Monday Morning Update 9/21/09

From Carpluv: “Re: CCR. It has been reported that a group in Wisconsin has actually tested and exchanged CCR record from a different ambulatory EHR system. This is big news since hospitals tell doctors they have no interoperability unless they work through them. CCR and CCD are part of CCHIT certification and are certainly a component of future HIEs, but nobody really did it until this week. This reduces the drama and cost of interfaces on both sides and plays well in the small physician market.”

From Clint Gristwood: “Re: Epic. I consulted a friend and Epic employee when considering a job there. According to him, turnover is extremely high. In his trainee class of 20, only five or six were left standing after a few months. Responsibility and workload constantly accrue, and those who are struggling will only get buried. Most of the people who fail try moving into consulting or return to school for graduate studies. As far as the employment contracts, Epic cannot legally enforce them, but will try other tactics. One trick they pull is threatening to not work clients who poach Epic’s human capital. This puts a steep price on employers picking up talent out of contract.”

From Eli Cummings: “Re: Emdeon. I believe the stock analyst’s sour note on Emdeon should be taken with a grain of salt. Emdeon has a solid core transactions processing business that is unlikely to see an erosion of its recurring revenue anytime soon. This analyst previously worked at Leerink Swann, where he gained notoriety for making outlandishly bearish calls on healthcare IT companies. eResearch’s stock was devastated by a report of his, even though the thesis has yet to play out in fundamentals. Perhaps the fact that this analyst was one of only two analysts covering that company had to do with its precipitous decline. He launched a similar assault on Computer Programs & Systems (CPSI) with an Underperform rating, albeit less successful. After leaving Leerink, Bret Jones resurfaced at Brean Murray, completely turning around his opinion by launching with an Outperform on CPSI. Some stock analysts will go out of their way to craft outrageous statements if it gets them the limelight.”

From Rex Wife: “Re: smart phone software. Do you have a good list of healthcare software for the iPhone? It’s too hard to find the good stuff in the apps store.” No, but I could start one. Good idea or not?

I asked in my previous poll how much influence Dell will have now that it’s jumping into the practice EMR fray. Not much, according to readers: 62% said none and 31% said a little. New poll to your right: we keep talking about vendors as employers, so if you had an equivalent job offer from the ones listed, which would you choose?

Those computer programs that crunch through long lists of kidney donors and would-be recipients to find compatible pairs are very cool, making it possible for family members to get a transplant for a loved one even when their blood types are incompatible. University of Michigan announces that it has developed its own organ matching software. Profiled are two husbands whose tissue incompatibilities precluded donating a kidney to their respective wives, but the program matched them so they could donate to each other’s wives. Confusing, which is why it takes major software to sort it out when dealing with thousands of people and infinite possibilities.

Speaking of transplants, here’s a sad tale of family bickering: a man accepts $37,500 from his leukemic brother to donate bone marrow to him, but then backs out and says he’s too sick, claiming the money was a loan. In a statement to the newspaper, he said, “I did not make David ill, and I am not to blame for his illness” and suggested his brother find a donor registry or hit up their other brother. His brother responds, “If he knew he had this Wizard of Oz disease, this magical disease that he won’t disclose to anybody, then why did he take the money? And to say I loaned him the money, then, gee, it’s a coincidence that he needed money and I needed a transplant".”

Welcome aboard to new HIStalk Platinum Sponsor Apelon of Ridgefield, CT. The international clinical informatics company focuses on data standardization and interoperability. Its computer scientists, informaticians, and clinicians are involved with projects involving Mayo, CDC, NLM, Stanford, and many others. The company is heavily involved with deploying and maintaining terminology and vocabulary such as SNOMED CT, UMLS, RxNorm, ICD-9 and ICD-10, also working with US Cancer Institute, VA, FDA, NIST, ONC, the Social Security Administration, and Canada Health Infoway. All the work involving EMR deployment, interoperability, and data mining will require stringent deployment of expertly designed terminologies, so I’m sure their phone is ringing a lot these days. All that plus it’s their tenth birthday this month. Thanks to Apelon for supporting HIStalk and the people who read it.

The CIO of two hospitals in London is named in a whistleblower’s complaint for hiring a former colleague to do $3 million worth of no-bid consulting over six years. An internal auditor concluded, “The arrangement — and in particular, the dollars involved — begs the question as to whether LHSC should just be hiring TV (Tom Vlasic) as an employee, and stop paying the exorbitant per diem rates of a consultant. An in-house solution would most likely be more economical.” Nobody’s claiming the work was subpar, so at least the money wasn’t wasted. Also in question is whether the hospital should be working on regional integration projects (observations from the audit are above).

An LA Times article covering California’s 12.2% unemployment rate mentions a hospital IT guy who lost his job eight months ago. Shown are union members picketing Toyota for daring shut down their plant, which is full of all kinds of irony. Maybe we’ll all learn lessons about not getting too complacent about being someone else’s employee since it’s a voluntary arrangement both ways. Personally, I wish more people would hang out their own shingles instead of just looking for someone else to pay them since the idea of working for yourself is just as foreign (no pun intended) as paying your own medical bills. Small business is usually what keeps the economy moving, not multi-national corporations.

A VA inspector’s report finds that the Hampton VA Medical Center misdiagnosed a man’s stroke that left him permanently disabled. The former paramedic told the ED clerk that he was having a stroke and presented with classic symptoms, but was sent home. Also noted was that another patient’s lab result had been posted to his EMR, leading to the incorrect assessment that his labs were OK. The doctor, whose contract was not renewed, had copied and pasted results from another patient.

I interviewed Justin Barnes and Mark Segal, the chairman and vice chairman of the HIMSS Electronic Health Record Association, on HIStalk Practice.

I don’t think I’ve heard of Accretive Health, but a reader says their primitive and information-devoid Web site hides a powerhouse revenue cycle company. I found this Crain’s Chicago Business article (warning: PDF) on CEO Mary Tolan, who sounds like a fireball (the “happy, confident capitalist” fires the bottom 10% of company employees, or as she says, “invites them to their next career chapter that is not us”). It’s a $250 million company with former Secretary of State George Shultz on the board. Gearing up for an IPO, so I’ve heard.

Weird News Andy loves this, proclaiming “I’ve heard of inhaling your food, but your utensils, too?” A man puzzled by months of coughing spells and lack of energy sees several doctors who eventually figure out there’s something stuck in his lung. One offers to remove the lung, but he fortunately he seeks more opinions. Turns out he had a one-inch chunk of a Wendy’s spoon stuck there, apparently inhaled as he gulped down a drink. The doctor summarizes: “We’re looking at it and realizing that there are letters on it … We started reading out loud, ‘A-M-B-U-R-G-E-R,’ and realized it spelled, ‘hamburgers.’ Everybody was shocked. We had no clue why something that said, ‘hamburgers’ would be in someone’s lung." The patient is doing great, saying he can get around and breathe again.

Andy also noticed that two Central Florida hospitals have put up electronic billboards showing their ED wait times, updated every half hour.

Former Healthlink/IBM VP Stacey Empson joins Courtyard Group (or Couryard Group, if you believe the misspelled headline) as partner.

Two Johns Hopkins cardiologists write a Washington Post editorial extolling VistA as a cheaper, more effective practice solution that is “much more user-friendly than its counterparts.”

Boston Medical Center, a safety net hospital on such shaky financial ground that it could be closed, pays its retiring CEO $3.5 million on top of her $1.3 million salary.

Speaking of Hopkins, JHMI, MedStar, UMMS, and Erickson Retirement Communities are mentioned as the organizations behind Chesapeake Regional Information System for our Patients (CRISP), which is hopefully better at creating an HIE than it is at brute-forcing a cute and irrelevant acronym out of the uncooperative name it also chose. It’s getting $10 million in Maryland money to get going. Also mentioned is Baltimore vendor Salar Inc., which sells documentation and charge capture applications.

Former Cardinal Health marketing director Laura Bellon is named VP of healthcare solutions and strategy of Perceptive Software, makers of the ImageNow document management system.

Anesthesia systems vendor DocuSys raises $9 million in financing. It also says business has slowed and its plans to add 300 Atlanta-based employees to its current 55 have been postponed.

Allscripts shares hit a 52-week high on rumors it has signed a $20 million contract with North Shore Long Island Jewish Hospital. Market cap is at $2.69 billion, more than double that of Eclipsys and nearly half that of Cerner. Share price has nearly quadrupled in a near, so like all other investments you didn’t make, it was a natural.

Perot Systems gets its first international outsourcing deal, winning a 10-year contract with India’s Max Healthcare hospital chain worth $18 million. Perot will also deploy VistA there.

Someone goofs at Great Ormond Street Hospital in London, e-mailing detailed patient care complaints from the family of a teenager who died there to the local newspaper by mistake. It’s the usual story – the employee was trying to send an e-mail to someone by name, but instead got someone else with a similar name, in this case a newspaper reporter. The paper, showing restraint that would be surprising here, alerted the hospital and declined to disclose details about the information.

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