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Monday Morning Update 10/1/07

September 29, 2007 News 9 Comments

From EMRNurse: “Re: Epic. Reporting from the Emergency Nurses Association conference in Salt Lake City. Lots of IT vendors, most of the big ones that have ED or Health System wide products. One seems to be missing – Epic. There is also a group forming to write a best practices document on ED applications. See the ENA technology listserv for details in the next few weeks. It can be found at ENA.org.”

From Phillip Elliott: “Re: tamper-proof prescriptions. I disagree that the tamper-proof paper script mandate is anti-EMR. Making paper harder to work with should drive people to e-prescribe, no?”

From Mike Bossy: “Re: Siemens. Bobby Orr wonders about Siemens’ focus with MS4, Soarian, and INVISION. What about their relationship with NextGen? Is NextGen their partner du jour until they toss them aside when their EMR is finally ready (or they think it is ready)? Where does Soarian Clinicals end and NextGen EMR start for Siemens customers?”

From The PACS Designer: “Re: iGUARD. iGuard keeps you updated on the latest findings on drug interactions and their side effects along with any new safety alerts. There’s a live webcast October 4th on this subject.” I tried it and was less than impressed. You enter your list of drugs and then wait for an e-mail back on each one, but most of mine said to wait several days for a response. All I could figure out that it does is flag a “risk rating” once you finally get the e-mail, but I’m not sure exactly what benefit that offers. Ask your pharmacist, look up your drug on any of thousands of patient information sites, buy a drug reference book — all provide more actionable information. I don’t see the point of it at all, but that’s just my opinion.

From HITman: “Re: HIPAA. What Ivinson Memorial Hospital is doing is right on track with HIPAA. Employees, when it comes to their own medical records, are no different than any other patient under HIPAA. They must follow the same policies and procedures to request access to their records. The reasoning that they have a computer password or the key to the file room doesn’t make them exempt from HIPAA. Covered entities must protect PHI. They must treat every record the same and every patient the same. Accessing records outside the scope of the minimum necessary or the need to know the information in order to perform job duties is not allowed under HIPAA. Kudos to IMH for sticking to their guns and HIPAA!”

From Philip Rivers: “Re: Ted Borris. Ted came to QuadraMed with CPR. We are excited to have him.”

John has a summary of this week’s AHRQ meeting. Nuggets: research hasn’t proven that healthcare IT improves quality, NHIN is a pipe dream, PHR privacy is getting no attention, and AHRQ-sponsored studies show that e-prescribing doesn’t reduce adverse drug events. I’m not surprised since AHRQ’s HIT studies are usually inconclusive at best. Could it be because it’s the user and not the system that drives the results, especially when looking at an unrelated marketbasket of healthcare organizations as though it were a population-based healthcare study? IT, if deployed wisely with process change, can sometimes make good organizations better. That’s it. Anyone who expects more is being naive. It isn’t what you have, but how you use it, a concept that somehow seems lost in the pre-purchase optimism of hospitals convinced that their carefully aimed checkbook can painlessly cure all organizational ills.

Scott Shreeve opines on athenahealth’s IPO. I like reading his stuff because he’s so energetic and positive. It’s like the standard war movie scene where the wisecracking fresh recruits are marching excitedly off to battle and pass a returning group of battle-weary veterans whose gaunt faces show the horrors of war they’ve witnessed and possibly committed. I realize I’m in that latter group.

Advice from a BI consultant to providers: “Stop thinking like a healthcare company. Providers are notorious for making known vendors and established consultants their trusted advisors. Instead, they should think like retailers. ‘Cerner and McKesson don’t have all the answers,’ one HMO administrator confided to me recently, as if it were a secret. ‘What we’d really like to know is what McDonald’s and Target are doing.'”

Thoughts on the healthcare IT vertical market from the perspective of Microsoft channel partners: “Moreover, some larger hospitals are hiring partners to build their EMR applications from scratch. Once you factor in annual maintenance fees, Velu says, some packaged EMR products can actually cost more over their lifetimes than handmade systems do … Hospitals, for example, tend to be wary of risk. ‘They’re followers, not leaders’ … Doctors can be tough customers too. ‘They’re notoriously cheap’, says Summers.” I don’t know of any hospitals building EMR applications from scratch. If you do, let me know, because I’d be interested to learn more.

A hospital CFO blames its new Dairyland system for not getting bills out on time. From the article: “The hospital has had many problems getting its issues solved with the software company.” Somehow I doubt it’s all Dairyland’s fault since they’ve installed quite a few systems in their time, but every patient accounting implementation starts out rough.

Strange: a UK government official was late for a hospital construction group picture, so his image was Photoshopped in (not all that skillfully, judging from the result). The kicker: he’d just scolded the press for faking footage.

The Australian Medical Association wants airlines to pay doctors who treat fellow passengers or upgrade physician passengers upfront for being “on call”. Once doctor was refused an upgrade for helping vomiting fellow passengers, so she sent the airline a bill.

A big UK hospital will use Sentillion for single sign-on and context management.

Thanks to these sponsor supporters of HIStalk. Please click their ads to your left and consider their offerings. I admire their bravery in convincing the beancounters to send money off to some anonymous blogger. Anyway, these vendors support HIStalk, so I appreciate your support of them in return.

Design Clinicals, LLC
Hayes Management Consulting
Healthcare Growth Partners
Healthia Consulting
Inside Healthcare Computing
Intellect Resources
John Muir Health
Lucida Healthcare IT Group
MedMatica Consulting Associates
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Novo Innovations
Pring|Pierce Executive Search
R. Gaines Baty Associates
SCI Solutions
Stratus Technologies
The White Stone Group, Inc.

Inga’s Update

Sue Ellen Mischke: Ever noticed there are two HMAs and they couldn’t be more different except their names are exactly the same? Health Management Associates, the hospital chain. For-profit to the nth degree. Then, Health Management Associates (www.healthmanagement.com) the consulting firm, which specializes in public hospitals, public health departments, and Medicaid agencies. They couldn’t pick customers with less money if they tried. Actually, I never quite put that together, but that is a great observation. I’m learning that I am not always great at observing little details. Like I just found out yesterday that when a major league baseball team plays at home, their jerseys say the team name (e.g., Yankees), but, when they are away, the jerseys say the name of their city. Who knew?

The market for physician financial information systems is expected to grow from $3.5 billion in 2006 to an anticipated $6.22 billion by 2013. This according to a Research and Markets study.

Susquehanna Health, the first facility to go live on both Soarian Clinicals and Financials, has signed on with Siemens for additional technology and service solutions. The Williamsport, PA-based health system plans a “facility revamp” project to be completed over the next five years.

E-mail Inga.

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Currently there are "9 comments" on this Article:

  1. Another product Siemens has purchased/partnered with is German, SAP-related, G.S.D. I wonder if anyone knows where Siemens is going with the product?

  2. Re: EMRs built from scratch, I believe Avenade is building one for MD Anderson. So there’s one example (if my information is correct–and if it isn’t correct, well, I read it all here on HISTalk 🙂 ).

  3. Thanks for the mention of the AHRQ summary. And yes, you are correct about most of these AHRQ studies – very academic, and do not always look deeper at how IT was deployed, staff trained, workflow enabled, etc. Easy to blame the technology, or fail to find conclusive value of an implementation in such studies.

    But tucked into all the research that AHRQ supports are some interesting findings.

    What I would really like to see is for AHRQ to extract out some of the better findings and best practices from this bevy of research they have funded, separating the wheat from the proverbial chaff, and get that out into the public domain so others may learn.

  4. EMR Nurse Re: ENA. I noticed that there were a couple of presentations by folks from Intermountain on EDIS documentation. Any insight as to what is going on with the IHC/GE partnetship?

  5. RE: tamperproof and EMRs. Agreed that it SHOULD push people to e-prescribing, but creating the regulations without any additional resources (our vendor certainly has no e-prescribing capability; plus many of our patients have no idea what pharmacy they go to) and then making life comparably easy for those still handwriting felt like punishment!

  6. I, too, think Athenahealth is one to watch, but their stock doesn’t “deserve” its recent run up, and I feel sorry for those who joined the party late. When the stock comes down to a more realistic valuation, let’s hope the investment community doesn’t panic and throw the baby out with the bath water. A more realistic valuation for ATHN won’t mean there’s anything wrong with the company’s underlying fundamentals.

    Wall Street sure is hungry for anything health IT-related right now. There are so few public investment choices in this space, so I suppose it’s no surprise everyone rushed to buy shares of Athena. In a few more years, once more small players go public, I imagine everything will change and valuations will come down to more realistic levels.

    EMR Software Guy,

  7. Want to know a large hospital system that is self-developing their own EHR…? Look no further than Henry Ford Medical System in Detroit… They are self developing their EHR with an outsourced IT department… and development in India…. And they are only planning to spend about $90+ million on it…

  8. To Bobby Orr and Mike Bossy: You have lots os questions about Siemens and their current product lines. I will add my two cents:
    – MS4 continues to survive because of its performance/price ratio. Siemens (then SMS) acquired MS4 in the 90’s to help compete against Meditech, which it can still do today in 2007 in new business situations (e.g. Texas Scottish Rite)
    – Siemens, in my opinion, had to invest in MS4 clinicals because not all of Siemens hospital clients, especially MS4, can afford the Soarian migration and were willing to wait until Siemens was finished tinkering with it over the last 5-6 years
    – NextGen, I feel, not only provides a physician EMR, but also a nice up-to-date practice management billing solution for Siemens compared to their very tired and long-in-the-tooth SIGNATURE product.
    – Does Siemens seem unfocused? I feel it is more protective than non-focused. Protective of their existing client and revenue base which has been declining for many years. You got to give your clients some form of enhancements while they wait for a replacement product, otherwise, they will move on.

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