find it interesting that this statement was even made. If you would like the truth, Neal recently made the gym open to the entire Cerner workforce and not just those “trying to get promoted quicker”. Additionally, Neal and the cabinet have issued a challenge to the associate base to become healthier and offered additional health insurance incentives as well as additional paid time off for those who meet certain goals within the coming 8-10 months. I’m sure someone, somewhere will try and also twist that into a similar uneducated comment around employees living longer so that can serve Neal that much longer as well.

    Cerner is great place and I would encourage anyone who would make such unwarranted and unfounded comments to look at the facts before making such a statement.

  2. Why is everyone so surprised to learn that Cerner has an on-site gym? I thought this had been public knowledge for quite some time….

  3. Keeping an updated antivirus isn’t difficult or costly if you use one of several free versions that are available. Avast and AVG have been out there for some time. Microsoft Security Essentials is relatively new but has become a solid program lately – one that I suspect will eventually cut into Norton and McAfee’s market. I was helping a friend just last night remove a nasty rootkit virus that Norton let in and later recognized but could not remove . . . it’s recommended action was “ask for help” 🙂 Between that lame response to this virus and the heavy-handed changes that Norton recently implemented eating up valuable RAM resources, my friend dropped Norton, a trend I suspect will grow.

  4. “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.”

    I’m glad that’s been cleared up by a panel of experts.

  5. This “Cerner is great place and I would encourage anyone who would make such unwarranted and unfounded comments to look at the facts before making such a statement.”

    Contrsts THIS: “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. ”

    One would conclude that they need more time at work and less time in the gym to get promotiions.

  6. First, since when did the theory of “working out earns you a promotion” become the gospel for Cerner…especially from those looking in from the outside? My BMI is below 10% and I work out at the gym…does that mean I get a promotion? No…I earn it through performance just like everyone else. Pretty ridiculous statement to begin with.

    Second, I’m somewhat dumbfounded on WHY it took someone in billing and/or IT at this hospital a full month to catch something that was all of the sudden not happening. I’m not saying Cerner is perfect, but I am saying is that neither are the people on the ground managing the system on a daily basis. Why was this not caught 2-3 days into that month long time frame…do they only bill monthly for charges accrued? The way I see it is that it is of the fault of the hospital staff and the software, not solely on Cerner. It’s shown time and time again on this forum that if your name isn’t Epic…it’s 100% the vendor’s fault.

  7. Re: Truth seeker

    Number of page views/readers might not be the metric they’re really referring to.

    See for example this report on influence of healthcare blogs, from the UK’s FDA-like organization, the Medicines and Healthcare products Regulatory Agency (MHRA):

    http://www.fileden.com/files/2008/5/6/1899375/Market%20Sentinel%20Report.pdf

    It was prepared for the MHRA by Market Sentinel, a company specializing in:

    … measuring, monitoring and benchmarking influence in relation to issues, brands and companies. This includes social media monitoring (blogs and messageboards) but is not limited to it. We provide clients in the public and private sector with hard facts that enable them to better understand the playing field; more effectively bring their messages to market and increase their influence …

    Of interest is the citation analysis-like “stakeholder analysis” method used to rate the influence of various Old and New Media outlets.

    [From Mr. HIStalk] I found the organization’s mention. They referred to those sites as “the two most widely read health care blogs in the United States.” THCB uses the same site analyzer that I use, so I know I can directly compare stats with Matthew. KevinMD is on Quantcast just like HIStalk and I assume he has more traffic, but he has hidden the traffic count so you can’t tell. Not that it matters — I’m only interested in the HIT audience anyway.

  8. Inga – as was stated in a previous comment, get a Mac. You will not have any issues, great support and the laptop will last 4 years (I am on my 3rd round of 4year laptops). While the initial up front cost may be higher, over 2-4 years, the Total Cost of Ownership is lower.

  9. If providers are self-certifying, then do they, too have to meet all the menu set items even if they’re not going to implement them all? If so, that certainly gives critics of HITECH, who say that the whole thing is designed to promote proprietary solutions over internal development and open source, some ammunition.

  10. First, there has been a gym on the Cerner campus since 1998.

    Second, MB hit the nail on the head. Again, the difference between a public company and a private company.







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