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News 3/26/08

March 25, 2008 News 4 Comments

From Mitch Router: “Re: PatientsLikeMe. This really isn’t my bailiwick, but I thought your readers might be interested. It’s easy to see why doctors and researchers (in particular) would not like PatientsLikeMe.com. As a social network, great. But without scientific scrutiny collated anecdotal data may well be “interesting-in –> mathematical model + statistics –> garbage-out.” Link. An interesting New York Times article on PatientsLikeMe, where patients with a handful of specific conditions are posting detailed information about their treatments, right down to drug dosages correlated to their symptoms. It’s advertising-free, but hoping to sell information to drug companies (of course). The article has some interesting thoughts on the privacy implications of such a service and physician questions about having patients take actions based on what other patients report.

From The PACS Designer: “Re: creating your PHR. TPD has been a member of the ASTM International Healthcare Informatics E31 Committee for some time and worked with others to create the Continuity of Care Record or CCR.  Now, anyone can create their own PHR using the CCR format by using the Consumer Empowerment National Demonstration website called CEND PHR, sponsored by the American Academy of Family Physicians Center for Health Information Technology. After you creating an ID and password, you will find the following categories available for inputting your health information: Personal, Emergency contact, Insurance, Primary physician, Problems, Medications, Allergies, Family history, and Social history. After completing entries into the PHR, you can save the file and then access your PHR Portable Document File (PDF) for local printing and also save an XML file to a storage location.” Link.

From Mrs. Brown’s Lovely Daughter: “Re: McKesson Paragon. It’s cleaning Meditech’s clock in a number of regions. Key replacement announcement pending”

From Bearly Stern: “Re: Allscripts-Misys. The amazing thing about the Allscripts-Misys merger is that it could have happened years ago. John McConnell repeatedly pitched the idea to Goldberg and Skelton, but they were so focused on becoming a mini-Cerner or Epic that they squandered $500M and a huge lead in the ambulatory space. Was there any real growth or value added to Misys from year 2000 onward? Leadership’s main ideas were cutting cost as a growth strategy and making it prohibitive for existing practice management clients to buy a non-Misys (read: workable) EMR. This while touting ‘interoperability’ in a failed strategy to connect the products of three business units.”

From Esther: “Re: data mining. I CANNOT confirm the vendor, but I can tell you, as an ex-[company] employee, that [company] is very interested in data mining of patient information. Prior to the opening of the [company] employee clinic, we were told at a town hall meeting that any lab work done in our clinic could and would be used for a DNA project [company] was working on. Trust me – you could hear a pin drop during that announcement. There was a lot of uneasiness expressed after the meeting, but as far as I know, no one ever took them to task on it. Those of us who were truly concerned made sure that we didn’t get any blood work done on the premises!” I expunged the company name since it’s a bit of a hot topic right now and I don’t want to cast any unearned aspersions, but you can probably figure out who she’s talking about. Unconfirmed and still waiting on the smoking gun. Possible clue: four million patients? That’s a big footprint. Maybe it’s a clearinghouse owned by an EMR vendor – the Perlegen press release didn’t say it was EMR data, only an EMR vendor, and it refers to an “information warehouse” that would imply either hosted systems or a transaction database. Hmm.

From Dutch Treat: “Re: data mining. What about this company helping the pharma sector?” Link. IntrinsiQQ LLC, the company behind web-based chemotherapy dosing system IntelliDose, didn’t rack up enough paid monthly subscribers, so it started selling de-identified information about drug usage to drug companies. At least the drug companies don’t have plans to re-identify data or contact patients. Still, patients not only have to trust a company with which they have no legal relationship, they probably don’t even know their data is being bought and sold. Somebody could start a nice little company testing and certifying de-identification processes.

From Larry Lonesome: “Re: development. I would be interested in the perspective of users/purchasers of clinical applications, as well as developers of these applications, regarding AJAX application development versus smart client versus any other relevant methodology. Do hospitals have a preferred technology platform? Is AJAX development robust enough to handle the heavy lifting of clinical applications? Does a .NET smart client really solve deployment issues as neatly as a web application?”

Recommended: if you’re a Firefox user like me, upgrade now to the Beta 4 version. I don’t generally use beta releases, but this one’s a screamer (many times faster in Google Docs and other AJAX-type apps). Most plug-ins aren’t available yet for the Beta version, but all I really use is the Google toolbar and it already has a Google search box. Zero problems here.

Girish Kumar of eClinicalWorks passed along a short comment on the Mass BCBS conclusion that EMRs aren’t worth their cost to doctors. He says that eCW has a 95% adoption rate and that most of the physicians using their system would say they’re better off with it than before.

Reminder: if you’re not getting e-mail updates, put your e-mail address in the “Subscribe to Updates” box to your right, even if you’ve already subscribed from the old site (which is no longer being updated, thus not sending out e-mails). If you’re not sure, sign up anyway – it will tell you if your address is already on the list and you won’t get double e-mails.

Intercepted e-mail: Kaiser’s medical group will start a pilot this summer of a thumb drive-based Personal Electronic Medical Record for emergency use. Files are encrypted and read-only, printable to PDF. Contains a concise record of hospitalizations, allergies, doctors, visits, labs, problems, and demographics. Sounds pretty cool.

Tennessee Medicaid will pilot e-prescribing using Cerner software.

Donna Krause is named CIO at Truman Memorial Veterans’ Hospital, having worked her way up from pharmacy aide over a 25-year career there. Congratulations – darned impressive.

Financial Times says investors are skeptical of the proposed Allscripts-Misys merger, with investors passing on the new shares issued to fund it, leaving ValuAct Capital to eat them themselves. From the piece: “… suggesting US shareholders either don’t believe Misys Healthcare is worth this much, don’t believe the deal will go through, don’t understand it, or don’t trust a management that has presided over 64 per cent share price decline over the course of the year.” They missed one: that continued Misys involvement might actually be negative to the business Allscripts was already doing.

The CEO of MedAssets is team director of the US Olympic wrestling squad. Something else to wrestle with: its Q4 numbers, Revenue up 45.7%, EPS -$0.20 vs. -$0.16. Shares are down a third since the December IPO, with a market cap of $706 million.

Stolen, unencrypted, PHI-containing laptop #650 or so: NIH.

An Australian hospital is accused of hiring a nurse to manipulate the “time seen” ED triage data to make the hospital look better.

Robert Wiebe, formerly of the VA, is named SVP/CMO of Catholic Healthcare West.

E-mail me.

Inga’s Update

Lynn County Hospital District (TX) selects Opus Healthcare Solution’s OpusClinicalSuite for its patient information system. The three rural hospitals within the district will use OpusClinicalSuite ASP.

Design Clinicals adds a new client in Iowa. Myrtue Medical Center (IA) is implementing its MedsTracker medication management program.

Medinotes partners with Hawaii’s Akamai Practice Management to provide EMR to small, independent practices. Akamai is a practice management and reimbursement service provider.

digiChart’s OB-GYN Version 7.0 is the latest EMR ambulatory package to receive CCHIT certification.

I suppose because it is such an important use of our tax dollars, HHS just opened a second public comment period to define the following terms: EMR, EHR, PRH, HIE, and RHIO. Actually HIE has already been defined as “the process of electronic health information exchange, not a governing function or entity” so HHS now needs names for a sixth term that will describe “the function or entity that governs health information exchange beyond the confines of a specific regionally based community.” Personally I think Mr. H and I should have opened the blog up and gotten readers to define the terms and then pocketed the millions HHS is spending on this project.

Transcription system provider Healthcare Technologies is partnering with GSA vendor Network Federal. The agreement will facilitate the delivery of HTI’s medical transcription programs to federal, state and local government healthcare customers.

EMR Dude sent me a link to his blog “The Crabby Daddy,” where he provides some commentary on the Allscripts-Misys deal, noting his ties to both companies (he worked at Medic and A4 and now Allscripts.) His take is that the market was in need of consolidation and sends a reminder to the new management that “people enjoy working for a company where quality of life and a fun factor are present.” Probably a good reminder if Misys is involved. Remember this post from a few months back? “From Dan Panama: Re: Misys. Vern said at the business update yesterday that an overwhelming number employees in the employee survey said they are not having fun anymore. Vern’s response: ‘You have to earn the right to have fun.'”

And while I was on Crabby Daddy’s site, I noticed a post about the Common Ground Clinic going live on EMR. This is one of the New Orleans clinics that received funding from HIMSS (and Allscripts in this case) to fund EMRs in the Katrina aftermath. It’s led me to wonder how many other clinics have successfully gone live as part of the HIMSS Katrina Phoenix project and what applications they are using.

I sat in during part of HIMSS’s first virtual conference last year and found it interesting enough, especially for a person who lacks the discipline to listen to a webcast without checking e-mail and taking the occasional phone call in between things. I am almost positive that the first time around that you had to pay a fee if you wanted to participate in the education sessions for CME credits. However, for this third one coming up April 23-24, I notice the whole event is free. Plus there seems to be a strong list of speakers, including Jonathan Bush, Matthew Holt, and John Halamka. I have to assume the exhibitor packages (which start at $5,000) are selling like hotcakes or else HIMSS wouldn’t be offering the conference at no charge.

I am sad to report that I a clear loser in the basketball pool. I knew my selection of Duke was risky, but who would have guessed they wouldn’t make it past the second round. My sole consolation at this point is that I am ahead of Mr. H, but given North Carolina is his top choice he still has a good chance for a strong finish. I’m cheering for Davidson here on out.

E-mail Inga.

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Currently there are "4 comments" on this Article:

  1. Warning, that PHR which TPD referenced is something no one should consider until more is known about the site, its purpose and how the data ill be secure and private. As it stands now, the biggest banner on this site is for a web-based provider of EMR solutions that I never heard of, Solventus. So is this really nothing more than an advertising/marketing vehicle for them?

  2. re: data mining. How is it that OHRP hasn’t stepped in and stopped something they really should be stopping? I know that at my institution, where I sit on the IRB, anything to do with tissue or, even more so, DNA, gets extreme scrutiny because DNA can never be de-identified or made anonymous.

    The idea that a vendor could use blood for a “DNA project” without any sort of review, IRB or otherwise, is appalling. The reason they could hear a pin drop is because everybody in the room did a gut check on whether or not that was right, and it came up wrong.

  3. AJAX is nice, but it’s still requires more effort than an equivalent AJAX-free website. Comparing costs of AJAX-type development to fat client (or smart client) development is tricky, and I won’t comment on that.

    Anyway, if your application targets a huge number of casual users, i.e. where client-side deployment is a big problem, and you don’t want to work with/pay for Citrix, then AJAX is probably the best choice. Thankfully now there are a lot of Javascript libraries and vendor components that make this easier for you now, than a few years ago when Google Maps and GMail were exciting new developments.

    Speaking of adoption curves, please stay away from Silverlight for the time being. The tools are still primitive, and thus it’s not worth your time to even bother.

    .NET One Click deployments are unfortunately not as pain-free as they are hyped up to be. One thing they do for you is they can guarantee all your users are using the newest client, i.e. when the client starts up, it checks its version versus the server’s version and attempts to upgrade. It can be set to be FORCED to upgrade. Whether or not that upgrade succeeds is another question. Summary of One Click deployment: definitely better than fat clients, but not pain-free.

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