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March 17, 2011 News 18 Comments

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3-17-2011 9-48-06 PM

A lawsuit against Walgreens focuses on the selling of medical information gleaned from patient prescriptions. Previous lawsuits focused on patient privacy violations, but this one charges Walgreens with depriving patients of the commercial value of their own prescriptions by selling their de-identified information to drug companies for marketing purposes and keeping the money for itself. The plaintiff argues that Walgreens doesn’t own the information, so it shouldn’t be selling it. The suit cites a 2010 SEC filing by Walgreens that lists “purchased prescription files" as an intangible asset worth $749 million.

3-17-2011 9-49-24 PM

Senator Sheldon Whitehouse (D-RI) introduces legislation that would expand EHR stimulus incentives to include eligibility for behavioral health, mental health, and substance abuse treatment professionals and facilities.

3-17-2011 10-02-07 PM

Harris Corporation and Johns Hopkins Medicine announce a joint venture in which Harris will develop medical image management solutions for Hopkins that it will then commercialize.


Reader Comments

From Stephen Yoder: “Re: appointment scheduling. I’m an applications specialist with Cerner and Epic experience and have also worked with a Mammo RIS from a small company called PenRad. It does something that Cerner and Epic can’t – it allows scheduling two or more successive appointments ordered by one provider from different locations (or organizations) and then correctly routes the signed results via fax back to the location from which they were ordered. Those other systems send everything to one location, or require entering dummy doctors. Faxing isn’t going away and neither is FNPs, PAs, and MDs working on multiple locations. Comments welcome, even statements that I’m silly for expecting the big dawg HISs to perform as well at a specific task.” Unverified. PenRad is the #1 KLAS-rated mammography information system, according to the company’s site.

3-17-2011 9-50-53 PM

From Lamprey: “Re: CTIA. The wireless conference is hyping the conference in saying that healthcare billionaire Patrick Soon-Shiong will make some kind of major announcement during his keynote.” He’s buying lots of companies (and a chunk of the LA Lakers) so that could be the case, although I don’t know why he’d tip his hand to a conference organizer in advance. He’s made other big announcements about healthcare, society, etc. that haven’t amounted to much so far. We’ll seen next Wednesday.

3-17-2011 10-06-14 PM

From Mr. Sandman: “Re: Qatar. Two big deals are going down, with Sidra and Hamad Medical Corporation choosing systems. These are right up there with Cerner winning Abu Dhabi awhile back and the Dubai meltdown where Epic won and then had the contract cancelled. Eclipsys won the Hamad bake-off, but last month Allscripts told Hamad they were withdrawing. That’s walking away from possibly the biggest deal Eclipsys ever had as vendor of choice, essentially giving Cerner the business and a major foothold in the Middle East. I don’t know if Epic will jump back in due to the huge expense involved and their experience with Dubai.” Unverified.  

From Former Eclipsi: “Re: new Allscripts India-based offices. Not sure why they are referred to as new. Eclipsys was doing development and support for Sunrise at that same Pune location and Allscripts has been in Bangalore for almost that long.” I wondered that, but I assumed they were moving additional services there. I heard from someone who should know that the offshoring works well to eliminate the US-based resources from doing drudge work, but things go downhill fast when problems go off script (this person swore that a senior Windows engineer in India had to be walked through finding the Windows Start button). Eclipsys had apparently replaced all of its American remote hosting help desk analysts with India-based staff, resulting in some clients demanding that their calls not be routed there after service problems (not unheard of with offshoring in general, sometimes for good reason, sometimes not).

3-17-2011 9-51-49 PM

From Perry Natal: “Re: Inova Fairfax. Any idea why they de-installed GE Centricity and switched to Epic?” Here’s the much-appreciated response from Inova SVP/CIO Geoff Brown:

We have not deinstalled GE Centricity and switched to EPIC. As of 3/16/11 we do not have an agreement with anyone other than GE and McKesson as our core HIS vendors. We did conduct an assessment of our current and future state requirements which led us to issue an RFP to GE, EPIC and other vendors. The catalyst for this centered on our 10 year projected business plan goals and objectives. Drivers included health reform / mu, aco, enhanced analytics requirement, 5010 / icd-10, ambulatory & inpatient system interoperability, physician, patient care and patient experience requirements. I won’t hood wink you because we are strongly considering our options but as of today while rumors are swirling nothing has been finalized. If something should happen I’ll be happy to update you.  Obviously I’m a fan of HIStalk and have found it viable as a useful source for information and insight relative to industry activity.    

3-17-2011 9-52-37 PM

From Will Weider: “Re: Ministry Health Care. In response to the earlier post, we are running a system selection process to choose a single HIS with a single patient database. Today our hospitals run eight HIS instances, and we want to simplify this environment and improve the patient experience. Thus far the selection is limited to our two incumbent partners, Meditech and GE. We have not made a decision and we have not made a commitment to upgrade to GE Centricity Enterprise 6.9. Regarding HITECH EHR Incentives, our current plan is to certify ourselves using our combination of EHR technologies, rather than rely on a single certified EHR.” I’ll call this “verified” since Will is the CIO.


HIStalk Announcements and Requests

Listening: I can’t get enough of Deer Tick (goofy name aside), which I know I just mentioned, but I’m hooked. It’s the best thing I’ve heard in months and I’m playing it constantly. This song is amazingly good and world-weary considering the band is made up of kids in their early 20s (and a little Googling raises the strong possibility that the hard-miles singer is the son of Rep. John McCauley Jr. of the Rhode Island House of Representatives). I’ll be shocked if they don’t blow SXSW away this week.

The first day of spring is Sunday, just so you know. I’m definitely spring feverish.

On the Job Board: Regional Sales VP- West Coast, Account Manager, Content Writer/Media Specialist. On Healthcare IT Jobs: Physician Informaticists, RN Systems Analyst, Marketing Technology Programming Analyst, Implementation Consultant.


Acquisitions, Funding, Business, and Stock

Document management vendor Accentus acquires speech-to-text technology vendor Mrecord. Accentus acquired two transcription-related companies in December.


Sales

3-17-2011 10-35-01 AM

Franciscan Health System chooses TeleHealth Services to provide interaction patient education and entertainment services at its new St. Elizabeth hospital in Enumclaw, WA.

The board of directors for Sharon Regional Health System (OH) approves a five-year, $13 million Cerner purchase. The health system also hires Donna M. Walters as senior director of IT to lead the EMR project and other IT efforts.

Also choosing Cerner: Sheridan Memorial Hospital (WY), in a $9.8 million deal. The hospital’s CFO anticipates receiving $3.1 million in stimulus funds after its August 2012 go-live.

The William W. Backus Hospital (CT) will use a charitable foundation’s donation to fund a two-year extension of its subscription to MyHealthDIRECT, which allows referring non-emergent ED patients to the appropriate level of care by searching the open appointments of community-based providers.

St. John Providence Health System (MI) selects Intuit Health to provide a patient portal to its physician practices.

3-17-2011 9-57-41 PM

St. Peter’s Hospital (MT) picks SeeMyRadiology.com for the sharing of images with patients and physicians.

Georgia Hospital Association signs a purchasing agreement with Prognosis Health Information Systems that gives members special pricing for the ChartAccess Comprehensive EHR. The solution includes hosting on a shared server at Georgia Hospital Health Services.

NextGen reseller TSI Healthcare partners with The Center for Arthritis and Rheumatic Diseases (TX) for the NextGen EHR, PM, and Patient Portal solution.

Creative Testing Solutions (FL) picks Mediware Information Systems’ LifeTrak software to manage blood testing procedures.

Pine Rest Christian Mental Health Services (MI) chooses CareLogic Enterprise EHR for its 18 behavioral health facilities.

3-17-2011 10-00-31 PM

UMass Memorial Health Care (MA) selects Informatica EMR Data Migration Foundation as a key component of its five-year, $140 million upgrade of core clinical and financial systems. UMass is implementing Siemens Soarian clinicals and financials.


People

Healthcare portal company Omedix hires former IntraNexus VP Tom S. Visotsky as VP of sales and marketing.

Insurance industry business intelligence vendor Intelimedix names Michael A. Newman as chief informatics officer. He was previously VP of medical informatics at BCBS Florida and was already on the board of Intelimedix.


Announcements and Implementations

Orlando Regional Medical Center and MD Anderson Cancer Center Orlando go live with PerfectServe’s clinical communication system.

EChart Manitoba, the first province-wide EHR system in Canada, goes live on the first stage of its $22.5 million EHR sharing project. IBM is the project manager for the initiative and dbMotion is providing the software platform.

A data review by Curaspan Health Group finds that 168 eDischarge customers studied in 2010 saved an average of $1.5 million each by having a preventable readmission rate of 14% vs. the national average of 20% .

Evangelical Lutheran Good Samaritan Society will collaborate with WellAWARE Systems, Phillips Lifeline, and Honeywell HomMed in offering wireless sensor technologies to help senior citizens live independently at home. They will study the effectiveness and cost benefit of sensor technology, personal emergency response systems, and telehealth applications.

Baltimore’s technology incubator and its graduate company WellDoc are named finalists for incubator and incubator graduate, respectively, of the year. WellDoc develops chronic disease management applications.


Government and Politics

The second most highly paid local government official in California is the CEO of Palomar Pomerado Health at $1.15 million, according to a review. Eight of the top 20 mostly highly paid employees are hospital executives. At number one was an administrator from Bell, California, population 37,000, whose exorbitant employee salaries triggered the salary review in the first place. The former Bell administrator (now facing charges) made $1.25 million. A similarly outraged article in the New York Post lists the salaries of state hospital executives, with the top end exceeding $3 million.


Technology

Doximity launches its smart phone application for physician collaboration and networking (text messages, photos, telephone dialing, physician locator, provider lookup).

3-17-2011 8-24-35 PM

The Toronto paper mentions Ottawa-based Epiphan Systems, which sells a video “frame grabber” used for remote medical image viewing, but also distance education, security monitoring, and navigation. Henry Ford Health System is named as a customer, which uses the company’s $700 device to capture 30 frames per second video from a laparoscopic tower on a standard laptop via USB, where it’s converted to MPEG-4 video and e-mailed as an attachment.


Other

The EMR market was valued at $15.7 billion in 2010, but no single company dominates the market, according to Kalorama Information. It calls Cerner, GE Healthcare, McKesson, and Siemens “established hospital IT giants” and says Allscripts will build share this year. The press release does not mention Epic as one of the big players. Buy your copy for only $3,500 and maybe you can find out why.

Now for something completely non-HIT related: the average women owns 17 pairs of shoes, yet only wears three of those on a regular basis. She also purchases (only) three pairs of shoes a year. I can confirm that I am well above the mean. The editor-in-chief of ShopSmart provides an excellent analysis of why women love shoes:

Shoes never make your butt look big, you don’t have to worry about squeezing into them if you’ve put on a couple of pounds, and they can instantly make you feel sexier.

3-17-2011 12-45-08 PM 3-17-2011 12-20-49 PM

The photos above, by the way, were sent by readers who support my shoe fetish.

The former CEO of closed Parkway Hospital (NY) is charged with bribing a state senator to help him acquire to other hospitals. He was working with John Krall, CEO of HIT vendor Pegasus Health Restoration, to re-open Parkway. Krall says he has $70 million of capital to reopen the hospital and will serve as its CIO. A community board member wasn’t impressed that Krall declined to name his funding source, saying, “He just came out of the blue. You can’t just come and open a hospital.”

I don’t usually do this, but I thought I’d mention a friend of HIStalk who happens to be a marketing executive looking for a gig. She’s got senior-level HIT experience in working with brand image, brand awareness, social media, PR, product launches, etc. She got our attention as a sponsor contact and definitely raised the visibility of the company she worked for. I offered to forward to her any inquiries sent my way.  

3-17-2011 9-16-37 PM

VisualDX diagnostic decision support software outperformed ED docs in diagnosing cellulitis, according to a research study that also found that 28% of admitted patients with cellulitis were misdiagnosed in two hospitals.  
 


Sponsor Updates

  • United Medical Centers (TX) will implement Sage Intergy for its eight-practice community health centers.
  • Desert Sun Gastroenterology (AZ) selects ProVation MD software from Wolters Kluwer Health for its gastroenterology procedure documentation and coding.
  • ProHealth Solutions, a new ACO formed by ProHealth Care hospital system (WI) and the Waukesha Elmbrook Health Care IPA, selects MedVentive Population Manager and Risk Manager.
  • Microsoft says that since its purchase of Sentillion in February 2010, deployment of Sentillion products has expanded to 575,000 total users across 220 organizations. Over 50 new customers signed up for Sentillion products in 2010 and Microsoft is now distributing Sentillion solutions in the Asia Pacific market.
  • Medworxx will distribute perioperative and critical care systems from iMDsoft’s MetaVision suite in Canada and iMDsoft will offer the Medworxx patient flow, compliance, and education systems outside of Canada in a just-announced reciprocal distribution agreement.
  • Several applications of 3M’s eHealth Documentation Solutions are awarded certification as EHR Modules.
  • MedAssets announces that it will market the PatientSecure palm vein biometric system from HT Systems to customers of its Access Integrity suite, giving patients faster check-in and more accurate medical records retrieval.
  • CEO Jennifer Lyle of Software Testing Solutions will participate on the Meaningful Use panel of the iHT2 Health IT Summit in Atlanta next month.
  • Workforce and incident management systems vendor Concerro announces a joint marketing agreement with Sydion LLC, which offers tracking technologies for emergency response organizations.
  • Healthcare Management Systems earns ONC-ATCB certification for its HMS Ambulatory EHR, following the recent certification of its inpatient EHR and EDIS.

EPtalk by Dr. Jayne

Despite the spring flowers peeking through after the long winter, my week started with more snow. A bit depressing until the FedEx driver appeared with a package destined to lift my spirits.

3-17-2011 6-20-13 PM

The RelayHealth “gift basket to welcome Dr. Jayne” contest goodies had arrived! Chocolate, red wine, great hand cream, and fuzzy slippers. What more could an overworked CMIO want? As an added bonus, the “basket” is a waterproof nylon cooler/tote with an integrated bottle opener which will be great for my local Concert in the Park series this summer. (Yes, dear readers, I do have a life outside health IT, although sometimes it doesn’t feel like I do).

Mr. H alerted me over the weekend to an article by David Blumenthal in Health Affairs. I’m not sure he ever sleeps, but I’m glad when he makes sure I don’t miss interesting things in my ever-expanding inboxes, whether electronic or paper. After snuggling up with the aforementioned red wine and fuzzy slippers, it was an interesting read.

The subtitle is a little underwhelming: “The Benefits of Health Information Technology: A Review of the Recent Literature Shows Predominantly Positive Results.” Where’s the flash and bang? I’d love to see something more like “A Review of the Recent Literature Shows HIT is kicking ass and taking names.” But then again, that kind of concrete statement would require a lot more data than what we have here.

The first thing you note is that all four authors are currently or formerly with the Office of the National Coordinator (although they did list Blumenthal last). Nothing like a little potential author bias to start an article out right. I’d have been more impressed if the same data and conclusions were arrived at by someone independent, such as a university. Although the authors state that over 92% of recent HIT articles were positive, they recognize the cold hard reality that providers are unhappy with EHRs and adoption is a significant barrier.

Building on two previous studies which looked at data from 1994-2007, they examined the months between July 2007 and February 2010 using the same methods and selection criteria. Ultimately they looked at 154 studies (with 100 of those studies being from the United States). Outcomes were ranked as positive, neutral, mixed-positive, and negative based on the proportion of improvement in at least one aspect of care vs. whether any aspects were negatively impacted.

I give them full credit for noting their limitations. The first is publication bias, where negative findings aren’t published as often. The second is weighting all studies equally – independent of study design or sample size. These are very real concerns when performing a meta analysis, whether looking at EHR outcomes or some other parameter.

Reaching the lengthy section on statistical hypothesis testing, I felt myself slipping and had to self-medicate with some of the RelayHealth chocolates, STAT! That got me through to the Discussion section, which was more relevant for most of us. The authors validate what some IT departments seem to forget: “that the ‘human element’ is critical to health IT implementation.” One tidbit that most of us already know is how strongly correlated provider satisfaction is with negative findings.

One key finding is that the data hasn’t changed much from the previous reviews. There’s no real benefit to being an early adopter and slow-moving groups are seeing the same outcomes. For those of us that live every day on the bleeding edge, that’s not a big comfort. Maybe we need to remember The Tortoise vs. The Hare.

I think the best thing they clearly stated that I wish I could make required reading for every CIO, CMIO, CMO, and physician champion: negative findings can be a good thing if they’re used to figure out how to do health IT better / faster / stronger / safer. My spin: don’t take criticism personally – use it to do your job better.

If we’re ever going to get to that “Healthcare IT is kicking ass and taking names” article (which I will happily co-author under my real name with any of you) we need more studies on how to address the challenges we all face and what training and implementation strategies make for the most successful outcomes.

Have questions about CPOE, clinical decision support, or which shapes of chocolate candies have the best middles? E-mail me.


Contacts

Mr. H, Inga, Dr. Jayne, Dr. Gregg.

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Currently there are "18 comments" on this Article:

  1. Steve Yoder’s observation about Epic & Cerner scheduling is classic. Anybody that’s been in this business for more than a few years knows that EMR-HIT vendors are a mile wide and an inch deep in functionality. Best of Breed and niche vendors are a mile deep, and an inch wide.

    So why do providers still buy the ‘thin’ solution. It comes under the heading ‘less work for mother’. And mother is the CIO. Get rid of interfaces (the new term is interoperability) at any cost – even if it means a sub-functional system for the department. With less interfaces, there is less work for IT, but as your example shows more work for the operating department. The typical IT response – ‘it’s not perfect, but they can live with it’

    Unfortunately with the ONCHIT push for certified systems from full EHR vendors the BoB challenge is getting more difficult. Now the CIO can not only say, hey let’s get rid of the interfaces, but lets only buy a certified EHR.

  2. Seems a little odd that a marketing executive needs your help marketing them for a job. I guess I’ll give them credit that they know you as one upside to their marketing skills.

  3. Inga, while I’m sure your friend appreciates you giving her a generally good reference and link to her resume, many of us who have been friends (albeit anonymous) for many years might object. I don’t know of any post on HISTalk (or its “children”) that has so directly promoted an individual. Boo Hissssss.

  4. Just a small correction: Sharon Regional is in Pennsylvania, not Ohio. The website you linked to, WKBN, is in Youngstown, Ohio – just a short 20 minute drive from Sharon, PA.

  5. How does Mr H stay on top of new music? Since leaving college I find I don’t have as much time to sample lots of different music and don’t have the built-in network of peer-listeners to keep pushing new stuff in front of me. So I continue to listen to the Dead, the Stones, Elvis Costello, and the Red Hot Chili Peppers…..

  6. Re: Yoder and Poggio’s comments – linking orders to scheduled events with their locations has been an issue since Ambulatory Order Entry has been available. It can add a layer of complexity when maintaining a set of tables cross referencing locations to the order master. It also depends upon how one chooses to model encounters – is a scheduled encounter an encounter (and then all the clean-up logic for dangling encounters and future orders not yet scheduled).

    I understand Mr. Poggio’s sentiments about best of breed but there are certain areas where interfacing adds a major layer of complexity and unreliability.

  7. Re: Yoder and Poggio’s comments – linking orders to scheduled events with their locations has been an issue since Ambulatory Order Entry has been available. It can add a layer of complexity when maintaining a set of tables cross referencing locations to the order master. It also depends upon how one chooses to model encounters – is a scheduled encounter an encounter (and then all the clean-up logic for dangling encounters and future orders not yet scheduled).

    I understand Mr. Poggio’s sentiments about best of breed but there are certain areas where interfacing adds a major layer of complexity and unreliability.

  8. Stay out of the exectuive recruiting business and focus on what got you here!! Thanks

    [From Mr. HIStalk] I’m trying to help an unemployed friend – why is that offensive? It’s a blog and I say what’s on my mind (which is exactly what got me here). A couple of sentences out of the hundreds I spent hours writing last night surely didn’t wreck your day.

  9. Interfacing always adds a layer of complexity and unreliability.

    Sometimes it is necessary and sometimes it’s not.

    But by definition it is another layer of complexity.

  10. Art and Blah…
    Yes it is very true an iface adds another layer, but why are we ignoring the extra layers (of usually manual effort) the department manager or clinician has to deal with given a less than fully functional tool? Doesn’t their time count for something?

    There was an excellent article written by Marco Iansiti in the Harvard Business Review, May 2003, about the future role of the CIO. He said “The CIO’s primary role is one of architecture and integrating…They need to figure out how the different choices fit because they must be the ultimate integrators of all external suppliers”. In effect, Iansiti describes the CIO as the Chief Integration Officer. If he/she does not accept that role and pushes it off on the ‘single’ vendor solution, he/she in my opinion is nothing more than a high paid purchasing agent or contract administrator.

  11. Frank:
    Fatal flaw in your cited article is that it assumes hospital CIOs are universally competent. They aren’t, which is why so many are desperate to buy Epic. Easier to blame the vendors for not being “integrated” than to just do your job well. What’s a few extra million here or there if it makes a CIO look good?

  12. I’ll side with Mr. HISTalk on whether to post on behalf of a friend needing a job. It is his blog and he can do whatever he dang well wishes – after all, that is pretty much the purpose of a blog – right?

  13. Art,
    I realize that we are all in HIT and tare preoccupied with connectivity issues but it is not the most important consideration. This scheduling example given is trivial compared to many other challenges, which if not addressed during the scheduling process lead to significant problems both clinical and financial. The sad fact is that all scheduling products from the major HIT vendors can’t handle even the basic stuff such as the example given without human intervention and complex workarounds. Bad scheduling systems lead to higher labor costs, more denials, less cash flow, physician frustration and self-pay issues for the patients to name just a few. Bad systems have ramifications far beyond the problems of connectivity.

  14. Re: Walgreens. I am so, so glad that someone is bringing this lawsuit and using this rationale. Private data about me is my data. I own it in the same way that a copyright owner owns the copyright. If I book an airline ticket, my itinerary is my data, and the airline does not have the right to sell it, share it, or tell me that I can’t sent it to TripIt. If I get a prescription filled, Walgreens does not own that information. Naturally, this is different from public information, such as if I am photographed in a public place.

    This isn’t just a healthcare issue, though healthcare is a place where it’s easy to see the importance. I was hoping we’d see some legislation that would enforce this right, but in this case I would be happy if a court would recognize that we have the right to own our own data – the resulting lawsuits would bring a quick stop to lots of seedy practices.

  15. I think the best thing they clearly stated that I wish I could make required reading for every CIO, CMIO, CMO, and physician champion: negative findings can be a good thing if they’re used to figure out how to do health IT better / faster / stronger / safer.

    I have been writing on that issue since 1999, at a site now at Drexel Univ., and taking quite a bit of flak for it.

    It’s nice to see the Federal Government catching up with common sense. The pity is that it took them a decade.

    I can make the same comment about the health IT industry, but at least they have a somewhat plausible excuse – competition, margins and stock price.

    — SS

  16. [From Mr. HIStalk] I’m trying to help an unemployed friend – why is that offensive? It’s a blog and I say what’s on my mind (which is exactly what got me here). A couple of sentences out of the hundreds I spent hours writing last night surely didn’t wreck your day.

    I must support Mr. HIStalk in this.

    It is *his* blog. You don’t like something, read another blog – or start your own (can be done for free at sites like blogger.com).

    That is ‘freedom of the press’, 21st century style.

    — SS







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Reader Comments

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