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News 10/5/07

October 4, 2007 News 9 Comments

From Joe Bob Priddy: “Re: Battery Ventures/Quovadx acquiring Healthvision. So far, they have purchased two questionable assets under the theory that if you tie two boat anchors together, maybe they’ll float. Maybe three or four anchors is the key.” I love succinct cynicism about the company’s acquisition plans. I was offered an interview with Quovadx’s CEO, so I’ll stay neutral like a journalist until I hear first-hand.

From Gunga Din: “Re: the former El Camino CEO. He was fired from Legacy Health System after a tenure of 18 months.”

From O.W. Shaddock: “Re: physicians on planes. I got the dreaded tap on the shoulder on a recent long flight, where I stabilized a patient who was later met by an ambulance on the tarmac. The airline’s response was tremendous: food and gift packets for my family, moved us to business class, gave us a $250 certificate for the in-flight catalog, let us off the plane first, and sent three bottles of wine with a thank you note. I don’t sent a bill to the state when I’m first on the scene of an accident, but this sense of entitlement has become more prevalent in the physician community at a time when overall volunteerism and social responsiblity is on the rise. On the other hand, treatment was delayed 40 minutes waiting for the airline’s on-call physician to give permission to open a surprisingly skimpy drug box, I was unable to speak to him directly because passengers aren’t allowed in the cockpit, and many cars today come equipped with a better first aid kit than a plane holding 500+ passengers – no otoscope or ophthalmoscope.” I’m doing everything I can… and stop calling me Shirley. A little doctor-plane humor for you.

From Duude: “Re: your editorial, ‘I’ll Have What He’s Having’. I discussed this with my aunt, who used to be in the industry. She asked how the industry was going, whether hospitals are doing a better job in system selection, etc. I had the misfortune of telling her that health systems still follow the pack, still rely on vendor products more through past associations rather than a comprehensive and unbiased system selection process, C-level backroom deals, pissy-pant ‘not feeling current vendor love’ feelings, etc. It was interesting to see her reaction when she realized nothing has changed. We all know that C-level people from the more controversial system selections read HIStalk. I dare them (Kaiser, Stanford, etc.) to refute me. Explain your system selection criteria and let us believe that it really didn’t have to do with ‘I know Neal’ or ‘the system next door is using Vendor Y, so we need to also.’”

I heard from Lynn Vogel, CIO of MD Anderson, when I mentioned their EMR development work. He tells me that the redesign of their ClinicStation EMR suite is going great. It’s now off VB6 and fully SOA and .NET driven, with up to 4,000 service calls a second (!). Interestingly, MDA is following a vendor-like quarterly release schedule, with a faculty committee overseeing the agenda. Lynn also says that SOA is letting them link the EMR to their research software, even though much of that is open source. He also mentions that the CIOs of four big hospital development shops will speak at AMIA in Chicago: Lynn, John Glaser of Partners, Bill Stead of Vanderbilt, and Justin Starren from Marshfield Clinic. I’ve argued previously that hospitals are too reluctant to do their own development (or contract it out), so that’s an interesting topic (how can you excel competitively when you’re using the same off-the-rack systems as everyone else, at least if you really believe that IT is strategic?)

Microsoft is the star of the day for introducing its HealthVault PHR and health search engine tweaks. The HealthVault Search is OK and has a scrapbook feature to save stuff you find, although the results are already peppered with ads (if you have medical issues with a certain male body part, the ‘sponsored sites’ can help you with just one claimed outcome). I still think PHRs are a waste of time since patients won’t keep them and doctors won’t really use them (is it illogical to keep a Web-based record that you can talk to your doctor about only by making a weeks-ahead appointment and sitting in front of him or her?) The Connection Center is a good idea, assuming it works (plug and play medical devices, anyone?) The need to have Windows Live ID, however, will kill what little interest there is. I used to curse emotionally and loudly about Passport and Wallet, previous (and also bad) attempts to lock users into some sort of mindless and proprietary Microsoft loyalty. My reaction to all the HealthVault hoopla: it’s like watching a once-vibrant and edgy man turn gradually into a doddering senior citizen that the whippersnappers make fun of without his catching on. I’m just not finding Microsoft to be all that relevant to what I want to do any more, either on my PC or on the Web. HealthVault won’t change my mind. Hotshot companies always want to profit from healthcare without getting into the ugly trenches of care delivery, contracting, procurement, and labor management, cherry-picking the fun consumer stuff and building a business model on advertising.

Speaking of HealthVault, you may have noticed that its PHR isn’t really that at all, it’s just a document repository. A later announcement today may have explained that: CapMed will create an “In Case of Emergency” (ICE) PHR for HealthVault. icePHR will provide users with a custom URL that emergency providers can securely access. A demo is on the site. It seems to hold basic contact, condition, and allergy info. They sell it for $9.95 a year. It’s maybe enough to help a paramedic, that is, if they have an Internet-connected laptop to use while you’re convulsing on the floor, if you’re coherent enough to tell them about it, and if you’ve kept it up to date (like a piece of paper strapped into a MedicAlert tube, in other words). Maybe I’m just being curmudgeonly, but this looks like a solution in search of a problem. I can’t imagine either patients or doctors taking PHRs seriously enough to trust for making treatment decisions.

Listening to now: The Apparitions. Recommended by a reader. Sounds good, kind of Frank Black meets The Magic Numbers. Also, the best album in history: Bowie’s Ziggy Stardust. I’m desk-drumming.

A milestone for eScription: the company’s product now handles over a billion lines of transcription a year. They’re at AHIMA in Philadelphia next week, booth 225 if you’re inclined to drop by and say hello. If you meet Paul Egerman and don’t leave happy, I’ll reimburse you for your footstep mileage.

Speaking of AHIMA, it gets a $10 million CMS contract to evaluate the possible changeover from ICD-9 to ICD-10.

Wow, am I ever humbled by Scott Shreeve’s writeup in honor of HIStalk’s soon-to-be millionth visitor. My version of blogging is lonely and free of feedback (other than e-mail), so it’s sure nice to hear it mentioned as though it’s something real, not just the empty screen in an empty room that I see from this end. I’m not emotional, but it choked me up a little after I got over being embarrassed by the attention. Right back at you, Scott.

Cerner has their big Health Conference cranking up this weekend, with 400 education sessions led by Cerner customers. What’s cool: chief marketing officer Don Trigg is hooking me up with some attendees on a live call Monday evening for a report. I’ve never attended, but colleagues who’ve attended in previous years speak highly of it. I’ll have to think of insightful questions to pose to them.

Lightning round housekeeping stuff that I always forget: use Search to your right to zip through four years’ of HIStalk, sign up also to your right for instant E-mail updates (at the top) or the Brev+IT newsletter (below that). E-mail me for a sponsor packet. Feel free to e-mail me otherwise, although I confess I’m absolutely buried in jobs (day and other) and can’t always reply. And no, I won’t send you a picture of Inga (ask her yourself).

Unibased Systems Architecture brags on its KLAS surgery system scores. I honestly don’t know a single hospital that uses it, even though it’s perpetually up there. I’m taking away points for using the word “space” four times in a short press release. I can’t help but think of sleazy, dot-com salespeople when someone lobs out a “space” instead of “market”, as in “I’m in the dogfood space” or “I specialize in the porn space”.

Carilion uses software from Scalent Systems to roll out Citrix boxes for its Epic implementation. “They’re allowing you to re-provision a virtual server very quickly — within five minutes.”

Who knew Glen Tullman’s big brother is a CEO, too? Both are on the agenda of a Chicago business event. Hope Howard doesn’t embarrass Glen on stage by holding him down and giving him noogies.

Mediware adds to its stack of Nasdaq notifications, but says this one doesn’t threaten delisting.

E-mail me.

Inga’s Update

Nuance Communications, Inc. acquires Commissure. Nuance provides speech and imaging solutions (they are the ones that bought Dictaphone awhile back). Commissure provides speech-enabled radiology workflow optimization and data analysis solutions. Also this week, Nuance announced a new president of their Enterprise Division, Wes Hayden, who had been president and CEO of Alcatel-Lucent’s Genesys Telecommunications Laboratories unit.

Advocate Home Health Services, the home care and hospice division of Advocate Health Care, selects Misys Homecare for their 250 home health associations and 225 support employees in the Chicago area. It is interesting to me that, despite all the turbulence among the physician and hospital divisions, the home care group has kept such a low profile.
McKesson announces a new Web-based BI tool for health information management departments.

Since joining HIStalk I have come to the realization that there is an award for everything. (Guess it is kind of like all the kids on all the soccer teams getting trophies.) McKesson and Kaiser Permanente are two of nine organizations receiving the Electronic Product Environmental Assessment Tool (EPEAT) Green Electronics Champion awards. The winners have moved to EPEAT-certified equipment, which is more energy efficient. Between McKesson and KP, the energy savings is enough to power about 5000 homes per year. (Which actually is pretty impressive.)

Hyland Software will provide a document management solution to integrate with Epic EMR at Texas Children’s Hospitals and clinics. Maybe this is a silly question but doesn’t Epic have a DM system as part of their offering?

E-mail Inga.

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Currently there are "9 comments" on this Article:

  1. I’m not so sure I agree with the boat anchor comment from Joe Bob Priddy. The two companies have $50M in annual revenues. 2000-plus Cloverleaf customers who have been asking for something other than an integration engine from Cloverleaf… Access to the European market where there is more interest in the HIE than here in the US… Oh and $3 Billion in financial resources for acquisition and growth initiatives.

  2. I agree that current PHR implementations (including HealthVault) are less than optimal for patient-doctor interactions. I think the PHR vision for the future of EMR makes a lot of sense though. If you look through my EMR postings (http://rdn-consulting.com/blog/category/emr) you’ll see some of my thoughts on this. It doesn’t matter whether it’s Passport, CardSpace, or any other type of authentication, providing real security will be absolutely critical for PHR to succeed. In the end, for better or worse, individuals will need to take control of their health records in the same way they control the rest of their on-line lives (financial, purchasing, e-mail, etc.).

    The subject that’s closest to my heart though is interoperability. Seeing that HealthVault provides device interfaces at least shows that they consider this an important component. The SDK (http://msdn2.microsoft.com/en-us/healthvault/default.aspx) appears to be full featured and allows third parties to quickly add applications and devices. Any attempt to lower the barriers for device interfacing is a step forward and benefits everyone.

    Google also has plans to move into this arena. It will be interesting to see what they counter with.


  3. HealthVault hoopla, huh? Well Tudor my boy, you obviously sound like a card carrying Linux-head. I might be one of those there “user-wasers” but this is the era of Baby-boomer consumer driven healthcare and we want our MTV~PHR.

    I seem to remember way back in the middle of the 1980s, a consumer-driven 50-page laboratory health assessments was delivered by pulp version to consumers who paid out of pocket for this uniquely personal service. Today, this pulp version health assessment would be an ideal impetus for migration to launch the mystical Web 3.0 and a reputable high profile HealthVault would be the consumer’s file box.

  4. Epic does not have a robust document management system of their own. I worked at a large IDS and we used Hyland’s system alongside Epic for clinical and revenue cycle document management. It worked very well! Epic and Hyland worked together with us on the integration.

  5. Re; Unibased Systems: they have 200+ hospitals, 50 contracts. In major places like Florida Hospital and Inova. Customers love’m because they know how to treat a client and are not a revenue crazy public company.
    Suggest you contact their President (Larry Covington) and do an interview. He has some interseting takes on the industry having worked in the commercial world before.

  6. Re: HealthVault hoopla

    In my opinion, this is a bunch of hoopla. The web makes little sense in an area where it may not always be available. What would be useful in a world of “consumer-driven healthcare” (gawd I hate that term. Can we at least use “patient-driven”?) would be something equivalent to a smartcard or USB flash drive of your medical record. You need something you can carry with you everywhere.

    Of course, for something like that to happen we would need vendors to agree on a standard, and who knows when that would happen. It’s a pipe dream, but it’s a lot more practical than the web-driven mess these vendors are heading for. Microsoft (and probably Google and the whole lot of the PHR promoters) is trying to gain a foothold like they did in the PC world, by snagging the user first and then getting the server sales as kind of an add-on sale. I don’t see it happening that way, but I don’t think that will stop anyone from trying.

    To end this incoherent rant, I’d like to add the disclaimer that I haven’t used a PHR myself. Is there anyone out there who has a good personal experience with one to share?

  7. HealthVault hoopla revisited:

    Don’t want to beat a dead horse here, but as a consumer, have several decades of experience with what could be consider one-of-the-first commercial personal health record and experienced the same in-the-box mentality in 1985. Peer review of the time dictated that the “patient” should not receive their own diagnostic data. So uniquely personal preventive health went stealth into the oncoming New Age of crystal therapy and spiritualism but my personal health record survived based on subclinical findings.

    By the way, the wonderful people at wikipedia tells us that a patient is any person who receives medical attention, care, or treatment. Well, let’s all drive a truck through that definition. The word for patient it states is derived from the Latin work patiens, meaning “one who suffers.” Could this not be a better moniker for the 21st century citizen in the United States that the World Health Organization rated 24th, or an average of 70.0 years of healthy life for babies born in 1999.

    Patients of old, circa 2007 usually relinquished their humanity to the “doctor” in charge of their sufferings and received a lifetime longitudinal regimen of miraculous pharmaceutical remedies. The health enthusiast of the New Health Millennium wants to address human conditions before manifestation of suffering but most 21st physicians are not equipped mentally to provide proactive or prodromal care to suffering because there is minimal to no reimbursement incentives. Physicians in this country are some of the best trained and brightest minds in the world but appear to be dependent on pharma best practices for common self-limited to esoteric pathological conditions.

    Let’s give this healthcare paradigm shift a chance to succeed or fail but let it stand on it’s own merits of providing the average person, yes us Baby-boomer again, with options for our own health information system (his) rather than relagate that data to monolithic Healthcare Information System (HIS). The prime directive for the Internet can be programmed and mandated by man – Internet Do No Harm!

  8. One last hoopla:

    I’m not disagreeing that patients need to be in charge of their own data, I’m simply arguing that the web is not the platform to do that. The Internet is a wonderful way to exchange data, but it is not the only one and we should not let ourselves be blindsided into thinking that it is the only solution that exists. The Internet can indeed do a lot of harm if the wrong database gets hacked.

  9. Re: Marshfield Clinic

    To clarify, Carl Christensen is the CIO at the Marshfield Clinic that has led their effort to internally develop an EHR over the last 20 years.

    Justin Starren is their very talented researcher that heads their Bioinformatics group.

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