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News 06/06/07

June 6, 2007 News 1 Comment

From Terry McKay: “Re: HIMSS and nursing ratios. HIMSS came out against mandated staffing ratios, saying some other acuity-based method would be used. That hasn’t happened, of course. Who will protect nurses and patients? Even California’s mandatory ratios are being gamed, with hospitals cheating and assigning housekeeping and dietary duties to nurses, with big problems (infection control crisis). I have no love of unions for nurses, but I don’t see an alternative to get the attention of hospital executives.”

From Nickie Ferrante: “Forget the rumors about Misys purchasing Bond or e-MDs. Misys is looking for an established ASP EMR and not another turn-key solution.”

From TenaciousD: “Re: Eclipsys. Andy Eckert, Jay Deady, Brian Copple, and others are dumping stock. Are they regular, scheduled sales to take profits or is
something else going on?” I’ve not heard anything, but these are all new guys who were given tons of “welcome to the company” shares, so maybe it’s routine. Anyone know otherwise?

From Seimore Skinner: “Re: Kaiser. I thought you might be interested in this article on more problems at Kaiser.” This one’s about their botched kidney transplant program, but with a different angle: information management problems were largely responsible. Examples: inability to transfer data in for the first 1500 patients; no database of patients to check to make sure records were complete; missing or incorrect data in patient records that caused patients to move down on the national transplant waitlist; delays in completing paper records; extensive use of fax machines as middleware; and no way to track complaints. Kaiser eventually shut the program down and its lawyers are working hard to get suits against it into arbitration and out of the public eye. “Core questions remain, including why it wasn’t until Kaiser decided to close the center that it put in information technology, such as custom spreadsheets and a virtual private network between it and UC, to help manage patient data. Why, despite Kaiser’s pioneering work in electronic medical records since the early 1990s, the new transplant center apparently managed most incoming patient data on paper. Why it didn’t use one of the specialized transplant databases available from health-care technology vendors. Why it wasn’t until the end that Kaiser developed basic policies and procedures, such as weekly meetings and monthly reports, to ensure data didn’t go missing and appropriate parties stayed apprised of Kaiser’s progress with patient records.” Good article by Baseline.

From Richard Gilmore: “Re: Health Quest. Heard through the grapevine that Nicholas Christiano, Jr. resigned as the CIO at Health Quest effective last Friday, June 1. He was also the CIO (and CEO?) of their for-profit IT business known as HealthServe.”

From lolhit: “Re: Misys. Misys may be in the process of acquiring Medicity.” Kipp says no. Strongly. Emphatically. Medicity is doing just fine, at least from my cheap seat.

From Soul Survivor: “Re: Misys. Misys needs to buy something. Call Vern and ask about sales from the physician group the last two months of the fiscal year. Despite the feel-good press releases, sales are at a five-year low. Little new is being sold – all to customers. Boston Consulting Group’s recommendations are not due until August, so the sales meeting was postponed until then.”

Potential sponsors have asked several times about having ads created like the cool ones to your left. I’m graphically challenged, but I finally got smart: I’ve engaged the services of someone who does great ads, banners, and any kind of graphics. Here’s a deal I’ll offer: if you’re considering sponsoring HIStalk (thank you!) but have held back because you don’t have a nifty online ad, I’ll have it done for you at no extra charge. I’m anxious to see how my new guy does, so e-mail me if you’re interested. And as far as value, I strayed onto Modern Healthcare’s price list (warning: PDF): a smaller ad with 1/4 of HIStalk’s page views is 3 to 25 times more expensive there than here, depending on placement.

Speaking of ads, the text ads to your right are getting great page views and clicks. They’re inexpensive, short-term, and very noticeable. Suggested uses: meeting announcements, job notices, links to report downloads, booth numbers for a conference, subscriptions, mailing list signups, etc.  Now’s a great time to run one since the price may go up and lots of folks may sign on. More information.

Needed: a couple of folks willing to test the new HIStalk discussion board and recommend any changes before I open it up. It’s a lot more powerful than the old one (and better looking). E-mail me.

A reader sent over an article from the March 2007 Journal of Patient Safety called “Evaluation of Nurse Interaction With Bar Code Medication Administration Technology in the Work Environment.” It describes a human factors study from University of Wisconsin that looked at how nurses use medication barcoding systems. Conclusions: (a) bedside barcoding is a highly touted idea that few hospitals are using; (b) the most frequent nurse workaround was to scan after giving the med instead of before; (c) non-barcode checked meds were given in a third of the observations, either because the barcode couldn’t be read or the nurse just didn’t do it; (d) 16% of observations found a potentially dangerous practice, like giving the med without scanning the wristband, not documenting administration at all, or recording a med as given when it wasn’t; (e) ‘automation surprises’ occurred in 16% of the observations, including problems with the scanner or network; (f) warnings came up in 42% of observations, most of them legitimate. The biggest problems for the nurses were interruptions, messy or low-lit work areas, scanners that weren’t working, and scanning meds for isolation patients. It’s a pretty good article (small sample size, though) that calls attention to the mostly overlooked human aspects of automation.

I hear from a reliable source that Misys Healthcare is shopping its hospital business around, hoping for a quick sale. I think that’s a good idea, one I’ve advocated all along.

Cerner CFO Marc Naughton says the company is doing fine without GE or McKesson. Analysts threw out names they thought were more likely to acquire CERN: Oracle, SAP, IBM, Philips, and Sismens. Move along, nothing new to see here.

I mentioned previously that I hadn’t seen a study proving that a clinical system can reduce mortality. A reader reminded me of VISICU, whose eICU program I’ve mentioned before. I have no doubt that it really does reduce mortality and I think it’s a great advance medically and not just technically. I wasn’t including it because I don’t really consider it to be a traditional IT system. If I was admitted to the ICU, would I want to be in an eICU-serviced bed? Oh, yes.

An interesting twist to the iSoft saga in the UK: CSC can take over iSoft’s R&D if iSoft’s NHS code deliveries run behind. If that occurs, iSoft is automatically thrown into default on its debt convenants. And if that happens, and if CSC manages to buy enough of that outstanding debt, then guess who gets the keys really cheap, all via a nearly automatic process? iSoft had to sell its soul to keep afloat throughout its accounting scandal.

I had an odd PC problem, the solution to which I’ll describe in case you have it happen. I couldn’t access a particular website from home, but it worked fine at work (I was getting a 404 error in Firefox, IE, and Opera and swearing it was the site going down.) The fix: I flushed my DNS cache (from the WinXP command line: IPCONFIG /FLUSHDNS) and then powered my modem and router off and on again. This help desk moment is brought to you by HIStalk.

Don’t forget Matthew Holt’s Health 2.0 conference, coming up in September.

I’ve got an offer to speak at a conference that I’m considering, thinking about some kind of phony mask (William Shatner from Halloween?) to keep anonymous. All I need is something profound to say. I’m not sure how much I have left after spilling my guts here. Maybe I can just have a reading like those hoity-toity authors. HIStalk turns four years old in a week or so, by the way.

Newt Gingrich’s for-profit Center for Health Transformation has something new to sell: a book called “Paper Kills.” Hint: it’s not about paper cuts. In it, people who sell technology and not paper advise you to use more of the former and less of the latter. Maybe Weyerhauser should do an expose of medical misadventure caused by faulty information technology, of which there is much.

Lancaster General Hospital (PA), loathe to give the residents who own it any of its $98 million surplus (or, God forbid, to reduce rates) will instead spend $60-100 million on electronic medical records. They claim patients expect that.

India’s Apollo Hospitals offers telemedicine to small hospital, providing second opinions free. The only cost to sign up is for a digital EKG machine. Cool idea.

Computerworld names the top 10 dead or dying computer skills: (10) OS/2; (9) PC network administrators; (8) NetWare engineers; (7) PowerBuilder; (6) C programming; (5) ColdFusion; (4) cc:Mail; (3) SNA; (2) non-relational DBMSs; and (1) COBOL. Certainly there could have been more: RPG, TurboPascal, Smalltalk, Visual Basic, FrontPage, Pick … well, obviously this could be a long list, even if covering only healthcare.

News, rumors, top secrets: e-mail me, or use the confidential Rumor Report form to your right. If I don’t say it enough, thank you for reading.

Inga’s Update

Quality Systems, Inc., parent company to NextGen Healthcare Information Systems, announced a $0.25 per share cash dividend to be paid to shareholders this month. While as a shareholder a dividend is great, I am wondering why a dividend is being paid at all (and am asking for opinions of you gurus.) In this day and age where every IT company is constantly trying to leapfrog one another with the latest, greatest offering, why not re-invest in your products? Or, does QSI just have that much cash on hand?

The New York Times reports that David Brailer is starting a $700 million private equity fund, Health Evolution Partners. The focus will be investments in technology that will reduce healthcare costs.

Healthcare management company MED3OOO, Inc., (MED3OOO) has become a major stakeholder in Scottsdale-based InteGreat Concepts, Inc. InteGreat provides browser-based electronic health record (EHR) systems for physician group practices. MED3OOO will provide InteGreat with substantial capital and knowledge resources for its next generation of product improvements

Allscripts and NaviMedix announce an agreement to provide Allscript’s eRx NOW ePrescribing solution to NaviMedix’s network of more than 190,000 physician customers. eRx NOW will be offered at no cost to users of NaviNet, NaviMedix’s free web-based provider communications solution. As part of the agreement, NaviMedix also will become an executive sponsor of the National ePrescribing Patient Safety Coalition (NEPSISM).

E-mail Inga.

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Currently there is "1 comment" on this Article:

  1. Regarding nurse to patient ratios and what will keep hospital management from under staffing: CMS has proposed that starting in 2008 they will no longer reimburse for 13 “hospital-acquired conditions” – i.e., preventable adverse events. Research has shown a clear link between nurse to patient ratios and resulting adverse events.

    While P4P may be the carrot to improve patient safety (and maybe not so effective per the Duke study), ending reimbursement for preventable adverse events is the stick. It will become a big stick when the 13 becomes 27 and commercial payors follow suit.

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