Giving a patient medications in the ER, having them pop positive on a test, and then withholding further medications because…
Monday Morning Update 11/3/08
From Barry S: "Re: Breakway Company comment. I have the same question. The focus group that they hosted seemed to be all about ‘how’ they can get into healthcare and trying to figure out what the next best thing would be, not about what they can do for us or the industry. Granted, the groups are designed to give them feedback. However, I was disappointed that it wasn’t very substantive. I am thinking that it just may be fluff."
From Sophie Sheridan: "Re: DR Systems patent lawsuits. I’ve heard from one industry source that the payoff (and settlement) for admitting you infringed on the DR patent is $500,000. However, a credible – and successful – defense to dismiss the suit would cost about $1.5M in legal fees. I wonder how the presumed income of $500,00 a couple of times a year fits into a business plan?"
From Frankie Saluto: "Re: ICD-9 vs. ICD-10. Looking at the list of ICD-10 codes for insect bites, it seems like a classic example of what may happen when one does not NORMALIZE a data model. The whole list could have been translated into three interrelated entities: anatomy (scalp, abdomen, etc), pathology (insect bite in this case) and visit/encounter (first encounter, subsequent, etc.)"
Thanks to everybody who responded to my 2009 marketing survey. Some interesting facts from it:
- 29% of companies anticipate spending more on advertising in marketing and advertising in 2009, with 43% expecting to spend the same and 29% planning for less
- 93% will spend as much or more on blogs in 2009 as they did in 2008
- 67% of respondents said they will spend less on magazine advertising, which was also rated as the least effective program and the lowest return on investment
- HIStalk’s sponsors ranked their sponsorship as their most effective program (tied with trade shows)
- HIStalk was ranked #1 in return on investment by current sponsors
- The most important benefit reported by sponsors is mentioning company news and announcements
Also a surprise: readership shot up again in October, breaking the all-time record (September) by around 15%. Thank you for being part of that – I personally appreciate the support. It’s always slower in November and December, so if you want to help offset that, click the "Email this to a friend" graphic to your upper right to tell a few friends about HIStalk. Thank you.
Listening: Calexico, recommended by Tom. Kind of like Nick Cave meets a mariachi band on the way to a Pink Martini concert. Easy to listen to, unlike some of my weird picks. Like it lots, great suggestion.
Premise announces its patient flow solutions consulting services, led by Barbara Bryan. I keep predicting that credit problems will force hospitals to increase capacity virtually rather than physically, something that experts can make happen.
Lehigh Valley Physician Group (PA) chooses MDaudit compliance audit software from Hayes Management Consulting.
eHealth Ontario names Sarah Kramer, previously VP/CIO of Cancer Care Ontario, as president and CEO.
Jobs: Senior Software Engineer (WA), Senior Product Manager (UT), Client Services Director (NC), PMO Eclipsys, Cerner, or Epic (nationwide). Weekly job blast signup is here. In this economy, it’s best to be prepared.
Former FCG CEO Larry Ferguson joins the board of business intelligence systems vendor Accelrys.
Husband-and-wife professors from Case Western Reserve University want the federal government (CMS specifically) to oversee electronic health records with "rigorous regulation", citing security and privacy issues.
The SVP of Medtronics says the end of the line is near for medical devices. "You can’t keep stuffing gizmos into people to treat end-stage disease. When biotechnology gets right, we’re finished. Because it’s restorative, not palliative as devices are.” He also said easy investor money rather than American ingenuity led to this country’s leadership in such devices, noting that most of them were invented in other countries.
Hospital layoffs: Valley View Regional Hospital (OK): 127 employees. Newark Beth Israel Medical Center (NJ): 100 employees.
A UCF professor develops computer-generated patients that will be used to help medical students learn to make better decisions.
Odd lawsuit: a former hospital priest is fired after a woman claiming he seduced her files a $25 million lawsuit. She says he had Viagra mailed to her apartment and complained by e-mail about a groin rash he said he got from having sex with other women.
Another odd lawsuit: Washington Adventist Hospital (MD) is sued by the family of a heart patient who coded on the toilet of the locked bathroom of his hospital room and staff couldn’t find a key to get to him before he died.
Merge Healthcare announces Q3 numbers: revenue up slightly, EPS $0.01 vs. -$4.17.
WebMD’s Q3 numbers: revenue up 17%, EPS $0.18 vs. $0.19.
Shands-Jacksonville Medical Center (FL) fires 20 employees for accessing the medical records of pro football player Richard Collier. I noticed that the TV station’s story, which spelled out what HIPAA stands for, abbreviated it first as HIPPA, then changed it to PIPAA, shattering any illusion that that highly paid talking heads who read the news to you actually know what they’re talking about.
The CEO of Saddleback Memorial Medical Center (CA) gets a writeup in the business paper for its $60 million push for electronic medical records.
Intel has a November 11 announcement, apparently of its FDA-approved Health Guide PHS6000, which allows patients or caregivers to enter and transmit medical data.
A BlueCross BlueShield venture fund’s first investment is $5 million in Initiate Systems.
A hospital’s cancer care manager, testifying in an inquiry about the hospital’s lab mistakes and its failure to notify patients, has been on the stand for 129 days.
Vendor Deals and Announcements
- Midwest NeuroSurgery & Spine Specialists (NE) selects Intergy EHR by Sage for its eight-physician group.
- MedAssets releases a new Alliance Decision Support solution to help healthcare providers analyze and utilize operational information to improve financial performance.
- Patient Placement Systems partners with Iatric Systems to develop interfaces for to connect MEDITECH’s solutions to Patient Placement’s web-based admissions and referral management systems.
- The 30-physician CORE Institute (AZ) signs a three-year agreement with MedSynergies for revenue cycle services.
- A study by The Mary Imogene Bassett Hospital (NY) shows the implementation of its SIS perioperative system raised on-time first case starts by 35% and turnaround times by 33%. The hospital was able to reduce supply cost by $200 a case and increase surgery-related charge capture by 30%.
- Johns Hopkins is implementing iMDsoft’s MetaVision Anesthesia Information Management System.
- Methodist University Hospital (TN) has installed ForHealth Technologies’ IntelliFill I.V. for the automatic preparation and labeling of intravenous doses.
- NextGen announces Q2 earnings, with a 9% increase in net income over the previous year and a 31% rise in revenue. The company met analysts’ expectation for EPS and beat revenue estimates by $1.4 million with its $59 million performance.
- Henry Ford Health System is purchasing MRO’s RAC Tracker Online to manage its recovery audit processes.
- Innovative Consulting Group announces (warning: PDF) it is expanding its service offerings with the additional of an Epic practice. Serving as Epic Practice Director is Todd Shavor, an Epic Certified Ambulatory consultant who has worked on multiple projects including implementations at Baylor College of Medicine and the Harris County Hospital District.
Re: ICD-10-CM. I think Frankie Saluto actually referring to post-coordination when he (or she?) uses the term “normalization”. Post-coordination is where a user of a structured structured terminology identifies a concept by selecting one code for each of several axes (e.g. one code for the disorder, like “insect bite,” one for the anatomic location, and one for the ordinality of visit). Pre-coordination, on the other hand, is where the terminology includes pre-built concepts that specify values for all the relevant axes, like the ICD-10-CM codes. The problems with post-coordination include:
1. You end up with many more potential combinations than with pre-coordinated codes
2. Many post-coordinated codes might be meaningless (e.g. “classic migraine” combined with “right big toe.”)
3. It is easier for the user to select a pre-coordinated code (if the user can be presented with a list that is reasonable in length and includes something representing what they have in mind.
The problem with ICD-10-CM is that it is really the worst of both worlds. The lists of codes are in general a slavish enumeration of nearly every possible combination of pathology, anatomic location, laterality, and ordinality of visit-It is essentially a set of pseudo-post-coordinated codes.
But, amazingly, they have made it impossible for information systems to automate the process of code selection, because of inconsistency as to which of the 7 characters in the code represents what concept. In some cases laterality (i.e. left vs. right) might be represented by the value of 4th character in the code, in others by the 5th. Thus, it is impossible to design a solution for end-users that allows them to, for instance, have a handy radio button to indicate right vs. left, and have the application reliably select the right ICD-10-CM code behind the scenes. FEH.
I’d love to know when the last time Sage was relative in the ambulatory space. The fact that they are announcing an 8 doc current customer “upgrades” to Intergy is staggering. This company (when it was Med Mgr) had a huge chunk of the market. Now, it’s an afterthought unless it’s an existing customer.