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Monday Morning Update 3/5/12

March 4, 2012 News 26 Comments

From Observer “Epic CIOs. After seeing that two more Wisconsin CIOs that are installing or expanding Epic have lost their jobs recently, I noticed an interesting trend that I call ‘Epic – the Teflon Vendor Effect.’ Have you noticed that when an Epic clinical system install stumbles and fails, it is the CIO’s fault and when the same thing happens with a different product, it is the vendor’s fault?” I will defer to readers on this question,  but following the same logic: does Epic and not the CIO get (or deserve) all the credit when a project succeeds? And do CIOs get the credit when other products are successfully  implemented?

From Reluctant Epic User “Re: Anodyne. My large practice (over 200 providers) is considering Anodyne for BI. The word is that it can extract Epic’s data at the flip of a switch. Do you know or have you heard anything about their implementation? How much effort was required to by the Clarity SQL writers to connect Anodyne to Epic’s Clarity Database? Thanks in advance for the amazing work you, Mr. H, and the two doctors do. It really does make my job and life easier.”Thanks for the kind words. I know very little about Anodyne but I bet we have readers who are experts and willing to share their experiences.

inga Mr. H has left me to my own devices for the week while he is taking some R&R with Mrs. H. I must confess I am wildly jealous of Mr. H’s gallivanting across the globe, especially since my mind and body are still  experiencing a HIMSS hangover. Do a girl a favor and drop me an email this week and tell me all the secrets you would have told Mr. H. Or,  just send a note reminding me that my vacation will be coming soon. And thanks for reading.

A tornado rips the outside wall from three patient rooms at Harrisburg Medical Center (IL) and forces the evacuation of patients. The storm damaged multiple windows and tore heating and air conditioning systems from the building’s roof. Hospital administrators estimate damages in the millions.

3-4-2012 11-39-35 AM

Saint Alphonsus Health System (ID) signs an an agreement to implement MedVentive Population Manager and MedVentive Risk Manager.

The House Energy and Commerce Committee’s subcommittee on commerce, manufacturing, and trade hears testimony in favor of helping state build interoperable drug monitoring systems to reduce prescription drug misuse.

3-4-2012 10-39-17 AM

In case you didn’t get your fill of HIMSS and booth critiques, Dodge Communications sent a link to their fun post highlighting the best and worst from the exhibit floor. They name GE’s booth “Best in Show” based on its approachability and messaging. They also poke some fun at a few vendors’ lack of creativity:

Now, we know it’s tough to find relevant imagery in this business. And we see lots of free stock photography depicting smiling, multi-racial healthcare workers reveling in their use of the exhibitors’ technology. Definitely not easy. But pictures of bridges (“Bridges to meaningful use!”), stethoscopes (“We’re in healthcare!”), puzzle pieces (“Putting all the pieces together!”), and chain links (“We’re the missing link!”)  are not cool! C’mon people, be more creative! The most effective way to see if your imagery resonates is to test it with the market. It’s easy to test, and it doesn’t take long to realize that your audience doesn’t think it’s cool either.

Geisinger Health Plan reports that its use of telemonitoring technology has reduced 30-day hospital readmissions by 44%. Using interactive voice response technology from AMC Health, case managers track post-hospital discharge patients’ biometric and symptom information in real-time.

3-4-2012 7-19-57 AM

Oakwood Hospital and Medical Center (MI) prepares for its August 1st go-live of Epic’s EMR.

3-4-2012 8-03-43 AM

A PwC study finds that 61% of hospitals and physician groups have formal clinical informatics programs and most plan to add additional technical analysts and clinical informaticists over the next two years.

Cumberland Consulting Group promotes John Waters, Charles Flint, and Leah Wilson to executive consultants.

3-4-2012 8-22-10 AM

First Databank launches a corporate rebranding initiative designed to focus attention on the company’s growth and future in clinical decision support. Mr. H checked in from his vacation long enough to point out that FDB’s press release mentions their sponsorship of HIStalk, which they call an “influential industry blog.” We like that.

3-4-2012 8-30-15 AM

EHR Scope launches AIMSConsultant, a service to provide anesthesiologists and operative facilities with information on anesthesia information management systems.

The Milwaukee paper profiles the Wisconsin HIE, which currently connects 13 area hospitals. No surprise here: the HIE’s executive director notes that the organization’s biggest obstacle to growth is not technology, but money.

3-4-2012 10-58-10 AM

HFMA awards Winthrop Resources its “Peer Reviewed” designation, based on the effectiveness, quality, price, value and support of Winthrop’s offerings.

3-4-2012 11-04-39 AM

CincyTech and Cincinnati’s Children’s Hospital Medical Center form QI Healthcare, an HIT company to commercialize Children’s proprietary quality-improvement software. CindyTech and Children’s are each investing $200,000 and have named John Atkinson (WebMD, Mede America, SourceMedical)as the new entity’s CEO.

3-4-2012 11-12-10 AM

HKS Medical Information Systems changes the company’s name to OTTR, d/b/a OTTR Chronic Care Solutions. OTTR is a provider of transplant patient tracking solutions.

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Currently there are "26 comments" on this Article:

  1. I’m sympathetic to the clinicians and IT folk who are trying to get their own data out of their own Epic system. Ditto for Cerner users. In any rational industry, anything that prevents users from obtaining 100% of their own data would be a non-starter. In HIT, it’s a chance to sell more services or software… or perhaps SSRIs. Why to we tolerate such actions? Being able to mine the data is the basic step to quality improvement, patient safety, and improving efficiency. If we are smart enough to buy their systems, give them hundreds of millions of dollars, implement their systems, why are we not trusted to use the data we produce to perform better healthcare? Oh, and I’ll accept that we should work on a copy of the data…thereby removing the objection that we shall mess up the seemingly pristine dataset they claim they are guarding for us.

    Postscript: Last year at HIMSS, I ran into about 4 vendors who said their prime effort was to break into the Epic databases. This year, I didn’t survey the vendors, but many noted that was one of their top priorities.

  2. Well you know then, but, at Geisingers. those numbers on readmissions sounds too good to be true. Almost, you, sounds like infomercial for devices of the company.

    You know then, if patints not randomly selected or similars in illnesses and ages, and dementias, numbers could look very very good. Or well you know, the numbers could be massaged to help look good. Then you know, they did have a point to prove.

    Well also you know, what moneys and investment Geisingers gets from the deal?

    Where is the manuscript published in what peers reviewed journals. pray tell all.

  3. My oh my, I go to the HIMSS12, do not gamble, and all in all, there ain’t no meaningfully useful talks on safety, efficacy, and usability. Even the highness, F. Mostahari ignores the issue. Patients are a dying from defects in the CPOE and from the disruptions in thinking caused by the distractions of the user unfriendly devices.

    When are the HIT pushers and ONC going to wake up to the harsh reality that their devices are not improving outcomes, and the costs of the humans to run the sytems and the systems are astronomically high?

  4. Anodyne is fine but I don’t know about any switch. You have to send them the data in flat files (extracted from Clarity) and if you want to do anything special, you have to teach them the entire logic. Sure, it’s pretty dashboards and stuff but you could do that in-house with Xcelsius or even Epic’s dashboards. Seriously over-hyped!

  5. Reluctant Epic User – Anodyne dashboards are pretty but agree with Humble Clarity Dude, anything special or custom is a hurdle. Also, the extract is typically monthly, and a more frequent refresh rate is additional cost. The Anodyne BI is proprietary. You could this yourself with industry standard BI, and there are companies that also specialize in building data marts that can accelerate your efforts with BI and reporting.

  6. RE: “Epic – the Teflon Vendor Effect”

    It appears that Epic has designed its project management methodology and its focus on direct communication with the CEO in order to “frame” issues with the project. This framing allows for the “Teflon effect” and is intended to create/ensure it.

    If I were in an Epic PM (Implementation Coordinator or Implementation Manager) and I was understaffed or had more green resources than I needed to implement then I may try to blame the hospital CIO as opposed to taking the blame myself or accepting it for Epic.

  7. That’s amusing that they are trying to break into the database structure. The problem with epic (and its strength) is that the database is different for every customer. As they do the installation they modify where the data is stored and determine how it is stored in the datasets and there is no method to plug and play. I wish I could just connect with these businesses and explain to them how mumps and globals work and how the epic datasets are actually setup, it would probably save them time and money and my epic customers headaches because we’d either do it right or not do it at all.

  8. Anodyne is a good product. I know there is a small vendor that has pushed the data interpretation and BI space further with IDX and Epic than the usual suspects. They did a large project in Sacramento and work with very large organzations typically. Cure is or cure it. I’ll see if I can get more details.

  9. I don’t know anything about Anondyne, but our company, Healthcare Quality Catalyst does what you are looking for: extracts data from Clarity into an Enterprise Data Warehouse and enables clinical process improvement. Most of our clients are HDWA.org members. There you can get unbiased opinions about the solution.

  10. PDS (practical data solutions) is a company that has done a bunch of DW and BI projects for IDX and Epic clients as well.

  11. v12 of Epic is coming with an enterprise data warehouse integrated with it. They showed it at HIMSS and it looks good.

  12. Madison Dolly:

    Who are Epic’s EDW partners?

    They had some Oracle cast-offs working there a couple of years ago…

  13. RE: Reluctant Epic User – Re: Anodyne

    Anodyne is slick looking product for CXOs to look at, but falls short of expectations. And by the way is seriously $$$$$$ intensive. My first recommendation – do NOT use Clarity extracts but go instead for the straight-up Chronicles database extracts. And as per Dewitt – if you aren’t going to invest the extra money to do the extracts more than once a month why bother?

    If you want to use Anodyne like Anodyne intends you to (and shows you how to) you need to go all in, do the weekly extracts and invest in full time staff to do the data analysis necessary to use it meaningfully. Otherwise you’re just buying something that will make pretty and colorful graphs to show your CFO and that’s something you can do in Excel by yourself with a good Epic Chronicles extract.

    Got extra money and extra staff? take a look at Anodyne. Don’t have either? invest in good report writers with experience in (or can learn) Clarity, Reporting Workbench, Chronicles and/or the MyEpic reporting module which encompasses all of the above.

    My advice would be to invest in your staff, not Anodyne. Not because they don’t have a good product, but because you’ll be doing your staff and your budget a favor if your short on either.

  14. Skimpy is right about chronicles.

    But it’s also possible to get real time pulls of data from Epic using which ever message format you want. SOAP and Restful services are possible, as are just about any other format you want. In real time, with no human interaction. It always makes me laugh when people say its a closed system. You have dozens of options. Why don’t you know about them? Invest In staff.

  15. Hi all –

    First time poster! Mike thanks for the email about these comments.

    My name is Chris Sawotin. I am with CureIS healthcare, Inc. We are a healthcare software manufacturer and service provider. I believe what Mike was referring was our CurePM (Performance Manager) product. I do not want to get it confused with traditional BI. This product is more about managing and displaying information in an actionable system (how can data anomalies create tasks and or alerts). We always leave the information in its system of record when possible. If not we have deep expertise in extracts and know all the limits from the various systems. Our typical differentiator is our agnostic system abilities. We really excel when you don’t want just one system in your dashboards but 5 systems to paint the picture accurately. ACO’s are great example of when this aggregation will be very effective. I would be happy to mail out marketing materials if interested. Our website is being rebuilt to reflect the product stance and new product naming conventions. Please forgive the existing CurePM that is now part of provider onboarding.

    Good luck,

    Chris Sawotin

  16. “If I were in an Epic PM (Implementation Coordinator or Implementation Manager) and I was understaffed or had more green resources than I needed to implement then I may try to blame the hospital CIO as opposed to taking the blame myself or accepting it for Epic.”

    David~
    As an IC or IM it’s unlikely that this method would work as well as you’d hope the majority of the time (unless the customer is a known “problem child”). This is especially true if you are a newer IC. When you work in a project management capacity at Epic, you’re expected to own the project issues (or application issues, if you’re an AC or AM) even when they are truly the customers fault. If the issues are due to Epic’s staffing choices you are definitely going to be expected to own them. I’m not saying “the blame game” can’t be played. I’m just saying that normally Epic’s management isn’t real accepting of it internally.

  17. Why not unlock the power of your Epic shadow database, near real time analytics with Intersystems DeepSee. Map your Epic globals to Cache sql tables and away you go, at speed. Keep your single source of truth and save a few million and yes, invest in decent taff.

  18. Epic’s way of addressing their green staff is to try and force their customers into the model system mold. When a customer needs to deviate Epic is becoming increasingly inflexible because they have been losing the ability to respond quickly to customer needs for a long time. The CIO is one of the roles where this friction presents itself the most and Epic points their finger at the CIO for deviating from the script. There is also a lack of highly skilled analysts with a deep understanding of how Epic works which makes ordering something outside the model system menu even more difficult.

  19. In regard to the EPIC CIOs could it be that the law of averages are at work here. The more organizations that begin installing EPIC, which we all know is quite significant now, the more chances that bad CIOs will be flushed out. I wouldn’t necessarily point blame at anybody else. If the CIO was able to create the right expectation going in with senior leadership and formed the right relationships with the implementation team there would be a likelihood that they would still be in place. It is possible that there are some old time, less than dynamic, void of vision CIOs out there who are not ready for projects such as EPIC. Just saying…

  20. Interpret an SQL query in to an none compiled language for getting data. Super slow and recource intensive. KBSQL needs to die.

  21. No Product placement, Epic runs on a Cache DB and a Cache license gives you DeepSee. Agree with the above on KBSQL too.

    Making a nightly copy of production, to Clarity ($) then copying that to a BI solution (more $) is redundant and provides at least day-old data that has also been massaged between copies. ‘Big-data’ databases are typically noSQL. Cache is noSQL and is also fast and scaleable; your shadow database is your friend. Add in staff that know the clinical data structures and understand the data they are working with to write your analytics.

  22. These are not the first two CIO’s who have been let go once Epic got involved…….Epic + CIO = Career Is Over

  23. I am totally humbled by these responses. I forgot I sent the message to histalk until I checked in this evening. I sincerely thank you all for your thoughtful and honest words.

    Mr. Histalk and Inga, please send me an address where I can ship each of you a box of wine for all of the work you do for our community (I came out of the closet and submitted my e-mail address on this comment form just so you can contact me).







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