News 10/24/08

From rbsavage3: "Re: HealthVault. Microsoft scores with Aetna e-records pact. As a member of Aetna and an employee of a large hospital system, I’m not sure I like this. I wonder what the community thinks." Link. The deal connects Aetna’s PHR to HealthVault and adds a connection in the other direction next year. The pitch is that HealthVault lives on even if an employer change requires leaving Aetna’s coverage. I’m not sure how the information is coordinated between the systems, but I’m sure they’ve worked that out.

From Leopold Stotch: "Re: bikers. I know we’re all used to ‘Hospital X lost a boatload of personal information data’ stories, but you never know who you’re dealing with with the Mongols support themselves through identify theft." Link. Federal agents arrest dozens of LA members of the Mongols motorcycle gang on charges ranging from drug sales to murder after undercover agents infiltrated the group (which is an amazing story of bravery on its own). The former Mongols president, who wrote a memoir about his tenure, is a night shift CT tech at LA County-USC Medical Center.

From The PACS Designer: "Re: Web-oriented architecture. You are going to be seeing another fairly new concept gain some momentum in the next few years — Web-oriented Architecture, or WOA. While we have been familiar with service-oriented architecture recently, the move to WOA won’t replace SOA, but will provide an architecture that is resource-oriented rather than service-oriented. Since resource-based solutions are more plentiful, they will give the developers a quicker on-ramp to the Web and provide a easier way to test and use new Web applications." Link.

Inga did a little more sleuthing on Magellan EMR, although I’m not sure tracking down the founder will help if the company is kaput, which seems the case. Somebody put in a ripoff report about a problem with a non-medical software package from them. The founder is scheduled to speak at a technology conference this month. He was looking for a programmer last month. Inga e-mailed the founder and the conference planner but hasn’t heard back so far. She tried both phone numbers we found; one doesn’t answer, the other doesn’t have him in the PBX and the address for the company doesn’t come with their name in Google.

A reader asked about an acquisition rumor earlier this week. We’ll have an answer Monday when "An HIT Moment With …" features the company’s CEO answering five questions from Inga and me (and you just know what one of those questions will be). We haven’t seen the answers yet, so we may all be surprised. Our impression is that readers really like these abbreviated interviews and they are fun to do, so if you have an interviewee in mind, let me know.

I kind of hinted at this when talking about Greenway’s PrimeResearch EHR-to-research connectivity, so here‘s a coincidental prediction that’s similar: a patient’s tumor genes may someday be compared to EMR data to tailor patient-specific treatment, aka personalized medicine. I’m a cynic most of the time, but I think this is eminently doable. With an EMR full of patient data that can be linked to vast databases of other patient records, drug trial results, registries, etc. there is no reason to blindly go down the treatment tree in search of a winner for a given patient. Cancer is not one single disease. Even if you don’t buy the concept that evidence-based medicine works, the idea that looking at one patient in context with a bunch of similar ones to choose the best therapy is pretty compelling.

A Michigan doctor develops a disease database to be used in India, working with the Bill & Melinda Gates Foundation to make it available. NxOpinion apparently suggest a diagnosis from provided data. I don’t really understand parent company Robertson Technologies, but it lists a lot of management people, so maybe it’s big.

If you’re ever in Algona, IA, you might as well drop in and see the EMR you’re paying for. USDA gives Kossuth Regional Health Center $134K for it, calling it a "Distance Learning Telemedicine Grant," which sounds like a stretch. It actually sounds more like an portal-type project, but it’s hard to tell from the political high five-ing.

McKesson launches InterQual in the UK. I always called it case management software, although it’s now a bit more grandly portrayed as clinical decision support (i.e., "are you well enough to go home so we don’t lose money on your stay?")

I’m behind on e-mails, but I still like hearing from folks and, even though my replies are often long in coming (I usually try to catch up on the weekend), I read every one. A few folks have asked about the Brev+IT weekly newsletter and I had to admit that it’s "on hiatus." It was taking up a lot of time I don’t have and the e-mail spam filters were keeping readers from getting it. I may bring it back as a weekly HIStalk post if I can think of some other life activity to give up in its place.

I’ve also forgotten to recently recite the list of stuff you can do here, all to your right: (a) put your e-mail in the Subscribe to Updates box to get an instant e-mail update when I write something new (that list now has over 3,100 confirmed recipients); (b) click the "E-mail This to a Friend" to tell your friends about HIStalk, which I greatly appreciate because I want to be anonymously famous; (c) use the Search HIStalk box to sift through 5.5 years of HIStalk; and (d) click the ugly green Rumor Report button to securely and anonymously send me highly sensitive and scandalous information. And, some of the best parts of HIStalk live in the reader comments below each article, so click Show Comments to check them out.

My guest editorial in this week’s Inside Healthcare Computing, which the publisher said was "very sharp, well-written, and insightful" (I’m preening because I have perpetually low self esteem, maybe justifiably), is entitled Ask the Magic 8-Ball: Who HIT’s Winners Will Be in a Recession, Depression, or Whatever You Want to Call the Crappy Times Coming. Some of the 10 items I listed came from reader ideas here, like # 3: "Consultants of the non-PowerPoint variety. Nobody cares about a five-year strategic plan when financial survival into next week is questionable, so eloquent glad-handers or fresh-faced noobs need not apply for these gigs. We’re talking gunslingers here, the battle-hardened vets who simultaneously impress and scare the bejeebers out of you. When you want a system brought live quickly or a sleepwalking vendor slapped to attention, you need someone who looks and acts like Lee van Cleef in those old Clint Eastwood spaghetti westerns." I don’t put out unless you buy me dinner, so you’ll have to subscribe to see the other nine and to receive my routine literary emanations.

Allscripts posts its last results under the old company. For Q3: revenue up 17%, EPS $0.07 vs. $0.07, missing consensus estimates by a penny (or a pence going forward now that Misys is involved).

Speaking of Allscripts, if you want to support WakeMed in Raleigh, NC, watch this video sometime before Friday at midnight. Allscripts will donate $3 for each viewing to the Just for Kids Kampaign that supports construction of a new children’s hospital.

St. John HealthPartners (MI) signs for Cielo Clinic CQMS software from Cielo MedSolutions.

Bridgeport Hospital (CT) is looking for a CIO. I’m not sure what happened to Mark Tepping, who I’ve chatted with a time or two. Big Cerner shop including ProFit, its seldom-mentioned (and even more rarely praised) patient billing app.

This article describes what’s different about Mayo Clinic ("the Big House on the Prairie"). I like the point that there’s a "firewall" between the money and the doctors, who don’t even know or care what Mayo gets paid because they all receive the same salary after five years’ on the job. "We’re all salaried staff—paid equally. This is very good for collegiality, and people working together. The culture here at Mayo doesn’t encourage egos. There is not the same cult of personality that you find at other places.” I checked its tax forms and the highest paid people, all surgeons, make around $700K. Not exactly starving, but there are lots of boondock quacks swindling multiples of that from Medicare.

Congratulations to Cerner again on some damned impressive numbers. Companies are turning in bad reports left and right and there’s good old Neal chugging along like there’s no economic problems at all while expanding globally. That’s a big story. I noticed in the call transcript that the acquisition of LingoLogix was finally mentioned: "which strengthens our revenue cycle offerings immediately … the NLP component of this technology can change the landscape for clinical search by bringing clinical meaning to unstructured clinical documentation, helping aid research, clinical trials and potentially provide a bridge to interoperability constraints as the personal health record becomes more pervasive."

The local paper writes up McKesson Horizon Enterprise Visibility (which staff call "The View") at Oakwood Hospital & Medical Center (MI).

Patewood Memorial Hospital (SC) goes with Omnicell OptiFlex for surgery materials management, including preference cards and real-time usage tracking. I looked for a good picture but couldn’t find one.

T-Mobile’s G1 phone (powered by Google’s Android operating system) is now on sale. iPhone killer? Too early to say, but the T-Mobile part killed my interest. Medical apps on the iPhone are a big hit (partly because of the "store" concept), so maybe coders are working on stuff for this one.

Speaking of Google, the company joins the Continua Health Alliance personal health group. I should interview someone there.

Natividad Medical Center (CA) chooses the NeoIntegrate integration engine from NeoTool.

Some company is auctioning off "telemedical information management" intellectual property on October 30. Included: a smart card-based EMR, HIM workflow, and a implantable RFID chip reader. Actually, Ocean Tomo seems to be entirely reputable in the IP biz, even partnering with NASA, so maybe it’s worth a look if you’re a vendor. Maybe I should cover it live.

Houston emergency preparedness officials team up with the University of Texas School of Health Information Sciences at Houston, a biomedical informatics school, to develop a medical support system for disaster and to deliver more care by telemedicine. I didn’t know that open source guy Fred Trotter works there on its HealthQuilt project, an HIE prototype. I did know that UTMB has one kick-ass telemedicine program that probably leads the entire industry, yet is rarely mentioned, since we’re talking about the Gulf Coast of Texas.

I must have missed this: a new rule that takes effect in a few days that puts hospitals under FTC jurisdiction in requiring them to check for medical ID theft for patients not paying upfront. That sounds onerous.

Patty Miller, a Sunquest sales exec, is voted president-elect of the Central New York chapter of CLMA.

That’s all I have time for since I’ve now worked directly from the uninspired dinner I cooked for Mrs. HIStalk until boudoir time without a break. She just stuck here head in to see if I was still respirating, so that’s probably a hint. We’ll pick up here Saturday. Have a good weekend.

E-mail me.

HERtalk by Inga

From Janeen: “Re: RelayHealth booth. Did you come by? We were trying to keep an eye out for you at MGMA. We had a theater experience that involved a consumer/patient, physician and an administrator we were hoping you got to watch. Let us know if you saw it.” I did lurk by your booth a few times, and even chatting with someone about how PHR fits into the RelayHealth model. RelayHealth had an “exam room” setup with a cute doctor who explained the ins and outs of RelayHealth’s offerings.

Overheard in the San Diego airport: “MGMA was a really good show for us. Lots of traffic.” Standing in the security line, I stood in front of a guy from Fujitsu chatting with another vendor (sold lab coats, I think.) The Fujitsu guy said that MGMA and HIMSS were their two biggest shows and they were pleased.

On the other hand, I did hear a number of people say that attendance seemed a bit sparse. My opinion was I didn’t go to a single session that was standing room only and didn’t have to push through crowds at the exhibit hall. It wasn’t HIMSS, but there were folks everywhere all the time. With such gorgeous weather, I can imagine a number of folks stepped out for some sightseeing.

Anyway, I am glad to be home. I’m worn out from so much fun and long days in high heels (but I looked good.) I’m trying to tell myself that I’m tired because I am out of practice (not used to all that traveling, walking, sitting, wine-drinking, sleeping in a strange bed, etc.) and not because I am getting to be a 3-letter word that rhymes with cold.

Eclipsys co-founder and Carefx founder Terrence Macaleer joins Allscripts as VP of sales for Enterprise Solutions. I also see that Centra (VA) has selected Allscripts ED IS solution.

The VA contracts with Qwest Communications to provide $60 million worth of voice and data services to connect its 1,300 hospitals and other facilities.

More proof here that healthcare is not totally immune to economic troubles. Several new reports confirm that more of us are delaying doctor visits and tests, and skimping on medicine. Kaiser Family Foundation determined 36% of Americans are skipping recommended tests and treatment, up from 29% just six months ago. The number of prescriptions filled has fallen .04%, the first time in at least 12 years a drop has been recorded. Elective surgeries are falling; ER visits by the uninsured are rising.

Also suffering: Yahoo announces a 64% drop in Q3 profits and a plan to cut at least 1,500 jobs. On the other hand, Google’s are up 26%.

Sentillion adds a record 11 new customers and over 200,000 new user licenses in Q3.

E-mail Inga.