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December 23, 2008 News 5 Comments

From Tom Tubow: "Re: blogs. I was thinking about why I read HIStalk instead of the other blogs and I realized: theirs feel like work, yours feels like fun." Thanks for noticing, but it’s by necessity. I have a short attention span, so you won’t get many long, weighty theoretical essays from the standard roster of self-anointed, frowning experts here. I’m more Howard Stern than William F. Buckley. If you leave here both informed and entertained after just a few minutes, Inga and I have done our jobs.

From Long-Time Reader: "Re: article. Here’s one from the Denver paper on local EMR integration." Link. It’s about the Colorado RHIO.

From Josh: "Re: McKinsey report. Puts 2/3 of what it believes is $650 billion excess cost on the backs of ‘specialty outpatient care’ providers, noting that ‘current outpatient reimbursement methods reward providers for delivering more care, or care that is higher intensity.’" Link. The conclusion is so obvious that it’s often missed: professionals will perform whatever services they can get paid for. If you’re paying for diagnostic imaging, expect a lot of diagnostic imaging to be done. Don’t expect providers to cut their own income just because it might be beneficial to a particular insurance company or society in general ("first do no harm, but second, make sure to bill what’s paying well this month.")


From The PACS Designer: "Re: file sharing. Another cool online application TPD recently found is drop.io, which gives online file-sharing possibilities to those who work in teams to accomplish tasks and goals." Link.  I was annoyed that the only "how to" help is by video, which I generally refuse to watch online unless it’s something stupid on YouTube, but theirs is by DemoGirl, of whom I’ve been a fan for years. The service looks cool … you can password protect files, e-mail them in, and share them selectively. Not the cheapest, starting at $20 a month, but pretty slick.

From He Hate Me: "Re: Microsoft. I hear they’re putting a presentation together for Daschle’s team. Maybe Amalga HIS isn’t as far away as people are saying." I hope Daschle’s smart enough to recognize that Microsoft’s healthcare toe-dipping hardly makes the company an expert (its Azyxxi acquisition and Visio add-ins aside). Lots of folks, including those who have actually worked in healthcare as something other than a recent growth target, could give him the unbiased scoop if that’s what he wants.

From kb: "Re: Epic. You’ll be happy to know Epic will be contesting another frivolous lawsuit from Acacia. Doesn’t sound like Epic was the only one named in the lawsuit either." I assume that was the one by Document Generation Corp. that I mentioned last week. I said then I was surprised that Acacia, if it’s really behind the suit, would want to tangle with Epic again. I was reading something the other day about how many corporate infringement lawsuits are filed by shell companies with zero to five employees and a no assets other than a patent, using the high cost of mounting an infringement defense as leverage to extort money from big companies. No wonder other countries are eating us alive in everything from manufacturing to science — we’re too busy suing each other to actually produce anything.

From Darth Tater: "Re: HIMSS. The HIMSS staffers must be deluding themselves – probably being from Chicago, they think they have some special ‘in’ with the administration. They need to learn what happens once people move inside the beltway. More to the point, HIMSS is hardly the only source of information. John Halamka mentioned during a HITSP meeting last week that he was testifying earlier in the week. I am aware of other projects where they are personally working with specific Senators – more directly than ‘staffers.’ And anyone that thinks IEEE, RSNA, AMA, etc. etc. aren’t in front of people also doesn’t know what they are talking about." I give credit to the incoming administration – they’ve got people believing that their vote and participation count, so thank goodness for that. The reality is, though, that not everybody will leave with a lollipop. Not everyone will be happy with the direction. Not all groups have the influence they think they do. Politicians are good at saying "maybe" when they really mean "no way." And despite the good work that a lot of people do in healthcare IT, HIMSS is, using its own words, a trade association of vendors, and those don’t typically carry a lot of weight. That’s where being vendor-heavy probably curtails their influence.

UPMC Presbyterian reaches Stage 6 of the HIMSS Analytics EMR adoption model, joining 23 others.

What do lobstermen, victims of ice storms, and potential users of electronic medical records have in common? Maine’s finance authority agrees to extend financial help to all three.

Motion Computing, maker of the C5 Mobile Clinical Assistant, gets $6 million in new funding. The press release says the C5 has been deployed to over 4,000 healthcare organizations, which is a lot more than I would have guessed. They must be selling lots of them in other countries since I’m pretty sure their hospital penetration is nowhere near 50% here and even that would only be 3,000.

Listening: Skarlet Blue, hard-rocking Aussies. Video here. Catchy and nicely done.

I had the HIStalk server upgraded again today, as I nearly forgot to mention. There were times, especially on weekday mornings between 9 and 11 Eastern, when you may have received a "page not found" error because the user load was redlining the Apache service, which means … well, that too many people beat you to HIStalk before the memory ran out. It’s hard to believe I could once get away with a little $4 a month shared Web hosting hosting account. Anyway, hopefully it will work better now.


EnovateIT partners with Metrologic to provide 800 bedside medication barcode scanners for Novant Health (NC).


AC/DC singer and local resident Brian Johnson dedicates a music room in his name at Sarasota Memorial Hospital (FL), paid for by the foundation of former Who bass player John Entwistle, who died of a cocaine-induced heart attack in 2002.

Deborah Peel’s Patient Privacy Rights is upset by a letter (warning: PDF) from Confidentiality Coalition to Congress. What it says (despite that group’s name): healthcare IT is so important to healthcare and the economy that principles like accounting of disclosures, consent for TPO, and "unnecessary" notification of a privacy breach should be scratched from any HIT plan the government undertakes. Don’t let patient privacy stand in the way of progress, in other words, kind of an eminent domain on PHI. The group behind it appears to be Healthcare Leadership Council, a self-described "business league" that spent $1.6 million on lobbying last year. Some of the members are predictable (drug and medical device companies, GPOs, and the Big Three drug distributors) but I don’t understand why a few non-profit hospitals have signed up (and Vanderbilt’s School of Nursing). Their main pitch seems to be that US healthcare is a great value because of all the "unparalleled improvements in the field" brought to you at high cost by the folks who would rather not have their gravy train derailed.

Forbes uses athenahealth’s payor ratings to determine The Worst Places to Be Sick and Poor. The bottom five states: Virginia, Florida, Georgia, Texas, and … drum roll … New York, which takes nearly 140 days to pay Medicaid claims despite billions spent on software. You know it’s going to get worse as states, especially those addicted to growth, find their coffers empty and, unlike Uncle Sam, they can’t just print more money.

RelayHealth wins a consumer engagement award for its connectivity offerings for consumers and providers, specifically its Results Distribution Service.


University Hospital in Dubai signs up with Epic. Judy is actually quoted. Come to think of it, that’s an opinion I’d like to hear: does Judy think the government should subsidize EMRs since she’s selling all she can without its help?

The Philadelphia paper debates the cost and benefit of electronic medical records, talking to Doylestown Hospital and Abington Memorial. It also invites the public to attend one of those local discussion groups that HIMSS is arranging to generate policy recommendations for the Obama administration. I would expect the lay people to suddenly be heavily in favor of healthcare IT investments they were unaware of previously since HIMSS is facilitating, but I’ll defer to anyone who was actually there.


A Kansas urologist develops cell phone software that protects highly unskilled and overconfident teen drivers from killing themselves and the rest of while yapping and texting while driving. It blocks the phone while the key is in the ignition. Ingenious.

A former Cedars-Sinai billing employee is charged with setting up a fake laboratory company and submitting patient bills that insurers paid via a post office box, using the identities of over 1,000 patients.

The British Medical Association fights a government plan to open up patient databases to researchers, including those from private companies. They say companies could harvest (or "hoover," as they say) patient names in order to market to them.

University of Wisconsin-Madison will put up signs warning patients that their doctors might be taking drug company money for research or consulting (without doing anything about it – kind of like those "unauthorized solicitors" signs in airports that let you know Moonies are around, but still leaving you on your own to deal with them. The medical school dean wants doctors to report the money they receive, with one example cited being an orthopedic surgeon who checked off the maximum amount — over $20,000 year — which in his case was actually $400,000 a year for eight days of work. Of course, patients still have to decide what to do even if they know Doc is pocketing drug company money, so it probably won’t amount to much.

Paul, an HIStalk reader in the UK, sent this message: "My current organisation is a New Zealand based Systems Integration Company, called Simpl, and they have been commissioned by 10 of the leading District Health Boards in NZ to procure a system which could potentially be a national standard across New Zealand. We would very much like to publicise the fact this procurement is underway and invite interest from any USA software providers that believes they have a solution that could fit. I suggested HIStalk may be a great way to alert the USA market to this potential. Up to 10 New Zealand District Health Boards are seeking to procure technology that will support the transformation of healthcare delivery by providing an individual-centric health management system that is health provider agnostic. Therefore the solution must address not only their hospital PAS requirements, but also enable seamless access to an individual’s health information by registered health practitioners / qualified health professionals wherever they work (hospitals, the community and primary care, rest homes etc) and even by the patients themselves. This procurement is being managed by Simpl, a New Zealand based Systems Integration company that specialises in Healthcare." The tender system is here and the reference number is 24585. I have the RFI, but I think you can get it there, or contact Paul.

The Nashville business paper reports that business is great at Brentwood-based 24-employee credentialing software vendor Sy.Med Development, on track for $3.2 million in sales this year. The piece has some interesting business pearls from the CEO, such as "You can change industries rather easily and hard work, belief and passion can make up for lack of knowledge."

A former Wachovia VP in the Miami area gets three years in jail for helping an accomplice with a $48 million Medicare fraud and money-laundering operation.


UnitedHealth Group launches its free public Web portal, myOptumHealth.com, run by its health and wellness subsidiary. The site run ads for United’s insurance products and will also sell advertising space (there’s already a Cymbalta ad running on the front page, I see). You can fill out a PHR online.

Oracle claims its DB Machine is the most successful launch in company history.

Emageon says its would-be acquirer, Health Systems Solutions, Inc., is taking too long to close the deal. Emageon says HSS is giving it the runaround by continuing to make due diligence requests despite a signed merger agreement, avoiding setting a closing date, and claiming Emageon misrepresentation. Emageon stock tanked on the news Monday, down $0.92 to $1.30. HSS is smaller than Emageon, so you never know if they’ve run into financing problems since that’s about the only valid excuse unless they’ve really found a skeleton in Emageon’s closet.

Enjoy your holiday(s), whatever they might be. I’ll be around if you want to e-mail me.


Twas the Night Before Christmas
By Inga

‘Twas the night before Christmas, when all through IT
Not a creature was stirring – not a single PC.
The charges were updated by users with care,
In hopes that more money would make its way there.

The doctors were finished, all smug in their heads,
While nurses were checking on every last bed.
And the CIO in his office, and I in my cube
Had cleaned up our e-mails (and watching YouTube).

When out from MS-Windows there ‘rose an odd chatter,
I switched off Minesweeper to check on the matter.
Away to the Internet I flew in a flash,
Launched open HIStalk and hoped nothing would crash.

The tune on Pandora was silenced at once
My laptop moved slowly – it seemed to take months.
When, what to my wondering eyes should appear
But a miniature Mr. H and Inga, that dear.

With my VGA driver, so lively and quick
I knew in a moment it must not be a trick.
More rapid than eagles, his rumors they came,
And he whistled, and grumbled, and called them by name.

“Now Neal! Now Vern! Now Hammergren and Judy!
Now Glen! Now JB! Now Pappalardo and Andy!
To the top of Web page! To the top of the crawl!
I know all your secrets! Yes I do know them all!”

With news and some gossip, those wild rumors fly
The leaders read closely, hoping they’ll not win The Pie.
So onto HIStalk the top dogs would click
To read Mr. H and his Inga, with all of their shtick.

And then, in a twinkling, I heard a new sound
My disk drive was churning and chugging around!
As I drew down my head to refresh the screen
Out popped Mr. H – an amazing sight to be seen!

He was dressed in polyester, from his head to his foot,
He had quite the old-fashioned programmer look.
A bundle of gadgets he had flung on his back,
As well as the Blackberry, still new from the pack.

His eyes – how they twinkled! His dimples how merry!
He looked ready to scribe a new fun commentary!
His droll little humor was clear from the start
This was man who made blogging an art!

The stump of a pipe he held tight in his teeth
And a light was encircled on his head like a wreath.
He had a kind face and pooch at his belly
So this was who turned vendors’ knees into jelly?

He was quiet and quick – the picture of stealth
As he checked out the tech things in our office of health.
A wink of his eye and a twist of his head
He noted our software and computers by beds.

He spoke not a thing as he took a keyboard,
I recalled how his words were stronger than swords.
Then touching his finger upon the word “send”
Today’s posting had clearly come to an end.

He sprang to my laptop and gave a short whistle
Then into cyberspace he went – as fast as a missile.
But I heard him exclaim as he slipped out of sight
“Happy Christmas to all, and to all a good-night!”

E-mail Inga.

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Currently there are "5 comments" on this Article:

  1. Emageon latest: HSS, the acquiring company, is 86% owned by Stanford International Bank, based in Antigua and run by the mysterious playboy cricketeer billionaire Allan Stanford. Stanford International Bank is contractually obligated to pay for the purchase of Emageon, but has so far refused to do so. No explanation given. HSS is demanding that Stanford International Bank pony up the dough. Sort of like me demanding that I give myself money for a new suit. This may end up in court, with Emageon suing HSS in Delaware to sue Stanford International Bank in Florida. Stanford International Bank is, meanwhile, busy building a big American institutional financial consultancy (in addition to its many other US operations) even as it blithely ignores contracts signed with American companies. Perhaps some regulator somewhere might want to take a closer look at these guys.

  2. “Motion Computing, maker of the C5 Mobile Clinical Assistant, gets $6 million in new funding. The press release says the C5 has been deployed to over 4,000 healthcare organizations, which is a lot more than I would have guessed. They must be selling lots of them in other countries since I’m pretty sure their hospital penetration is nowhere near 50% here and even that would only be 3,000.”

    they have penetrated every nook and cranny of the med surg units in my house. stacked up in corners, collecting dust and repair tags, mostly. no keyboard, low resolution, only responds to tethered stylus (ie cant even punch keypad with my pen tip). used mostly by TA for POC and VS documentation. no clinicians use them. and the expensive built in features (biometric and bar code scanner) aren’t even enabled. unbelievably useless POS at 5K a pop. but they are washable in case they ever actually get used…

  3. RE: HIMSS Stage 6. I’m sure HIMSS has HIT in its best interest but has anyone actually read the ISO Standards that HIMSS is purporting as their EMR Staging Model (SM) although I have not seen any reference notation to or credit to ISO Standards ISO/TR 20514: 2005. Health Informatics – electronic health record. http://www.iso.org/iso/iso_catalogue/catalogue_tc/catalogue_detail.htm?csnumber=39525. The key to reaching ISO Stage 7 is the integration of comprehensive Clinical Decision Support modules that HIMSS fails to addresses as essential to reaching HIMSS EMR Nirvana (SM).

    For those of us working stiffs that do not want to PAY FOR VIEW the original ISO technical report, here is a modest overview of the ISO Standards for Shared Electronic Medical Records. (warning PDF)

    BTW – We say Merry Christmas!

  4. Update on Emageon II: Stanford International Bank refused to fund the purchase of Emageon by Stanford’s portfolio company, Health System Solutions. No explanation given for refusal (or inability) to fund the transaction.

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