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Monday Morning Update 9/29/08

September 27, 2008 News 7 Comments


Goroko General Hospital in Papua, New Guinea (148th of 190 countries in world healthcare) is the first hospital in the country to set up a web site, which was created by its volunteer IT manager Robert Schilt. It looks great and is running in WordPress. Schilt has also established a 12-PC training center, rolled out 50 PCs, set up Internet and e-mail access for staff, built several departmental applications, and almost finished a hospital Intranet and a discussion forum for doctors. He build everything using open source software. He’s also looking for second hand items to help the locals, who he says "do not have two spare coins to scratch together." You’ll notice that his own family has donated a long list of items. Why can’t we get a selfless volunteer IT guy like Robert on the HIMSS podium instead of the usual Taj Mahospital people?

Microsoft chooses Philips SpeechMagic for Amalga. Wonder if the reader’s rumor will pan out that Philips will sell it? Maybe MSFT is interested.

Tom Skelton’s new company, MedcomSoft, turns in not-so-great FY2008 numbers: revenue down 46%, expense up 5%, losses up to $5.8 million. They’re running low on cash, have never made money in seven years, and need ongoing financing to stay open (good luck with that). Surely Tom’s job is to clean up the books and shop it around. Shares are at $0.06 and market cap is $6.2 million. If you want to pick up a CCHIT-certified vendor as an acquisition (and consider MEDCIN to be an advantage), you could probably get a great deal. I had heard it was expensive, but the company claims it’s $11,500 for the first doc and $6,500 for additional ones, still not the cheapest, but far less than some.

Fred Trotter seems surprised that "HIMSS is a lobby for proprietary for Health IT vendors," basing that on its refusal to support Pete Stark’s health records bill that includes pushing open source systems (not necessarily new systems – you may recall that the President’s early call for HIT specifically said VistA was to be made widely available). I’ve been pointing out the HIMSS business model for years:

  • Bring in provider members cheap ($140 a year, now basically free for Organizational Affiliate organizations that pay $2,975 a year for the all-you-can-eat plan for unlimited employees, apparently designed to boost the numbers and increase booth traffic at the conference)
  • Sell the usual books and all that, but push the annual conference like crazy since that’s where the profit comes from (cheap, too, for provider attendees – the Ladies Drink Free approach to bringing in the horndog men — vendors — who pay full price and expect ROI)
  • Charge vendors astronomical prices for booth space and ad exposure during the conference (aka Boat Show booth)
  • Provide feel-good infomercial publications that send a message that buying IT is always the right thing to do, making sure to spin or avoid stories suggesting otherwise and minimizing the organizational expertise needed to actually get ROI (you saw it in a booth, so write that check and don’t worry about the change management aspects that most hospitals do poorly)
  • Give CIO decision-makers extra special treatment during the annual conference and CHIME, letting vendors pay the tab in return for even more access to them
  • Provide some OK education during the conference (even letting vendors themselves take the podium for some of it), but make sure to leave huge swaths of non-education time during prime hours to force attendees into the exhibit hall, which will be even easier in Chicago in April when it’s too cold to be tempted away by golf or enjoying nice weather
  • Buy up vendor-specific user groups (Cisco and Microsoft, for example) to give even more sales opportunities to vendors
  • Get provider members to give HIMSS Analytics all kinds of internal information for free, then sell their information dearly to the vendor members so they can make well-informed cold sales calls to those same members who willingly participated
  • Create advocacy organizations whose charter is 100% vendor-driven (buy more stuff and lobby politicians to use taxpayer dollars to do it)

HIMSS should not disappoint anyone since its methodology is obvious: get providers to join and attend its vendor-heavy conference, a neatly closed loop that makes HIMSS the paid matchmaker. There is absolutely nothing wrong with vendors and they are straightforward about participating in HIMSS to get an audience with prospects. HIMSS members sometimes are naive to that fact (although they’re rarely decision-makers anyway) and somehow expect that HIMSS will advance only inarguably noble and unbiased causes (no different than they expect of hospitals, and with which they are equally likely to be disappointed). I pay membership and conference costs out of my own pocket, so obviously I think it’s a good deal. You just have to swim against the tide sometimes to avoid being controlled. Do I feel they represent the best interests of my hospital employer or me personally? Absolutely not, nor do I expect them to. It’s a trade show, nothing more and nothing less, and free software doesn’t pay those bills. That’s my opinion and you are entitled to your own, of course.

Ivor Kovic, an ED physician in Croatia, likes the iPhone and lists some applications that are useful to doctors.


SCM Microsystems is rolling out this smart card reader, the eHealth 100, to support Germany’s electronic health card for 82 million people.

A city government uses cool PR technology that I’m surprised hospitals and vendor haven’t thought of (assuming they haven’t, of course.) Cheap 1 gB flash drives with logos are handed out to potential investors. Plugged in, they refresh themselves over the Web, then play a slide show, video messages, and provide links to detailed reports and electronic books. The "refresh" part allows running seasonal pictures and other fresh information, infinitely extending their useful life and also allowing the city to track how often they are used.

I noticed that the HIStalk e-mail blast list has just hit exactly 3,000 recipients, so thanks to all of you reading (blasted or not). Daily visits are at over 2,000, so this may be a record month. Thanks, too, to those who signed up for the reader-created HIStalk Fan Club on LinkedIn, now at 264 members. If you’re on LinkedIn, Inga and I would be honored to boost your connection count by approving all requests. You can help spread the HIStalk word by clicking the "E-mail this to a friend" graphic to your right and e-mailing a few of your colleagues about HIStalk.

Paul Newman dies at 83, having given away $200 million to causes such as his Hole in the Wall camps for sick children. He was also a World War II veteran. I can’t imagine today’s pack of shallow "celebrities" doing anything close.

Idiotic lawsuit: a TV reporter (an Air Force veteran) spices up her gun story with a showy stunt in which she fires a semi-automatic weapon at the police gun range wearing a noise-protecting headset. She claims she suffered permanent hearing damage and is suing the police department for medical bills, pain, suffering, and anxiety. The police department says she was negligent and didn’t see a doctor soon enough.

UCI Medical Center (CA) is put under state supervision and could lose its CMS funding over poorly kept anesthesiology records. Inspectors found some post-op forms that were signed and filed before surgeries were performed. Half of the anesthesiology professors signed a 2003 letter complaining that its mission had been altered from education to money-making. Previous scandals include selling body parts and implanting patient eggs in other patients without the permission of either.

Leapfrog Group’s "Top Hospitals" are trending down in number, although not as starkly as its drop-off in members. The numbers: 50 hospitals in 2006, 41 in 2007, and 33 in 2008. They blame a new requirement that requires hospitals show that their CPOE systems provide clinical alerts. If they add a future requirement that CPOE show a demonstrable benefit in cost or patient outcomes, that 33 number will look huge by comparison. Maybe the goal is to have no top hospitals.

Vendor Deals and Announcements

  • Virginia Cardiovascular Specialists selects MedAptus’ Professional Intelligent Charge Capture and eRx applications for its 38 physicians.
  • The Family Health and Help Center (IN) is implementing PracticeOne’s e-Medsys Solution for their community health center.
  • QuadraMed’s Pharmacy Integrated Management solution is now implemented at Ashtabula County Medical Center (OH).
  • DB Technology announces the release of its Enterprise RAS solution to automate and streamline paper-centric processes.
  • El Camino Hospital (CA) selects eClinicialWorks for its affiliated physician groups.
  • Picis announces several new enhancements to its core perioperative and critical care applications. Also introduced: Picis’ new eView for CriticalCare Manager solution to consolidate clinically relevant information for the ICU census and present in a concise web-based view
  • With technical assistance from Medicity, the Delaware HIN has become the first fully operational statewide HIE and successfully connected with other NHIN participants.
  • Jefferson Community Hospital (NE) has implemented IntelliDOT Bedside Medication Management system at its 25-bed facility.
  • BayCare Health System (FL) is using Fujitsu’s PalmSecure biometric security system integrated with its Siemens’ HIS to protect medical record privacy.
  • St. James Healthcare (MT) signs with AHI Software for registration QA service.
  • Phytel is becoming a member of the American Medical Group Association’s Value-Added Services program to promote the proactive management of health and disease management protocols.
  • Sentillion is positioned in Gartner’s “visionary” quadrant in its recently published Magic Quadrant for User Provisioning, 2008. The evaluation was based on Sentillion’s ability to execute and its completeness of vision.
  • CareTech Solutions is chosen as IT outsourcer for Port Huron Hospital (MI). The company also announced that it earned the top score (94.6) in a recent KLAS study on extensive outsourcing, including a 100% "would you buy it again."
  • United Hospital System (WI) is replacing its McKesson Orbit surgical scheduling system with Unibased Systems Architecture for its periOperative Resource Management System.
  • Florida Cancer Specialists is contracting with Fletcher-Flora Health Care Systems for their LIS solution.
  • Sacred Heart Medical Center (OR) has implemented Versus Technology’s wireless locating system.
  • Harrisburg Hospital (PA) claims a 12-month payback after installing Radianse’s RTLS solution.
  • The Health Alliance of Great Cincinnati is deploying Streamline Health’s documentation workflow and coding products across their five hospitals.
  • Neurological Associates (LA) has selected CureMD’s EMR/PM SaaS solution.

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Currently there are "7 comments" on this Article:

  1. Regarding HIMSS – I would love to see a lobby to bring back John Page to HIMSS. John’s tenure at HIMSS was in an era when it had integrity as an organization. While I’m not saying HIMSS has or hasn’t done anything wrong in recent years, the smell of purity and independence from vendors “has left the building”. HIMSS has hitched itself much too closely the the vendor train. Sadly, I’m not sure it can disconnect itself at this point.

  2. As a practicing physician also working in Informatics I have been an active member of HIMSS for over 5 years and currently am a member of their Pateint Safety and Quality committee. I have found that the problem is participation by those who are not vendors and not the organizations willingness to respond. I have participated in the preparation of numerous response papers to government initiatives and rule making and my voice has always been welcomed and included even when not vendor friendly. es This goes for CCHIT as well where I was co-chair of the Interoberability group even though I have never worked for any vendor and have had some significantly opposing views. Sure it is hard finding the time from medical practice etc but we don’t change things by sitting by the side and complaining! I think those who protest about the organization being vendor driven should stand up and PARTICIPATE by volunteering on the many committees available. You make an organization your own that way!!!!! This means YOU!

  3. agree with smalltowncio. John was a good dude and Steve is all about making money. The educational part of HIMSS used to be pretty decent. Now the hole conference is a horror show for sellers and buyers.

  4. Over the years, HIMSS has really become a venue for vendors to view each other, netword, trade (or steal) competitive brochures, and a great place for sales personnel to look for jobs. At one time, it was “Must” show to attend. If you weren’t there, you were automatically considered to be closing your doors. This is no longer the case. Vendors are spending their marketing dollars much more wisely.

  5. You are correct that The Leapfrog Group reduced the number of hospitals awarded “Top Hospital” designation this year. That’s because this year for the first time we required Top Hospitals to have adopted CPOE, and additionally that they test the effectiveness of their CPOE system in picking up medication errors. To help them do this, the Leapfrog Hospital Survey 2008 includes the first-ever CPOE evaluation tool–a pioneering move in the world of healthcare IT. Hospitals run through a series of simulated orders, and Leapfrog offers a score on how well the hospital did. Unfortunately, despite significant evidence that effectively deployed CPOE systems reduce medication errors anywhere from 50% to 85%, less than 8% of hospitals nationally have adopted CPOE. The public at large and the employer purchasers we represent have a right to expect hospitals to enter the 21st century and reduce medication errors. Top Hospitals awards will be reserved for those who do.

    You also make a side comment about the size of the Leapfrog membership having something to do with the influence of our survey. This is a common misunderstanding about how Leapfrog’s work is structured. Most of the employers that work with hospitals to advance use of the Leapfrog survey are not members of Leapfrog in Washington, DC, but members of regional business coalitions on health in one of the 48 states participating in Leapfrog’s Regional Roll-Outs. These coalitions engage over 3000 businesses at the local level to encourage participation in the Leapfrog Survey and drive employees toward high-performing hospitals.

    I would be glad to talk with you to clarify or discuss any of these issues.

    Leah Binder
    The Leapfrog Group

  6. Hi,

    Thanks for the plug on the 29/9/08.

    I am curious what the HIMSS podium might be? If it means I get to stand up in front of an audience (with fat cheque books) and sprook about the benefit of Open Source in PNG Hospitals – then count me in!!

    As they say around here… em tasol!


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