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Monday Morning Update 1/3/11

January 2, 2011 News 19 Comments

From Mighty Mite: “Re: HISsies Lifetime Achievement Award. I like that proposed category. The name that comes to mind is Rob Kolodner, MD for his incredibly important work at the VA, his ONC work when Bush gave him a mission and no money, and his open source work, where he’s trying to build systems for poor countries that can’t afford $100 million systems (can we either, really?)” I can’t quibble with your pick. In the interest of offering choices, other names that come to mind are Octo Barnett, Neal Pappalardo, Paul Egerman, John Glaser, Bill Childs, and many more from the provider side, although their work maybe hasn’t been quite as non-commercial as that of your nominee. I’ll be interested to see who readers suggest. The HIT industry has finally been around long enough to have a history worth recognizing.

1-1-2011 1-52-38 PM

Nearly 2/3 of my survey respondents say their software vendors focus on releasing enhancements that help sales instead of current users (we could have another debate about why those desires differ). New poll to your right: what employment changes do you see for yourself for 2011? The poll takes comments, so leave yours if you want. My vote: same employer, same job. I get recruiter calls all the time like everybody else, but I’m really happy at the hospital where I work.

It’s hard to believe it’s 2011. It’s comforting that the person I kissed as the ball dropped was the same as last year and presumably will be the same next year (I like romantic predictability). I lost Internet connectivity for nearly a day starting Friday afternoon, but the broadband company was good enough to send a tech out on New Year’s Day to replace my modem while I was making chili and whipping up killer guacamole (probably because I have business class service paid for by the hospital). I was lucky during that Netflix-free period to accidentally spot an IFC marathon of the funniest TV show in history, The Larry Sanders Show, which is being DVR’ed as we speak. Hey now!

1-1-2011 10-19-00 PM

You know what 2011 means: it’s HISsies time. Nominations are open here. In a week or so, I’ll use the nominations to create the final voting ballot, which I’ll send to HIStalk e-mail subscribers only to prevent ballot box stuffing. I’ve deleted some tired categories and added some fun new ones. Winners will be announced at HIStalkapalooza and I always invite some of the big category winners to say a few words there (they usually pass since they don’t get the HIStalk thing, but what the heck – at least I offered).

Inga e-mailed sponsors about our little appreciation lunch at HIMSS and is sending out RSVP information this week. If we missed you somehow, contact Inga.

I need your advice as readers for my New Year’s resolution. I’m fortunate to not need to make a living from HIStalk since I work full time and have little interest in money, which gives me the freedom to do work that’s not necessarily commercial in nature (or even projects that cost me money, if I think they are useful to the industry as a whole, especially the provider-siders). What projects should I be working on? Education, sharing of best practices, innovation, social networking, charitable work, etc. purely for the benefit of hospitals, practices, and patients? I have limited time, but I do have connections and resources that could be put into play for the right initiatives. I need your help in identifying those possibilities. E-mail me if you have suggestions.

1-1-2011 10-20-05 PM

Cerner must be throwing out some low prices lately, even based on per-bed license charges. This article on Idaho hospital EMR projects describes Cerner, being implemented at North Canyon Medical Center for $2 million, as “an economical system that works well for smaller rural hospitals.” Syringa Hospital (a strangely satisfying hospital name) paid $1.3 million.

A reader mentioned not being able to find a 990 form (the IRS tax form for for non-profits) on the Patient Privacy Rights Web site. I asked Deborah Peel, MD and she says they’re putting it up, but she sent over a copy anyway. I’ve given it my usual look-over and there are no secrets: income and expense of around $200K, it pays one relatively modest salary to a full-time executive director, and Deborah Peel takes no salary, In fact, she’s the organization’s biggest individual donor, so it’s costing her money, not to mention time. I’m disappointed that HIMSS didn’t invite her to speak at the conference this year. I don’t necessarily agree with her in every case and sometimes she provides more emotion than hard data, but I’m glad she crusades for privacy and security since without her there might be no rational compromise. She’ll be the keynote speaker at the Computers, Privacy , and Data Protection conference in Brussels, Belgium (January 25-27). I spent time with her at HIMSS last year and she’s a hoot, not just smart and sincere, but cynically funny in an HIStalk-approved way.

New announcements from Medicity: (a) Children’s Dayton chooses Medicity’s Novo Grid to connect with its partners and affiliated physicians, sending out results, reports, and face sheets from Epic clinicals and McKesson patient accounting and receiving back lab and rad orders; (b) CHRISTUS Health will expand its use of Novo Grid to include ProAccess Community, MediTrust Cloud services, ambulatory orders initiation, referrals, and CCD exchange, all across seven states and extending to an additional 900 physicians; (c) Hoag Memorial Presbyterian Hospital (CA) announces that it connected 250 providers to its HIE in five months using Novo Grid; and (d) Medicity’s iNexx platform has been certified as a modular EHR by Drummond Group, qualifying its users for Meaningful Use.

1-1-2011 7-49-44 PM 

Hospitals always announced their first baby of the new year, so I’ll proudly flash the picture of the first new HIStalk Platinum Sponsor of 2011: Marietta, GA-based Nuesoft (not to mention that they’re also supporting HIStalk Practice at the Platinum level, too). You saw their fun Lady Gaga parody video and the pic of their booth people dressed in hideous 70s fashions, but that’s not all they do. Their offerings include NueMD PM and billing software; NueMD EHR (CCHIT certified); Nuesoft Express management software for college health clinics; Nuevita student health clinic management and EHR; RCM and billing services for college health; and the Nuetopia medical billing service in which the company provides an EHR, PM, billing, EDI, clearinghouse, and services. NueMD, they note on their site, is Internet based, not just browser based. Thanks to Nuesoft for its support of HIStalk and HIStalk Practice.

Speaking of Nuesoft, they’re darned good at making videos. I ran across the one above on YouTube. If you’ve seen other fun, HIT-related videos, let me know.

A job site’s annual list of weird interview questions that gets picked up by newspapers everywhere includes one from Epic: “An apple costs 20 cents, an orange costs 40 cents, and a grapefruit costs 60 cents, how much is a pear?” You figure it must have something to do with logic and formulas since it’s a programmer test. Nothing related to word length or consonant count makes sense (since the first two fruits have the same number of each but different prices), but the formula of (vowels-1) x 20 works, which would price a pear at 20 cents. I’m lazy and immature, but the college tested my IQ as 162 back in the day, which offers no real benefit except I can answer questions like this.

A hospital in England starts conducting patient satisfaction surveys via iPads.

MedTech Publishing, which publishes Healthcare IT News in a business relationship with HIMSS (and also Healthcare Finance News), takes over the HIMSS-acquired Government Health IT. I wouldn’t consider that good news since I’m a semi-fan of the latter but not at all of the former (even though I don’t read either, so I probably shouldn’t have an opinion at all). HIMSS will continue running the Government Health IT Conference and Exhibition. Also part of the deal: MedTech will take over the dead tree publications related to the HIMSS conference that it has previously printed under contract (those papers that are always being thrust at you by cute girls in ball caps every 15 feet as you try to traverse the convention center, necessitating hilarious evasive maneuvers). Neil Rouda, MedTech founder and chairman, is being replaced, and rather vague wording suggests that HIMSS is buying a majority interest in the company. It’s not like they were running a lot of hard-hitting, industry-unfriendly stories anyway.

E-mail me.

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Currently there are "19 comments" on this Article:

  1. I also consider myself lazy and immature, so your answer to the Epic question confuses me. I would have answered “the pears are not for sale at this time”. The voice of authority on fruit, Epic (or the test narrator), has information on all of the fruits except pears. Since Epic hasn’t priced pears yet, then the pears are not ready for market and are not for sale. Until we get more information, there is no correct answer. Particularly if we are dealing with a MUMPS system. I can SET (A,E,I,O,U)=.10 at the outset of my routine and then implicitly state SET PEAR=”$100″ at some point after that. All of my other fruits would still cost the same, except pears now cost $100. Pretentious crap like this is why I would never work for Epic (one of many reasons). This is something I’d expect from Will Shorts, not a serious job interview.

  2. You asked, “What projects should I be working on? Education, sharing of best practices, innovation, social networking, charitable work, etc. purely for the benefit of hospitals, practices, and patients? ”

    Psssst: SAFETY!!!!!!!!!!!!!

  3. Re: Epic question on pears

    I don’t think either of you seem very lazy…I think a lazy person like myself would’ve answered “Don’t know, don’t care”.

    I don’t think I would consider it pretentious, however, it’s no worse than any questions that Microsoft asks.

  4. Pete, I think you misunderstood the self-deprecating joke Mr. Histalk made – running Histalk as a side job, and still having time for his family is neither lazy, nor immature. His ability to make sense out of a seemingly nonsensical information is a quite important troubleshooting skill, and shows that the question is anything but “pretentious crap”.

  5. Re Epic weird interview questions: These are deliberately patterned on the interview hazings at Microsoft, Google, and the like…

  6. EPICTest(String)
    S Vowels=0
    F Loop=1:1:$L(String) D
    . I (“AEIOU”[$E(String,Loop)) S Vowels=Vowels+1
    S TotalCost=(Vowels-1)*20
    Q TotalCost

    Can i get a job now Judy? Judy?

    IF Answer=”No” WRITE “Not really bothered”

  7. Re: Epic interview question: Years ago at Compucare, I worked for a former nuclear submarine officer. Up for a promotion, he once asked me to role play based on the following question: You are walking through the forest, and from out of nowhere an enemy battleship is coming directly at you. What action should you take? Thinking about his background, I said “Torpedo it”.

    I got the promotion.

  8. Pete, as someone who has never worked for Epic, but spent 13+ years working on 10+ Epic implementation projects, I find your diatribe to be a clash of culture. I find Epic staff to be consistently bright and hardworking. Maybe that has to do with their interview process. Say what you will about Epic’s indoctrination and singular approach to hiring young, healthcare inexperienced college grads. The opportunity to mold them into individual thinking project team members and problem solvers, sure beats some of lame resources I’ve seen from other vendors.

  9. The Cerner implementations at Syringa and North Canyon are hosted offerings, not full installations. Both are CAH’s. Believe those prices are annual subscriptions not outright licensing fees.

  10. re: Tom C
    ignorance is bliss. a young college grad just happy to have a job will work hard and try to flourish. when that young college grad gets enough experience to know better, though, he/she moves on from Epic in a hurry, often with bitter memories of the place. Epic prides itself on its culture, but really its culture is predicated on expendable entry-level programmers

  11. HIMSS reports as here_***MedTech Publishing, which publishes Healthcare IT News in a business relationship with HIMSS (and also Healthcare Finance News), takes over the HIMSS-acquired Government Health IT***

    Does this means that we will all hear and read honest and unbiased reports of the successes and debacles of the HIT experiments from HIMSS and EHRVA?

  12. No comment on Epic interview process or inclusions therein.

    No idea if the vowel count algorithm proposed above is correct for pricing fruit, although it fits the limited scope presented here.

    Nothing against smart alecs.

    But one should be a smarter alec when calling someone out publicly with hastily written code.

    My opinion is rarely sequestered, but I think that writing code well is more important than writing code quickly.

    1. Important functions should be reusable in new contexts. This allows a smaller code base, and greater maintainability over time. If you count vowels once, you might need to do so again. With or without attaching a price.
    2. Variables should be initialized and scoped to prevent undesired consequences.
    3. Check or force upper/lower case, to prevent function failure on poor assumption.
    4. Why couple the number of operations performed to the character length of the input? Since there are only 5 vowels, why not perform an operation on the input string for each vowel?Assuming that average input length will be less than 5 characters, leading to a lower total operation count, is risky. That type of assumption often leads to response time variance for reasons hidden to end users and thus very frustrating.

    FruitPrice(fruit) ;
    new Price
    set Price=($$VowelCount(fruit)-1)*20
    quit Price
    ;
    VowelCount(string) ;
    new vowel,count
    set string=$ZCONVERT(string,”U”) ; not M standard
    for vowel=”A”,”E”,”I”,”O”,”U” do
    . set count=count+$length(string,vowel)-1
    quit count

  13. Seems to me the answer does involve vowels but is much easier than your formula: apple has 2 vowels; orange has 3; and grapefruit has 4; therefore a pear would be the same as the apple, or 20c. Incidentally a banana would cost 40c.

  14. IANAMP (I am not a MUMPS programmer), but it would seem that neither coded solution could gracefully handle a fruit like “Cherry”, “Blueberry” or “Papaya”…

  15. RE: EPIC Interview Question

    Could “pear” also be “pair?” As in, how much for a pair? Just saying if you heard it verbally, that is what it could be construed as…

    Then again, if it’s not I would just respond with “what’s the difference between a duck?”

  16. I figured it out my way before I saw it was a programmer’s question. As i read the question, I took it for a sales thing (even though I am a former programmer), yet came up with the same answer. Clearly, the question infers that the price is all up to me as long as I can support it, so: I decided that if I was to be the seller of said pear I’d price it with the highest (.60), because that’s the value I choose to promote for the benefit of my company. But, if I’m the buyer, then I choose to value it at the lower of the fruits at .20, because that’s what I’m willing to spend, again for the benefit of the company.

    But then I thought maybe this is a physics thing… like the harder the fruit is, the more it costs, so a pear would be .20 or less. If you throw the apple against the wall it will smash pretty easily, but the orange would require greater force to break through all the tough skin – and the grapefruit all the more, maybe even would require dropping from a tall building. This puts the pear pretty much on a par with the apple at .20.

    In any case, I immediately lose all interest in companies that ask those sorts of questions. In my 32 years in IT I’ve never once seen where that would be relevant. Cute maybe, but not relevant to the job. If you want to know my abilities in logic, ask me increasingly difficult math or accounting or whatever science questions, because they are relevant.

  17. My favorite question I’ve heard was for a young internet startup company with a really young work force. So, they’d ask the question:
    “Who let the dogs out?”

    Any answer was fine as long as you knew the reference.

    Granted, on this website, many probably aren’t sure about the reference (it’s a song). However, the fact that I’m still referencing this song and not something like “Why are California girls incredible?” dates me as well.

  18. My interview at Epic didn’t include that question, but it included a similar seemingly-useless mind-bender. I tried to answer it and did a horrible job in my attempt. I got the job anyway.

    Methinks these brain teasers don’t weigh heavily in Epic’s interview process. Maybe they’re just trying to separate the “Give your best shot” crowd from the “Don’t know, don’t care” crowd. Maybe it’s a test of endurance and composure instead of a 1-question IQ test. Sooner or later someone is going to ask you something that seems ridiculous. Are you going to answer it and move on, or are you going to melt down and declare that you’re above all of this?







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