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Monday Morning Update 12/5/11

December 3, 2011 News 12 Comments

 12-3-2011 4-30-02 PM

From It’s All Good: “Re: [vendor name omitted]. In post-acquisition happenings, staffers have been required to sign a highly restrictive non-compete agreement or face termination, with a number of 10+ year veterans opting not to sign and accepting termination instead. Next up, aptitude tests for those who remain. Pushing out seasoned veterans without having ready replacements is not a best practice.” At least it’s a free country, where the employment commitment works both ways. I admire those who took their walking papers instead of sticking around if they were really that unhappy. Complaining about your job while staying in it is like telling everybody how your spouse mistreats you – if you truly feel demeaned or endangered, stop talking and get out of the situation immediately. The bad thing about company belt-tightening is that you first lose the people with marketable skills and experience, leaving you stuck with those who don’t have anywhere else to go. Update: I concur with a reader’s comment that my “spouse” comment sounded insensitive, so I reworded to be clearer what I meant.

From Farina: “Re: being anonymous. It’s a shame you’re anonymous as you know more than pretty much all of the people that I talk to at vendors, VCs, or healthcare orgs. You’d also make a great advisor for a lot of companies.” I’m happy keeping a low profile, which also keeps me as focused and honest as a monk in a locked-down monastery. Not to mention that “knowing” is different from “doing,” obvious since I still toil in the salt mines of a non-profit hospital. Sometimes I’m envious of those with greater ambition and different skills who create and run large organizations and make names for themselves, but this is still the best “job” I’ve ever had (and the longest held at 8.5 years and counting.) I’m not motivated by money, power, or fame, so I’m fine. I firmly believe that if you do something you really enjoy for reasons other than making money, the money will find you anyway.

12-3-2011 3-19-32 PM

It surely cannot be possible that Christmas is just three weeks away and the HIMSS conference is just eight weeks after that. I get slammed every year in January and February doing the HISsies, gearing up for HIStalkapalooza, setting up our little HIMSS sponsor appreciation lunch, handling a big surge of e-mails of all kinds, and running around the conference anonymously and telling you about what I’m seeing (and trying to keep up with my real job at the hospital, of course.) If you need anything from me, this is a great time to let me know since I’ll be heads-down from New Year’s until March.

12-3-2011 3-07-27 PM

Nearly half of respondents say they have a problem buying into healthcare-related ideas that are presented by someone who’s overweight. New poll to your right: did you go to HIMSS last time and will you be going in February? I registered and made travel arrangements last week. This past year on February 20, Las Vegas was sunny with a high of 46 degrees compared to the normal high of 64. Exhibitors are going to hate the location since they’ll be competing for attendee attention with casinos and showgirls.

12-3-2011 3-50-28 PM

Our own Travis Good MD of HIStalk Mobile will be reporting from the mHealth Summit in the DC area starting Monday. Here’s his preview and links for following along with him this week (sign up for updates and you won’t miss anything). HIStalk Mobile is a media partner, meaning Dr. Travis gets to play intrepid reporter and prowl around areas that are off limits to regular attendees (OK, I’m not sure there really are any of those, but that makes it sound more exclusive than just taking notes along with everybody else.) Big-name keynoters include the Surgeon General, the chairman of the FCC, Kathleen Sebelius of HHS, and some notables from Qualcomm, Apollo Hospitals Group, Verizon, and West Wireless Health Institute.

12-3-2011 9-22-42 PM

I’ve just posted on HIStalk Practice Micky Tripathi’s gripping, highly educational account of having his organization’s patient data breached. It’s long, detailed, full of documentation and like nothing you’ve ever read since nobody has ever talked so openly about their own organizational mistakes. We all know data breaches are potentially embarrassing, but you’ll be surprised (unless you’ve lived through a breach yourself) at the gray regulatory areas, the “who’s really responsible” question (shocker: legally, it wasn’t Micky’s organization, Massachusetts eHealth Collaborative), and just how much money and effort is required to go through the required steps. I’ve preached for years about encrypting mobile devices, so if budget is your barrier, send a copy of the article to your CEO and I bet the project will be quickly funded. I always enjoy Micky’s regular HIStalk Practice columns since he’s not only an expert, he’s also one of the most engaging writers I know. In this case, has served the entire industry, for which we should all be grateful. I consider this piece to be mandatory reading for just about everybody.

Listening: Odessey and Oracle from The Zombies (and yes, I spelled it correctly). This is the innocence, psychedelia, and British Invasion fascination of the 1960s captured permanently on vinyl like a prehistoric bug in amber. By the time this album came out in 1968 the band was broke and disbanded (they could barely afford studio time and had to record it in mono.) Time of the Season climbed the charts and the group still declined to tour, so fake groups gave concerts using their name, with one even grabbing the band name’s trademark that had expired. For my money, I’d take this album over Sgt. Pepper’s and Pet Sounds as the best of the decade (right up their with Love’s Forever Changes and either The Doors or Strange Days from The Doors).

I had some major upgrade work done on the site over the weekend. Most of it is behind the scenes, but if you read HIStalk, HIStalk Practice, or HIStalk Mobile on a smart phone or iPad, you may see some improvements. I noticed that the iPad display was sometimes fuzzy for reasons I could never figure out and that seems to be fixed, plus there’s new support for Apple’s Retina display.

My Time Capsule editorial this week from five years ago: HBOC 1, Everybody Else 0, in which I opine, “Among those involved were certainly some crooks and some fools, but let’s not forget those who suffered most, those McKesson lifers who had stashed away years’ worth of shares of their unexciting company’s stock instead of risking their future on flaky fads like Microsoft and Dell. When lonely old conservative widower Dad McKesson brought home a sexy young step-mom named HBOC, she stole the kids’ piggybank.”

12-3-2011 6-36-13 AM

Welcome to new HIStalk Platinum Sponsor Etransmedia Technology. You may recall that the Troy, NY company facilitated the offering of Allscripts MyWay nationally through Costco, but they’ve created quite a few products of their own related to PM/EHR, patient connectivity, physician mobile, revenue cycle, and clinical documentation. The SaaS-delivered EtransConnect ACO product suite has tools for connectivity, patient identity management, a clinical data repository, and an orders report portal for providers, rounding those solutions out with a community patient portal and back-end analytics tools. The company’s ambulatory EHR toolkit provides a full-function patient portal (appointments, health histories, messaging, refills, consents, online statements, and structured data exchange such as by CCD). Also offered is custom reporting modules and a mobile charge capture app that lets physicians document their hospital rounding activities to send charges back to their own EHRs for billing. The company just announced that it’s  #155 on Deloitte’s Technology Fast 500 with a 647% revenue growth over the past five years. Thanks to Etransmedia Technology for supporting HIStalk and its readers.

12-3-2011 6-56-08 AM

Thanks to Intelligent InSites for supporting HIStalk as a Platinum Sponsor. The Fargo, ND company’s tagline is Enabling the Real-Time Enterprise, which it does with an extensive list of RTLS-powered solutions (asset management, patient flow, bed management, infection control, patient and staff safety, environmental monitoring, and mobile information access.) The company just announced its enterprise Big Data analytics solution that uses the wealth of information it captures to identify trends, track key performance indicators, and call out process improvement opportunities. Also just announced is a consulting service that helps hospitals identify specific areas (and hard-dollar impact) in which RTLS-powered solutions can improve outcomes, patient satisfaction, and cost. I was intrigued that the company’s largest investor and interim CEO is Doug Burgum, who bootstrapped and ran fellow Fargo company Great Plains Software until Microsoft bought it for $1.1 billion in 2001. Thanks to Intelligent InSites for helping me do what I do.

I like to get the big-picture view of a company by checking out an introductory video (I’m lazy and have a short attention span), so I found the one above for Intelligent  InSites on YouTube.

The new Plano, TX office of MedAssets will consolidate over 1,000 employees in a building covering 225,000 square feet. The company’s corporate headquarters is in Alpharetta, GA, which I note has a population around 60,000 and about the same number of HIT-related company offices (slight exaggeration.)

12-3-2011 8-32-45 AM

The IT team behind the US Army’s MC4 battlefield EMR wins the top IT team award from the Association of Military Surgeons of the United States. Receiving the award above is Lt. Col. William Geesey, project manager (on the right.)

Vince Ciotti takes a slight detour from his ongoing HIS-tory of HIT software vendors, this time leading off a series on consulting firms. Vince is looking for your first-hand stories, so if ampersanded names like Coopers & Lybrand and Ernst & Whinney cause one of those TV dream bubbles to appear over your upraised head as you dreamily recall the glory days of dark-suited Big Six accountants descending on your hospital with their weapons of choice (legal pads, expense accounts, and blank RFPs for selling add-on work), then feel free to reminisce with him for future installments.

An ED doctor in Canada admits that he looked up medical information on his girlfriend’s former husband during a child custody dispute. The hospital’s computers have a 10-minute logout period, so the doctor would go behind users who left their PCs logged on to look up records under their user ID. The hospital’s SVP of medicine says it hopes to implement a card-based computer system that automatically logs users off, so there’s a sales opportunity if your company offers those.

12-3-2011 4-08-15 PM

Ed Marx has a big go-live at Texas Health Resources and found this signage amusing.

A fascinating Forbes article called The Bomb Buried In Obamacare Explodes Today – Hallelujah! says the only truly important part of the Affordable Care Act took effect on Friday. That’s when the medical loss ratio part of the law kicks in, requiring insurance companies to spend 80% of the premium dollars they collect on medical care (if they underspend, they have to write customers a check.) The author says this marks the slow but sure death of for-profit insurance companies because they know they can’t do that and still make a profit, so they are already moving to more profitable businesses (but read the comments at the end for some interesting counterpoints, with a notable one being that insurance companies make most of their profit from investing the money until it’s spent anyway and that’s not changing.) A snip from the article:

So, can private health insurance companies manage to make a profit when they actually have to spend premium receipts taking care of their customers’ health needs as promised? Not a chance – and they know it. Indeed, we are already seeing the parent companies who own these insurance operations fleeing into other types of investments. They know what we should all know – we are now on an inescapable path to a single-payer system for most Americans and thank goodness for it. Whether you are a believer in the benefits of single-payer health coverage or an opponent, mark this day down on your calendar because this is the day seismic shifts in our health care system finally get under way. If you thought that the Obama Administration chickened out on pushing the nation in the direction of universal health care for everyone, today is the day you begin to understand that the reality is quite the contrary.

12-3-2011 9-30-03 AM

Raul Recarey, president and CEO of the Missouri Health Connection HIE, quits after eight months on the job.

12-3-2011 9-46-00 AM

HCI’s USA-built Android-powered RoomMate Healthcare TV for hospitals includes a patient and visitor whiteboard, a web browser, video and music options, a pillow speaker, an an optional hard drive for video streaming. It comes in screen sizes from 22 to 42 inches and includes just about every kind of connectivity available. It integrates with the company’s MediaCare2 product, which allows hospitals to send “information prescriptions” to specific patient TVs, such as educational videos, images, and announcements. It also allows hospital staff to control patient TVs from a central location.

Stupid lawsuit: a prisoner sues his former hostages, a newlywed couple whose home he broke into while evading police on suspicion of murder. The couple agreed at knifepoint to hide him, but called police when he fell asleep. He brandished the knife again and was shot by a SWAT team officer. He’s suing the couple for $235,000 worth of medical costs and emotional distress, saying they breach breached  an oral contract by turning him in.

E-mail Mr. H.

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Currently there are "12 comments" on this Article:

  1. RE: Insurance carriers’ MLR

    They will skimp on everything administative except for the compensation of the corner suites.

    They will cut commissions to those sales people in the fiels who spend hours trying to make sense of the legal, but legible, computer spewed gibberish for the consumers.

    Last, but not least, they will shift administrative costs to physicians’ offices and hospitals by demanding they purchase devices that spoon feed the patient data to the carrier.

    For example, there is now a take it or leave it contract out there in Pennsylvania, by Highmark, requiring doctors to take all (no opt out) its poducts; AND, to submit information to Highmark and its HIEs electronically in a format it requires, thus requiring small offices already on a shoestring budget to purchase expensive, user unfriendly, IOM maligned HIT equipment (with a token chance of nibbling the carrot of a few bucks of the HITECH cash).

  2. Confirmed on this posting. Vendor is Vitera and their non-compete is egregious. Two years out of healthcare if you choose to quit. They lost a number of top performers as a result.

    Are they still relevant to the the EMR game? They remind me of what John McCain said about France, namely that they are an aging Hollywood starlet still trying to get a free meal on their fading looks.

  3. You Wrote, “Odessey and Oracle from The Zombies”…for someone who has such an eclectic musicology and is deeply rooted in the sounds of the 60’s you should give a try to “Ogdens’ Nut Gone Flake” by The Small Faces. R&R HOF nominees this year. The Small Faces were influential to The Who and Led Zeppelin and begat Humble Pie and The Faces with Rod Stewart and Ronnie Wood.

  4. The trick with non-competes is simply to sign the rigidly over-restrictive ones.

    Then ignore them. They won’t hold up if your previous employer tries to enforce them, which is highly unlikely if you have not deliberately maligned that employer or abused your prior privileged information. Make sure you don’t harm your previous employer or divulge confidential information, and then go work for whoever you want.

    Think about the number of faces you see in this industry year over year with different boiler plates attached to their name tags. Within my company the non-compete clauses are simply ignored, and we are not the exception, based on what I see.

    No, I am not a lawyer, and this is not legal advice. It’s a water-cooler observation on a blog.

  5. Apparently skeptic has never had a prospective employer deny a job offer after HR read his previously signed non-compete even though the clauses were likely unenforceable and the current employer had no history of ever enforcing a non-compete.

  6. Non-competes (especially an absurd 2-year non compete if the above comment above is true) are ridiculous in almost every instance and should be struck down especially if in an industry where employment is ‘at-will’ and you could be sacked at any time. Practice that is much more prevalent than it should be in a number of industries but we have moved the pendulum so to the right in many cases where a majority of individual workers generally don’t have much more than a ‘take it or leave it’ commitment from their employers.

  7. “Are they still relevant to the the EMR game? They remind me of what John McCain said about France, namely that they are an aging Hollywood starlet still trying to get a free meal on their fading looks.”

    Heck, from what I hear, it may be scary on the inside on the nth acquisition, but also seems they now have a management team that at is focused and gets along or has been picked to? We’ll see what an exec team brings with a shared goal vs in-fighting and back stabbing with no medical industry knowledge. Looks like most new execs are from Sunquest – not sure who can shed light on how they performed under Vista’s purchase before moving over. Just a shame that the strong talent left or are leaving based on the above instituted moves – sure is a good way to clean out dollars to give them runway though… Also consider there are a lot of folks out of work that would love to contribute with great skills.

  8. RUMER: Microsoft Health Solutions Group – the wind of change is a blowin’. Big shake up this week. GE Healthcare is either aquiring, merging or doing a joint venture with HSG. It will be interesting to see who is in and who is out!!

  9. Epic addresses some of their non-compete issues by forcing clients and partners to sign secret no-hire agreements. This trick also catches long time employees with old contracts and non competes that only covered the first few years of employment with them. It works pretty well for them because the employees don’t need to agree to it and they are less worried about competitors hiring away employees and more worried about clients and consulting firms who can offer shorter hours and/or better pay.

  10. Highly restrictive non-compete? Aptitude tests? Sounds like the boys from Vista Equity Partners are at it again. I would imagine they are doing the same thing with Sage that they tried to do us at SIS. Some great people left there as well. Good luck.







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