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Monday Morning Update 5/6/13

May 5, 2013 News 16 Comments

5-4-2013 3-43-24 PM

From MaineMan: “Re: MaineHealth / Maine Medical Center. Names interim CIO.” According to the March 25 employee newsletter, Andy Crowder (JC Solutions Group and Florida Hospital before that) is serving as interim CIO.

From The PACS Designer: “R: Intel’s Haswell. We are about to enter a much faster PC user experience with architecture from Intel called Haswell. One of the key features is Haswell provides is a nine-hour battery life through the use of more efficient chips. You can expect to see Haswell powered PC’s in the fourth quarter.” The article says the chip may revive the rapidly dying PC business by making them more competitive with tablets. Of course, that’s what Intel said about the Ultrabook, which hasn’t made Intel-powered laptops a bit more attractive vs. a Macbook Air or an iPad.

5-4-2013 2-00-21 PM

Three-quarters of respondents don’t think it makes sense for innovation conferences to exclude hospitals and physicians under the assumption that they helped cause the problems that seen to require more innovative approaches. New poll to your right: several hospitals have reported financial losses that occurred as they were implementing an EHR. Who is to blame?

Thanks to the following sponsors, new and renewing, that have recently supported HIStalk, HIStalk Practice, and HIStalk Connect. Click a logo for more information.

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Two NHS trusts running NPfIT’s Cerner implementation issue tenders for replacement systems.

5-4-2013 2-51-08 PM

Centegra (IL) will go live on McKesson Paragon on May 6.

Some quotes from Jonathan Bush during the athenahealth earnings call Friday:

  • The company that started as an ill-fated birthing clinic and used to hold all-hands meetings from the tailgate of the Jeep Wagoneer is entering the big show. We have done well at the land war that is selling back office services doctor-to-doctor and hospital-to-hospital, but for the first time, we have a crack at the hearts and minds campaign.
  • Take athenaCoordinator. It is a really easy way for any health caregiver to connect to every other one without the complexity of an organ transplant. It is a two-week sales cycle and a two-hour implementation process.
  • We’ve already just announced today Epocrates EDU, which is a whole version of Epocrates to help educators, medical schools, the texting that we are going to be rolling out, secure HIPAA-compliant, patient-related texting between doctors. We’ll be able to attach links to athenaClinicals next year so that doctors who aren’t clients of athenaClinicals will be able to take a quick look at a patient face sheet in athenaClinicals.
  • I think we are seeing — particularly the folks who got pregnant with Epic, sort of they’re going to this sort of desperate burn-bright tactics. We heard where Yale-New Haven has told all the doctors that have privileges that they will either this piece of shit Epic that none of them want or do you have their privileges revoked. So there’s that kind of tactic going on. "Oh, we can’t interface." I’m like, "What you mean? Epic interfaces all the time. They actually do it really well." … The folks that have gone off and laid down more money than they have on Epic have, in the back of their mind, that they are going to make a real impact on referral patterns by getting doctors on to Epic that don’t want to be on it. And it’s — really, Epic is the only one. Cerner builds interfaces, no problem.

5-4-2013 3-19-19 PM

TriZetto announces that CEO Trace Devanny will leave the company immediately after two years on the job “to pursue other opportunities” as a search is undertaken for his replacement. EVP/COO Jude Dieterman is promoted to president, a newly created role. Board member Vicky Gregg will assume the role of non-executive chair.

Intermountain Healthcare is working with Blue Cirrus Consulting to develop a homegrown tele-ICU solution.

UCSF lauches MeForYou.org at the OME Precision Medicine Summit. The precision medicine project will link people with genetically similar others via their genomic information, environmental factors, and their EHR information to help guide clinicians. They differentiate it from personalized medicine in that in precision medicine, the information used goes beyond genomic data and scientists can tap into that information directly to guide research and treatment.

5-4-2013 4-41-19 PM

Team Break Fix won the $25,000 grand prize at the Cajun Codefest 2.0 in Lafayette, LA last week.

Weird News Andy says this gives heart attacks the finger. The EndoPat test predicts heart problems by checking blood flow in the fingers.

Vince has a Part 3 installment on GE Healthcare in this week’s HIS-tory.


Sponsor Updates

  • Cynthia Davis, RN, co-founder and principal of CIC Advisory, is named Entrepreneur Woman of the Year by the St. Petersburg (FL) Area Chamber of Commerce Women’s Leadership Council.
  • Allscripts posts the agenda for its ACE conference, to be held August 20-23 in Chicago.

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Mr. H, Inga, Dr. Jayne, Dr. Gregg, Lt. Dan, Dr. Travis.

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Currently there are "16 comments" on this Article:

  1. Re: Haswell. It is more power efficient but to say ‘we’re about to enter a much faster PC user experience’.. is quite a stretch. It’s a 10% sequential improvement. 10% is negligible for most users. 10% yoy increases for 5-10 years — that’s what takes us to new eras.

  2. 1) Why does it appear that Jon Bush speak like he’s on crack? Or is that just the way you typed it up Mr. H? That whole quip is incoherent and hard to read. I didn’t see any comment of their 9% stock drop–this comes on the heals of Greenway’s 20% drop earlier in the week. Pure play EMR vendors are in for some dark days, how many more months before we have 100s of EMR vendors not meet stage 2 and no other technology to sell? I say they all convert over to cerner, allscripts, mckesson.

    2) Is it me or is Epic already getting a critical mass of a bad rep for their cost and dated technology. Reading more and more stories about Epic busts. Just like your cell phone, its old and outdated the second you buy it. You don’t hear anymore success stories on news ticker– rather Epic caused us to go over budget….Epic is hated by our doctors…Epic doesn’t interface.

    A lot of these hospitals and their execs are going to look like idiots for having no insight and stuck with a clunker 5 yrs from now. When asked why the bought Epic–“i dunno I saw someone else do it”. Remember when Nokia, Erickson, and Blackberry were the darlings of cellular. Apple came in blew them out of the water with their open platform (iTunes, app store).

  3. Re: OGMD

    Many people seem to forget that at the end of the day, EHR is just a tool. How well it’s utilized depends entirely on its wielder. It was inevitable that the stragglers to Epic won’t have implementations that go as smoothly as the early adopters because their organization isn’t as well organized/talented. Yes, Epic’s technical infrastructure may be old and outdated but its end product is still superior to its competitors. I’d be embarrassed if I were Cerner leadership – how does a company that’s around half your size shipping better products than you guys? At least the other companies can say Epic has more resources than them.

    Also, this is the first time I’ve heard someone describe Apple’s system as open. I’m not sure how to respond to such a statement.

  4. RE: Ex-Epic

    Are you another Epic cheerleader who forgets that it takes two to tango. Both the hospital and Epic are responsible for implementation issues as is the case with any EHR implementation.

    Epics early implementations went well because the larger hospitals had unlimited budgets and Epic provided more than enough Epic staff at significant cost to ensure every physician received one on one attention to facilitate adoption and ensure physicians had things customized to suit them. Also there were more then enough go live staff.

    As Epic has grown, many of its more experienced implementation consultants have left and there are not enough remaining ones with experience to go around to all of the new sites. Also as Epic moved to smaller hospitals without unlimited budgets cost actually mattered so sending far more than enough Epic consultants was no longer possible.

    In its project management methodology, Epic also reports directly to the CEO as opposed to the CIO. When things go wrong who do you think takes the blame in those status reports?

  5. Congrats to Blue Cirrus Consulting on their contract with Intermountain Healthcare. They are a small company in the market of giants, but offer their customers excellent service, knowledgeable staff and high success rates. They are a class act who treat their customers like people instead of a number.

  6. Apple isn’t an open platform- it’s the textbook example of a “Walled Garden” (think: Police State with Flowers) and weirdly it’s probably the best analog to Epic you could have mentioned:

    •company built and steered by a single, charismatic leader
    •dominance of its target market segment starting in the early 2000’s
    •largely succeeds by dictating market trends rather than following them
    •accusations of “cult-like” company culture (Epic’s food is better, but more expensive)
    •more expensive than open alternatives
    •sales bolstered mostly by reputation
    •not exactly famous for interoperability
    •somewhat outdated technology (the top 1/3 or so of the Android device range generally outclasses its Apple counter part )
    •widely favored in the market for usability despite outdated technology and (periodically accurate) pundit criticism

    Another company I might compare Epic to is Pixar (which is a lot like Apple for obvious reasons)- for a decade, everyone was waiting with baited breath for the first Pixar movie that wasn’t great (i.e., did not make them weep) so they could FINALLY write something negative. I’m not defending Cars 2 or the Maine implementation (I’ve been exposed to neither)- but I am 100% certain that if Dreamworks or Fox or an independent studio had released Cars 2 (exactly as it hit theaters), it’d have a higher Rotten Tomatoes score.

  7. After listening to Jonathan’s drunken “F-bombing” rant about EPIC and Judy’s success in healthcare IT and now reading this out take of the meeting, I’m wondering if he is secretly in love with Judy, jealous of her or simply drinking too much.

  8. Apple was the first to bring an apps store. Fine, walled garden and have other people pay for planting the flowers. Epic isnt anything close to an apple–Insult to Steve Jobs.

    If judgiong off looks, I highly doubt Bush is in love with Judy. However, judging by last name, he probably does enjoy drinking one too many.

  9. To game genie:

    Fish hooks are baited; breath is bated.

    Yes, I am pedantic.

    Have a lovely day.

    Cheers, WN

  10. Re: David

    I don’t understand why people have to brand others as an Epic cheerleader/kool-aid drinker or as a hater. Is it not possible to have a more nuanced view? Yes, the turnover at Epic is embarrassing (despite the “official” stats Epic tells its employees) but it has been this way for time in immemorial. One of the most striking thing about reading employees’ review of their experience at Epic is how little has changed – you will not be able to tell one apart that was written in 2005 vs 2013. But do hospitals hire consultants because Epic’s implementers are not knowledgeable enough? 99% of the time, consultants are hired because the customer analyst team is incompetent and they aren’t getting the work done. In essence, these “consultants” are staff augmentation – although to be fair, unlike the analysts they usually get the job done albeit at a much higher price. If customer analyst teams did their jobs, 99% of the demand for consultants would disappear.

    You also mention that the monthly reports go to the CEO, insinuating that Epic blames the CIO when installs go poorly. They are both copied on the monthly reports. It’s funny you think that Epic goes around blaming the customer because ANYONE that worked there knows that’s a huge no-no (no matter how badly the customer messed up). If anything, the opposite problem occurs at most customer installs where the customer will throw a fit if there are any yellow stoplights on the report so Epic acquiesces and makes the report all green. This goes on for a few months, then all of a sudden go-live is a couple of months away and they’re nowhere near on schedule despite all the previous reports full of green stoplights. That’s when they decide they need to bring in a consultant to hopefully salvage the implementation.

  11. RE: Ex-Epic

    Do you really think that 99% of demand for consultants in any EHR implementation is due to the lack of implementer staff being competent? You do not have a lot of faith in hospital IT departments. We place many Epic consultants in places where Epics one size fits all methodology is too rigid and someone with clinical and Epic implementation experience is needed to push back against a green implementation team from Epic. With Epic like other EHRs most of our consultants are there to provide experience from someone who has both implemented before and has clinical experience enough to help the implementation go better. Some is staff aug but there is a lot of value in having implemented the module before.

    When someone copies both you and your boss on their status report about a for which you are responsible do you consider this equally informing you and your boss or something else? Regardless of what is stated internally it is meant to show that you are not the target of the communication. Also, what we hear from clients is that Epic CIOs do seem to be fired more often than other CIOs after an implementation or a year or two after when the true cost of ownership becomes reality.

  12. Let’s get one thing completely straight. Epic is NOT Apple. The two should never be compared. Ever.

  13. It is true that Epic staff are pushed to lie and mislead on the reports. Often areas that should’ve been red / yellow / risk were indicated as green or near green.

  14. While working at Epic, I was never pushed to lie or mislead on status reports.

    While working at Accenture on an Epic project, many ACN team members and team leads pushed Epic to lie and mislead on the status reports so the client higher-ups would think everything was on-track.







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