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News 10/31/07

October 30, 2007 News 6 Comments

From Dr. Lisa Cutty: “Re: Microsoft. Microsoft to Acquire Innovative Healthcare Technology and Assets From Global Care Solutions. Does MS really want to enter the battled HIS arena?” Link. MSFT buys the application developer that built systems for big-name medical tourism magnet Bumrungrad International Hospital. For the dirt on the company, see here from alleged employees, and a few more comments here including some shots at Cerner and others. I don’t know why Microsoft wants to be in this business either, although maybe Azyxxi needs a little brother.

From Big Fan: “Re: first mover advantage. Check out Bruce Freidman’s column from the weekend. Great insight. He’s also from University of Michigan, the lab side, and was department head when they decided to back out their Millennium PathNet upgrade. I’d like to hear his explanation for that.” Bruce argues that companies that develop their own IT systems often regret it because commercial offerings will eventually surpass them. He cites an article that claims Wal-Mart’s much-lauded internally developed IT systems now place the company at a disadvantage. I don’t know that I necessarily agree since even a short-term competitive advantage may make self-developed applications worth it, but it’s an interesting discussion.

From M_Miller: “Re: Misys. Steve Lohr, the leading software writer for the New York Times, slams Misys’ open source idea. Everyone knows that Newt is paid to give these quotes to Misys and Allscripts as part of his lame group, but man, Misys just can’t catch a break. The piece then goes on to call out athena’s model and Jonathan Bush’s take on what needs to be done.” The article agrees with me: dumping a poor-selling product onto the open source market doesn’t usually work. There’s no passionate developer community behind it. The article mentions Gartner’s Wes Rishel, who was “unimpressed” and who brought up that users would be clinicians, not the usual techies who embrace that kind of stuff (so he says, anyway, although that’s not what I thought Connect was). He likes Web-based SaaS technology. Sad that the Connect strategy was the supposed future of Misys Healthcare just a few months ago and now the related accoutrements have been donated like a rusted out Chevette.

And speaking of Misys, CFO Charles Lambert has been officially announced as departing, I’m told.

Former University of Maryland Medical Center CIO Mike Minear is named CIO of UC Davis Health System. If you want excruciating detail of what he’s being paid, see here (warning: PDF). He replaces Tom Tinstman (previous HIStalk mentions here).

This week’s Brev+IT is here. Sign up to your right.

Listening: new Coheed & Cambria. I’m in a prog-metal mood.

KU Hospital and KU Medical Center did nothing wrong in choosing a $50 million hospital system from Epic Systems despite a lower bid from Cerner, according to a report by state auditors. Cerner was somewhere between $1 million and $12 million cheaper than Epic over five years, but users had a strong preference for Epic.

The folks at Medicity, always anxious to be helpful, think they may have a few “I Am Mr. HIStalk” buttons laying around and offered to mail one to Lacey Underall if so. No promises, Lacey, but send me an address and we’ll see. I’m still trying to think of something fun and slighly guerrilla-ish to do at HIMSS. Many I should hire an obnoxious band to play on a flatbed truck outside the convention center (I’d be stealing the idea from Howard Stern). Or, I could offer speakers an under-the-table $50 to slip an HIStalk pitch into their PowerPoints and claim it was a mistake (it was a proud moment last year when my man John Glaser wore his button up on stage). Inga and I will be running around causing anonymous trouble, I guess.

A big year for SCI Solutions – their biggest ever, actually. They signed 33 new contracts, including Sutter, UVA, and Health First. Nice.

Justen Deal has thoughts on Kaiser’s potential outsourcing, “Together Again: KP and IBM.” He mentions IBM’s offshore presence (could that be a way for KP to offshore without taking the black eye it might bring?) Spoiler: Justen thinks that bringing in IBM would be good for both KP and Epic.

Rumor: Perot is laying off 1,000 people. Reason unknown.

Want to follow HIT stocks? I made a page with the big HIT stocks listed and a 20-minute delayed quote. Bookmark it if you’re so inclined.

The local paper profiles eClinicalWorks: 32 profitable quarters, 3,000 customers, 600% revenue growth in three years up to $38 million, and a tripling of employees to 550 in two years.

Miami Children’s hires a former GE Healthcare guy as CEO: M. Narendra Kini, MD.

To your right is a new poll: who should run clinical systems projects in hospitals? And to your left is a new Gold Sponsor, AT&T, which has mobility and wireless offerings for healthcare organizations. Hey, they’re my cell provider, so here’s a shout out and thanks for supporting HIStalk.

Sumter Regional Hospital is in first place to win an MRI machine. You can vote daily through December 31.

E-mail me. Happy Halloween, if you’re into evil undead and candy.


Inga’s Update

I reached out to a few folks asking their opinion of the status of the Kaiser/Epic implementation. Here is a note from someone who has been involved:

So the truth is that KP has successfully implemented more software in the past three years than they had in the previous 10 years. When you think about their size and compare that to anyone else, this has got to amaze anyone who really knows what this takes. They have had to industrialize their infrastructure to support the heavier load, and there have been a few hiccups with that infrastructure work, but they have already realized enormous benefits of this investment … it has been an unqualified success. Every installation of electronic health records requires physicians to significantly change their behavior in order to adopt and optimize the use of the system. The vast majority of KP docs who have used the system for more than six months adamantly reject any thoughts of going back to paper, but the changes involved in a deployment of this size invariably results in individual physicians who actively and vocally resist the change. The most surprising thing is how quickly the overwhelming majority of docs get past this reflex resistance to change.

If anyone else cares to share an opinion, we are happy to listen.

I have been mulling over the announcement that the HHS and CMS will pay 1,200 physicians for reporting quality measures using their EHRs. The government is calling it the “largest step yet” for boosting physician adoption (though if the country has 800,000 active physicians, helping 1,200 doesn’t seem that big a step.) The program will supposedly pay for itself with the reduction of duplication tests, ER visits, and medication errors. I realize that some private insurance companies offer quality care bonuses, but if there was that much of a savings wouldn’t all the insurance companies be jumping on the bonus bandwagon? I am all for using EMRs and agree they can improve care. But is there enough to this initiative to have any real affect?

All you ambulatory fans know that the MGMA has been in full swing this week in Philadelphia. Consequently, vendors are making numerous company and product announcements. A sampling:

Greenway Medical Technologies announces that Q1 sales were up 64% over the previous year.

Athenahealth announces that the 38-provider orthopedic clinic Campbell Clinic selected athenahealth’s PM and collection solutions.

Offering software as a service is suddenly fashionable. Sage Healthcare, Allscripts, and McKesson all announced new ASP offerings for their EMR/PM solutions.

Remember eClinicalWorks? From December until May, ECW was announcing one major deal after another. Since the summer, little news has been reported (Busy implementing? Marketing department on vacation? No big sales to announce?) ECW reappeared this week, announcing their partnership with the Hudson Valley HIE to provide the member doctors ECW’s EMR/PM system.

What is old is hip again! Demand for vinyl records is on the rise. Music purists are convincing more people that the sound quality is superior with analog recordings compared to the digital CD. I would bet money that Mr. H has a huge stack of Pink Floyd and Jimi Hendrix albums that he secretly listens to while writing HIStalk posts.

Heard that at a user conference not so long ago, a certain married, male HIT executive was busy sending text messages to some participants at 3 a.m., asking if they were “ready to party.” Anyone care to guess whether or not the recipients were young, attractive, and female (and if they ignored the message?)

Another fun game – fill in the blanks. I heard that [executive] is asking [beancounter] to do some things regarding revenue recognition that [beancounter] is not comfortable with; e.g., recognizing revenue a little on the early side. And, [company] just downgraded their forecast.

E-mail Inga.



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Currently there are "6 comments" on this Article:

  1. Couple of words:

    1. eClinicalWorks is doing well because they have a really strong integrated product that is selling well through physician referrals/word-of-mouth to their colleagues. Can’t buy better advertising. Plus, there 8.0 release early next year is going to have some really interesting updates that supposedly focus on workflow/EBM.

    Just as with any small company that enjoys a ton of success in a short-time period, they are having growing pains supposedly with implementation and deployment. Hard to say when they will turn the corner on this but I bet a bunch of the recent hires are meant to address these issues.

    2. As for the Pay-for-Performance program (PQRI) and CMS, it really plays out by specialty. A 1.5% bump for reporting quality may not seem like a lot but it adds up for a specialty practice that has a heavy Medicare payer mix and codes for a bunch of intensive services.

    Put it this way, this program may be worth $10-$12k a year for a cardiologist in Florida and only $300-$500 bucks a year for a family practice doc with a bunch of younger patients. A doc not care about $300 bucks but I bet they are going to be pretty interested about leaving $10k or $12k on the table.

    The bigger issue though with P4P is that a doc may be in a couple of P4P programs now and leaving a bunch of money on the table. That 1% or 2% adds up if you are in 3 or 4 P4P programs. What if a practice is passing up a potential 7-8% upside annually? Time to get a new office manager.

    Plus, since it is likely that CMS will expand on the PQRI program in the near future, it makes sense to get a handle on this now. Here is an interesting scenario – CMS ties a portion of potential increases in future Medicare Physician payments to a series of quality metrics?

  2. Here we go again!! I have been in the HIT world 35 years and it NEVER changes (not technologically speaking). So now Miocrosoft jumps into HC apps! So did IBM in th e 70’s, DEC in the 80’s, and oh yeah… GE in th e 60’s! Doesn’t that sound familiar.

    None of these companies (and there’s more) ever made it long term. No doubt in my mind the nature of healtcare and medicine will spit them out in about 5 years.
    Good luck MS you’ll need it.

  3. Medicity may be a great company but it’s cool ad on HISTalk has a basic error. The parachutist jumps out of the plane, freefalls and then opens a paraglider wing. Any one going to Point of the Mountain in Utah near Medicity’s HQ (I think) has probably seen a paraglider wing, and they are NOT the same as paracutes used by freefallers.

    I hope they’re more careful than their ad agency.

  4. I heard the same rumor about Perot layoffs from another source. 500 associates at corporate will be let go and another 500 spread out along client accounts.

  5. Re; Microsoft acquisition of GCS
    Interesting move by Microsoft going from an infrastructure play to application layer with this acquisition. They did a similar move back in 2000 & 2002 when they acquired ERP companies Great Plains and Navision. Neither of those acquisitions made quite the splash to MS’s top line that they hoped for, it did not trigger massive consolidation in the ERP market (it was already occurring) and it did manage to alienate a number of MS’s ISV partners who were also selling ERP software.

    This acquisition will probably not have the same impact as it is a very small acq of a company that has seen very little traction in a very young, emerging regional market. An odd acquisition to say the least.

  6. For M_Miller: Misys can’t catch a break because they don’t deserve one. The announcement of Connect as open source is a thinly veiled attempt at some good PR for a company that is in major turmoil. They’re about to lose a bunch of their top sales reps (which they either a. don’t care about or b. are too egocentric to even know to care about). If they were sincere in their efforts to help the small physician offices they would have put their .net based pm/emr they purchased from Pfizer out for open source or some other systemthat had a chance of helping with small office physician automation. Interoperability is important. But, it’s kind of like building super highways that are 10 lanes wide when most of the drivers are still either traveling by foot or at best traveling on horseback.







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