Merge Healthcare’s board hires an investment bank to seek strategic alternatives for the company that could include a merger or outright sale. Merge, which has lost money for six straight quarters, has seen its share price drop 40% on the year, although shares were up 10% Thursday on the announcement. Above is the one-year share price compared to the S&P 500 (green) and Cerner (red).
From Acorn: “Re: emergency power off switch. An engineer fell onto ours today.” Been there. We had just moved into a new data center at my previous employer and the entire data center was going dark a couple of times per day. We couldn’t figure it out, but suspected a construction mistake. The UPS wasn’t kicking on and the standby generator wasn’t coming up, so all systems were going down hard, creating a nightmare of system outage and recovery downtime (we’re talking every server, connection, telephone system, etc. spanning several hospitals). We eventually figured out the problem: the big, red emergency power-off switch was right beside the exit door where the old data center’s “press here to open door” button was located. Employees were smacking it by habit as they exited, and then sheepishly running for the hills without telling anybody when the data center suddenly went dark and quiet. We put a $1 plastic cover over the switch and that was the end of the problem.
From Sadie: “Re: Merge Healthcare. Three weeks after an RIF in France and one week after a 56-person RIF in the US, Merge announces plans to sell the company. I hate to say that I called this months ago.”
From MindYourOwnBusiness: “Re: UPMC. They’re in the hospital (and EMR) business, not the law enforcement business.” A patient who says she contracted hepatitis C from syringes infected by a drug-using radiology tech at UPMC sues the hospital and two of its staffing agencies. The lawsuit says UPMC caught the tech in the act of stealing fentanyl from the OR and told his contract employer to stop sending him to work there, but didn’t notify anyone else. The tech then worked at eight more hospitals, spreading hepatitis C to at least 30 cardiac cath patients and possibly hundreds or thousands. I’ve negotiated the “resignations” of a couple of hospital employees for known or strongly suspected drug theft over the years, and as irresponsible as it sounds, begrudgingly let them walk away without a resume blemish. The reason: the hospital’s legal counsel said that unless we had an airtight case against them (which is almost impossible to obtain) and ran them through a couple of cycles of optional drug rehab at our expense, they would probably sue us immediately for even insinuating to a potential employer that their records were anything but impeccable. In this case, the tech wasn’t even a UPMC employee. Nobody is bothering to sue the actual criminal, of course, given his unattractively shallow pockets.
From Curious: “Re: Dell. Heard they’ve cut a large number of experienced senior people from their outsourcing group.” Unverified.
HIStalk Announcements and Requests
HIStalk Practice highlights from the last week include: MGMA urges CMS to remove duplicate e-prescribing requirements in the MU and PQRS programs. Physicians express concerns about the impact of the ICD-10 transition on finances and practice operation. GenX physicians want a life outside of work, rely heavily on EMRs and smartphone apps, and like sharing the load with other doctors. Dr. Gregg has a geeky moment about Scanadu. The HIStalk Practice Physician Advisory Panel provides insights on patient volumes and the impact of EMRs and other technologies and the anticipated impact of the Affordable Care Act, with the possibly surprising finding that many of them won’t increase their patient volumes or workload even if it means higher incomes. Thanks for reading.
Travis’s post on HIStalk Mobile, What I Learned about Health IT in Medical School, seems to be popular based on who’s linking to it or tweeting it (including some high-profile folks). Sign up for his updates and you’ll get the viewpoints of somebody who’s both a doc and an mHealth expert.
If Inga, Dr. Jayne, and I were running for office, we would kiss babies, try to appear humble by wearing carefully casual costumes to our scripted photo ops, and make a lot of promises we know we can’t keep. We aren’t, so the only vote we seek is one of approval, which you may cast by (a) connecting with us on the usual social not-working sites (and thus enlarge your own network significantly); (b) signing up for spam-free e-mail updates; (c) sending us news, anonymous rumors, and anything else that might amuse us; (d) enjoying the company as we do of our much-appreciated sponsors, whose click-worthy electronic greetings you see entirely coincidentally on this page (they look a bit like ads); (e) peering into the Resource Center, which contains more detailed sponsor information; and (f) telling others that you are shocked by the irresponsible and objectionable material you see here since nothing draws Internet page views like bad behavior. We thank you for reading, and if you were in the room with us, there’s a good chance Inga and Dr. Jayne would plant a kiss on each of your cheeks simultaneously.
Acquisitions, Funding, Business, and Stock
Registerpatient.com, which offers a Web-based patient registration and scheduling system for $50 per provider per month, raises $1.1 million towards a $4.1 million target.
Pamlico Capital acquires home health technology provider HEALTHCAREfirst from fellow PE firm The Riverside Company.
Vocera Communications announces a public offering of 4.5 million shares of common stock.
MobileHelp, a provider of mobile emergency response technology for personal use, acquires Halo Monitoring, a developer of home monitoring products.
Harris Corp. is investigating potential violations of US anti-bribery laws by its Carefx China division, whose employees were found to have provided gifts and payments to prospects and customers. Healthcare executives in government-run healthcare facilities in Europe and Asia are considered foreign government officials by the Justice Department and SEC.
Physician networking site Doximity secures $17 million in series B financing led by Morgenthaler Ventures, bringing its total funding to $27 million.
Intermountain Healthcare (UT) chooses Accelarad’s medical imaging solution for its 22 hospitals and 185 clinics.
Medical Center of the Rockies (CO) selects ProVation from Wolters Kluwer for GI documentation and coding.
Healthcare Quality Catalyst names Todd Cozzens (Optum) to its board. Todd got in touch to say that the company is building data warehouses and Subject Area Marts on top of Epic and incorporating quality and workflow principles developed at Intermountain into more of an industry quality engineering type capability. He’s been around healthcare for a long time and has a nice viewpoint from his work at Sequoia Capital, so when he says it’s the next big thing, it just may be. I interviewed Steve Barlow, CIO and co-founder, a year ago.
Intelligent InSites appoints Margaret Laub (Policy Studies, Inc.) president, CEO, and board member. Interim Doug Burgum will become executive chairman of the board.
Ivo Nelson (Encore Health Resources) is announced as a financial partner of Health Care DataWorks, where he has served as a board member.
Announcements and Implementations
HIMSS Analytics recognizes the University of Iowa Hospitals and Clinics with its Stage 7 award for EMR adoption.
Caverna Memorial Hospital (KY) and Palestine Regional Medical Center (TX) go live on their HMS information systems.
OB-GYN PM/EMR vendor digiChart will integrate Dialog Health’s text message patient reminder system into its product.
Oregon Community Health Information Network will provide Epic to 10 public health centers in King County for $500K per year.
Government and Politics
CMS reports that through the end of July, 128,000 EPs and 3,624 hospitals have collected almost $6.6 billion in MU incentives from Medicare and Medicaid.
A BMJ editorial by two professors says that, based on their fields of behavioral economics and social psychology, pay-for-performance probably won’t deliver the expected results. Their reasons: (a) risk adjustment methods are inconsistent; (b) the system can be gamed by upcoding; (c) process-based indicators are poor proxies for quality of care; (d) social characteristics of patients can make good doctors look bad; (e) overly detailed criteria may encourage just checking off the boxes instead of really taking care of the patient; and (f) doctors may stop exhibiting empathy and pride in their work since nobody’s paying them for those qualities.
A new report from the Institute of Medicine says that the US healthcare system wastes 30% of its cost, or $750 billion, on unneeded care, administrative overhead, and fraud. It says that if other industries worked like healthcare, an ATM transaction would take a full day, laborers building a house would each use different plans without talking to each other, stores wouldn’t post prices, car warranties would not be offered, and airline pilots would make up their own pre-flight check list if they felt like following one at all. Many of their potential solutions for creating a continuously learning healthcare system involve technology.
Surescripts will connect Epic’s Care Everywhere interoperability framework to its network, allowing Epic users to exchange patient-specific information with other providers regardless of their technology platform.
Forbes puts Cerner in good company as one of the 10 most innovative companies in America, citing it as #8 because “its servers handle 150 million healthcare transactions a day.”
Florida’s HIE adds Broward Health, Health First, Martin Health System, Mt. Sinai Medical Center, and Tampa Bay Regional HIE to its clinical exchange network.
Bill Clinton was such a good president (especially when graded on the 25-year curve) that the man formerly known as Slick Willie has completed his ascent to Elder Statesman/Rock Star, capped by his ad-libbing convention speech this week (how many people were like me and thought, “Why can’t we vote for him?”) and the announcement that he will deliver the Wednesday afternoon keynote at the HIMSS conference in New Orleans in March. HIMSS didn’t mention Hillarycare or his Monica Lewinski-driven impeachment, which I find myself being OK with since his relatively benign scumbaggery was eclipsed by his results in office. He could easily be elected president again, I expect, were it not for the anti-FDR 22nd Amendment that limits him to the two terms he already served. I don’t know what HIMSS is paying for his hour or so at the podium, but his rumored rate is in the $400K neighborhood. Also announced on the post-election, politics-heavy HIMSS keynote schedule: James Carville and Karl Rove, which I would find more interesting as a boxing match.
An ACO formed by Blue Shield of California and Dignity Health (the former Catholic Healthcare West) saved $37 million in projected costs over two years for the CalPERS state retirement program, with most of the improvement due to shorter hospital says and fewer readmissions.
Temple Community Hospital (CA) notifies 600 patients that their information was contained on a computer that was stolen from a locked office in the radiology department. The hospital says it will upgrade its security, presumably meaning it is belatedly considering encryption.
Lucile Packard Children’s Hospital (CA) announces a 150-bed, $1.2 billion expansion ($8 million per bed, $2,300 per square foot).
The San Franciso Jewish newspaper profiles David Jacobs, who started kidney paired donor-matching software company Silverstone Solutions within a month after his own kidney transplant in 2004. He expects to add several large hospital groups as customers in the next few weeks.
The feel-good Weird News Andy, temporarily changing his e-mail signature to Wonderful News Andy, likes stories about surgeons who help others (“a cut above,” he calls them). Two Salt Lake City surgeons win awards for their combined 100+ foreign medical trips, taken at their own expense to treat individual patients and educate physicians. WNA’s carriage turns back into a pumpkin with what he calls, “Doctors – The Flip Side,” as he reads the story of a patient undergoing surgery in a Swedish hospital whose anesthesiologist decides to knock off for lunch at the stroke of noon even though he’s the only anesthesiologist working. The patient crashes an hour later, employees can’t reach the anesthesiologist, and in the confusion someone turns off the respirator of the patient, who dies weeks later of brain damage.
Ministry Health Care (WI) tentatively agrees to join Ascension Health. Ministry’s stats: $2.2 billion annual revenue, 12,000 employees, 15 hospitals, and 46 clinics.
Self-proclaimed “EMR geek” Rob Lamberts, MD lists 10 ways EMRs could be made better. Ones I particularly liked: (a) require all visits to have a simple summary entered; (b) since the patient is often the “interface” between EMRs anyway, allow them to pull up their own records and show them to their new doctor; (c) maintain one comprehensive patient calendar that can be shared among providers; (d) let the patient manage the information they provide, such as family history, meds list, and social history; and (e) make patient records searchable.
- A letter to the editor of SIIM by Brad Levin of Visage Imaging offers suggestions on how the organization can decrease radiology technology commoditization by offering crowdsourced innovation theaters, product showdowns, and demonstration of extreme use cases.
- Trustwave introduces security education services to help organizations protect against security risks and compliance missteps.
- Jay Deady, president and CEO of Awarepoint, discusses RTLS technology in an interview.
- MED3OOO announces that its customer PriMed (CT) will participate as an ACO in the CMS Shared Savings Program.
- SimplifyMD will offer Capario’s EDI platform to its customers.
- 21st Century Health selects Sandlot Solutions as a profiled business.
- MedHOK’s 360ACO solution is NCQA certified for P4P, HEDIS, and disease-management performance measures.
- NextGate begins operations at a new corporate office in Monrovia, CA.
- Divurgent hosts The After Party September 12 after Epic’s UGM.
- Wellsoft demonstrates its EDIS at next week’s 2012 ENA Scientific Assembly in San Diego.
- T-System issues a call for presentations for its April linkED emergency care conference.
EPtalk by Dr. Jayne
I’ve spent a lot of time the last several weeks digesting everything there is to read about Stage 2 Meaningful Use. My eyes are glazed over and my brain has become addled. To help providers make sense of it all, CMS has released some tables comparing Stage 1 and Stage 2 Objectives and Measures. I’ve found them helpful, although I wish their page breaks made a bit more sense and didn’t chop a single row into multiple pages.
Mr. H wrote Monday of the Epic vs. McKesson patent appeal. For those readers who enjoy shoes as much as Inga and I do, here’s a bit of patent news. The 2nd US Circuit Court of Appeals reversed a lower court decision, with the outcome that Christian Louboutin was entitled to trademark protection of its well-recognized red soles, but only on contrasting shoes. Competitor Yves Saint Laurent is still allowed to make red soles, provided they are attached to red shoes.
A Medscape article reveals results from a survey on physician EHR preferences. Although nearly two-thirds of users were happy, that means there are a lot of unhappy users out there. Other interesting (but not surprising) tidbits: many physicians are unaware of whether their systems are hosted vs. locally installed, the magnitude of maintenance or installation costs, or what happens in the back office.
CMIO magazine has renamed itself Clinical Innovation + Technology, citing a recognition of “the ever-growing convergence of the IT and technology management teams within the provider setting.” I’m pretty sure that at most places the IT and technology management teams were already intermingled. I think it would have made more sense to say that the IT and clinical management teams were converging. For those hospitals that are still in denial about the need for a CMIO in the first place, it’s probably validating.
A recent study demonstrated that men who consumed chocolate reduced their likelihood of stroke by 17%. It’s not entirely proven how chocolate provides health benefits, but dark chocolate in particular is thought to have anti-inflammatory properties. Maybe I should try some medicinal cocoa instead of ibuprofen after my next workout.