Giving a patient medications in the ER, having them pop positive on a test, and then withholding further medications because…
News 12/28/07
From Bruce Teeler: “Re: MGMA. Does anyone have any feedback on this organisation? They claim 21k members, which doesn’t seem like a lot to me.” MGMA is the defacto member organization for physician practice management. 21,000 members sounds like a lot to me (I don’t recall how many HIMSS has, but I bet MGMA is nearly as large.) If anyone has first-hand experience with MGMA or its conference, feel free to provide an opinion and I’ll run it here.
From Neal’s Pizza Guy: “Re: Cerner. Rumours abound that Fujitsu is pulling out of the NHS contract, leaving Cerner in a prime contractor role for the Southern Cluster of England. Townsend has been spending a lot of time in the UK to negotiate, along with Neal, who presented how they would take on a cluster direct. Get the pizza ready!!!!” Speaking of pies and Neal, I’ll be opening up the HISsies nominations very shortly. If you’re new here, you can check out the writeups for 2005, 2006, and 2007. Neal’s a three-peater for The Pie, of course, the most recognized subset (and least desirable) of the HISsies awards. So if you’ve been anxious for this year’s round, I’ll say just this: tick-tock. Billy “Biff” Jutjaw is getting fitted for a new tux for the ceremony since he’s put on a few pounds since the last one, so I hear.
From EX-Xtenity: “Re: layoffs. It seems that one of the only certain things in this industry is that there will be layoffs. My heartfelt condolences to those who were recently laid off during this time of year. You might want to consider pulling together as a group for the purpose of networking. Best of luck to you all from someone who has been there a few times.” Agreed. It’s not much consolation while the wound is still fresh, but I’ve known a bunch of people who were laid off and nearly all of them ended up better off because of it. The companies doing the deed don’t usually fare so well (how talented are executives who can’t plan far enough ahead to dump payroll expense sometime other than November or after December knowing how bad that makes them look?) It’s a good reminder that, despite feel-good HR talk about being a “valued associate,” we’re all expendable horseflesh. I’m not against that concept at all since it’s a two-way street in our capitalist society, but sometimes companies say one thing and behave entirely differently and I’ve got a problem with that. I’ve laid off a bunch of people in my time and didn’t like it one bit (like a death camp guard, the clueless commandants didn’t exactly give me a choice). One thing I’ve learned: a company that’s laid people off more than once is entirely likely to do it again, meaning think twice before taking a job there no matter how superior you believe your skills are. Those laid off aren’t necessarily the least-capable employees, just the easiest targets because of their assignments or lack of political connections. There but for the grace of God go you.
From Matchless: “Re: St. Joe’s. I don’t think you published this, but St. Joe’s in Atlanta has to pay the government $26m for overbilling Medicare. Case workers of the world unite!” Link. The most interesting part of the story: a nurse whistleblower gets $5 million for documenting that the hospital billed outpatient and observation services as inpatients. Sweet.
From TheCoolerKing: “Re: [British EMR vendor]. Fired their SVP of Sales last week. It took over two years to find him and he is gone in less than a year. 50% of plan will do that to you.” I expunged the company’s name because that would single out a guy who’s out of work (if the rumor is true, anyway). Those who care will easily figure it out. Hint: it’s not Misys.
From Malvern: “Re: selling patient data. The desire to keep patient data confidential is understandable, but we tend to forget what is known about each of us who uses a credit card, takes out a loan, or swipes the grocery store tag to get the store discounts. When you ask the credit report companies what they know about most of us, there is not a whole lot that escapes the electronic eye.” True, although they need to know lots of stuff to gauge your credit risk and there’s no morally acceptable equivalent in the healthcare insurance business. Maybe that in itself is illogical: other insurances are priced by risk (living in a flood zone, driving like a maniac, skydiving, etc.) but health insurance is supposed to be blind to higher-risk purchasers with no cost adjustment for risk factors. If we were designing the concept from scratch, I don’t think we’d come up with today’s system of voluntary participation and employer-based signup.
From Billie Jean Queen: “Re: mining EMR data. Issues include: disparate standards across specialties and vendors; HIPAA and patient consent information, which requires metadata; control of the repository and how it will be secured, since search engine technology is so good that re-identification of patients is frighteningly easy; and getting enough data to make it useful for research (how BP was collected, for example: sitting, standing, etc. and most EHRs don’t capture that). The most useful thing that could be done would be to get device vendors to output all the information about how a signal was collected, such as device name, parameters for the study, methods used, software version, patient ID, etc. and automatically put that in the EHR in a standard form.”
A Washington Post article describes the software-driven ED turnaround at Inova Fair Oaks, with sophisticated applications forming the cornerstone of Inova’s plan to integrate its six Washington-area hospital EDs and several more freestanding emergency centers. GWU Hospital is also mentioned. The software isn’t mentioned by name, but a little Googling turns up that it’s Picis ED PulseCheck at both places.
Housekeeping reminders: you can sign up to your right for electronic updates when I write something new or for the Brev+IT weekly newsletter. New interviews are coming soon to HIStech Report, whose interviews delve deeper into vendors and their products (it will swell right before HIMSS). HIStalk Forum gives you a place to start discussions or participate in them — we’re planning to open up a Best Practices section there with an assigned focus area every couple of weeks for tip-sharing (grateful kudos for Noteworthy Medical Systems for sponsoring HIStalk Forum). There’s a site-specific Google Search box to your right, the first place I look when someone asks a question about a company or person since it covers 4 1/2 years of HIStalk. Lastly, please take minute to read and click those sponsor ads to your left and text ads to your right since they make HIStalk possible (and free).
A group of Paris hospitals withdraws its $110 million contract for patient systems development, awarded to GE and other companies, because the companies struggled to define their proposal. The tender has been reopened and a local paper says Capgemini and McKesson will probably jump back into the bidding.
Jobs: Medical Knowledge Engineer, Clinical Content Production Manager, Corporate Manager of Clinical Applications, Project Manager.
Barring last-minute voter fraud or eBay-type sniping, it looks like Sumter Regional Hospital will win an MRI machine from Siemens. The hospital has accumulated 244,000 votes, far ahead of #2 Grant Regional Health Center with 151,000.
Odd story: the Fiju hospital trust is running its own IT system after its vendor failed to meet its needs. The vendor’s owner is a businessman wanted for questioning over an alleged assassination plot.
Varian Medical Systems completes its acquisition of a radiology equipment distributor in China. Maybe I should study the Chinese HIT market since everybody seems to be looking there for growth unattainable elsewhere.
Idiotic hospital lawsuit: Wisconsin’s governor takes $200 million from the state’s medical malpractice fund to balance the budget. A patient is suing St. Luke’s Hospital for a medication error that occurred before state pain and suffering caps were enacted, with a potentially huge payoff on the line. The state’s medical society has filed a counter claim against the hospital to make them pay their own damages, claiming the hospital’s employee training is inadequate. The state’s hospital association, as you might expect, begs to differ, saying St. Luke’s should be covered by the malpractice fund because that’s why it was created in the first place. Now the medical society is suing the governor. An epidemic of lawyer paper cuts and 30-hour billing days is next.
Healthcare spending in California’s prison system has doubled in two years. Prisoner count is up 8% since 2003, but the budget increased 79% to $8.5 billion and expected to exceed $10 billion next year. The state faces a $14 billion budget shortfall, which surprises no one in the 49 other states who find it hard to suppress a guffaw. Surely The Terminator will blow away the deficit and save El Lay.
Interesting: an electronic stethoscope under development will use onboard Linux despite perceptions that it will make FDA approval difficult.
athenahealth’s IPO was the ninth best of 2007, one of 10 that doubled their IPO price. Implantable RFID chip maker VeriChip was the worst IPO of the year, down nearly 62% from $6.50 to $2.49.
I hope you’re enjoying the holiday. Shockingly, it’s just nine weeks or so until HIMSS. Save the early evening of Monday, February 25th if you’re headed to Orlando. That’s all I’m saying for now.
Regarding St Joe’s and Medicare fraud – you’d be surprised at the nurses that could collect whistle blower awards for overcharging observation patients.
Re: FDA approval challenges using Linux. There are numerous medical devices running Linux with FDA premarket approval. Getting approval for a device using open source software is just a bit different, but not necessarily harder than “black box” software from a vendor like Microsoft.
In my experience and opinion, MGMA is an influential organization that cannot be overlooked, especially if you have a product or service directed at medium to large-sized practices. (Some of their membership falls in the very small physician practice space.)
In many cases, the MGMA member is a primary decision maker in the group practice. Common member profile (my own experience, so please feel free to double check): A 10-doc physician practice with a few nurses, a few medical assistants and a group manager (essentially the C.O.O. of the practice). The group manager has a lot of power in the practice, although s/he does not always make the final decision.
MGMA also produces excellent research on various elements of physician practice (average reimbursement by specialty, average profit per physician per year, average salaries by state, etc.) that are very helpful to the collective membership.
Don’t let the “small” membership number fool you. As I recall, each membership entitles up to three people to enjoy access to member benefits, so there’s little reason for a group practice to purchase multiple memberships. Even if that were not the case, there are only so many group practices in the country.
For the record, I’m a big fan of the MGMA conference. Solid attendance by members who have some say in a final purchase decision (if not a major say in all decisions), and lots of Wall Street attendance, too.
Fellow HISTALKers: Please feel free to add comments if you think I overlooked or mischaracterized anything above. I never pretend to know everything , but I think this was a fair overview??
EMR Software Guy,
http://www.electronic-medical-record.blogspot.com
MGMA is an important organization for those who are selling to/marketing to decision makers in ambulatory care practices of all sizes, but particularly larger practices. If your target is hospitals, I wouldn’t consider them a player.
It’s also a great professional organization for those who work in group practices. Their educational, professional development, and networking programs are excellent.
Re MGMA: I was a long time member when I was working in the HealthPlan and physician office management area. Conferences were far more educational than HIMSS has become and always relevant to current practice in medical groups. Their research library was one of the best for practice management and group model HMOs when I was a member. They had a lot of member involvement through committees and Special Interst groups.
I also was a long-time member. In my mind, they target small to mid-sized practices. Although there is value for leaders of large IPAs, PHOs or similar organizations. The conferences are great and offer excellent networking opportunities. They conduct excellent primary research via surveys. Their journal is very relevant for practices with relevant information for all aspects of practice management (for ex: Human Resources, Operations Management, General Policies, Billing and Collections, Information Systems). I believe they also author a “practice management body of knowledge” and offer certifications like HIMSS now does.