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Monday Morning Update 11/2/09

October 31, 2009 News 8 Comments


From HISJunkie: “Re: InfoLogix. Looks like they are on their last breath. Never did think this outfit would make it. They always seemed kind of shifty to me — did the Wall Street dance, pumped it up, took it public, made a killing on stock sales … then puff!” The company, which sells an odd lot of healthcare systems ranging from RFID to ERP, defaults on loan covenants requiring it to keep $1.5 million of cash. They were supposed to either raise $12 million or sell themselves by July 31, but missed the deadline. Share price has dropped steadily over the last couple of years, from over $5 to the current $0.18 and a market cap of less than $5 million.

From CK: “Re: Lindsey Jarrell, CIO of BayCare. He was awarded the CHIME-AHA Transformational Leadership Award on Thursday at CHIME’s Fall Conference.”

Jonathan Bush in the athenahealth earnings call, acknowledging that the company is at capacity in its EMR implementations: “.. our Clinicals implementation process still has some vestiges of the early EMR thought that went into building it. EMR is a shitty way to get a practice online. It’s just garbage, and we still have that stock inside of some of our thinking. It’s almost gone … we are getting much more of our thinking oriented towards, ‘This is a clinical information network.’” He answered a question about enterprise deals with a little jab at the big HIT vendors: “We don’t have massive professional golfers on the ground ready to be buddies with these people the way some of our giant competitors do. The athena jet doesn’t fly people into the experience center to have a day of visualizing the software of the future.”


Interpreters at UNC Hospitals (NC) replace their pagers and cell phones with the iPod Touch at half the cost, also rolling out a customized version of their ServiceHub dispatching software to work over WiFi.

British parliament member Richard Bacon gets his answer on how many people actually use NHS’s Lorenzo system in the five early adopter trusts: 174 total, with a peak concurrent user count of 19, according to NPfIT. Bacon’s cost estimate of up to a million pounds per user may not be far off.


Data analysis vendor Initiate Systems (I challenge you to concisely describe what they sell after a quick glance at their Web site, but they’ll always be an EMPI vendor to me) acquires interoperability vendor Accenx. You may recall that Initiate was initially an investment and also a vendor of the CIA (identity intelligence stuff, which was big during the previous administration) and also pulled its $75 million IPO last year.

Weird News Andy, straying from his core competency of weird news, recommends this healthcare series by noted thinker Dr. Thomas Sowell. I like it that Sowell is not only brilliant, but actually writes so you can understand it (unlike the 99% of academics who lapse into obfuscatory journo-babble). “In reality, an injured, deformed, or brain-damaged baby and an eloquent lawyer can lead to jury awards in the millions of dollars, even when it is by no means clear that the doctor who delivered that baby was in any way at fault … It costs a jury nothing to ‘send a message’ warning doctors to be more careful, and the particular doctor in the case at hand probably has insurance from a company that can pay a few million dollars easily out of its billions of dollars in assets.”


The HIT Standards Committee wants to hear about your EHR experiences, good or bad. You can also vote on the submissions of others. “Today, the Health IT Standards Committee within the Department of Health and Human Services will begin an unprecedented effort to get the public’s view on how our work might ‘pull forward’ the benefits of healthcare information technology (IT). Specifically, we’re interested in uncovering new strategies to accelerate the adoption of health IT standards.” Your comments are welcome by November 19, the date on which they will be presented to the committee. 


Results of my CPHIMS poll are above. Apparently, the credential doesn’t hurt but also doesn’t usually help, which is what I would have said. New poll to your right: should clinical software be treated as a medical device under FDA guidelines?


Border unrest escalates between Missouri and Kansas, bitter combatants fighting for the right to pay Cerner hundreds of millions of dollars in incentives to lure its office complex and the pro soccer team that Neal and Cliff own chunks of to their apparently economically desperate states. Right as Cerner was choosing its new BFF state, Missouri hires the commerce secretary of Kansas who was instrumental in putting the Kansas package together. Kansas officials, sustaining mortal wounds in the civic pride area, said that’s was like a baseball player switching teams during the World Series, with one adding, “We thought (Kerr’s) Number 1 goal was to bring jobs to Kansas, but find out now he was working to take his own job to Missouri.”


Doctor complaints about patient safety and an increasing backlog of delinquent charts lead Jefferson Regional Medical Center (PA) to go back to paper for some reports. They’re using Siemens, as evidenced by this cheery article about how swell it was going in 2007. You wouldn’t think chart completion would be such a big deal.

TPD has updated his list of iPhone applications.

A quiz question for you non-newbies, spawned from some random Googling: in what year did these companies first make the Healthcare Informatics Top 100: Per-Se, Applied Healthcare Informatics, Object Products, and Triple G? (hint: it was the same year that these companies were acquired and therefore fell off the list: Phamis, Amisys, Medicode, Medicus, HPR, Bukstel & Halfpenny, SDK, Rothenberg, and HCI).

The Teamsters put out an angry press release against McKesson, which sided with the minority of shareholders in continuing to allow “golden coffin” provisions to be offered without shareholder approval. Those provisions pay a lump sump to heirs when a senior executive dies, $25 to $39 million when John Hammergren meets his maker (in addition to the $80 million his family would get from his retirement plan). “Mr. Hammergren took home $29 million in total realized pay last year alone and has ample opportunities to provide for his estate. We believe shareholders should have a say in whether they’re saddled with payments made without receiving any services in return, and clearly our fellow McKesson shareholders agree.” For the first time ever, I agree with the Teamsters. Hammergren is always in the top ten lists of executives salaries, benefits, and security costs. You would think he founded the company instead of just coming on board eight years ago. Maybe Senator Grassley should look there if he wonders why healthcare is so expensive. But, if MCK shareholders would rather he get the money than them, so be it.


A hospital in Ireland reduces appointment no-shows by 44% by sending patients text message reminders.


Speaking of text messaging, StaffKnex, a nurse scheduling vendor whose product sends text messages about open shifts and schedule changes, raises $1.3 million in funding. The product originally sent only text messages, but it now converts them into voice messages for recipients who don’t like texting. Interesting: recipients can respond to the message (“I’ll work that shift”), the scheduler is alerted to the overtime cost involved, and the request is routed to the supervisor for approval.

A group of California hospitals that includes Stanford, San Francisco General, and two Kaiser facilities says it reduced medication administration errors by 88% by following best practices from the California Nursing Outcomes Coalition. I was hoping to find a list of those practices but struck out.

Patrick Soon-Shiong, the billionaire drug company founder with a keen interest in healthcare technology, offers to back $100 million in loans to reopen MLK-Harbor in LA. He’s on the board of Dossia. I tried to line up an interview awhile back, but he passed.


Charlie McCall’s attorney says he’ll call former HBOC president and CFO Al Bergonzi to the stand. He says Bergonzi, convicted years ago, will back Charlie’s story that all the phony accounting happened without Charlie’s knowledge.

Merge Healthcare’s Q3 numbers: revenue up 16%, EPS -$0.02 vs. $0.01. 

Confidential records of House ethics investigators are made public when a junior staff member working on documents from home accidentally makes them available to his peer-to-peer file sharing application.

Quality Systems’ Q2 numbers: revenue up 22%, EPS $0.41 vs. $0.37, meeting expectations on earnings and exceeding on revenue. ARRA is accelerating PM/EMR sales, the company says. Market cap for the company, including its QSI and NextGen divisions, is at $1.74 billion, of which founder and chairman Sheldon Razin holds over $300 million worth.

Odd lawsuit: drug company Amgen is sued by 14 states for offering doctors kickbacks for using the anemia drug Aranesp. The suit claims that Amgen intentionally added extra overfill to the drug vial as a “free sample” that could be billed to insurers.

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Currently there are "8 comments" on this Article:

  1. Re: NHS Experience

    And yet we rarely hear our “experts” reflect on this experience in all their touting of EHR. During obne of their interviews, you might ask how the US, with a much more varied environment, is going to avoid the same cost overruns and poor utilization.

  2. “Specifically, we’re interested in uncovering new strategies to accelerate the adoption of health IT standards.” Your comments are welcome by November 19, the date on which they will be presented to the committee. ”

    They are closing the gate after the horses ran away. Laughable research. Are they reading this blog and transferring your reports, both good and bad, to their registry?

    The most dangerous components (CPOE and CDS) are neglected by this request for commets.

    The survey does not appear to the right as you state. I do not see the survey.

  3. “I tabled a question yesterday about the number of hospital trusts where Lorenzo has been partially deployed, asking how many users — how many concurrent users — of Lorenzo there are.
    “It is literally just a handful, which means that the cost per user is not what one would expect… the cost is going to be many hundreds of thousands — possibly even more than a million — pounds per user per year.”
    Bacon said there has not been a single deployment of Lorenzo in 2009 because these early adopter trusts were having such problems.
    “The reason is that the handful of deployments attempted have been an absolute mess, causing chaos in the hospitals where they were tried,” he said.
    Deployments of Cerner Millennium have also caused problems, with St Barts in London now facing fines of £400,000 a month for missing patient care targets as a result of problems with the system.
    Bacon also points out that the recently signed contracts with BT to deploy Cerner Millennium at hospitals in the south require BT to be paid even if the hospitals refuse the systems – a possibility if they think they will not work.
    “If the trusts cannot be persuaded to take the systems because they do not work — they will not, of course, if they do not work — the taxpayer will have to pay BT 60 per cent of that £73m for not taking them,” he said.”__from the UK

    Does Commerce Secretary Kerr and the Kansas and Missouri officals know about this? Does the soccer team perform better? Hmmmm.

  4. “British parliament member Richard Bacon gets his answer on how many people actually use NHS’s Lorenzo system in the five early adopter trusts: 174 total, with a peak concurrent user count of 19, according to NPfIT. Bacon’s cost estimate of up to a million pounds per user may not be far off.”

    You must be joking. This has to be the biggest government and IT producer waste, ever. Even $500 toilet seats are cheap by comparison.

    This would be material for standup comedy…except it’s not funny at all when healthcare money is wasted due to foolishness and fraud.

  5. I can’t understand your Marxist outburst Mr H.

    Surely John Hammergen’s wife, kids, grand kids, great grand kids and on have all directly helped in rocketing the McKesson share price back, high high above where it was before the mess that Hammergen came in to clean up. Therefore they must deserve the money!

    (OK so the stock was 27 when he took over and its 60 now. Which is only $5 less than the day they announced the HBOC fraud and only $25 or so less than it was before the HBOC acquisition. SO I guess for $29m a year plus the golden coffin benefit the shareholders might expect a touch more….)

  6. The “golden coffin” benefit for Hammergen is just the tip of the iceberg in the amount of insane and completely ridiculous extra compensation benefits that CEOs receive after THEY LEAVE THE COMPANY. There isn’t remotely a “capitalistic” or free market practice yet where is the moral outrage and anger from both the left and especially the right on this issue?

  7. The Sowell stuff is more of convervative agenda piece, masked as a neutral economic discussion, but using a specific, limited, set of economic arguments. For instance, in the first article he trots out wait times for procedures as a measure of quality, but makes no mention of the multitude of ways our healthcare system is worse in international comparisons, all of which are much more valid measures. In the 2nd section he characterizes all the additional care provided by a gov’t-run program as wasteful, and will probably lead to a drop in services and people gaming the system, but makes no mention of how lack of access kills tens of thousands per year in this country. I guess I shouldn’t be surprised, he’s a very well-known conservative columnist.

    Sadly, he probably has some good points to make on some items, and if he’d had a solid economic discussion without all the misinformation it could have been an interesting read. I’d be especially curious to read an economic discussion about the dynamic of decreasing payment to physicians and the resultant supply/demand impacts on physician shortages, wait times, quality care, etc., but unfortunately I’m not finding that here.

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