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Monday Morning Update 5/2/11

April 30, 2011 News 10 Comments

From Kelli: “Re: Epic Beaker lab system. Epic isn’t much help in installing this application. Neither the technical or application side is a font of knowledge. I know it’s not a seasoned app, but I would still expect the company that coded it to have more knowledge about it.”

From Madeleine: “Re: immunization registry EMR interface. After multiple communications with [vendor], they decided that if the test submission of the Immunization Interface to the I-CARE registry fails, they will still charge us the full price of the interface. I asked for a refund if it fails and they declined to do so. The cost to our practice with be $6,000 for the interface and $900 for interface support, unfortunate since our three-provider practice already invested heavily in hardware to be able to upgrade to the vendor’s MU version. Even if all three providers are awarded MU in 2011, we will have paid more into the system to obtain MU than we will get back from the EHR Incentive payment.” We forwarded the comment to the vendor, giving them a chance to explain or maybe change their minds even though we (and possibly they) don’t know who you are. In the mean time, I’ll leave their name to give them time to respond. Hopefully you didn’t implement for the money alone because it won’t be the pot of gold you might have thought (as you are now finding out).

4-30-2011 6-04-49 AM

Nearly 3/4 of respondents to my last poll don’t think Meaningful Use will improve patient outcomes and patient safety. New poll to your right: given Oppenheimer’s initiation of coverage of certain healthcare IT stocks, which company’s shares would you buy today for long-term appreciation?

Meanwhile, the newly issued “underperform” rating that Oppenheimer gave Cerner didn’t dampen investor enthusiasm after the company posted strong quarterly numbers after Thursday’s market close. Shares closed Friday at $120.18 after touching on a new all-time high of over $124 in mid-morning. Cerner’s market cap is just over $10 billion, pushing the value of Neal Patterson’s holdings to beyond the half-billion dollar mark.

The Boston Business Journal reports that athenahealth’s SEC filings indicate that CEO Jonathan Bush earned $4 million in total compensation in 2010 and made another $4.4 million from exercising stock options. ATHN shares are at $46.21, double their July price and valuing the company at $1.6 billion.

From Meditech’s just-filed SEC quarterly reports: revenue up 20%, EPS $0.77 vs. $0.60. Product revenue made up $15.6 million of its $20.2 million increase in revenue. Meditech paid $13.7 million to acquire the remaining of shares of ambulatory EMR vendor LSS in February, with its total cost to buy the company just over $17 million.

This week’s Time Capsule editorial, revived from the slumber it has enjoyed since I wrote it in 2006: Just Back from HIMSS? Finish Implementing Yesterday’s Fads First. A sample: “Newly-minted experts fill HIMSS meeting rooms with audiences of the mildly curious, the crassly opportunistic, and consultants desperate for a fresh horse to ride.”

Weird News Andy is back after a break, entitling this find as “Here I sit, broken-hearted” and in Rohrshach test fashion, observing that the photos look like Jelly Bellies to him. Scientists genetically engineer E. coli bacteria to release specifically colored pigments in the presence of various maladies, turning bowel movements into a color-coded diagnostic tool.

4-30-2011 6-28-57 AM

Helen Devos Children’s Hospital (MI) creates My Baby View, which allows parents of newborns (who have an average length of stay of 27 days) to view their babies remotely. Parents ask for live video by calling the nurse, who positions the camera and e-mails back instructions for logging in to a secure Web site to view the video stream. The system was funded by a $25,000 grant from Ronald McDonald House Charities of Outstate Michigan.

4-30-2011 6-33-36 AM

Welcome to new HIStalk Platinum Sponsor dbMotion of Pittsburgh, PA. The company’s service oriented architecture (SOA)-based interoperability and HIE solution gives caregivers a real-time view of integrated patient information from disparate clinical systems and multiple facilities, providing the benefit of integrated patient records without system replacement. Providers get better information to make decisions and less time searching for important information, reducing unnecessary procedures and poor integration between acute and primary care settings. Its Semantic Framework enables information exchange across diverse systems. It also supports clinical effectiveness through population management, turning mountains of information into meaningful information for use by clinicians, for health surveillance, and to enable disease management. Thanks to dbMotion for supporting HIStalk.

India’s newest export: American babies, carried there by Indian women willing to become birth surrogates for cash in an arrangement called “rent-a-womb.” India’s minimal regulation and low prices encourage doctors to manage the high-profit process and for women to carry the babies of foreign strangers in return for several thousand dollars. A couple from Canada complain that the Indian doctor jacked up the price right before their baby’s due date, saying the original proposal was the “base price,” then billed them for the hospital stay at triple the usual price without paying the hospital its share. The couple paid the hospital directly, but the doctor’s staff prevented them from getting an exit visa to leave the country. It ended costing about the same as it would have in the US.

Driscoll Children’s Health Plan (TX) chooses Sandlot for its HIE, connecting it with Driscoll Children’s Hospital.

4-30-2011 4-55-58 PM

Mary Anne Leach, VP/CIO of The Children’s Hospital (CO), is named by the Denver Business Journal as its CIO of the Year for non-profits.

Sad: the Seattle Children’s Hospital critical care nurse and 27-year hospital employee who killed a baby with an overdose of calcium chloride last year after making a calculation error hangs herself.

Michael Dell speaks at the Health Evolution Partners Leadership Summit, saying the “insights gleaned from working with healthcare organizations around the world” have convinced him that higher-quality care is correlated to higher-quality information. He encouraged healthcare leaders to unlock healthcare information (buy Dell EMR solutions), empower caregivers (buy Dell mobile devices), improve business processes (buy Dell revenue cycle services), and use information for innovation (buy Dell medical archiving solutions).

API Healthcare and Kronos have explained why they cancelled merger plans, but the Department of Justice offers an explanation of its own, saying Kronos would have controlled 70% of the time and attendance market in healthcare and that “the abandonment of this transaction means that consumers will continue to receive the same benefits of competition, including greater innovation and lower prices, they’re now receiving.” That would make a great quote for API’s marketing collateral if you ask me.

4-30-2011 5-02-38 PM

More on the $4 million lump sum retirement package (plus $150K per year for life) given to the president and CEO of Salinas Valley Memorial Healthcare System (CA), which has one 269-bed hospital. The payouts were apparently structured into seven different plans to skirt IRS rules, with the board president justifying the amount by saying the payouts were OK’ed by an outside executive compensation firm and that the hospital has to pay big bucks to compete with for-profit companies. The union president says the district should be ashamed since the hospital is cutting 25% of its workforce and that the consulting firm who recommended the layoffs was paid $10 million in the last year to “do the job (the executives) should be doing.”

Strange: EMTs are called to the home of Doctor #1 to transport Doctor #2, who the inebriated partygoers thought was having a heart attack. During the ride, Doctor #2 unfastens his seat belt and starts hitting the EMT’s female co-worker. Doctor #1, riding shotgun, swore at the EMT and told him he would have his EMT license revoked. At the hospital, Doctor #2 unfastens his seat belt again, so the EMT holds him down to prevent the cot from overturning, inspiring Doctor #1 to rush over and punch the EMT in the jaw. Doctor #1 later pleads guilty to battery; the EMT files suit against him and wants his medical license revoked.

E-mail Mr. H.

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Currently there are "10 comments" on this Article:

  1. > parents of newborns (who have an average length of stay of 27 days)

    That sounds like neonatal intensive care unit newborns, which are a special category for sure (in our hospital about 1/2 of these are premature, and the other half have congenital defects, infections, etc.).

    Normal tem newborns have an average length of stay that’s well under 3 days pretty much everywhere as far as I know.

  2. Re: Oppenheimer and “underperform” on Cerner:

    Just goes to show that the reader who posted about our (Cerner’s) looming financial fall was also unwarranted. Funny how not having a long position in a stock makes someone envious…

  3. Underperforma in Cerner, you know, then the raters read the events in down under Australia, Sydney. Can not ignore, so they get worried like where there is smoke, there is fire, they say. Then the COO leaves with textbook reason to pursue interest.

    I diss appointed you get into rating stocks on this otherwise gosspiy but academic blogger.

  4. Mr. H,

    Your response to Madeleine is very insightful. I love your pithy comments. This one, ” Hopefully you didn’t implement for the money alone because it won’t be the pot of gold you might have thought (as you are now finding out)” is one of your best ever.

    The question that you provoked is why would doctors caring for complex patients implement these systems and create the problems that Madeleine experienced?

    It is challenging enough to manage the care of the patients; now, Madeleine must manage a second patient (the EHR and POM system) for each real patient.

    Is any one listening to the plight of the doctors?

  5. Salinas is down highway 101 from Silicon Valley, and the financial contrast between the two is the same as from Beverly Hills to the Bell, a California city where officials’ sky-high salaries sparked national outrage and then arrests. Can we expect the same in the Salinas hospital case. Can running a 300 bed hospital be that difficult?

  6. Based on the price for the Immunization interface, I have a pretty good idea who the vendor is. They, and most others, have supported the VXU transaction for several years now. However, the registries have used paper or a web-based form submission. Only recently has the push been to accept the VXU HL7 feed – and that is thanks to the CDC. So if/when the tests fail, I wouldn’t be so fast as to point fingers at the vendor. I-CARE falls under the historically web-based registries.

  7. @Ralph Hinckley

    As far as I know I-CARE uses Chameleon for their VXU interface and according to the Illinois HIE operations plan I-CARE is accepting HL7 v2.3 and 2.5.
    http://www.himss.org/content/files/hiesop.pdf

    I don’t see why a transmission test should fail if the interface is tweaked to work with the published I-CARE HL7 specs, and if it does fail initially, the vendor should fix it.
    http://illinoisaap.org/wp-content/uploads/HL7-Compatibility.pdf

  8. So glad Weird News Andy is back – I missed him! And you gotta love the “Here I sit, broken-hearted”… wonder how many of us remember that little saying! Welcome back, WNA!

  9. @Margalit Gur-Arie

    Thanks for the link! The HIE operational plan provides information that the I-CARE website does not. I agree that the vendor should make sure the interface is functional as long as all parties agree to the “standard” HL7 VXU specs.







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