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Monday Morning Update 5/13/13

May 12, 2013 News 6 Comments

From The PACS Designer: “Re: PACS advice. TPD worked with Herman Oosterwijk at a previous employment and benefited from his knowledge of DICOM and its attributes. He just published an Aunt Minnie article on the top 10 things to consider when replacing your PACS. It’s well written and can help lead the migration to more robust PACS/RIS/Archive solutions. ”

From Leverage: “Re: MModal. For your expert to further reflect on, from S&P’s ‘Leveraged Commentary & Data,’ May 10, 2013.” I fear my excellent MBA finance grade may have been a sham given that I understood very little of the writeup, which was summarized as, “MModal is seeking roughly two years of covenant relief via a loan amendment package that launched yesterday afternoon. The deal is on a tight time frame, with responses due on Monday, sources said.” One Equity Partners, which acquired the company last year, will instead of executing an “equity cure” add $20 million in new equity.

From Quietly Working: “Re: McKesson. Has concluded that a shareholder relationship with Automation isn’t required to enable clinical and technological integration with healthcare software and pharmacy distribution providers. As such, McKesson has made the decision to divest the Automation business. Their intent to sell was announced earlier this week.” I did mention that along with the company’s decision to sell its international technology business in summarizing the earnings call last week.  

5-11-2013 7-48-14 AM

EHRs aren’t the problem when hospitals experience financial setbacks during or after their implementation, with 40 percent of respondents saying it’s more that hospitals have unrelated issues that they don’t address. New poll to your right: should Meaningful Use Stage 2 be delayed a year as recommended by CHIME?

5-12-2013 11-42-47 AM

Welcome to PerfectServe, sponsoring HIStalk, HIStalk Practice, and HIStalk Connect at the Platinum level. PerfectServe’s cloud-based, HIPAA-compliant platform helps hospitals improve efficiency and care by providing reliable and secure clinical communications (voice, online, and mobile.) It’s used by more than 30,000 physicians to communicate more easily, representing more than 10,000 practices and 60 hospitals that include Advocate Health Care, MemorialCare, Hoag, WellStar, and Orlando Health. PerfectServe connects every clinician, whether on campus or off, allowing them to use voice-powered lookup by name or service and incorporating on-call schedules and physician preferences with every transaction documented and analyzable. Patient-endangering communications breakdowns caused by complicated coverage and communications rules are eliminated, while the average customer saves 12,000 hours each year in wasted nurse time. Just announced last week was DocLink, a private and secure HIPAA-compliant texting, voice messaging, and real-time call routing system for doctor-to-doctor communication. The company offers case studies (the one I read randomly involved reducing time to treatment of stroke patients by simultaneously notifying both the neurologist and neuroendovascular specialist with escalation or backup for non-response), white papers, and studies. Thanks to PerfectServe for supporting HIStalk, HIStalk Practice, and HIStalk Connect.

Here’s a YouTube video illustrating how nurses contact physicians using PerfectServe by telephone.

5-12-2013 2-12-26 PM

UPMC made an $18 million profit on its $35 million investment in Israel-based interoperability technology vendor dbMotion when the company was sold to Allscripts for $235 million in March 2013. 

5-11-2013 7-58-58 AM 5-11-2013 7-59-57 AM

CIC Advisory names Liz McNamara, MHA (ECG Management Consultants) as business intelligence service line leader and Eric Zuhlke, RN, BSN, PMP (Abrazo Health Care) as IT strategy and planning service line leader.

5-12-2013 11-05-51 AM

Aventura will announced Monday that it has promoted VP of Sales and Marketing John Gobron to acting CEO, replacing the retiring Howard Diamond.

5-11-2013 8-46-31 AM

Eric Novack, MD, PhD (Valley Orthopaedic Consultants) joins Intelligent InSites as senior medical advisor.

5-11-2013 8-54-47 AM

Bobbie Byrne, MD, MBA, VP/CIO of Edward Hospital (IL), tells me they went live on Epic big bang at both hospitals on April 28, on time and on budget. They’ve hit CPOE numbers in the 75 percent range since go-live day, impressive given that it’s a community hospital with few in-house physicians. I interviewed her in December 2011 (she had some very interesting thoughts, having been an Eclipsys SVP and CCHIT clinical director) and I have proposed that we do an update.

MModal’s Catalyst for Quality wins the top healthcare IT innovation award from the North Carolina Health Information and Communications Alliance and Intel.

A Brandeis professor of health policy says CMS’s release of hospital charge master data for common Medicare DRGs is “useless and misleading” because nobody pays list prices for services, hospitals tune their individual charges based on payor mix and desired margin, and the public has no idea what any of this means. A Harvard public health professor says the information offers one benefit: “It helps people understand how ridiculous and complex our system has become.”

5-12-2013 11-11-55 AM

Vince Ciotti offers a tip for frequent travelers: spend the $100 for a five-year registration for TSA’s Pre-Check program. He used it for the first time at LAX last week and skipped the mile-long security lines, only needing to have his boarding pass scanned at the empty pre-check security lane, a standard X-ray with shoes and belt on instead of the full-body scan, and then a standard bag X-ray except that laptops and liquids don’t require removal. I also noticed that the program was expanded to some international flights last week.

Forbes contributor, Avada CEO Dave Chase, says Tampa, FL is throwing out the marketing and tax breaks approaches to get corporations to locate there and instead will pitch its lower healthcare costs, second only to payroll expense as a cost of running a white collar business. The city’s May 13 MediFuture 2023 event features Harvard professor author Clay Christensen talking about disruptive healthcare innovation. Chase, who is also speaking at the event, says hospitals are making the same mistakes newspaper publishers made in the 1990s in worry about competition from each other instead of from outsiders. Examples of the “shadow” healthcare system are workplace clinics, national primary care providers, retail clinics, domestic medical tourism, and Medicare Advantage programs.

District Medical Group (AZ) implements a medical scribe program at two Phoenix children’s clinics as doctors learn to use their new EMR. An orthopedic surgeon says the scribes eliminated transcription costs and improved the revenue cycle, adding that, “Scribes may have very well saved the clinic by helping with the implementation of the new EMR. Having EMSS [the scribe service] here definitely allowed the clinic to get back up to its running speed in less than the anticipated amount of time."

In the UK, debt-ridden Rotherham Hospital Trust is criticized for paying a US consultant almost $40,000 per month to try to save its struggling $60 million Meditech implementation that has caused lost appointments and financial problems.  

5-11-2013 8-40-18 AM

Allscripts (one-year share price in blue vs. the Nasdaq above) reported all-around bad quarterly numbers last week. From Thursday afternoon’s conference call:

  • CEO Paul Black stated that the lawsuit against New York City Health and Hospitals Corp., filed when Glen Tullman was running the company, was dropped because, “This management team does not believe it is in the company’s long-term interest to pursue such litigation.” You may recall that the lawsuit won the attention of HIStalk readers, who proclaimed it the “Stupidest Vendor Move” of 2012 in the HISsies awards voting.
  • Black predicts that rip-and-replace projects will wane.
  • The company’s focus seems to be moving toward integrating disparate systems, or as Black described it, “Innovation to accelerate our leadership in ensuring multivendor interoperability through open community architecture.” That led to the acquisition of dbMotion and Jardogs (now Follow My Health) as well as the GA of Allscripts Community Care Director, which hospitals use to manage post-hospital care.
  • Black said, “Sunrise Financial Manager is one factor impacting our ability to capture larger mind share within our client base.”
  • The consolidation of offices was mentioned as one cost-cutting move, with the hopes of saving $50 million per year by 2014.
  • Company revenue was down because of the shift to subscription-based contracts (apparently that excuse was part of the Eclipsys acquisition since that company used it every quarter for years). Allscripts reported revenue drops in both system sales and maintenance for the quarter.
  • Less than 25 percent of Sunrise clients are running 6.0, with many of them planning to skip that release and jump to 6.1 instead.
  • When asked how Allscripts pitches against competitors, Black mentioned revenue cycle management, hosting, total outsourcing, and population health management.

Also notable from the Allscripts earnings call is the highest and most annoying concentration of the phrase “kind of like,” this impressive demonstration of a verbal crutch firepower coming from the Morgan Stanley analyst’s question: “So can you just kind of like give us a little bit more color about kind of like your clients? Are they making kind of like long-term retention commitments? Or are clients more kind of like taking it — taking more of a wait-and-see approach and kind of like taking it kind of like one step at a time?”

5-12-2013 11-22-20 AM

ESD celebrated Mother’s Day by providing surprise Mother’s Day gifts for each of the women at Mom’s House of Toledo, which helps low-income single mothers earn an education that will allow them to break the cycle of poverty and welfare.

Vince finishes up his HIS-tory of GE Healthcare, covering its very early entry into healthcare in the 1960s, its exit in the 1970s, its re-entry in the 1990s, and what Vince says could be the company’s fall back down the healthcare IT revenue chart. He brings up an item that I may have missed: GEHC sold its Centricity Pharmacy product to Canada-based BDM IT Solutions in March 2013, which is interesting because GE bought BDM Information Systems and its RxTFC system in 2002 and renamed it Centricity Pharmacy.


Contacts

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

More news: HIStalk Practice, HIStalk Connect.

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Currently there are "6 comments" on this Article:

  1. Did you read the link about the Rotherham MEDITECH hospital that was spending $40k a month. I am laughing MAO, that LB is considered a expert or even a PM. His golf handicap is pretty low, so I guess that qualifies. I have been around to long I guess.

  2. TSA Pre-check – one of the best government programs today:

    * Time ROI at least 25:1 – avg wait time at problem airports 30-45 mins time through Prs-check line 30-90 secs
    * Outcome: satisfaction pff the chart – walking through without disrobing or tsking kf your shoes while taking in Starbucks or water that does not cost $4 a bottle, priceless
    * Elite members of airlines have cost paid for them

  3. I use TSA pre-check every week at LaGuardia terminal D. Didn’t cost anything but they do NOT allow bottled water through. That’s the only drawback.

  4. I am so darn skeptical of scribe programs. Aren’t they just another (potentially weak) link in the chain of patient care? Aren’t we supposed to be eliminating the hand-offs between physicians and the EMR to minimize mistakes & oversight? If properly done I would imagine that nearly all work done by a scribe should be cosigned by a physician which means that the physician has done a chunk of the workload if he/she had simply entered the order or documentation to begin with.

    I welcome others’ thoughts on this, however. I am just extremely leery of these programs and I am willing to bet my lunch money that ONC & others will be pushing Meaningful Use in the direction of sidelining these scribes.

  5. I don’t mind the scribes for documentation, but I don’t like the idea of them queuing up orders. That to me destroys the point of CPOE. I kind of like the idea of unpaid scribes that are premed learners, I don’t love it when it’s just a doctor that thinks he’s too busy. I’ve always thought in this case, I might just tell the doctor I don’t want anyone else in the room just to spite him/her.

  6. RE MModal: covenant relief basically means you do not have the cash to pay your loan terms, and/or your quarterly ratio of debt to assets is below par. Essentially you are in deep financial doo-doo and you try to get another loan hopefully on more lienent terms. Net net is you do not really want to be there…

    Re; TSA pre -check – greatt program…but you cannot get pre-check clearance every time. It is random sometines your in, sometimes not. I’ve been batting about 60% over the last year.

    Re: Mck to sell off of Rx automation. Me thinks this is a big mistake for McK HIS business. This was the one really big differentiator they had. Strong piece for end to end EMAR. Nobody else could do it.
    Hey, here’s an idea. Now that BDM is back on it’s own – they had one of the best niche Rx systems ever. Dalla Howe started back in 1970, is now BDM Chairman. They should buy up McK Automation, that would be a real ‘dream’ end to end Rx /EMAR package!







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