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July 7, 2009 News 13 Comments


From The PACS Designer: “Re: Palm Pre. Since the Palm Pre has employed its own Web operating system called the Palm webOS, TPD thought it would be good to give HIStalkers information on this new application. O’Reilly Media has posted the first chapter of a new book to the web on the Palm webOS covers some of the basics for this new system.”


From VSM: “Re: HITECH lawsuit. The supposed nurse (could not find evidence of license) who has filed a suit against Obama and HHS Secretary for HIPAA privacy violations due to HHS requiring EHRs has a history of legal issues. Her husband is a plaintiff’s attorney. See the court documents on their bankruptcy filing.” She’s licensed, according to the New Hampshire nursing database, and I don’t think her previous suits are relevant. It will be tough to prove her claim (warning: PDF) that HITECH is illegal because it forces disclosure of medical information from patients not on either Medicaid or Medicare. The suit’s claims wander all over the place, reading like a wacked out conspiracy theory rather than a serious challenge and making it less viable, I suspect.

From Joy: “Re: poll showing most readers don’t think providers are resisting IT to hide their profits. Isn’t this group of HIStalk readers already biased as medical and hospital informaticians?” Yes. But, we know the real reason hospitals aren’t adopting IT: they aren’t all that competent and confident about it. Still, when it comes to connecting to the outside world, I would guess that a fair number of practices and hospitals would be worried about outsiders seeing information like how much they charge and how much they make.

Listening: 10-year-old Britpop from The Charlatans.

Some calling himself or herself THR-IS Staffer left a scathing comment on Ferdinand Velasco’s interview that I deleted. It was curious for three reasons: (a) it was the only negative comment posted; (b) it was quite nasty and personal; and (c) the electronic footprints indicate that it actually came from someone inside arch-competitor Baylor Health. I like catching would-be scammers in the act, which I believe I just did.

SRSsoft bags another customer willing to drop their CCHIT-certified EMR in favor of the SRS hybrid EMR. Southeastern Orthopedic Center thought they were good to go with regard to HITECH, but says, “The CCHIT EMR we had purchased would have placed overwhelming demands on our physicians and resulted in a significant loss of productivity, even if we had overcome the initial implementation hurdles.”

A nurse poll finds that 50% would not want relatives receiving care at their workplace, 72% think staffing on their unit is inadequate, and 53% are considering leaving their jobs, most often because of staffing problems.

Emdeon, gearing up for its IPO, acquires claims processor eRX Network LLC.

sms phonelist

Vince Ciotti is arranging a November get-together of former SMS’ers to celebrate the 40th anniversary of the company’s founding. The shindig is aimed at those who worked in King of Prussia in the 1970s, but Vince says the Malvernians who don’t mind listening to “what I did in the big war” stories are invited as well. Full details, including some cool old customer newsletter scans, phone lists, etc.

Bill O’Toole will have to explain this healthcare-related lawsuit product to me since I don’t understand it even after reading the press release and the Web site (and unless “subrogration” is in your lexicon, you won’t understand it either). It seems to be related to insurance companies being able to find out which policyholders are planning to sue providers and to get their attorney contact information. I’m sure the people who might use it would understand the description, so this is my gift to all of those folks reading.

A study of VA data finds that abnormal CT findings are often recorded in the EMR a long time afterward, if at all.

Detroit Medical Center connects to an HIE whose bizarre, contrived, and entirely forgettable name could have only come from a committee of clueless marketing people: my1HIE(R). I’m including the provided italicization to make sure you see just how weird it looks in print. Maybe it’s the same perky, brand-obsessed bunch who decided that GE-owned The Sci Fi Channel would be much more of a hot property if it “relaunched” itself as Syfy. This quote from the Syfy (gag) president should really wow its entirely geeky audience: “We really do want to own the imagination space … It made us feel much cooler, much more cutting-edge, much more hip, which was kind of bang-on what we wanted to achieve communication-wise.” They’re even mimicking GE’s “healthymagination” assault on grammar, coming up with the radical variant “Imagine Greater”, which it says is “a call to action … an aspirational, optimistic message about enhancing people’s lives.” That’s asking a lot from ancient reruns of Battlestar Galactica and Mork and Mindy.

I don’t have the records to look it up, but I wonder if Barry Chaiken is the first HIMSS board chair who works on the vendor side of the fence instead for a non-profit hospital? I’m not sure how I feel about that.

Kaiser’s Health Care Innovation Center in the San Francisco area gets a mention in the Fort Wayne paper for some reason. I think someone invited me there once, so maybe I’ll check it out one of these days.


Another use of Twitter: selling “medicinal marijuana”, including home delivery (driver tips are appreciated).

In the UK, the conservative party says they would dump NHS’s Connecting for Health and replace it with HealthVault, Google Health, or other online services. “This is an agenda we are massively keen on. We’re thinking about how in government the architecture of technology needs to change, with people ‘owning’ their own data, including their health records.”

A reporter in the Philippines says the government there is monitoring his activities after he wrote a newspaper story last week claiming that the country’s female president had breast implant repair surgery.

Merge Healthcare announces preliminary Q2 numbers: revenue up 13%, net income less than $1 million vs. $2.8 million, all complicated by its pending offer to buy etrials and the sale of its equity interest in Eklin Medical Systems.

A former Red Hat VP launches the Axial Project, which will be some kind of open source clinical information delivery system. I’m not seeing any healthcare background among the principals, so we’ll see what they come up with.

Researchers from Carnegie Mellon University (misspelled in the article) have figured out how to guess the Social Security number of people born after 1988, sending their method to the Social Security people with the suggestion that maybe they ought to start randomizing the numbers. A Social Security guy pooh-poohed the findings, saying that the code-cracking suggestion is “a dramatic exaggeration,” but simultaneously admitting that  Social Security numbers will be randomly assigned starting next year.

Sunquest names Patrice Nedelec, previously with AMICAS, as VP of Quality and Regulatory Affairs.

A Canadian woman gets a $3 million jury award for a 1999 incident in which she sat on a hospital chair that collapsed under her, causing her no physical injury except claimed fibromyalgia, an ongoing pain whose diagnosis is entirely based on what the patient says they feel.

E-mail me.

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Currently there are "13 comments" on this Article:

  1. Funny story about Southeastern Orthopedics – the group purchased the previous EMR solution the day after a poor earnings report – got a pretty aggressive discount as well. Why anyone would buy the previous product on any day besides the last day of a quarter is beyond me (although the next best day would be after earnings).

  2. Um…technically speaking, providers seeing how much other providers charge is a trade restraint violation and, even when it’s not, most providers think it is. Most of the docs I know would *love* to know what other providers charge, they’re just afraid to do it. Don’t believe me – ask how much providers charge on an MGMA, coding speciality, or Academy mailing list and watch the list owners fly in shutting down the conversation.

    I cannot think of a SINGLE PHYSICIAN (and, like many here, I know 100s and 100s) who is afraid of I/T because of profit exposure. Instead, almost unanimously, they are afraid that EHRs are a waste of time and will kill their productivity…even those who have EHRs feel that way.

    The notion that docs avoid I/T because of profit exposure seems patently absurd.

  3. > Um…technically speaking, providers seeing how much other
    > providers charge is a trade restraint violation and, even when
    > it’s not, most providers think it is.

    How much sense does that make? I’ll bet K-Mart and WallMart both know how much each other charge for a 12 pack of pencils.. And I can call any mechanic in town and find out what a tune up will cost. It’s called competition and it’s the main force that keeps prices down in the capitalist system. Oops, what an I saying…

  4. Frank Marino says “technically speaking, providers seeing how much other providers charge is a trade restraint violation…”

    Docs can’t know how much another doc charges because it’s a trade restraint violation? If that’s true, wouldn’t this mean airlines are prohibited from looking at the advertised prices of their competitors?

    I think you’re wrong… MDs can know how much others charge, MDs are allowed to advertise prices if they want to. The trade restraint rule is that competing MDs aren’t allowed to fix prices in collusion. If MDs have the same prices, like many airlines do for the same route (even if you connect in different cities), that’s OK as long as they didn’t agree to have the same price.

    I’m not an expert in healthcare pricing, but I did stay at a Holiday Inn Express last night…

  5. Sigh.

    Really? and Homer Simpson need to familiarize themselves with the specific FTC protection that insurance companies have regarding physician pricing under the Sherman Anti-Trust Act. *Physicians are treated completely differently from airlines and hotels and supermarkets etc. It’s a fundamental flaw in our “free market” medical system*

    Yes, the law is designed to keep MDs from colluding, but even a discussion of prices among physicians is considered a no-no – ask any healthcare lawyer! There are specific rules regarding physician charge data (must have more than 5 samples, must be data older than 3 months, no individual practice can be identified, must be completed by a third party, etc., etc.).

    We all know that docs know what other practices charge to an extent and the rules are silly. But call up your healthcare lawyer and ask if it’s OK if you share fee schedules among a small group of docs. See what you get told. I know what *I* was told (and what I read).

    Or, do as I suggest: drop onto any one of the MGMA mailing lists and start a discussion asking people to share prices and see what the MGMA says. Or any one of the coding lists. It’s a weekly occurrence.

    [Note: most physician/insurance agreements also disallow them from sharing fee information as well. There was a standard UHC contract going around last year that would *penalize* physicians up to $50K each, if I remember, for sharing fee schedules with anyone outside of the practice, period. Including consultants. It was a BS agreement and not many signed it, but there it is.]

  6. I seriously almost stopped coming here after I saw that survey, it seemed so ridiculous, but the comment today made me realize that there are people who actually believe that medicine is a highly profitable business. It may be for some people, and I know a couple who do pretty well (all surgeons), but I can tell you that most of the doctors I talk to, and every hospital I know of are running on pretty razor-thin margins, if not in the red on a regular basis. Not that anybody is starving, but nobody would be terrified that somebody would find out “how profitable they are”. If anything, it would shock people, but because they are so not profitable.

    Everybody commenting on the health care reform saying that they need to cut back on how much hospitals and physicians get paid as the “cure” instantly loses credibility in the debate because they didn’t learn anything from the HMO heydays, and don’t have any awareness of what’s going on right now in healthcare.

  7. Well, it’s a fine line between mystery shopping to discover competitors’ pricing (legal) and colluding with competitors to set a price (illegal). So circulating a price sheet to your competitors is probably more illegal than legal, whereas asking someone what they paid on their last doctors visit is ok.

  8. House’s comment is along the lines of what I meant. I understood Frank Marino to say that MDs are not allowed to know what others charge. I believe they’re allowed to know, it’s just a matter of how they learn it. If they learn it from a MD’s advertisements (which an MD can do), that’s fine. If price lists are being emailed to one another, that’s potentially collusion.

    The airlines don’t send their price lists to each other, but airlines share their prices publically and other airlines use the data that way. I think it is no different for MDs.

  9. Product and company names like “my1HIE(R)” and “syfy” give marketing professionals a bad name. I’ll bet those came from C-level execs, most of whom in my experience think marketing is simple and too costly so try to do it themselves. Just got off a call with a CEO who introduced the word (?!) “gravativity” to the lexicon. Apparently, opportunity for my services abound!

  10. Ok so speculation from on online poll as to why Physicians resist HIT, blah. Here is a good reason for Physicians to not resist. Its estimated over the next 5 years Genomic profiles will start playing a huge part in healthcare. Many citizens are already purchasing their Genetic profile privately. These profile represent a huge amount of data and don’t change over time. A single test at a young age will be able to be stored in records of a patient. When new research is available it’s not feasible to search your patient population for patients who may respond to proactive treatment in a paper World.

    A study by the House of Lords in England (http://www.publications.parliament.uk/pa/ld200809/ldselect/ldsctech/107/107i.pdf ) has just been completed outlining the role EMR’s will play in this process. The report urges faster uptake to be ready for this sea change in Healthcare strategies.

    2015 and meaningful use, or 2015 and not being able to offer more than “Do you have a family history of…..?”.

  11. Really? [awful user name, as it looks like I’m being sarcastic] – all the docs who advertise their prices – representing, perhaps, a fraction of a percent of the physicians practicing – are all non-insurance. Please, point me to any real, constant display of pricing by physicians taking insurance. It certainly doesn’t exist in the specialities I know.

    Back to the original point: I don’t know a SINGLE PHYSICIAN who fears HIT opening up their books. I’m with DrM on this one.

  12. The Cerner–Sunquest rivalry has now extended to emails threatening their own employees. Unfortunately they have so far achieved but a pale imitation of Neal Patterson’s famous missive. The latest attempt shows promise, but does not go the whole distance of threatening termination.

    “Unless RA/QA has reviewed, approved and certified that the DHF is complete by COB Thursday, July 2, everyone in PD will be expected to be in the office working the 4th of July weekend to complete the DHF.  We would rather work late this evening than work this weekend, so make sure your priorities are in order. Let’s stay focused and complete the task at hand so that we can all enjoy the weekend.”

    As yet, history does not yet record if the product Development staff had a Happy 4th of July or not. Were I one of them, I know how I would feel.

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