Monday Morning Update 10/20/08

From Hoyce: "Re: inkjets. I wonder what these cartridges will cost?" Link. HP licenses its inkjet fluid technology to Home Dialysis Plus for mixing of dialysate and water for in-home treatment of kidney failure, saving the patients trips to the dialysis center. HP had already licensed the technology for administration of vaccines.

From The Blogfather: "Re: Cerner. Never let it be said that Neal Patterson makes idle threats. After bringing up the famous e-mail at the company meeting, he followed through and cut Cerner’s healthcare benefits in the middle of open enrollment. Cerner’s only contribution is $400 to an HRA account, leaving associates to fund the remainder of their care through old school FSA accounts." Unverified.

From The PACS Designer: "Re: Virtual Desktop Infrastructure. With the increased focus on virtualization, a term invented by VMware in 2006 is starting to gain some traction. Virtual Desktop Infrastructure (VDI) will be seen in the news more often now due to the virtualization efforts of VMware, Amazon, and now Microsoft with its soon to be introduced virtual desktop that runs in cache memory as a thin client. As more organizations look to reduce operating costs and simplify desktop application management, you will see more movement toward this thin client concept. The possibility of thin client PACS running on a virtual server that downloads the application to your cache memory could be a new trend in the years to come and would be a good cost saving application for smaller providers." Link.

From Fourth Hansen Brother: "Re: non-competes. They just got killed in California. Are people getting out of those that Epic writes?" Link. The California Supreme Court rules that employers can’t stop former employees from starting businesses or working for a competitor. Let’s face it: no court will stop you from making a living just because your former employer made you sign some questionably binding document as a condition of employment. Your problem isn’t the courts, though – it’s the new employer who doesn’t need the legal headache (or to make Epic mad if they depend on them). They’ll just hire someone else. If a former employee had the time and money to fight the non-compete, they would probably win and potentially set a precedent for everyone. I haven’t heard of Epic’s in particular, but I’ve heard that some Wisconsin attorneys were taking cases awhile back.  

From Lucy Ewing: "Re: physician contracts. Will doctors sign anything someone puts in front of them? A friend mentioned that a practice was getting terrible service from their billing service and planned to change. The billing service’s CEO freaked out and threatened to sue, pointing out that the contract they signed legally obligates them to send all billing through that company." I know doctors hate lawyers, but so does everyone else … until you need one. Like when signing a contract. 

The Raleigh paper just can’t accept the fact that Allscripts has moved the former Misys Healthcare’s headquarters to Chicago. The reporter pestered Glen to the point he finally said, "I wouldn’t rule out the fact that the headquarters may be here at some point in the future," surely just to get the reporter off his back. For some reason, the reporter then checked with John McConnell, who’s not part of the deal, and he fanned the dying HQ embers by saying Glen works for Misys and they’ve always liked Raleigh. My opinion: the important products going forward are Enterprise, Professional, Payerpath, and Connect. Everything else in Raleigh other than product maintenance (sales, administration, non-HealthMatics R&D) is way overstaffed under the new model. As tough as it is to hear, Misys brought little to the table except lots of indifferent customers, so it’s certainly not going to business as usual in Raleigh since Allscripts really needs to put up good numbers right away. I hate that "trim a tree to make it grow" stuff too, but that’s reality.

PatientKeeper’s Suzanne Cogan will speak Monday and Tuesday at MGMA (at Sage’s Booth 615) on "The Physician on the Go: Improving Revenue and Practice Operations with Mobile Applications."

I never heard of company Conceptual Mindworks of San Antonio, TX or its EHR product Sevocity (I must not pay enough attention to CCHIT certification since it earned Ambulatory 2007 in May). The name’s a stretch ("a combination of two words: seven, which signifies good luck or prosperity and velocity, which means speed or journey") but it looks of cool and is cheap ($800 startup per provider, then around $500 a month for EHR; another $200 for PM) with 24×7 support. They seem to have made their money from Air Force contracts.

Here’s a bit of McKesson history that I hadn’t heard. In 1938, its predecessor, drug wholesaler McKesson & Robbins Inc., faced bankruptcy after it was discovered that the CEO had cooked the books (he was actually an ex-con and swindler who used a fake name and medical background to buy the company). At an emergency company board meeting, word got back that the CEO had committed suicide. Said a Goldman Sachs partner who sat on the company’s board: "Let’s fire him for his sins anyway." The same thing happened with the HBOC acquisition, announced October 26, 1998 (maybe McKesson will be providing cake and punch for the tenth anniversary) except that McKesson’s executives didn’t kill themselves (only their careers – they were all canned after the fact) and the numbers were a lot bigger ($14.5 billion). The happy union was frenetically consummated on January 13, 1999 and the cooked books were discovered only three months later, sending $9 billion of McKesson market value up in smoke in a single day, leading to an entirely new meaning for Pathways Accounting. Everyone I knew saw it coming, so either I had smart friends or McKesson had dumb executives. Believe it or not, the adjusted share price still hasn’t recovered from that self-inflicted disaster: shares were around $82 in the fall of 1998 and are a little more than half that now. Cerner shares have tripled since then.

Jim Riley, formerly of Payerpath, joins MedAvant as sales VP, reconnecting with his former Misys boss Andrew Lawson, now MedAvant president.

Picis will be at CHIME’s Fall CIO Forum next week in Lost Wages, so if you’re going, drop by and tell them you appreciate their support of HIStalk.

While I’m on that particular soapbox, show a little sponsor love all around when you get the chance: click their ads to see what’s up with them and tell their executives that you saw the company mentioned on HIStalk. I’m a foot soldier working a hospital job by day, so I need some allies in proving the sponsorship value here. Thanks.

Sisters of St. Francis Health System threatens to cancel its WellPoint contracts because the Indianapolis insurance company isn’t paying on time. The insurance company blames its BlueCard claims payment software. WellPoint has been sued by investors who claim the company knew about the problem but didn’t disclose it. A representative of the company’s Anthem subsidiary says the problems won’t be fixed until February. WellPoint’s former CEO walked away with $23.9 million last year and the current one is getting $9 million a year. Why deliver actual care when pushing the paper it generates pays so much better? Adding value is so 1970s.

Gartner places Sentillion in its Challengers quadrant for Enterprise Single Sign-On.

Alberta, Canada (always reminds me of "Prince Albert in a can") will make health information available online to its residents.

Healthcare IT consulting firm Global Works Systems opens its new corporate office in Colchester, VT, which it points out is near its partners Allscripts and GE Healthcare.

I hadn’t snooped around MEDITECH’s site lately, so here’s your info tidbit: the cafe lunch in Westwood Monday will be grilled steak tips with sweet potatoes and Brussels sprouts. I bring that up because I’m one of the approximately five Americans who will eat Brussels sprouts (as long as they’re fresh and not frozen). I see they’ve posted all new (to me, anyway) color photos of the executives and they look like the kind of people I like (few ties, some are kind of nerdy looking, and everybody looks happy, maybe because they’re wealthy). It’s the most successful company in the history of the industry (which it happened to create – look it up) so I like to pay appropriate homage. The only blot on their otherwise perfect HIStalk record is that I can’t convince Neil Pappalardo to let me interview him even though he’s a rock star to me, but Howard Messing did an inarguably fine interview back in the early days of HIStalk that I really enjoyed.

A huge federal raid in the Cleveland area involves MetroHealth Medical Center. Several companies were searched, among them a local division of Siemens, which got contracts for both public housing and hospital work. FBI agents told the Siemens employees to clear out while they hauled out boxes. "He is an employee at Siemens, which handled a $33 million energy conservation contract with CMHA that Phillips helped shepherd through. McMichael is named in a federal subpoena involving Carroll and Greco. The subpoena indicates that agents are looking into whether contractors, including Siemens, had any financial relationship with the hospital administrators or whether any contractor did work at the men’s homes." Bribery (several billions of dollars’ worth) appears to have been woven into the corporate culture, according to former executives. Somehow they’re still in business.

The preview looks wickedly funny: Children’s Hospital, an Web series on the WB. Doctor in clown makeup: "I’m challenging you to a healing-power-of-laughter-off."

Vendor Deals and Announcements

• InteGreat and Nuance extend their partnership, giving InteGreat the ability to provide its clients with Dragon Medical 10.
• eHealth Global Technologies announces the release of the Image Exchange Service for RHIOs and HIEs. The product facilitates the exchange of medical images utilizing a DICOM-compliant viewer.
• Ingenix acquires business intelligence company Bull Services/Integris. Bull Services also offers consulting services, systems integration solutions, and outsourcing.
• QuadraMed’s former VP of strategic services Vicki Wheatley is now VP of consulting services for HIT consulting firm Just Associates.
• North Hawaii Community Hospital contracts with Phoenix Health Systems to provide IT management and infrastructure services.
• Physician-owned MSO Premiere Medical Resources (Ohio) selects Noteworthy’s NetPracticePM and NetPracticeEHR for its 92 members.
• iMedica signs a sales and marketing agreement with CySolutions, a provider of community health center solutions.
• Munson Healthcare (MI) selects Lawson Human Resource Management Suite and Lawson Business Intelligence to consolidate its administrative processes and support its HR and payroll functions.
• MedAssets announces the release of its Medicare Recovery Audit Contract solution that helps healthcare providers throughout the recovery audit process.

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