From Dr. Know: "Re: Stanford. Spoke with a physician at Stanford today. They recently went live with Epic. The physicians are in revolt: ‘takes too much time and is very difficult to use.’ Also, if you admit a pediatric patient through the ER and they need to be admitted into the children’s hospital, all of the information needs to be re-entered manually from paper, as Lucille Packard runs Cerner and it is not interfaced with Epic, which is running at Stanford Hospital."
From kcstar: "Re: Jay Parkinson. For all of your fawning, it seems he was more of a self-promoter than a physician. The outcome was predictable, and as he even stated, ‘unsustainable’." Link. I interviewed him, but I wouldn’t say I fawned. He has some good ideas and I like the idea of going off the grid (as Scott Shreeve says), but he’s not fault-free. He thinks he’s got the entire system figured out despite being a new med school grad, he seems to be a bit smug, his kind of medical practice has zero relevance to the 99.99% of the country that’s not in New York City treating young and healthy hipsters for the occasional sniffle, and he seems to hate just about everything and everybody involved in medicine outside his little world. For a brand new doctor, he’s shrewdly wangled his 15 minutes of fame, but can his "tear it down and start over" ideas scale and is he really the best spokesperson for changing medicine just because he does magazine interviews and blogs and sometimes finds time to see a patient for cash? Time will tell. Give him credit for some pretty fresh ideas, at least, even though his experience with the non-fresh ones is minimal. I’m happy he took the time to be interviewed here since few in the industry had heard of him back in November and the ensuing debate was interesting.
Speaking of 15 minutes of fame, Dann, who started the HIStalk Fan Club on LinkedIn, let me know that it’s up to 58 members, which I find astounding and immensely gratifying (especially when I see the roster of highly accomplished folks who signed up – thanks!) I keep thinking I should offer something in return, like dibs on signing up for the HIMSS shindig or something (which, FYI, looks to be on track). Having a fan club is pretty darned cool, especially since being anonymous eliminates the possibility of egomania.
I do my share of Neal Patterson ribbing, but I’m also on record as being a fan in many ways (started Cerner and stuck around, didn’t sell out to some conglomerate, says whatever he damn well pleases). Case in point: Google is sweet-talking Cerner about jumping on the shaky Google Health bandwagon, but Neal is keeping them at arm’s length since he doesn’t buy the PHR concept, which he calls "electronic shoeboxes" that put the onus on consumers for record-keeping. I’m with Neal on that one. Consumers might use healthcare search engines and social networks, but they aren’t going to keep reliable medical records.
If you get Healthcare IT News, your information is available to anyone willing to pay $150 per thousand addresses for list rental. HIMSS calls the publication a "member benefit," i.e. you get a subscription by default to boost its ad rates, but apparently the benefit isn’t entirely yours. I must be the only person who has thousands of industry e-mail addresses that I won’t share with anyone.
Ah, to have minimally inquisitive publications willing to print whatever companies send over. Health Imaging News crows about McKesson’s "unveiling" of MyPacs.net. A 10-second Google fact-check would have shown that to be false: the original journal article describing its development was accepted in 2001 and the site was announced at RSNA 2002. Unless "unveil" means "bought the original company and put out a press release," it most certainly was not just unveiled.
Fundraising software vendor Blackbaud, whose products are used by many hospital foundations, will buy struggling competitor Kintera for $46 million in cash.
The 12-hospital group in Canada whose MEDITECH systems were down is back online. The company blames a corrupted file, but the media report says two US hospitals had the same problem at the same time. Seems suspicious that three customers all had corrupted files simultaneously.
Wyoming is considering allowing CNAs to administer medications, but only for specific drugs, most of them non-prescription. A waste of time, it would appear, since patients seldom need only those meds, so the nurse would have to go behind them to finish the med pass anyway.
Ontario will invest $109 million to improve ED efficiency, with part of the money set aside for IT.
Thanks for reading. If you aren’t getting the e-mail update or Brev+IT, you can sign up to your right (and I won’t sell your information). I’m always interested in rumors or thoughts, easily submitted by clicking that big green Rumor Report box to your right.
Art Vandelay’s 10 Tips for Finding IT Budget Cuts
1. Create a list of all contracts. Detail the benefits of the components to the business. Document the key terms. Be sure to include the impact of canceling and restarting maintenance. Look for consolidation opportunities. Also look for areas of low impact if a cut occurred. Possibly negotiate longer-term maintenance deals (ex: go from one-year maintenance to three-year). Review contracts for network carrier services, cellular and wireless data, pagers, real estate leases, and power.
2. Review your application inventory and document functions. Look for overlaps and apps with few benefits. Consider the cost of consolidation and migration.
3. Review the project inventory budget impact. Consider initial and recurring costs. Look for overlaps, low tangible benefits, and those with long paybacks. Consider leasing hardware or software. Also consider risk-based contracts for services.
4. Create chargeback reports if you aren’t doing so. This requires developing a list of all costs and an allocation method. Look for business units with an inordinate amount of costs with little tangible return. In more progressive organizations, the reports allow leaders to monitor and adjust their variable costs with some explanation of the impact.
5. Create a database of staff ratings including true performance reviews. Next, align the output with the project inventory and application importance or benefits. Identify staff that can be cross-trained to pick-up other projects in the pipeline if a staff reduction occurs.
6. Run a zero-based budget with a fair-minded financial analyst involved. Note the areas where cuts occur so you are ready if asked.
7. Analyze the use of your reporting applications. Provide real examples of where the tools can benefit this type of analysis, such as staffing, lost revenue, cost reporting, and supplies.
8. Consider virtualization and consolidation. Potentially related benefits include reduced power consumption, heat generation, and maintenance costs Align hardware with key benefits. Focus investments in hardware on those platforms benefiting the business the most as well as where you have the most skills.
9. Bid all hardware purchases even if it moves them away from your standard suppliers. Minimally, this gives you leverage to keep your suppliers honest.
10. Consider use of open source software where you have or can buy or build skills.