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Monday Morning Update 10/27/08

October 25, 2008 News 6 Comments

From Rose Michaels: "Re: Epic. From a reliable source (you’re probably already aware) Epic will be implementing in Dubai. Not sure of the details but figured if anyone could get them, it would be you. Thanks for doing the fabulous work that you share with us daily!!" I’ve mentioned it a couple of times back when University Hospital first made their selection, but hadn’t heard anything since, other than I saw an Epic user group story that said folks had come from as far as Dubai. More information is welcome. Seems like a lot of big deals are in the Middle East these days, but of course they’ve got the cash and have always been fans of US-style healthcare (at least the kind we deliver to our ultra-privileged patients).

From Al Borges, MD: "Re: Magellan EMR. Jason Murdoch, MD was able to get in contact with John, the owner. The EMR formerly known as Magellan has run into some business problems relating to being a small startup in a vicious EMR world. Magellan EMR has not been scrapped but is on the shelf. John is a reputable guy and took the site down to not mislead people." John e-mailed Inga back after her incessant sleuthing (we help readers however we can). Dr. Murdoch concluded with, "Does anyone know if Inga is a hot, Swedish blonde?" I do, actually, and all I’m saying is that she is indeed hot (and talented, and fun, and smart …) Swedish and blonde? I’ll never tell.


From Cliff Williams: "Re: Lincoln Park Hospital. At a Chicago meeting, I heard the hospital closed up shop, literally an overnight decision. Without warning, they called nurses and told them to come in and get their final check and sent patients to other facilities. Done. Sign of the times?" The hospital couldn’t find a buyer after it failed to find financing due to its $15 million annual losses and high Medicaid patient load. Deteriorating margins and tough credit will take more struggling hospitals out of the picture, although better capitalized groups may take them over if they have a presence nearby. That kind of Darwinism isn’t necessarily a bad thing, but some of the bigger groups got that way by minimizing the amount of charity care they provide. As always, uninsured patients take the biggest hit.

And speaking of closing hospitals, Physicians Medical Center Carraway (AL) also locked the doors on short notice this week for the same reason – it couldn’t get funding. I’ve been warning of that kind of situation for quite some time, but nobody seems to be noticing that it’s happening now (both closings and scrapping expansion plans).

From Al Borges, MD: "Re: HIT stocks. HIT in the USA is still in somewhat of a slump as compared to ‘Other Technology Companies’. HIT companies showed an unweighted YTD average return of -22.4% vs -14.2% for the OTCs." Link. There are probably lots of caveats to the list. Stock price movement within sectors tend to be amplified in both the up and down directions, so looking back one year may not be enough since all you’re seeing is performance in a historically awful market. The companies on the healthcare list are also a lot smaller and more focused than those international giants on the OTC list (Merge Healthcare vs. IBM?) Putting GE, Misys (shouted out as MISYS on the list for some reason), McKesson, Philips, and Siemens on the HIT side certainly muddies the waters since that’s a tiny part of their business and GE and Siemens are highly exposed to general international economic conditions. And, is looks like they simply averaged the individual one-year change, lumping in obvious low-cap losers like Merge (-77%), Emageon (-74%), and whoever I-Many is (-76%) with the big boys (half of the HIT companies have a smaller market cap than the smallest OTC listed). The list is pretty, but I’m not sure it really contains a lot of insightful or useful information. And, lots of the bellwether HIT companies aren’t publicly traded any more because of acquisitions, going private, or preference.

From Mike Donovan: "Re: Bridgeport. Mark Tepping is retiring after a long and successful career, but Bridgeport Hospital does not use ProFit – it uses Eclipsys’ AM/PFM for reg and billing." Thanks for that. I admire anyone retiring in today’s financial thrill ride. I must have confused Bridgeport with a ProFit user, which is surprising since there are so few of them. I don’t know anything about AM/PFM. That’s the old SDK, right?


Welcome and thanks to new HIStalk Gold Sponsor Satyam Computer Services of Hyderabad, India. It’s a big company ($2.5 billion in revenue and 53,000 employees in 66 countries) with a strong US and healthcare presence. Satyam’s services include hospital systems, portals, telemedicine, application development and maintenance, ERP, and consulting services. The case studies on the Healthcare Practice site include a couple from the Centers for Disease Control and Prevention. Thanks to Satyam for supporting HIStalk.


Former Caritas Christi CIO Dan O’Neil is named CIO of Quincy Medical Center (MA). And speaking of Caritas Christi, it gets $100 million in funding from Ascension Health, which probably means they’ll buy it eventually (which is a pretty good example of what I wrote about struggling hospitals being bought by bigger groups, which I promise I wrote before I read this story).

A hospital manager in Ireland quits after signing an unauthorized $1.6 million contract for software that turned out not to work. The hospital found out about it when they got a bill, but could not get out of the contract nonetheless.

Apple takes out Microsoft’s dopey $300 million Seinfeld ad campaign in one devastating blow. And if you’ve missed Terry Tate, Office Linebacker like I have, you’ll like his new Get Out the Vote video (but Palin fans won’t like this one).

Inga and I are curious about 2009 marketing plans of industry vendors. If you’re a vendor marketing or advertising person, please complete our seven-question survey and we’ll share the aggregated results with you (company e-mail addresses only, please, so we know you’re legit). Surely you are curious (like we are) about what companies are doing in a volatile economy.

As a reader reported in an article comment, the FTC’s Red Flag medical ID theft rule has been delayed for six months.

I’ve mentioned the teen metal group Jessica Prouty Band before because her proud mom (who works in the HIT industry) sent over a CD that I liked. Check out the first video on the page from Hard Rock Boston – playing all those gigs has obviously made them tight and confident on stage (remember, three of them are 15 and the other is 13!) Anyway, they’re in a girl-led battle of the teen bands contest, so vote for them here by October 31 and they might get a shot at playing Hard Rock NYC. We could make it an HIStalk party if Fake Ingas are available.

I was watching a video on the Google Android operating system and API and thought the kid in the opening was a bit over the top: big hair, careful grunge look, and not very convincing as someone who would really get it. Turns out it was Google co-founder Sergey Brin, the #13 richest American, who’s worth close to $16 billion. He looks like a guy who might serve you coffee at Starbucks.

CPSI’s Q3 results: revenue up 8.4%, EPS $0.38 vs. $0.30, meeting expectations. Some of that was due to a tax change, but guidance was positive. According to conference call transcript, they’re doing a lot with Linux.

A University of Florida professor develops a "birthing computer" that uses wireless monitoring of uterine muscle electrical activity to advise doctors whether a Caesarean section is recommended.

Dr. Wes isn’t an ICD-10 cheerleader. "Imagine, 290 codes just for diabetes! Yeeeee haaaaa! Diabetes with foot ulcers on the right foot gets one code, diabetes with foot ulcers on the left foot gets another code, diabetes with foot ulcers on both feet, but not involving the shins gets another code… I mean, a new code for every nuance of disease! You get the drift! Isn’t this SPECIAL? Just think of the COST SAVINGS those clever bureaucrats have found!"

I admit I’ve never heard of Pop!Tech, a big-ideas organization (although I see Jay Parkinson was a speaker at its just-finished conference). They just announced Project Masiluleke, which will connect South Africans to HIV/AIDS information via mobile phones (daily text messages, reminding patients of follow-up visits for antiretroviral drug therapy, and patient-staffed virtual call center helplines).

A sad medical error in Ireland, where a resident performing his first unsupervised kidney removal ignores the family’s objections and removes a child’s healthy kidney instead of the diseased one. The doctor relied on an incorrect x-ray that was six years old because all the newer ones were missing and there wasn’t a convenient computer to look them up on.

An English arthritis patient can’t get pain meds or a referral because her specialist’s dictation, which was sent off to New Zealand for transcription, but never made it back to her doctor by mail. Seems like they could have sent the document by secure Internet connection instead of mail.

UPMC will lay off 500 employees this week. If they’re doing it, so will everyone other hospital (and every other business, most likely). UPMC made "only" $5 million in 2008 compared to $612 million the year before.

Shands HealthCare (FL) will close Shands AGH next year, citing anticipated big shortfalls because of Florida’s tanking economy, propped up until recently by unrealistic housing prices. It could be worse: they could be in Detroit, where employees of car manufacturers are being cut loose in giant waves, sure to hit hospitals there hard in uncompensated care.


A nanoengineering researcher at UC San Diego’s Jacobs School of Engineering wins a Navy grant to create a biocomputing "field hospital on a chip" that will monitor biomarkers in the body fluids of soldiers, detect common battlefield injuries, and then administer medications to treat specific conditions.

Varian‘s Q4 numbers: revenue up 15%, EPS $0.62 vs. $0.61, beating estimates.

A former hospital compliance officer is charged with defrauding her two former employers, a Hawaii hospital and a Florida HMO, by issuing millions of dollars worth of compliance contracts (HIPAA, charge master review, compliance training) to sham companies she ran herself. The HMO hired her even though she allegedly applied for the job using a phony name, fictitious work experience, and her former husband’s Social Security number.


Central Washington Hospital (WA) gets a local paper writeup for its use of a tele-interpreter company to provide remote Spanish interpretation via computer screen, cutting cost and wait times.

Vendor Deals and Announcements

  • MEDHOST is now offering a patient self check-in kiosk option called Emergency Department Patient Access Self Service (ED PASS). MEDHOST’s first implementation will be at Northridge Hospital Center (CA).
  • The Radiology Institute Imaging Center in Puerto Rico is adding Thinking Systems’ ThinkingPACS solution.
  • St. John HealthPartners (MI) is purchasing licenses for the Web-based Cielo Clinic software to help manage their patient population and screen for chronic diseases.
  • Robert Wood Johnson University Hospital (NJ) is deploying the Eclipsys access management solution. The hospital has been an Eclipsys client for 10+ years.
  • Valley Medical Group (MA) has selected athenaClinicals for its 60+ providers. For the last eight years, Valley Medical has used athenaNet for practice management services.
  • Arrowhead Radiology Medical Group (CA) is implementing McKesson’s Revenue Management Solutions for its nine physician clinic.
  • NaviMedix has acquired TopLine Solutions, a provider of healthcare payment and collection solutions. NaviMedix has a solution that gives providers the ability to perform real-time financial, clinical and administrative communication with multiple providers.
  • Olean General Hospital (NY) and Bradford Regional Medical Center (PA) have signed a letter of intent to integrate and create a new parent company.
  • HealthFusion introduces a Web-based practice management system that integrates with HealthFusion’s clearinghouse services.
  • Billing service Medrium acquires Wilmington Professional Associates. Though no terms were disclosed, Medrium recently raised $10.46 million in Series C funding.
  • I like the clever name for MEDSEEK’s December 3rd webinar, “Do eHealth Portals Make a Difference to the Hospital’s Bottom Line: Calculating a Return on Information and a Return on Investment.”
  • Presbyterian Hospital of Plano (TX) is laying off 17 people in the face of slower than expected growth. Presbyterian is part of the 18,000 employee Texas Health Resources.

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Currently there are "6 comments" on this Article:

  1. Making stock performance comparisons between an extremely small niche like Health IT vs. broad technology stocks is kind of meaningless. Hell, GE is taking a beating because no one knows what gremlins lurk on the GE Finance ledger sheet since no US bank or insurer has come clean until they have either gone bankrupt or merged since this mess began. Really no indication on what the GE Healthcare group is doing really.

  2. I suspect my previous attempt at a response failed because I included a link (sorry, I’m new at this stuff).

    Dr. Wes is right on the money. ICD-10-CM is a boondoggle. Its official release format from the NCHS is a 2,392 page, 23MB PDF. Codes, delivered as free text! How can a coding system maintained by a word processor support a revolution in our health information infrastructure? Furthermore, shoving modern knowledge of disease into a 1970s classification scheme does not a large improvement make.

    I have cataloged the problems with ICD-10-CM at my bog, the Better Diagnosis Coding blog.

  3. Spero – you’re missing the point. They are distributing it in a text file to:

    1. Reduce the most “arduous” task – writing an upload and deduplication routine
    2. Keep a non-Government entity (3M?) on the payroll to “manage” the process for them

    Afterall, they have no experience with this sort of thing. They’ve only provided oversight to the UMLS for the past 10+ years. Oh yeah, most of the expertise through non-Government entities. Oops – a minor lack of foresight.

  4. AFAIK, ICD-10 has been the norm in Europe (and other places?) for years. How do they manage it, and why are they using it, if it is such a mess?

  5. Using it for what purposes and what are the demonstrative benefits over ICD-9?

    Most of Europe and others using ICD-10 don’t play silly reimbursement games with ICD-10 (nor did they with ICD-9). So one mess will be the shakeout of how ICD-10 (on which DRGs, APCs, etc, etc are based) affects reimbursement and the hoops providers have to jump through to get the “right billing code.”

    That said, ICD-10 as it comes from the World Health Organization is about 12K codes. The UK uses this version.

    The Australian modification of ICD-10 (ICD-10-CM) has approx. 16K codes.

    The Canadian modification of ICD-10 (ICD-10-CA) has approx. 30K codes.

    The United States’ clinical modification, in its 2007 draft form, has 68K codes, or more than twice as many codes as the next biggest modification.

    So, another answer is that other countries haven’t made nearly as big a mess out of ICD-10 as we have.

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