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News 5/30/08

May 29, 2008 News 3 Comments

From Moses: "Re: CCHIT. Big changes for 2008 CCHIT ambulatory certification criteria that goes into effect with the first application window 07/01/08. Two new extensions to the base certification, Child Health and Cardiovascular. Certified status good for two years as opposed to current three. Lots of new interoperable functional requirements." Link. The two new extensions are optional, but enhanced interoperability is not (sending and receiving patient summaries per HITSP standards). And, did you notice that those exciting new NAHIT acronym definitions differentiate the term EHR from EMR by basically saying that CCHIT-certified EMRs are by definition EHRs, but everything else is an EMR? Seems a bit self-referential. I personally think EHR is a standard no vendor has yet reached (longitudinal, containing health and not just medical records, accessible for reading and updating by all providers from pharmacies to acupuncturists, and contributing to aggregate data sources). But, who am I to argue with BearingPoint, especially when I’m not the one getting $500K?

From Craig Garrison: "Re: Misys. The end of their fiscal year is May 31 and apparently only about 10% of the sales force is expected to achieve quota. Bet that a number of salespeople become available for hire over the next few weeks (some by their own choosing and some to Misys choosing)."

From The PACS Designer: "Re: miniPACS. A new miniPACS has been developed by researchers in South Korea. The team at Seoul National University Bundang Hospital reports that the miniPACS they developed is wireless and saves time when compared to manual archiving of digital records. The researchers utilized a laptop computer with 802.11b wireless LAN functionality and incorporated internally developed DICOM modality and storage server modules. The mean time interval from image acquisition to main PACS server storage was five minutes and 42.4 seconds when the wireless miniPACS was used, compared with 38 minutes and 25.5 seconds without." Link.

From Curious: "Re: downtime. Last week, while visiting a patient at Hillcrest Medical Center in Tulsa Oklahoma (an Ardent facility), I heard the nursing staff complaining of their system being down. Being the curious HIS professional, I could not resist inquiring as to the nature of the problem. They were told the downtime was the result of a fire at the Nashville data center.  Also, they were told it could last several days. Not sure what happened, my friend was discharged the next day. Sounded like big news! Does anyone know if Ardent or McKesson made an announcement or possibly declared a sentinel event?" Perhaps Inga can make an inquiry.

Hartford Hospital will repay $800,000 to Medicare for chemotherapy overcharging. I don’t know why hospitals don’t complain more about the ridiculously complex software and process requirements just to get bills out to the feds, which I’m guessing gave Hartford heartburn. Example: now they want NDC numbers and complex package size calculations every time outpatients get drugs. Nobody barcode scans outpatients (surgery, cath, etc.) Nobody except the caregiver knows exactly what they used to prepare an individual patient’s dose. It’s nearly impossible to follow the guidelines about package size choice and wastage. Imagine the clinical good that could be built into systems if they weren’t constantly being overhauled just to keep Uncle Sam happy. Anybody complaining about how far behind healthcare IT is compared to other industries should have to sit through an overview of how grouper and case mix programs work. No industry I know of has to spend so much automation energy just to create an invoice.

This article on practice EMR adoption is more interesting when it talks about the inpatient EMR cost of a couple of hospitals: Texas Health Resources ($200 million) and Baylor ($240 million.)

Scott Shreeve noticed that Ingenix apparently plans to go open source with its analytics tools. Check this quote: "I think it is because we don’t define ourselves by our products alone, but the problems we solve and the imagination of our people and clients. Believe it or not, our employees would rather be known to our clients for solving bigger problems and being known as industry leaders than for competing based on proprietary data and methodologies. This represents a whole new way of thinking for us if we are willing to improve." That’s pretty cool. I’ve asked for an interview, so we’ll see.

Inga mentions below that Fujitsu is pulling out of its NHS contract (following Accenture, of course, which already retreated tail between legs). BT is the heir apparent, but here’s the rub: like Fujitsu, BT uses Cerner as its subcontractor for the London region. Some NHS folks have been bitterly and vocally opposed to Cerner Millennium, possibly the point that NHS could decide not to choose another contractor at all, letting the trusts go their own way. I’ve said all along that localization issues would be a struggle for Cerner and that iSoft had plenty of problems before it ever hooked up with NHS. Are there any vendors left ready to step up to the plate immediately with a greater chance of success? Just one: Epic. Here’s why that makes sense: they’ve proven through Kaiser that they can handle massive deployments, they’ve been rumored to have an interest in going international, it’s by far the highest KLAS-rated system, and just about every large US health system making a clinical systems decision seems to pick Epic these days and they’re all doing just fine (other than the monstrous cost). If they want to expand outside the US, the UK is the obvious choice, especially since it’s big business in one swoop. I don’t have any information (insider or otherwise), but if Millennium comes under serious UK fire, I bet Judy will be on a plane (if she hasn’t already been). CERN shares were down 2.7% today.

Proof that spell check still requires human oversight: this press release. Sunshine Medical Clinic became SunShine Medial Clinic, which implemented Electronic Medial Records software. And course, you just know that mistakes of that magnitude will conclude with a HIPPA gaffe and you won’t be disappointed. I could point out a few more errors, but that’s plenty.

A new problem: researchers are getting caught Photoshopping the images they submit to journals.

Jobs: Clinical Applications Specialist (MA), Database Administrator/Architect (MA), HL7 Interface Analyst (TX), Medical Billing Professionals (CO), Service Specialist (TX). Gwen writes a fun, chatty weekly newsletter with all the jobs that even I read, for which you can sign up here.

Orion Health is offering a white paper about the use of its integration products with MEDITECH.

Cardinal Health may have one of its drug warehouses shut down by the Ohio board of pharmacy for selling large quantities of controlled substances to a company that was peddling them on the Internet.

E-mail me.

Inga’s Update

The EEOC files a federal class action lawsuit against John Muir Health (CA), claiming that it didn’t hire at least seven nurses based on a doctor’s incorrect diagnosis of latex allergies. The lawsuit contends the organization acted "with malice and/or reckless indifference to (the nurses’) federally protected rights."

NHS terminates its $1.8 billion contract with Fujitsu for EHR implementation at a southern England hospital following a dispute over the government’s demands for more flexibility over the system being installed. NHS and Fujitsu could not agree on payment terms for the changes.

Meanwhile, the CEO of Worthing and Southlands Hospital says its Cerner Millennium system is still suffering from “inferior functionality,” leading to “significant level of discontent among clinicians.” He also goes on to say the hospital is unable to satisfactorily capture, record, and bill all activity. Sounds like they’ve got themselves one big ole mess over there.

Moses Taylor Hospital replaces Microsoft Exchange with Linux-based Exchange clone PostPath. The IT staff claims PostPath was half the price and is working well for its 700 users.

A few days ago, we mentioned the city of San Francisco is suing McKesson for allegedly conspiring to artificially inflate wholesale drug prices. Now Connecticut has followed its lead with a similar suit.

Microsoft announces it has bumped its funding an additional $1.5 million for its HealthVault Be Well awards, designed to “encourage innovative online solutions to address significant health issues.” If I were Mr. H, I would probably say something cynical, like Microsoft is simply trying to pay more companies to interface with HealthVault. Since I am Inga, I will instead say kudos for any effort to improve health and outcomes for patients.

Berger Health Systems announces its successful deployment of the PatientKeeper Platform and Physician Portal.

Aetna is named the top payer for its business dealings with physicians in athenahealth’s latest PayerView rankings, which are based on actual claims performance for athenahealth providers. The State of New York’s Medicaid program ranked last in the nation due to its complex patient referral authorization requirements, slow or non-existent reimbursement policies, insistence on the use of proprietary medical claims forms, and confusing and paper-based billing requirements.

A computer crash Monday affects 12 northwest Ontario hospitals. The hospital issued this statement Tuesday: “We currently know that this is not a hardware issue, but is rather an issue related to software code. Our vendor, Meditech, is working diligently to remedy the situation. The delivery of patient care will be slowed as a result of this interruption of service. Expect longer waits, especially in the Emergency Department.” Officials also say the outage poses no risk to patients or their data (assuming you are not bleeding to death in the ER, I suppose). They also claim it’s difficult to project when the problem will be fixed.

E-mail Inga.

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Currently there are "3 comments" on this Article:

  1. Judy and Carl did go to England and England did come to Madison (a couple of times). Under consideration with 2 LSPs and was talking directly with the CFH program for a while. Epic just doesn’t jump for the money unless they see a way to make it successful. Failure is too costly in the long run and not very much fun. Epic tries to avoid it. Most of the people who signed up for these deals originally did it knowing they were losers as defined initially contracted and thought they could all renegotiate along the way for more money and benefit in the mean time from the stock pump. Epic doesn’t take either of those paths and therefore its a pretty predictable situation for them to avoid.

  2. Epic has the luxury of not worrying about what Wall Street thinks.

    MEDITECH made the same decision when the original NHS contracts were being awarded. The contracts were too onerous for them to want to be involved, even though they already had several successful implementations in the UK.

    I don’t think either Epic or MEDITECH would get involved now unless the contracts were a lot closer to their usual terms.

  3. I saw the short comment on Moses switching from Exchange to PostPath for email and had to comment. Our firm recently switched over and so far have no regrets. Like Moses we saved at least 50% and have had no down time, user issues, etc. In fact most of the folks here don’t even know that they’re running off a Linux email server.

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