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December 27, 2011 News 17 Comments

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12-27-2011 8-39-42 PM

UPMC’s Cerner systems go down for 14 hours at most campuses last Thursday and Friday, forcing them to go back to paper. The PR person blamed “a database bug,” which makes the above Oracle press release from this past summer a particularly fun read. Cerner and UPMC have an atypical vendor-customer relationship since they’ve invested big money together in innovation projects and UPMC runs a Cerner implementation business overseas.


Reader Comments

12-27-2011 7-59-30 PM

From King Salmon: “Re: search. Is here a way to search HIStalk by keyword?” You can use the search box that’s in the right column. It’s not visible on mobile devices, though, in which case you can do a Google search by keyword, then click the gears icon at the upper right of the results screen (that’s where Google has moved the advanced search options, which used to come up on the main search screen.) Then, qualify your search down to the specific HIStalk site as shown above.

12-27-2011 8-27-04 PM

From Booth Boy: “Re: MEDITECH and Cerner. As I predicted, see the attached Las Vegas floor plan. Since they lost their HIMSS points by sitting out a few years, they are way back in the corner by the freight doors. If it’s cold on setup day, they’re going to freeze their butts off because the doors never close.” Just about every year I run the link to the rules of how HIMSS awards its much-coveted Exhibitor Priority Points, which rewards vendors who spend a lot with HIMSS by allowing them to buy bigger and better located booth space. Points can also be earned by buying sponsorships, booking hotel space through their housing company, signing up for corporate membership and paying your dues early, and buying services from HIMSS Analytics. Because they didn’t exhibit, MEDITECH is way down the list in the #727 spot (behind mostly companies you’ve never heard of and even some universities) and Cerner is at #429 (two notches below University of Alabama at Birmingham.) Needless to say, prime exhibit real estate isn’t happening for them this year, so you’ll need to seek them out.  


HIStalk Announcements and Requests

Inga’s taking a short break, so it’s just me (Mr. H) this time around.


Sales

12-27-2011 9-56-43 PM

The board of 125-bed Powell Valley Healthcare (WY) approves the purchase of NextGen EHR to replace its “dysfunctional” and old Healthland system, saying the hospital is getting a bargain because the company offered to drop $400K from the $2.65 million cost if the hospital signed by December 31. The hospital plans to collect $1.5 million in Meaningful Use incentives, which it says it could not have done with Healthland because, according to the IT manager, “The system we have now is not good. It’s terrible. It crashes. I can’t imagine being a nurse or a physician and working with it every day.” The money-losing hospital says buying a new clinical system probably means that other projects, such as needed renovations in surgery and the ED, may not get done, but a board member says the new system is even more important. “This is a have-to. We have to do this. I remember going into the lab a few years ago, and the lab girls were crying, and it was over Healthland (the current system). It needs to be replaced,”


People

12-27-2011 8-10-04 PM

Saint Francis Care (CT) names Linda Shanley as VP/CIO. She was previously with Stony Brook University Hospital.


Announcements and Implementations

12-27-2011 10-12-43 PM

Pikeville Medical Center (KY) goes live on Wellsoft’s EDIS, which is integrated with its McKesson applications.


Innovation and Research

An Ohio ED doctor develops NARx Check, which calculates a drug abuse “credit score” using Ohio’s prescription monitoring program data and alerts ED staff of patients likely to be abusing drugs. The application has generated positive comments from the state pharmacy board and local hospital association.

West Wireless Health Institute says that less than 1% of hospitals have deployed fully functional tablets, mostly because clinical systems vendors haven’t developed iPad-native apps, but also because wireless connectivity is spotty, iPads don’t fit into the pockets of standard-issue lab coats, and typing on an iPad is a pain when PCs are always close by anyway.


Other

The western regional chapters of HIMSS are putting on the one-day Women in Healthcare Information Technology Conference in San Francisco on Friday, January 20.

An insurance company sues the former COO of Christus St. Vincent Regional Medical Center (NM), trying to recoup the $3 million it reimbursed the hospital for fraud losses. The COO allegedly funneled hospital IT payments through corporations that were run by a woman with whom he was having a relationship. He supposedly even paid a part-time student to impersonate an engineer with the phony company when the hospital got suspicious. The hospital fired the COO for cause in early 2008 and says it’s still waiting for authorities to charge him with a crime.

12-27-2011 10-06-44 PM

Jacob Goldman, the former chief scientist of Xerox who created the famous Palo Alto Research Center (PARC) in 1970, died last week at 90. Xerox was happy making money from copy machines and didn’t commercialize PARC’s research, but those discoveries, such as the graphical user interface and ethernet, created the personal computer industry when further developed by Apple, Microsoft, Cisco, Adobe, Sun, and other fledgling Silicon Valley companies.

A new KLAS report says that while only 10-15% of hospitals use real-time location systems, 95% of those that do say they increased operational efficiency.


Several readers sent over a link to this article, in which another conservative publication takes some unfocused political shots at Epic’s Judy Faulkner using healthcare IT as its weapon of choice (actually, they aren’t new shots, just the same old ones recycled yet again for a new audience.) Her oft-recited transgressions:

  • She donates to Democratic political candidates.
  • She represents vendors on the Health IT Policy Committee.
  • She’s anti-competition and anti-innovation, at least according to the unbiased opinion of Allscripts CEO Glen Tullman, an Epic competitor, quoted from an interview we did with him on HIStalk Practice (being a conservative publication, they had to be grasping to quote a long-time supporter and friend of President Obama who had a lot more influence than Judy Faulkner in getting billions in HITECH money included in the stimulus package.)
  • She could have benefitted from politician meddling in which a group urged the VA to buy instead of build systems, mentioning as their argument successful clients that happen to be all Epic users. That’s true, but perhaps a fact worthy of inclusion is that the VA ignored the unsolicited advice and is sticking with its original plan to develop an open source replacement for VistA, so the net benefit to Epic was zero.
  • Epic clients (Geisinger and Cleveland Clinic) were named by President Obama as being good technology users.
  • Epic clients, like those of all vendors, have had some unrelated IT incidents that were listed.

The article concludes, predictably and with no facts whatsoever to back it up, that Epic is preventing patients from getting good care because of “partisan politics” (meaning beliefs that differ from the ones held by the authors.) You would think instead of just Googling up some old articles they could have turned up an actual expert in a hospital somewhere instead of just quoting a competitor’s CEO and a reporter. I’m a conservative more or less (fiscally, anyway) but this is just lazy political editorializing pretending to be reporting, indiscriminately throwing out loads of unrelated mud in the hopes it will stick to someone of a different political persuasion.

Surely someone could build a better case against Epic, although it’s probably hard to write around the inconvenient facts (its customers are among the best hospitals, they are voluntarily buying Epic given the other available options, and Epic tops every industry statistic by a mile, such as big-hospital sales, KLAS rankings, and hospital customers that have been awarded HIMSS EMRAM Stage 7.) Or maybe they can’t. The anonymous anti-Epic comments I get are almost always long on emotion and opinions and short on facts and first-hand knowledge (and they often come from the same handful of posters using different names, which makes me suspect that they are unhappy former Epic employees, spurned job-seekers, or employees of struggling competitors.) I don’t know that I’ve ever seen a negative comment about Epic from someone who actually uses it in a provider role, and I don’t recall hearing remorse from any of those users about losing the systems that Epic replaced. I get tired of writing positive things about Epic and keep hoping someone who’s actually in the game and not on the sidelines will provide an intelligent and convincing counterpoint to why they aren’t as great as the Kool-Aid drinkers say. I’m still waiting.


Sponsor Updates

  • Weed Army Community Hospital (CA) chooses T-System for paper-based ED documentation.
  • Salar suggests three New Year’s resolution in a blog posting.
  • Nuance releases a case study on Emerson Hospital’s (MA) use of Nuance Transcription Services powered by eScription.
  • Digital Prospectors Corp., which offers embedded systems engineering and healthcare information systems consulting services, is featured in Bloomberg Businessweek.
  • Jeff Wasserman, VP of Culbert Healthcare Solutions, discusses physician employment opportunities, job culture, and interview skills in an American Medical News article.

Contacts

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

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Currently there are "17 comments" on this Article:

  1. Re:Epic article

    The comments on that article are absolutely stunning. Wait, I think terrifying is the word I was looking for…

  2. Epic has very powerful system that can and does work well in the ambulatory and inpatient side. It is “configurable” to how ever you want to develop it (time and money) and the upkeep is far from cheap. Besides getting re-certified on a regular basis when the software changes to making sure the background setup is kept in place and tested before making a new release. It is good, but Judy is a brilliant business woman. She has led them to the top of the mountain for “World Domination” and 60-70% of the herd would jump off the top with her. There are specific ways to speak and Judy makes sure everyone talks her talk. Call it kool-aid or crazy, but it works and they have built a city in Verona.

  3. Thanks for being honest and open about Epic. No company or product is perfect, but they do have a great set of systems, especially considering the alternatives. Feelings about Epic do tend to be strong in one direction or another, but I believe you provide a very good neutral assessment of the situation. Nobody would put up with the quirks and high cost of ownership if the product wasn’t so good! I hope other companies DO make products that are as good or better – more competition is a good thing in my book, and it will just spur Epic on to better things. (As it should.)

  4. @ Innocent Onlooker:
    Jeez! After reading your comment I went over to the article and read the comments… WOW… full of racism and hate. I wonder why that guy is picking on the Indians? Terrifying is definitely the right word.

  5. While Epic has provided a good product and has a strong implementation methodology, I would suggest that those truely interested in why Epic carries such a strong reputation review a book called “Influence: The Psychology of Persuasion” which will shed light on how buyer perception and expectations can be shaped such that a product or idea is seen by a mass audience as far more positive than it is in reality.

    To make this more concrete as it is Christmas, how many people do you know who discuss faults with their new Louis Vuitton bag which cost over $3,000? In contrast, how many do you know that discuss with their friends faults with their $25 bag from Target.

  6. @David:
    Thank you for the note, I will read that book. However, I am pretty skeptical that all the top rated hospitals have been psychologically fooled into purchasing Epic just because they are more expensive and are good at persuading their clients that they are the best… especially given Epic’s lack of sales and marketing staff. Also that they are top rated by independent ratings boards. Just my $.02, YMMV.

  7. @Timmy D:

    I did not mean to imply that people have been fooled, only that there may be the perception of the system providing greater value or having fewer faults than is actually the case. As I mention in my original post, I do believe that Epic has a good product and a strong implementation methodology.

  8. Mr. H is correct in that the market has spoken and chosen Epic. It is probably the best product available with a large reference base. And health system purchasers like the safety of that.

    But relatively better does not equal good. It’s actually pretty darn mediocre.

  9. It should be noted that Epic is not usually chosen by senior leadership unlike Meditech and perhaps some other inexpensive systems. Epic is usually the choice of the clinicians who have to use a system every day they practice medicine. It’s very refreshing to watch their reactions to seeing the system in action and to hear their very positive comments about how it more closely matches their thought and work processes. The Epic system is not perfect and having it fully integrated has some issues as something in ambulatory can trip up something in inpatient. But clearly it deserves its accolades as the best in class even for all that money.

  10. UPMC 14 hour down – Given the customer and associated visibility I would expected Cerner to have issued a statement to it’s customer base regarding root cause and how to protect against it. This length of unplanned down time with current technology is not acceptable.

    As much as UPMC wants to deny that risks to patients increased it is just plain not true when a process change of this magnitude is unexpectedly introduced into work flows.

  11. The UPMC EHR crash started at approximately 6 pm, actually. They did not go to old faithful paper for a few hours in hopes that they could get it up and running. Thus, the outage was longer than the PR stated.

    Mr. Histalk, do you know if these crashes, aka “unplanned downtimes” must be reported and if so, too whom?

    There are many 30 minute downers that never become known but are equally as disruptive when the e-Mars and e-Orders disappear in the recovery rooms.

    We would all be interested in hearing from those would be brave souls who were there that night at one of the umpteen UPMC hospitals and had to readjust their workflows to save their patients.

  12. I have a few observations and questions.

    Penssylvania has Act 13 mandating reports of infrastructure failures.

    Is there a joint venture between the three business entities mentioned in your post?

    Why do you suppose that the PR at UPMC was so secretive about the other vendor?

    Have other hospitals used the EHR downtime protection system of Oracle?

    Thye EHR downtime protection system provided little, if any, protection. Thus, I wonder if this was a beta test site?

    Thank you Mr. H for a special resource for us nerds.

  13. Re: Epic

    My issue with Epic has nothing to do with the product itself.
    It is their control over the Epic job market. When have we ever seen a company dictate to other companies who they can hire and when people can make job changes? I understand a company having a non-compete that governs their own employees, but they control who their clienst and their consulting partners can and can not hire. I worked for a hospital and wanted to make a job change. I was told by numerous consulting firms that they could not hire me because my hospital had not gone live. Basically, Epic would not allow them to hire me. I had worked for that hospital for several years. Averaged 50+ hours a week. Great performance reviews. Was making just under 60k a year. Was tired of seeing consultants come through who were making three times as much money as I was and who constantly had to ask me build related questions.
    Figured that since I could travel 100% I would make a job change. Took me a long time to get around the Epic road block.
    That is my issue with Judy.

  14. @DB: I think that is a pretty valid complaint, but the counterpoint is that they are just doing it to try to help their clients. As someone who has been both an FTE and Consultant in the Epic space for over 10 years, I can relate to your complaint. I have had on two occasions interest in consulting companies that later had to back out because I was working for a large Epic client at the time. However, I must say that despite those challenges I have never had a problem finding a consultant company to hire me anyway – only “Epic Certified Partners” are shy about hiring away FTE’s, and there are plenty of consulting companies that are not Epic Partners. Of course, as long as you work for that company Epic will not allow you to have UserWeb access or complete NVT’s, but you can get around this by going to work for 6 months or so for a non-Epic partner consulting company and then jump ship for an Epic partner after your 6 months or so is up. I know, it is a hassle, but the problem is not insurmountable. Even if Epic’s position on this grates on the nerves, I can understand their position. They have been criticized for their noncompete agreements they use on their employees as well.

  15. Definition of financially conflicted= “Cerner and UPMC have an atypical vendor-customer relationship…they’ve invested big money together in innovation projects and UPMC runs a Cerner implementation business overseas.”

    Thank you Mr. His…, Inga, and Miss Jayne for fabulous reads.







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Reader Comments

  • DrM: Although I respect those involved, and standards work is not very glamorous, I'd really like to see a working implementa...
  • Anonymous: In addition to the Patterson Health Center, I know that Neal Patterson endowed Oklahoma State University's Center for He...
  • kevin: No Joy in reading this one, either for patients or for providers, especially primary care. And a pox on the corporation...
  • Associate CIO: Re: Former CIO and Mr Histalk - I can only go off the data that is listed in Definitive, which has proven to be a rela...
  • Colby: https://www.cerner.com/pages/communityworks...

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