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News 3/25/09

March 24, 2009 News 5 Comments

From GoSox: "Re: ONCHIT. Glaser to take six-month post as Blumenthal’s operations guy." John had shared his plans with me earlier, so your rumor report was an excuse to pester him to say something on the record. He did: "I am planning to spend six months at ONC, beginning in early May, as a Special Advisor to ONC. I will retain my position as CIO at Partners and be on loan to ONC. I plan to work with ONC and the field to help develop the programs and plans needed to implement the healthcare IT portion of the Stimulus Bill. There are still some i’s to dot and t’s to cross so this is arrangement is not final. I look forward to the opportunity to work with the Federal Government and all of the healthcare stakeholders."

From Dwarf: "Re: rumors. A former employee says Medhost let 12 people go this week (unverified). Also, at a recent ENA conference, Emergisoft did not man their booth and sales people were allowed in to inquire about new jobs."


From The PACS Designer: "Re: Fugoo. TPD loves digitally connected solutions and now there is another one called Fugoo. This new solution is for a Digitally Connected Appliance or DCA. So, if you want to access your coffee pot to brew java via a wireless network, you add a Fugoo box to a coffee maker that is Fugoo-enabled. Only problem is there are no Fugoo-enabled devices that will be available until the holiday season later this year!" Link.

From CYA: "Re: escrow agreements. CIOs need to review their software escrow agreements (and review the whole contract while you are at it). Worried about a vendor? Pull the contract right now. It is prudent to demand a statement of financial viability. If you cannot get such a statement from a vendor, you will at least have on file that you requested it and were thinking proactively. Your CFO may need proof of your request in the event of an issue arising. This is simple CYA work that one health system is requiring as a result of a recent failed vendor and the fallout that ensued. Remember the old adage ‘no one gets fired for choosing IBM’. There are bound to be a few mid-and small-tier vendors that do not survive in this economy. Ask your account manager if there have been layoffs at their firm. If the answer is yes, dig deeper. Build a contact list of other client facilities (CIOs) in the event you need to learn how other IDNs are handling the issue of a closed vendor. If you enforced an escrow agreement in your contract, build in contingency plans for execution of this escrow NOW for vendors that may be on the rocks. In most situations, the language for these escrow agreements is boilerplate fodder without much in the way of specific step-by-step procedures. Ask yourself if you truly have the staff to maintain a system if a vendor closes (even if you do have the escrow). Once a vendor starts cutting staff (intel), it is too late to make an escrow agreement have any value in terms of how you actually implement what has been escrowed … you only become ESCREWED. Additionally, make certain you obtain the PERSONAL contact information for key IT personnel at your vendors. The vendor will not provide this, so ask these personnel (those you know) for it directly. If personnel are let go from a vendor due to layoffs, those personnel become your assets during a product transition wait period. If there are any others that have experience (pro and con) with the escrow process when a vendor has closed its doors, please chime in. Hopefully you do not experience this, but given the economy you need to make this often overlooked CYA process a top priority in your IT department."

From Pat Patterson: "Re: Carilion losing money. Holy mismanagement, Batman! This the same company that was profiled in the Wall Street Journal recently as a near monopoly. In their profile, WSJ showed how the Roanoke region’s insurance costs went from lowest to highest during Carilion’s domination and subsequent raising of rates."

From HIT Insider: "Re: Sutter. It’s my understanding that many of the hospitals are not planning on switching to Epic due to the high costs, and will stick with the original vendor. I think Eclipsys has a few clients in the Sutter Health universe. Not sure who else."

From Dock of the Bay: "Re: Sutter. I am not at all surprised. As an outside M developer, I was amazed at the costs involved. Almost reminded me of the TARP bailouts. The money never seemed to stop. The second thing that made a big impression on me was Epic and their lack of interest in working with outside developers. I’m not sure if they wanted all the money for themselves, but it made for difficulties when trying to support the project. As a fan of open source software, I think I would have been inclined to go with VistA (VA) and develop it for user needs and requirements. The cost of the basic software is certainly not an issue. Free!"

Monitor 3 reported over the weekend that Joe DeSilva, CEO of EDIS vendor Emergisoft, had left the company. I e-mailed a contact there for a statement. Newly announced CEO Jordan Davis, a former regional sales VP who took the CEO job Monday, e-mailed me that same day. "Thank you for your inquiry and the opportunity to address recent events. Much has occurred in our industry, and Emergisoft is certainly not immune to the pressures that other healthcare software companies and providers are experiencing. We have recently realigned the company to meet the challenges of our clients, our investors, and the economy. The tough decisions have been made, but they are now behind us, and they were designed to grow the company, not shrink it. Our realignment has strengthened the chief executive position, bolstered our financial structure, and positioned Emergisoft to efficiently deliver our CCHIT-Certified ER solution to our clients and to the market. Our commitment to superior client satisfaction is the primary driver in all we do, and that will continue. I look forward to meeting you at the HIStalk reception. See you at HIMSS, booth #8051." I admire that, actually, jumping right in there with a personal and straightforward e-mail, pitching the booth number, and mentioning the reception. I’m sure he would be happy to say hello if you’re inclined to drop by the booth.

QuadraMed President and CEO Keith Hagen steps down for personal reasons, replaced in the interim by James Peebles, a company director and industry long-timer. His stated goals are to increase R&D, get QCPR certified by CCHIT, and to increase shareholder value. A national search is underway for a permanent CEO. Also announced: CFO/SVP David Piazza will take on additional responsibility as COO.

An OB-GYN sues a Utah hospital, claiming the CEO forced him out and that nurses falsified charts to make him look bad. He also claims he dictated a chart note that contradicted the nurse’s fraudulent changes, but the hospital deleted it from the EMR. The HIPAA audit trail should prove it one way or another, and surely the hospital won’t publicly claim that its systems don’t have one.


Penn researcher Ross Koppel’s new JAMA article concludes that healthcare IT vendors enjoy contractual and legal protections that keep them out of trouble even when their products cause patient harm.  Anyone who has signed a vendor contract from either side of the table knows that vendors disclaim most responsibility, saying it’s the licensed user’s job to notice software or hardware errors and prevent them from harming patients (like when an allergy warning doesn’t display or a dose is calculated incorrectly). HIMSS unleashed a vindictive and wildly pro-vendor barrage against Ross in 2005 for daring to write an article describing patient harm that occurred with a hospital’s IT implementation, but I expect they’ve got bigger, multi-billion dollar fish to fry this time.

Listening: American Hi-Fi, excellent and refreshing pop-punk with highly melodic guitars, somewhere between the Pixies and Cheap Trick. My head’s tired from bobbing. Kind of like when Mrs. HIStalk sat me through the Mama Mia DVD last week, a truly horrible non-movie with no plot, no singers, and no problem keeping my attention because I really like ABBA music despite all the theatrical distractions (Slipping Through my Fingers and Waterloo were always my favorites, so now they are re-stuck in my head after decades because Bjorn and Benny are genius songwriters).

Ricky Roma’s piece drew some fun interest, as I expected. I hope his cheek is OK from having his tongue jammed in there for all that time. Agree with him or not, he’ll make you think.


Irritated sent over an internal sales memo from his or her big vendor employer, part rah-rah and part carefully cushioned reorg news. I’ve never worked in sales, but every announcement I’ve read says the same thing, so the vendor here makes little difference: we’re doing great but we have to cross the goal at the end of the quarter, we have to get at every deal table and fight for market share, we need to be more agile and show more knowledge in the sales process, we will move to regional sales teams with specialty team backup, and we must reduce sales cost by cutting duplication. The same thing everyone else is doing, in other words. They should bring in Ricky Roma.

GetWellNetwork adds two pediatric content suites to its PatientLife System, some of the eventual 160 educational titles that KidsHealth (part of Nemours) will create for PatientLife.

The folks at Clinical Architecture, who do clinical content and decision support consulting for vendors, are offering a free 15-minute consulting session at HIMSS. 

You may have noticed the cool magazine-style layouts that we make available as part of HIStech Report (like this PDF). A freelancer does these for me and he’s looking for more print publication and layout work. If you’re interested, let me know and I’ll connect you with him.

UpToDate clarified their subscription options for patients seeking evidence-based health information. Some topics are available via free online access, but the full version is available at $19.95 for a week or $44.95 for a month.

E-mail me.

HERtalk by Inga

California’s attorney general files a civil lawsuit against seven private medical laboratories, claiming they defrauded Medi-Cal of at least $100 million by regularly overcharging the state for tests by up to 400%.

Shands HealthCare (FL) selects Micromedex CareNotes System from Thomson Reuters to improve patient education across its eight hospitals.

Demand for drug and alcohol rehab centers is on the rise as the global economic crisis grows, with current or former financial professionals making up a good bit of the volume.

st mary michigan

St. Mary’s Hospital of Michigan activates Eclipsys Sunrise Pharmacy in an on-time, under-budget project. 

Martin Memorial Health Systems (FL) adopts TractManager’s Conflict of Interest Disclosure Statement system to capture and track disclosures of board members, committee members, and physicians. Sounds like something our new administrator might want to look into.

Jackson Memorial Hospital (FL) notifies the public that a disk drive that contained the driver’s license information of 200,000 visits was stolen earlier this month. Authorities believe the theft target was the disk drive rather than the data (how do they know?)

PatientKeeper announces that its client base doubled in 2008 to over 30,000 users from new customers and expanded installations, triggering a 40% growth in head count and the hiring of two new executives. 

RSNA appoints Mark G. Watson to executive director, the position he has held on an interim basis since September. He’s been an assistant executive director for the last 15 years.

Fremont-Rideout Health Group (CA) selects QuadraMed for its revenue collection process. The three-hospital system is supposedly replacing applications from Allscripts-Misys and 3M Health Care with QuadraMed’s Revenue Cycle and Quantim Health Information Management solutions.

Nuance Communications summarizes the radiology workflow and productivity improvements at three different RadWhere installations.

Physicians Medical Group of Santa Cruz County (CA) implements Elysium Virtual Health Record from Axolotl.

A quick peek at the weather forecast has me convinced that spring has not yet made its way to Chicago. At least my version of spring.

One in five American workers are uninsured, according to a new study, a big jump from the one-in-seven number of the mid-1990s.

IV maker Hospira hopes to save about $150 million by eliminating 10% of its workforce over the next 24 months.


A California HealthCare Foundation report concludes that patient kiosks improve satisfaction by reducing waiting times and offering greater privacy and convenience, but less than 10% of hospitals have implemented them.

HIT vendors are experiencing above-market stock performance since President Obama’s election. Investors believe that the government’s economic stimulus plan will benefit companies such as athenahealth, NextGen, Cerner, and Allscripts.

Cleveland Clinic selects Infolinx WEB by Infolinx System Solutions for the tracking of study-related patient files. The solution includes RFID capabilities to manage paper records.

E-mail Inga.

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Currently there are "5 comments" on this Article:

  1. One foot in Partners, one foot in ONC? That gives at least the appearance of a conflict of interest. I sure wish my organization’s CIO could get such quality face time with Blumenthal.

  2. A while back someone wrote in singing praises of the recent Epic Resolute, Cadence etc deployment at Cedars Sinai in Beverly Hills. If this project was such a success … why have they gotten rid of most consultants/contractors that were there and are now on a mission to locate all new consultants? All new consultants will be coming in under Deloitte? That does not sound or look like a success. What project can be called a success if they are looking for almost total project resource over haul? Not one that I have ever heard of.

  3. Escrow agreements…good luck Mr. CYA.
    It’s maybe comforting to have an escrow agreement but the reality is they are not worth the paper they are written on. Here’s why.

    When a software company goes belly-up the only real asset they have is the software and the client base. Meanwhile, bankruptcy judges sit at the right hand of GOD. In one quick motion they can cancel ALL existing contracts or freeze them. Their main focus is to preserve all assets for possible satisfaction of creditors, and you bet the creditors will ask that the software be held back from any distribution. That means good-bye base contract and its escrow clause. Look at what the bankruptcy court has done for airlines – bye-bye labor contracts etc. (they could do the same for GM & Chrysler…but that’s for another blog).

    And by the way, even if you make sure the code is off site in the hands of an independent third party (escrow agent) the judge still can freeze it. Maybe if you ‘get wind’ the bankruptcy is coming you could try to get the code from the third party early…but the judge will make you give it back. Just like anyone that is paid by the company within the last 90 days of bankruptcy filing can be told to give the money back to the debtor. Having been both a vendor, and a buyer I’ve seen it happen.

  4. In the NEJM Blumenthal writes “The HIT components of the stimulus package — collectively labeled HITECH in the law — reflect a shared conviction among the fledgling Obama administration, the Congress, and many health care experts that electronic information systems are essential to improving the health and health care of Americans.”

    I would really like to see some comparative effectiveness research and/or robust studies that support this “conviction”, and that refute a growing body of literature that provide contrary evidence.

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