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Monday Morning Update 3/17/08

March 15, 2008 News 8 Comments

From Irwin M. Fletcher: "Re: Interactive Care. Do you or your readers have any knowledge and/or opinion of Interactive Care? They are a newer entrant to the telemedicine arena." I don’t think I’ve heard of them. Website here.  

From Terry Tate: "Re: consultants. I can’t believe I am saying this, since I have never been a fan of them. However, over the years I have learned that few hospitals have the people and skills needed to make the process improvements needed to optimize their HIS systems, and MUST turn to consultants. Since most will work on a percentage of the savings, this can be a win for everyone." I didn’t realize that most would work for a percentage. If so, I can still see some hospital folks still balking because they aren’t comfortable placing a value on even those improvements that involve critical success measures (maybe because they’ll be unable to actually capitalize on them or because reimbursement quirks mean they really can’t). Example: a hospital says its #1 priority is to reduce medical errors. I’m selling systems and services that I claim can help you do that to the tune of a 50% reduction and I want $500,000 or $1 million or whatever. What’s it worth to you? How many hospitals would happily write the check even when benefits exceed that amount? It’s as shortsighted as a vendor that thinks paying sales commissions is bad.

From Scot Silverstein: "Re: CMIO war stories book. I am one of those CMIOs. Expect stories a bit more PC than at my website on health IT difficulties, but with more analytics. I kept detailed analytics out of my web site, because 1) the lessons are obvious to all but the most obtuse; and 2) the best techniques for avoiding project failures cannot be learned from a book or website. You have to live it. But first, you have to accept that clinical computing projects are complex sociotechnical endeavors in unforgiving medical environments that happen to involve computers, not IT projects that happen to involve doctors. The book will be a good step in giving ‘gut understanding’ to those words to a wider audience."

From The Shelton Shadow: "Re: NPfIT. The NPfIT has started to prove that the effort to computerize healthcare in the UK is providing savings that will be significant in the years to come and attract attention from all over the world." Link.

Robert Miller, a director of QuadraMed, is named to the new board of Grady Memorial Hospital (GA), along with the CEO of Waffle House (if you’ve ever eaten in one, and I’m certainly not suggesting you do, you might be surprised to find that a corporate structure exists behind the equally tattooed short order cook and waitress who run the entire place.)

Physician, health thyself: a Westborough, MA psychiatrist loses her medical license for good after assaulting hospital police officers and hospital staff. She was taking psych call for UMass and refused to leave a party when paged. The medical director relieved her but she came in later and refused to leave when security guards told her. She was arrested screaming and kicking the officers involved. She was committed but released after two days.

E-mail me.


Blogger Boy on Exhibiting at HIMSS

Blogger Boy, a vendor person who thinks I know his identity even though I don’t, took a three-year hiatus since last describing his HIMSS conference experience. Here’s his account from Orlando.

Another HIMSS has come and gone. Here are some musings from a small vendor on the main aisle.

Thanks to all of you who came into our booth. Although most of you were there searching for items to take home to your kids (or to prove where you were) instead of a new Hospital Information System, we still appreciate it. All of you who registered at our booth either for the drawing you failed to attend on Thursday morning or because you felt bad just taking our giveaways (yes, all both of you), we still appreciate it. We love meeting new people who may one day remember when the need arises that we have a marvelous, function-rich system written entirely in the newer languages (even IF Mr. HIStalk is not impressed by that!). Silly me, I always thought mumps was a virus.

Traffic was light for us this year. We are always trying to find that combination it takes to get you into the booth for something other than a free pen. Again, we love having the opportunity to show our products even if you are not in a buying mode. This is such a small market that one day we figure you’ll give us a shot after the big guys make you mad with their ridiculous license fees, drawn out and overpriced implementations, and poor customer service.

On another subject, any one who thinks contracts are signed at HIMSS is misinformed. Oh, I am certain that decisions are set based on expensive gifts, dinners, and more exposure than most potential clients will see at any time in the future of their relationship with that vendor. But no one, and I mean NO ONE, comes to HIMSS to select a system. It continues to be our belief that most of you come to spend a few days away from home (and/or the family) at the hospital’s expense having a good time. Yes I know YOU actually come for the sessions and to see all the new stuff at the exhibit hall. I am talking about everyone else.

That is why there is not a single vendor who will complain about the show being in Chicago next April. Hell, we’d like them to have it there in February! Then instead of chasing Mickey or Shamu, maybe you guys would come into the exhibit hall and buy something from us. Oh wait, that’s right — you don’t do that either! But seriously, we do figure the number of people we’ll lose to golf during exhibit hall hours will decrease next year. While you can play in the snow, it takes an awful lot of mercurochrome to coat the balls so you can find them for 18 holes (related from drunken experience). Our biggest fear is that we will get snowed in and not be able to get home for Good Friday, the real reason HIMSS was moved to a Sunday start date for Chicago.

For just a second, place yourself into our shoes. Even the smallest of vendors is spending several hundred thousand dollars to exhibit at this show. So we come there and spend a pile of money, all the while hoping against hope that we’ll get some good leads. Then we spend the time and money over the next 18 months cultivating those leads, doing demos, meeting with the 15 different selection committees at each location, only to find that a salesman from one of the big vendors came in, planted some scary thoughts with key decision makers (AKA lies) and they wind up going with the big overpriced vendor because it is "safe". I guess it depends on how you define safe!

I see more and more often, high-profile CIOs are losing their jobs because of implementations that either never happened or never seemed to have an end in sight. Maybe next year we’ll get that one lead that we close before the end of the year! If I sound cynical, I apologize, but you guys are tough!

We did enjoy searching out all of the HIStalk ribbons. Many in our booth had at least four. I was only able to get three for my badge. It generated a lot of conversation. I hope HIStalk will do something similar for the next show. Sorry we missed your shindig. Let me know if it needs a sponsor next year. Do you give HIMSS points?

And to wrap up, trust me, we vendors know how you feel about being bugged. I swore I would move out of the country if one more offshore development person came by our booth to speak with me. I am now fielding no less than 10 calls a day from other vendors to whom I was simply cordial at the show. It is funny to hear them describe to me how enamored I was with their products. I simply don’t remember it that way in most cases! So when you get the letter from me thanking you for visiting our booth, just indulge me a little. Read it, then toss it. Who knows? One day you may want a vendor who has a great product, gives terrific service and does this because they love what they do.

Inga’s Update

You knew it was only a matter of time. UCLA Medical Center will fire 13 employees and suspend another six others for checking out Britney Spears’ medical records. Six physicians also apparently took a peek and face discipline as well. I can’t decide if I would have done the same thing in their shoes since I’m the nosy type. I might have just waited to read all about it in the juicy rags at the grocery checkout stand.

Mike Leavitt was in Pittsburgh this week stumping for the expansion of EHR systems in physician offices. An interesting number I hadn’t heard before was that the Medicare P4P project he promotes could provide physicians up to $58K over five years if they meet certain benchmarks of quality care. It’s not a ton of money, but for a primary care provider making $150K a year, that equates to a bonus of about 7.5%.

Bill Gates appears before the US House Committee on Science and Technology and makes some interesting technology predictions. The future includes tablet devices in place of textbooks in schools, natural user interfaces with sophisticated voice recognition software, and computers with the ability to recognize objects and people. Additionally, data centers will need less human intervention and software development will require less code.

HHS and AHRQ hand out $5 million of your money to Brigham and Women’s Hospital and Yale University School of Medicine to help develop and implement best practices using clinical decision support.

Mdical transcription and workflow software provider MedQuist supposedly had a nationwide system failure this week. For about a day, system issues prevented received transcription to be properly routed internally. Will vendors promoting in-house systems use this anecdote as a reason to avoid ASP software providers?

Investor’s Business Daily interviews Allscript’s Glen Tullman, who claims Allscripts’ stock price drop (almost 50% since the first of the year) is a result of not properly managing the Street’s expectations. He also indicates analysts are still predicting more than 40% earnings growth.

By adding MedBasics Family Health Centers to its network, CIGNA gives a thumbs up to retail health clinics. Other carriers will likely follow CIGNA’s lead, despite opposition from some medical organizations that believe the retail clinics should have more restrictions.

Coincidentally, Las Vegas-based Medical Marts just closed a dozen clinics last month after losing VC backing. Unlike most of the other retail clinic models, Medical Marts were staffed with physicians rather than nurse practitioners.

The 300-physician Carle Clinic Association selects D2 Sales’ new My Patient Passport ExpressT kiosk system for patient check-in and payment.

Not to have Mr. H outdo me at everything, I wanted to point out that I also have a profile on Linked In. Not surprisingly, his profile is far more witty and well-thought out than mine, but connect with me anyway. It makes me believe you care.

E-mail Inga.

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Currently there are "8 comments" on this Article:

  1. Regarding Tullman: Not a great interview on either side o the mike. Missed opportunity to find out what Tullman thinks is really wrong with Allscripts. Allscripts has an enormous market footprint, but badly needs an infusion of operational management talent. This company would be much better as part of a larger organization with greater management and personnel resources. Much better. Unfortunately, I doubt it will happen anytime soon.

  2. Blogger Boy is the CEO of IntraNexus. They were on the main aisle, they offer (sell?) a full HIS, and I’m sure they’re frustrated by the challenge of selling a whole HIS when they aren’t one of the big 5 or 6.

    If you’re wondering, IntraNexus is the old SMS Allegra system re-written.

    IntraNexus, it’s definitely them.

  3. Yep, as I read Blogger Boy IntraNexus popped into my mind. Most likely them. BB got the part right that the big boys always use the big Risk factor against small vendors, and against the best o’breed guys. Years ago IBM called it the FUD factor – fear, uncertainty and doubt. And since hospital administrators, almost by definition, are NOT risk takers, it usually works like a charm. As a former vendor I can tell you there are ways to fight it and win…but that’s another story. As far as small vendors at HIMSS go, I agree with John Holton of SCI – there are better ways to spend your money.

  4. Re: working for a percentage. This can work and have done it. However, many times getting an accurate baseline to measure the amount is a very disingenuous exercise due to the customer playing hide the ball or playing move the goal posts once it comes time to actually own up to the real amount of actual improvement. Sad but true.

  5. IntraNexus is not exactly Allegra re-written, but part of their business is supporting old Allegra customers. As for selling their HIS, all the big vendors have thousands of employees and revenue of at least hundreds of millions. Intranexus is probably 60 people and, best case, $10M in revenue. As much as I believe in smaller vendors usually being better, it’s hard to buy an entire HIS from a small vendor, wih few sales, supported by consulting revenue.

  6. RE: consultants and percentage take pay.
    Having been on both sides of this arrangement for equal parts of my career I feel this can and is done successfully – I have been both successful and less so as a consultant in my time. I do believe that the percentage of savings model is not available in the majority of consulting service opportunities however, and I agree with comments made about the difficulty. But know I have have both performed under these type of terms and have purchased under these terms and I think if possible they should always be pursued. Typically as I buyer of consulting services I am looking for something that I would not do oftern, or even more than once with my staff – for example a Meditech conversion or an ERP implementation. In these cases I find myself happy to go out and get services without the need for the sharing or percent savings model – because I can’t afford to have this type of talent on my staff. I do like and will pursue in the future having a portion of the fees on some type of incentive program – again I have done this as a consultant in the past as well and find it to be very helpful. These are ususally easy to determine and can be agreed right up front. It is what I am working on right now.

  7. Uhhh, not me guys. Remember, anyone can appear to be anything they want on the Internet. Why, NYer, I’ll bet you’re not even from NY! 🙂 And for the record, our new Web-based product is called SAPPHIRE. One thing is for sure, I do read HISTalk.

  8. RE: Interactive Care

    I know the 2 guys that started the company. They are pretty sharp and focused on the healthcare market. I believe that their technology uses the SaaS (Software as a Service) model to eliminate the hardware approach used by the big companies. Their product can do some healthcare data integration. The product is aimed at small and large (yet, mobile) groups.

    They just closed a big deal with some large hospital system in California.

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