News 3/14/08

From Gesundheit: "Re: CHW. Ben Williams, CIO at CHW, is changing the IT outsourcing model. They will insource part of the operations from Perot and eventually bring 40-50% of the functions in-house. With 800-900 Perot people on the account, major changes are coming."

From No Name in PA: "Re: UB. Any truth to the rumor that University of Buffalo has just signed with Epic as an EMR?" If it’s Epic and a rumored sale involving a hospital of over 400 beds, it’s usually true, but maybe someone will confirm. In fact, a second reader asked the same question, so there’s your smoke. Fire, anyone?

From Former High Level Exec: "Re: Eclipsys. I just heard that ECLP is going to outsource to India their Sales and Marketing responses to RFIs and RFPs. Can this even be possible for a sane executive to consider?"

From Mikey Likes It: "Re: consultant survey. Poorly worded question: does your company typically lay off or bench people when there is a gap in business? It should be multiple choice, not yes/no. Some companies will lay off immediately, some after a month, etc. Some will keep consultants on the bench for quite a while, maybe send them to training during that time. Whether and how long you’ll be on the bench is a BIG indicator of the company’s loyalty to their employees and their overall corporate culture. Good question when evaluating firms: ‘What’s the longest any consultant has been on the bench in the past 12 months?’ The longer the time compared to other firms, the better the attitudes, mutual loyalty, and likely the happier and more productive the consultants. Would you fire a bunch of nurses if the inpatient census dropped for a couple weeks?"

From The Real Deal: "Re: consultant survey. What every consultant should want to know is what percentage of the hourly rate goes to the company. It appears to be between 30 and 50%, which seems like a lot for job placement. Consultants eventually make their way to independent consulting to get a larger slice of the pie. You start out at more than you made at a facility or vendor, but over time, after you’ve developed knowledge, spent years on planes, and disconnected with family and friends, you start to question how much your time should be worth. The company values you at a high price when selling you to the hospital, but doesn’t place that same value on you as their employee."

Listening: The Concretes, Swedish pop. Mazzy Star meets The Supremes.

Unrelated: one of the funniest phony news stories I’ve read.

Great Red Hat Summit speaker lineup: BIDMC CIO John Halamka and a writer for The Simpsons.

McFarland Clinic (IA) picks Epic. Does anybody else ever win a deal any more? Of course, it’s kind of like taking candy from a baby when most of your competitors voluntarily carry the smothering baggage of being publicly traded.

Sounds interesting: NVivo qualitative research analysis software, which now handles media files. Free trial download. Costs a few hundred dollars. There are lots of cool, cheap data discovery tools coming out that can read just about any data source.

Big numbers for QuadraMed, but with an asterisk: revenue up 31%, EPS $0.68 vs. $0.05. Without a one-time tax treatment, earnings were flat. The company projects a revenue increase of 6-10% for 2008. The stock is down 4% after hours, a little above its 52-week low.

CDC issues $38 million in NHIN trial grants: Indiana University School of Medicine, SAIC, and Health Research, Inc.

Allscripts signs a deal to distribute its product to 1,000 physicians in Hawaii. Shares are still down 4% on the day.

Odd lawsuit: a fired hospital employee is suing her former employer, claiming she was fired because she was shipping out to Iraq with the National Guard. Her job: chaplain. Go ahead and make out the check.

E-mail me.

Art Vandelay on IT and Process Change

Mr. HIStalk has a great editorial in the latest Inside Healthcare Computing electronic update. The tagline is, "Everybody Hates Their IT Department: Where Alignment, Control, and Honesty Collide." The two-line summary is that IT is in the position to execute leadership’s vision, within a set timeframe and budget and usually with imperfect technologies. IT’s typical approach lacks the finesse to deliver in the middleman role between the users and leadership.

In the current Information Week, there is a short article about Jeanne Ross’ current thinking on IT. She is part of the IT Governance study team. If you haven’t read that book, I highly recommend it. She comments that systems will never deliver full-value without process change. CIOs are uniquely positioned be strategic execution officers responsible for delivering the change. The article stops short of providing advice about how to get the job done.

Two thoughts. To Mr. HISTalk’s point, IT organizations with expertise in process change that can effectively influence the users can get the job done. Those who don’t or can’t always have an uphill battle. The only means of getting through this challenge is highly involved and influential senior leadership; drafting cross-silo thinking users into the project; supporting them with process analysis staff who back recommended changes with hard data (i.e., turn-around time is "x" hours); and lastly, with incentives.

Second, the problem is intensified in this time of enterprise clinical systems, where change is required across business silos. The most difficult changes involve cross-silo handoffs, communication, and accountability. Implementing a department-based system is always easier.

How will organizations who are in the middle of implementing enterprise systems handle the current economic challenges? Will they back-pedal and focus on departmental systems? Will they try and eat the elephant faster to just get ‘er done? Will they try to eat the elephant slower, focusing on high-value processes? That still requires bigger bites when the system changes business processes.

Another option: focus on revenue cycle through the small systems that improve their aging systems. Somehow they have to cover the recurring costs of the enterprise clinical system they bought.

Inga’s Update

The University of Michigan selects McKesson’s Horizon Medical Imaging PACS for its three-hospital, nine-clinic health system. Expected go-live is early summer 2008.

Mark D. Barner is named Ascension Health’s new CIO after serving almost a year as interim CIO. He has had several leadership roles within Ascension and spent 19 years with EDS.

The Ohio State Medical Society releases the terms for its Standards of Excellence Program, plus the list of participating vendors. Allscripts, e-MDs, Greenway, iMedica, Misys, and Sage have all agreed to include OSMS’s "physician-friendly" terms and provide OSMS members with preferred pricing. Some of the special terms: the inclusion of upgrades in service agreements, a cap on maintenance fee equal to the CPI index plus 3%, stepped payment plans, and compliance with OSMS’s e-Rx requirements.

The U.S. Chamber of Commerce hosts an HIT forum bringing together stakeholders from government and private industry. The focus was on how businesses could improve healthcare quality and value for their employees with investment in healthcare IT.

I have been skiing for the last few days (with a very cute boy, I might add) and thus have been blissfully out of touch with much of the news of the world, much less the HIT world. Fortunately I had no need for direct contact with any healthcare facilities, though I do have plenty of aches and pains. Back to reality next week…

E-mail Inga.