Monday Morning Update 8/27/07

From Lacey Underall: “Re: VA. I wish I could have been in the room when the House Appropriations Committee scolded the VA for buying vendor EMR systems that weren’t interoperable. I would have laughed out loud. Next time I am looking at systems, I am going to be requiring (particularly if they state HL7 compliant) that the vendor be able to receive and post every single transaction type that they send out. Currently, I am working with an Atlanta vendor that won’t accept any flowsheet data from other systems. They are trying to keep their clinical documentation close to home. We have several systems that allow the input of clinical data elements, however we have to send them into our clinical record as text blobs. The clinicians cannot trend that data in our clinical record. How about stepping up for patient care?” Well said. I like that idea of requiring vendors to receive and manage the same transactions they send. Vendors won’t integrate unless customers demand it, especially the broad-line ones that refuse to acknowledge that customers might cherry-pick.

From Inside Outsider: “Re: liking your job. I’ve been in the industry for 15 years or so. I worked for Sunquest back in the day when it was just growing beyond the Mom & Pop business of Sid’s to the bureaucratic mess it became prior to the Misys purchase. I got out and was happier for it. I moved to the business side of healthcare for a few years before moving to a small consulting company. I love my job. Been here for about 7.5 years so far. We are small, but we all work hard. The company does not push us to bill 80 hours a week, they pay us decent wages, and we can earn bonuses. There is not really much deadwood in the company, unlike everywhere else I’ve worked. We are out there to make other people’s jobs easier, despite many of the negative comments I’ve heard about consultants on your blog. Our customers like us, and I think we do a  good job. So yes, I do like my job. I could make more money out there in the ‘real world’, but I’d probably have to put on clothes every day and go to an office. I don’t want that, and I don’t need that. The owners of the company are awesome. I hope they never sell our company to a big company, because that will probably be the day I go.”

McKesson is hiring 120 people to call people to remind them to refill their high-profit prescription medications … uhh, I mean “to improve patient outcomes by increasing adherence to prescribed drug regimens.” The shocking thing about this practice is that it took manufacturers a long time to figure it out. I was arguing that it was a great business tactic 20 years ago. Why chase new patients when it’s cheaper to just keep current ones taking more of the same drugs under the banner of compliance?

West Penn goes live on Eclipsys and claims nearly 100% CPOE in just a few weeks.

This letter to the editor sounds like something I would have written: “One area that he and Michael Moore missed in the conversation on costs is hospital waste, inefficiency, lethargy and plain stupidity. In my 15 years in the industry, I have witnessed unbelievable waste and ridiculous decision-making on the part of hospital administrators and health care technocrats. For instance, my employer makes imaging software that easily outperforms the GEs and Siemenses of the world at one-tenth the cost. But key hospital decisions are not fully researched; the best solutions are shelved in favor of ‘this is how we have always done it.’ We live in an age of marketing, not of patient care, intelligent decision-making and financial discipline. Our hospitals could function as true health care institutions if they were not consistently in a battle to build Taj Mahals.” I agree, with a caveat: the really dumb and financially irresponsible decisions are made almost entirely by big hospitals and IDNs, whose large egos and bankrolls allow it to happen without disastrous consequences. Little hospitals don’t have that luxury or that motivation. I’ve seen greed, corruption, and stupidity first-hand in hospitals, but never in one under 200 beds.

Here’s a local story on an Ohio hospital’s smart IV pumps (which the article calls SmartPumps). It claims the hospital’s “chemical coordinator” had to “write software”.

Cardinal Health is recalling the Pyxis Anesthesia System 3500 because it can lock up while being rebooted. Only 17 hospitals use it.

This must have been interesting: the 20-year-old doctor asking a 14-year-old girl in a chat room for nude pictures was actually a 72-year-old doctor hitting on an undercover agent. One of the deceitful parties faces a minimum 15-year sentence.

FDA will get access to Department of Defense electronic medical records to monitor prescription drug usage. It isn’t mentioned whether patients have to consent.

iSoft is tired of the one-upping between prospective acquirers IBA and CompuGroup, so it says it will auction itself off if another bid is made.

A UK paper says the Cerner Millennium implementation at its first London trust is “besieged by problems”. Bigwigs called them “expected teething problems”. Worker bees weren’t so nice: “It is an American system and is so long-winded. It has not been adapted properly for British use. Every day someone bursts into tears in my office. One woman is thinking of retiring early because of it. These are not teething problems – the system is rubbish.” They must have some terse software over there.

Say, I wonder who this internal e-mail is referring to? “Blogs” are casually mentioned as part of a list, sort of like that scene in American Graffiti where underage Terry tries to buy liquor: “A Three Musketeers, and a ball point pen, one of those combs there, a pint of Old Harper, a couple of flashlight batteries and some beef jerky.” Anyway, the e-mail concludes, “I trust all of you to exercise good judgment”, which must not be exactly true since an e-mail warning was necessary. I don’t blame the company, though. They should be encouraged that I didn’t get a copy of it for nearly four hours … I often get stuff like this in minutes, so maybe the loose lips are tightening up.

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