Giving a patient medications in the ER, having them pop positive on a test, and then withholding further medications because…
Monday Morning Update 11/12/07
From Red: “Re: KUMED. Cerner should be getting the last laugh with EPIC and KUMED. KUMED is going live with EPIC on Sunday night. However, they have apparently killed their budget for support staff. Their project manager (must be a Cerner lover) is putting the EPIC kids up at a 40-something buck a night motel. Judy and Carl heard and said that customers can make their employees stay anywhere they want. They should just suggest putting a whole brood in one room like a college slumber party- that would save even more.” Send me a picture!
From B: “Re: Epic. Epic doesn’t deal. If Cedars is convinced Epic is the way to go, this really won’t hurt them at all. This all goes back to Epic’s corporate philosophy concept, i.e. stay private, don’t do deals, and be frugal (a big reason for the presentation on the math behind building the new facility at UGM).The story goes that one of the first customers we signed bartered for a pretty good deal. A short while later, another organization didn’t barter with us at all and took the worse price. Judy didn’t think this was fair and changed the policy to only offer deals to regional (WI), research/children’s hospitals, and hospitals that serve the indigent.” I will add this to Mr. HIStalk’s hard-knocks MBA curriculum for the benefit of Cerner, Eclipsys, McKesson, and others: if your competitor can charge whatever they want and still beat you, your product needs work.
From Pogue: “Re: HIMSS. How about a daily report on booth giveaways? Who has the nicest toy to take back home to the kids, who has the single worst item you’d NEVER put on display on your desk, who has the giveaway most seen being played with as folks saunter the aisles, etc. Now THAT would be some real exhibit floor value!!” I like it. Maybe I’ll collect everything they put out and run photos for comparison (and then leave it all in the room for the maid to toss). I could get a Trinket Update up Monday so folks would know where to cruise the rest of the week.
From The PACS Designer: “Re: OpenMRS. There’s a new movement internationally to get medical records developed for third world countries and its called Open Medical Record System, or OpenMRS. The World Health Organization (WHO), the Centers for Disease Control (CDC), and others are involved, so there is some serious development work going on. They are looking for volunteers to speed the development effort.” Link 1, Link 2.
Roger Maduro sent over a very nice electronic newsletter he writes called VistA and Open Healthcare News. Topics like Medsphere and the VA’s Cerner decision are important, so you might want to sign up for a free subscription. Just send an e-mail to subscribe@lxis.com.
Speaking of open source, the new VP of open source at Misys responds to a Scott Shreeve posting about Misys Connect. See if you can interpret Scott’s closely guarded position based on words I pulled from his piece: perverse, land grab, confusion, silly, desperation. In his reply, the Misys guy says that Connect is live at only two sites (and this was to be Tom Skelton’s bet-the-bank company strategy?) and, basically, that it was open sourced because there were few customers with Misys products on both ends to care. I bet the community is really lining up to work free on that.
Scott also comments on the VA’s replacement of VistA lab with Cerner. That inspired me to put a new poll to your right: should the VA keep VistA, rewrite it, or replace it with commercial systems?
Photo: Associated Press
Veterans Day is Sunday, November 11.
A reader I’ll leave anonymous asked for an opinion. The customer had complained that a vendor’s app requires a 1280×1024 display resolution, limiting the ability to use it efficiently on tablets (they don’t provide vertical scroll bars, either) and therefore it requires dedicated workstations. The vendor replied that while that was true, the customer could use unsupported third party screen changer apps that are known to work. The customer’s question: is that an acceptable answer? Opinions welcome, but here’s mine: yes. The vendor suggested a third-party solution that supposedly works, so I’d try that. It would be nice to add the scroll bars, though (sounds simple). I always ask this question: would most customers be willing to give up other enhancements and fixes to get that change instead? If not, then it isn’t in the vendor’s best interest to develop it, other than in a competition-free world. I wish it weren’t true, but vendors are in the business of selling new systems and keeping current customers from defecting. If a change doesn’t contribute toward either, it shouldn’t be done.
Netscape co-founder and serial entrepreneur Mark Andreessen donates $27.5 million for a new ED at Stanford. Ever notice that celebrities and rich folks always put their money into hospitals that don’t need it, i.e. the kind of swanky places in which they themselves might inhabit an off-limits VIP suite? Doesn’t anyone care about tiny, struggling backwater hospitals taking care of average Americans? Certainly their largesse would go much further there. From its latest publicly available tax forms, Stanford Hospital made a $132 million profit in 2005, paid its CIO $465K, paid Perot $38 million to run IT, gave an ad agency $2 million for advertising, and paid the CEO $1.2 million. My heartstrings are untugged.
Sales: North Mississippi Health, Eclipsys Sunrise. Carolinas Medical Center-NorthEast, Allscripts Healthmatics ED.
University of North Carolina Health Care gets coverage on local TV for its use of an unnamed system that allows referring physicians to receive electronic updates when their patients are admitted and followed by hospitalists.
A University of Toledo pharmacology professor starts a company that puts pharmacists in medical practices to follow up with diabetics. He’s working with a vendor to develop a custom EMR application.
RXHub proudly announces (its words) that it has paid money to Newt Gingricht’s for-profit company. Why is that something to be proud of?
Latest non-news headline: CCHIT’s chairman is happy with CCHIT’s work.
Odd hospital lawsuit: a Kentucky hospital is sued for failing to render proper care to a woman bitten by a rattlesnake during an illegal snake-handling church service.
People in Buffalo are thrilled that their Congressmen have brought the US taxpayer bacon home. “The House has approved a spending bill for labor and health programs and military construction that includes a treasure trove of earmarks for Western New York — including projects that prompted Republican Reps. Thomas M. Reynolds and Randy Kuhl to buck the White House and support it. Nearly $4 million would go to local hospitals and agencies in the bill, which faces an uncertain future because President Bush is threatening to veto it.” Well, at least those politicians are freely spending dollars that will be worth next to nothing soon enough, also their doing. Expect a mammoth Canadian influx to Florida this winter since the once-mighty US dollar now buys only 94 cents Canadian. We’ll be like Southerners wheelbarrowing Confederate money across the border to Montreal to afford poutine.
RE: From Red: “Re: KUMED. Their project manager (must be a Cerner lover) is putting the EPIC kids up at a 40-something buck a night motel.
The place isn’t bad. If you’re a reasonable person spending your own money, you wouldn’t blink staying there Why assume that every consultant needs a JW Marriott room at KUMEDs expense.
Reasonable decision and a pretty decently run project all the way through. That’s the kind of decision making that keeps a customer healthy through a tough project.
I’ve been put up in some of the seedier Madison hotels when I’ve gone to WI…so hearing about Epic folks having to tolerate sub-par lodging warms my heart. Not for any logical reason mind you, Epic had nothing to do with my crappy lodging, but whats good for the goose and all.
A good rule of thumb – If you’re going to be cheap, be cheap with the vendor first, and with your employees second.
My take on the 1280 resolution – where were your hardware technologists who do the basic reviews of the vendor product? I’d hope the organization learns from this one and sets-up a checklist with the basics about what your organization can and does support (i.e., desktops, COWs, laptops, handhelds, Tablets, printers, labelers, all-in-one devices, servers, OS, database, middleware, other glue software programs like job schedulers, report writers).
Mr. HISTalk is right-on. The vendor has done their job. If this is a recurring issue, the smart vendors adapt and find a solution.
The vendor in question is VISICU. I suspect that concern came from one of my Ministry IT teammates. If not, there is more than one customer asking for this.
Art, it is always a matter of traeoffs. We have a very mature IT Assessment process, which includes looking at the required screen resolution. But, sometimes leadership is compelled by the potential benefits (in this case patient safety) and they decide to live with some workaround, in this case additional devices to support this unique application.
Will – absolutely correct, I was reading into this, as-if this were a surprise after the application was bought and in-use. Even with demonstration, dry-run, or paper simulations of use-cases with the vendor or other customers, it is difficult to truly grasp the depth of trade-offs until the application is in testing or more often live use. The most challenging trade-offs are usually around those items the users take for granted (i.e., behind the scenes functions, basic system operations) such as device footprint or capabilities, authentication, reporting on data and discrete value interfacing.