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Monday Morning Update 2/2/09

January 31, 2009 News 7 Comments

scottwhiteFrom Sam Axe: "Re: Scott & White. I am reasonably certain that GE/IDX is supporting the physician revenue cycle – not the hospital, which remains Siemens Invision. The GE article referenced in the response agrees with that and I believe they are probably accurate in their claims around the physician revenue cycle in academic medical centers." Thanks. I wish the press release had been more clear since both the customer and vendor in this case have separate offerings for inpatients and outpatients.

From Blago: "Re: Big shake-up at GE HCIT. Vishal Wanchoo out as CEO." Not according to Jennifer, a GE spokesperson and Inga’s new BFF, who said, "absolutely not." Inga was tickled, though, that Jennifer knew who she was when she called, even though she had thought Inga was someone I just made up. Now I’m inspired to invent up a huge staff of imaginary people, a seeming force to be reckoned with instead of some guy hunched over a PC for immoderate hours each day. Jade and Mariposa, massage my shoulders as I type, yes?

From Spanky: "Re: stimulus. How are pediatric providers going to get reimbursed for EHR use when they don’t bill Medicare?"


The Google, as our former president called it, became unusable Saturday morning as every search hit falsely triggered the "harmful site" warning, meaning you couldn’t click through to any of them. Above is one of those dastardly malware sites it protected me from.

Tom Daschle, HHS secretary nominee, has what sounds like a minor tax problem: he failed to pay taxes on a car and driver some rich guy loaned him. I’d be more concerned about his taking goodies from rich guys than whether he paid taxes on them, but the Senate doesn’t sound too worried about it. At least Daschle himself isn’t loaded, according to previous Senate reports, although he’s got way more than me.

Misys PLC turns in good six-month numbers: revenue up 22%, profit more than tripled. Pretty darned amazing, especially since it doesn’t include the spinoff of Misys Healthcare. Misys says 55% of its revenues come from healthcare in the US.

Speaking of Allscripts, Allscripts Professional (aka Healthmatics EHR) was CCHIT certified (Ambulatory 08 plus Child Health) just two weeks ago, so that stock board rumor was wrong. An analyst had asked Glen Tullman in the earnings conference call on January 8 about two expiring certifications, apparently thrown off (like me) by the two names, and somebody mistakenly picked up on that.

January’s HIStalk traffic set a new record, up about 40% from a year ago. Thanks for reading.

Listening: The Connells, jangle pop from Raleigh, NC since 1984.


Two Utah hospitals buck the trend and open up new expansions.

I heard from a CIO reader whose hospital, a big place, is 100% CPOE. I said I’d never heard of one doing all oncology and neonatal orders on a general CPOE system, but there’s at least that one. I agreed not to provide specifics, but I’ve asked for more information since I know many of us would like to know how they did it.

Who knew? The owner of ambulatory EMR vendor Purkinje, according to their site, is the famous VC billionaire John Doerr, backer of Compaq, Netscape, Sun, Amazon, Google, and others. His brother is the CMO and chairman of the executive board. John Doerr put $10 million into the company in 2007. The logo on the site now says GenesysMD even though the Purkinje name is used otherwise, so the company name appears to be changing (just confirmed with Margalit, the company’s product management director, who’s like me and working on the computer at 11:30 at night). Their deal: $399 per provider per month for software, unlimited support, hosting, interfaces, all clinical content (CPT, ICD9, First DataBank, etc.) and free training and implementation for users who sign up in February.

Over on HIStech Report, Inga interviewed John Shagoury of Nuance Communications.


DrM made a year-by-year table of payments and penalties for the House’s stimulus bill that just passed. I inserted it as a graphic above, so click to enlarge.

Hospital and employee information in Japan is exposed on the Internet when an employee copies data from a damaged flash drive to his PC, forgets the file is still there, then fires up his file sharing software at home. That’s happened before in Japan, I seem to vaguely remember. They love that Winny P2P client over there.

Speaking of which, a Computerworld article mentions on the danger of data exposure from peer-to-peer file sharing, citing a study in which a researcher found a document with full data on 9,000 lab patients, 350 mb of data from an anesthesia group, and an 82-field worksheet on 20,000 hospital patients. The last sentence is a little shot: "The range of health care information floating on P2P networks and the variety of sources from which it is being leaked highlight the disorganized and decentralized manner in which health care data is being collected, stored, used and shared, he said."

Here I go and run an interview with Peter Waegemann and he fails to tell me that they’re renaming TEPR to M-Health Conference. HITgeek has an idea: "If TEPR is changing its name, perhaps you could hold a contest or survey for what it should be."

A University of Chicago study finds that 90% of hospitalized patients couldn’t correctly name even one of the doctors taking care of them. Three quarters had no idea and 60% of the rest were wrong. Academic medical centers have a gaggle of people rounding in teams, of course, popping in for a few minutes once or twice a day, so maybe that’s not surprising.


Here’s an example of how insurance has corrupted the whole idea of patient responsibility: an LA Times article marvels that practices using real-time adjudication "can, and sometimes do, ask patients to pay those costs at the time of service." Shocking! Why can’t medical practices be like restaurants, gas stations, and mall stores in just letting people take what they want, walk out, and be billed sometime later to pay whatever amount is convenient? That should be the #1 step in healthcare reform — get patients to understand that healthcare isn’t free just because you have (or once had) an insurance card. The insurance companies escape consumer wrath because it’s the doctor’s office who has to come collecting what they didn’t pay.

The IT department was at fault in the recent PC virus infection in England, incorrectly configuring antivirus software on some PCs and failing to get AV updates to some of them, an outside IT auditor finds.

If you want to know how the HIT industry is doing, forget all those publicly traded companies with a mishmash of products and businesses and look at the software-only company that has the most hospital customers: MEDITECH, which 2,200 hospitals are running today. For FY08: revenue was up just under 6%, but net income dropped 60%, mostly on investments (I hear that). Interesting: CEO Neil Pappalardo and CFO Barbara Manzolillo asked that the Board give them only the same bonuses other employees get and not the special Director bonuses since the company didn’t do very well, reducing their paychecks by 64% and 52%, respectively, over their 2007 comp. Neil’s shares are worth over $500 million even at the internally set share price that the militant shareholders always complain is artificially low.

A WV doctor and former town mayor is ordered to repay an insurance company $180,000 for blood tests and injections that patients never received. The doctor blames his billing staff and software, says he has nothing to do with billing, and that judges discriminated against him. He was nailed in 2007 for underreporting income from 2000-2002, when he also worked as a day trader.

GE Healthcare is following its Burlington layoffs with mandatory unpaid employee furloughs.

Hospital layoffs: Clearfield Hospital (PA), 33; Saint Joseph Medical Center (PA), 40.

Sure to fuel the healthcare debate: is it a good use of healthcare resources to provide expensive fertility treatments and preemie care to an unmarried, apparently unemployed, and bankrupt woman in her 30s and her new octuplets that bring her up to 14 children, all of them conceived through in vitro fertilization? She’s trying to be self-sufficient, though: she wants $2 million and a career as a TV child expert from either Oprah or Good Morning America in return for her story.

I don’t get how magazines think. An article mentions that Philips sold CPACS to a hospital in Saudi Arabia, but the headline in SmartBrief says "Philips strikes a partnership with Saudi Arabian hospital." If that’s the case, I struck a partnership with the local sports bar at lunch today when I bought a very good burger there. Just because salespeople murmur the P word to make prospects comfortable doesn’t mean there’s a legal agreement to share expenses and profits. Anything else is called "a sale." Funny thing is, the article it referenced called it that — SmartBrief added the "partnership" line.

CPSI announces Q4 numbers: revenue up 14%, EPS $0.45 vs. $0.36, falling short of earnings expectations but raising guidance and declaring a dividend.

MEDSEEK announces a 47% increase in contracts and a 33% increase in licenses for 2008, referencing its KLAS 2008 Category Leader status in clinical portals.

California is out of money, so it plans to stop paying bills Sunday. The controller whines that withholding money from Californians will delay economic recovery, blaming everybody except the state itself. CA is $25 billion short for 2009, unemployment is 9.3%, and median home prices are down 50% in less than two years. Like Florida, they weren’t complaining during the boom that benefited them, but can’t accept the idea that the good times have already rolled.

Amanda Adkins, a 34-year-old Cerner executive, is named chairwoman of the Kansas Republican Party. It probably wasn’t a total shock since she was the only candidate.

E-mail me.

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Currently there are "7 comments" on this Article:

  1. re. Daschle:

    Of course the senate isn’t worried about his tax problems…what with him having the golden, get of jail free (D) next to his name.

    And what exactly do you consider “small”? According to this article,


    he owed $146,000. No mention of a car and driver…just all the speeches he made to various health care groups that he didn’t bother to pay taxes on.

    I’m reassured that John Kerry says it’s no big deal, just a simple mistake. I think I’ll make that mistake this year and just not pay. I’m sure Kerry will be in my corner.

  2. Note to MM, you should be thankful any vendors are calling on you! Next time you have a fund raiser you won’t hesitate to call me and ask for a donation to your “special” project, gala, or golf tournament. Last year I spent over $100,000 to support CHIME and pay for your trip to Lake Las Vegas and then listen to you complain to your colleagues during one of the $5,000 coffee breaks about how disgusted you are that one of those “vendors” tried to talk to you about their product or service and had the nerve to try and sell you something. How much did you pay to attend? I’m done! There goes another $100,000 you won’t get. I am paying someone to call you every day for as long as I can afford to….I would rather pay them than give it to you… Unfortunately I will probably see you at HIMSS

  3. Willy Loman Says: “Note to MM, you should be thankful any vendors are calling on you!”

    I am. I appreciate vendors and didn’t mean it as an insult. Only that the number of calls I’ve been getting since the first of the year seems unusually high.

    I will say I am surprised by your response. I sense hostility at the arrangement we find ourselves in vis-a-vis the relationship between healthcare IT vendors and customers.

  4. Nah ….it’s all good. Baseball has been very, very good to me. It’s just interesting how the game is played. We pay people to call you and you pay people to keep us from talking to you. The more we pay the less we talk. The truth is the game is changing and I’m spending more time changing the way we pitch and even more the way you swing. See you at plate!

  5. A better arrangement for customers (me) would be a place I could go to get “information” about products when I need it versus the current situation where vendors “pitch” baseballs (using your methaphor) at customers until they hit one who happens to be looking for that product at that time.

    But there is big money to be made for the “best” pitchers. And the process works. It may not be the most efficient process but powerful forces keep it from changing.

    Very interesting discussion. I appreciate talking over the fence every once in a while. Maybe because I used to play ball on your side years back.

  6. I just thought of an analogy of our discussion to present day events.

    Can you think of another industry that offered outsized payoffs to the “best” pitchers; and the outcome of that practice? Hint: think money and a street with a wall. 🙂

    It turns out the “best” pitchers will do anything to land the prize; including jeopardizing the very company that offers the prize.

  7. “I heard from a CIO reader whose hospital, a big place, is 100% CPOE. I said I’d never heard of one doing all oncology and neonatal orders on a general CPOE system, but there’s at least that one. I agreed not to provide specifics, but I’ve asked for more information since I know many of us would like to know how they did it.”

    I’m pretty sure we do all our orders on CPOE- I haven’t seen paper orders for more than a year. And we’re pretty big.
    Kaiser Permanente

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