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Monday Morning Update 11/9/09

November 7, 2009 News 18 Comments

I decided it was time to update the About page, which answers questions I’m sometimes asked (why did I start HIStalk, why am I anonymous, how I decide what to write about, etc.)


Respondents to my most recent poll have a slight preference for not having the FDA regulate clinical software. That’s pretty close considering that vendors usually have the strongest feeling about that and are likely to click No. New poll to your right: what do you think about a hospital with over $1 billion in revenue paying its CIO over $500K? That’s not a loaded question – I’m just curious. Note: if you’re still seeing the old poll, clear your browser cache. 

HIStalk interviews are highly educational, depending on who I’m interviewing, anyway. If you have someone in mind (and, better yet, if you can hook me up), let me know. The ideal subject: someone who works for a non-profit organization on the front lines of something HIT-related, is doing creative work that the industry could learn from, and comes across as interesting on the telephone since that’s how I do them.

Meditech held its Physician/CIO workshop recently (I assume it was recently, anyway, since the write-up doesn’t say when or where it was held). Paul Egerman was one of the speakers, meaning I would have enjoyed it.

Meditech also just filed its 10-Q. For the quarter, revenue was down 4%, but net income swung from a $27 million loss to a $20 million gain (EPS $0.57 vs. -$0.76), mostly due to investment write-offs last year. Product revenue was down a slightly alarming 16%.

The Chicago Department of Public Health (CDPH) still can’t bill for mental health services because of Cerner problems (the article is in some kind of union publication, but it seems solid). They are using a different system for billing since fixing Cerner remains “an active process.” This conversion says it all. [Alderman]: "You’re saying that after 18 months you’re unable to work out technical glitches that prevent us from billing the state?” [CDPH commissioner]: “That is correct.”


Some nuggets from the just-published 2009 HIMSS Security Survey (thinking ahead to ARRA, since stimulus dollars are tied to privacy and security, not just Meaningful Use): 

  • 61% said information security gets less than 3% of the IT budget, nearly unchanged from 2008.
  • Fewer than half of the organizations have a C-level security officer.
  • 74% have conducted a formal risk analysis, of which 52% found patient data to be at risk. Those problems took longer than six months to correct, said 40%.
  • Most of them collect audit logs (firewall, application, server, intrusion detection, etc.) and review them manually.
  • Electronic data sharing is already big (91%) and about to get bigger (HIEs, other hospitals, PHR vendors, and NHIN led the list), with 41% adding new security controls for that reason.
  • Most used wireless security and electronic signature, with 67% encrypting transmitted data, 60% encrypting e-mail, 44% encrypting stored data, and 39% encrypting mobile device data. Only 29% had single sign-on.
  • A third said their organization had experienced medical identify theft, although most reported no consequences.

From the Eclipsys earnings call: Sunrise 5.5, due out in the first quarter, will have a “more intuitive user interface”; the company is banking on heavy CPOE use by its customers to influence new ARRA-related sales; margin improvement efforts, much of them related to internal procurement costs, will consume $1 million in outside consulting fees each quarter but will pay for itself starting in the second quarter; they will target 600 hospitals of greater than 150 beds that do not have a recent-vintage clinical system; MediNotes / PeakPractice underperformed because it was run as separate businesses; demand for Premise / Patient Flow has slowed; 60% of their sales were to existing customers.

Cardinal spinoff CareFusion sells MediQual Systems (the Atlas clinical database vendor) to quality database vendor Quantros.

Speaking of Cardinal, neither it or CareFusion is doing all that great after the spinoff. Cardinal lost money (EPS -$0.11 vs. $0.69) and CareFusion’s Q1 profit was down 28%. Optimism was expressed.

Wound Management Technologies will buy the healthcare assets of VirtualHealth Technologies for $1 million in cash, 4 million shares, and royalty payments. I’ve written about the latter company before, surely one of the most bizarre business combos around: medical office software and gold mines (insert your own joke here). 


Interesting: Microsoft Research develops the $800 SenseCam, a low-res, wearable camera that takes two pictures per minute. It’s designed to help Alzheimer’s patients by letting them review pictures of their day, which seems to help them remember events long term since Alzheimer’s patients may store memories normally but can’t access them.

Henry Schein CEO Stanley Bergman on EHRs: “Electronic medical records will reduce the cost of health care, errors will be reduced, the quality of health care will go up. We don’t know exactly how long it will take, but it’s going to happen in the next few years. And we are the exclusive distributor for the number one player in this field, Allscripts.”

A Commonwealth Fund survey of primary care doctors finds that the US is way behind in several healthcare categories: access to care, providing financial incentives for healthcare quality, and using IT. Only 29% of practices provide after-hours care (other than the hospital ED). Less than half use electronic medical records, well behind the 90+ percent of several other countries. That’s despite spending twice as much per person as other countries.

Cleveland Clinic launches a site to teach student nurses how to use EMRs.

Some AMA members are upset that the organization’s trustees endorsed the House’s health reform bill without asking its members first (doesn’t HIMSS do that all the time?) Delegates will vote Monday on whether the endorsement should be withdrawn.

TELUS announces availability of its new mobile solution, TELUS MobileCare, for homecare providers.

HCA International wins the 2009 Innovation Award for its use of PatientKeeper Physician Portal.

HHS will award contracts to build out the Nationwide Health Information Network by the end of the year.

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Currently there are "18 comments" on this Article:

  1. AMA members are upset? You should see the MGMA mailing lists – I’ve never seen more activity in my years of reading. The “best” part is that about 75% of the messages are from folks who can’t help but use terms like “Obamacare” or make fun of Nancy Pelosi or use one of “idiot” or “stupid” before the word “liberals” and “Democrats.”

    That’s not to say that the bill is perfect or that I even agree with it, just that there’s quite a bit of Tea Party anger among the MGMA members, too.

  2. The healthcare bill is “Obamacare,” “Pelosiicare,” or “Democratic-only-way-care” last time I saw the latest vote on it. It’s the worse bill to come out of Congress in a long time and will be the reason why the Dems will lose big-time in the 2010 elections.


  3. I commend you, Mr. Histalk, on candid update on who you are. Us poor peons do not have the luxury of time to blog. Consider the fear of retaliation against us that we feel for being a patient advocate when you yourself are fearful.

    I never see where to vote on your polls. It never appears on the computer. Add my vote to having the FDA evaluate CPOE equipmant for safety and efficacy.

    In so doing, the FDA investigation and enforcement sections should launch into the criminal activity associated with deliberate violation of the Food Drug and Cosmetic Act and as others have described, experimenting on patients who undergo the testing of this unapproved equipment without giving consent.

    UCSF should be investigated to determine the number of deaths that were facilitated by mistakes caused by the aborted Centricity installation, and then move to Children’s in Pittsburgh.

    [From Mr. HIStalk] Thanks. The poll is a Javascript snippet, so if you have scripting turned off in your browser, it may not display.

  4. @ Suzie RN – I don’t know where this notion comes from, but UCSF never stated that they were stopping the rollout due to errors or other problems that they saw, only that it wasn’t working out the way they anticipated and they didn’t have faith that it was going to get to where they wanted it to in a reasonable timeframe. Given that their system was GE, that’s not exactly surprising.

  5. @ Suzie RN – The poll shows below the blog for me. Never understand why Mr.H always sez it will be on the right…?

    [From Mr. HIStalk] If you are seeing the poll below the article, then I assume you must (a) have your browser set to less than maximized, or (b) have your screen resolution set low. You should be seeing three columns side by side: sponsor ads, postings, and the column with the poll and links. The right column only wraps if you can’t display the full width as it’s laid out (as far as I know).

  6. Dear “Nudge”

    Tea Party anger? Ok, how ’bout I kick you in the groin, reach in to your pocket, take your wallet, then kick you when you’re down!

    Angry yet?

  7. If IE is crashing on the poll, click the ‘compatibility view’ button. It looks like a torn page next to the address bar. Most likely it will fix it.

  8. RE: “Ok, how ’bout I kick you in the groin…” Ah yes, the state of discourse in America. Why have a meaningful discussion when we can just flame each other? Why talk when we can scream?

    Healthcare is perhaps the largest, but just one of many, challenges facing this country. I don’t worry about the challenges themselves as much as the lack of will to discuss and debate in a meaningful way, without resorting to unconstructive, inflammatory language.

  9. RE : Polls.

    Clearly there is a coverup here. Plese don’t make it look like it’s user error. HISTalk must be regulated as a medical device before more people die.


  10. I have noticed Jack Newman’s name is no longer on Cerner’s leadership. Whagt happened to him?

    Just would like to know.

  11. Suzie RN – thinking the FDA is going to help is quite a stretch. They can’t seem to keep the peanut butter safe, prevent raw sewage from showing up on you salad or keeping unsafe drugs off the market.

    Anyone who’s worked on systems “regulated” by the FDA will tell you it doesn’t do anything to benefit core safety and instead curtails any change to those systems. Including change for the better. If you want to entrench the current status quo, that’s exactly the way to do it. What will happen is that it will lock in the biggest vendors today and that will be all you have for the future.

    You’re clearly on a mission, must have been abused as a healthcare worker, and are actively retaliating for something. The beauty of being anonymous to allow you to hide your history.

    Good set up. Mr HISTalk funds your soapbox to boot.

    Just could benefit by being a bit more thoughtful about what you’re really asking for. That is unless you’re asking on behalf of Cerner or something and know exactly what you’re doing.

    Industry leaders thrive above all others in a highly regulated world and in fact often seek to get more regulation introduced once they become leaders in an effort to shut out start ups through a high cost barrier to entry.

  12. Applause for the Cleveland Clinic’s creative idea, teachinng nurses how to use EMRs. Who is teaching the doctors? If HIT is to undergo suitability evaulation, then let us look forward to the day when there is a Board certification and exam for EMR and POE use as a condition for renewing practice privileges. If not that, institute a proficiency exam for all users…you know, like ask where do you find the orthostatic vital signs.

  13. Hey, ‘love the intellectual discussion..’

    It never ceases to amaze me how ignorant self proclaimed intellectuals can be. The purpose of my post was to make a point, not invite meaningless banter.

    So far, it is still a free country and citizens have the right to express their feelings i.e. tea parties, protests, via whatever means legal.

    Unfortunately, this is a Right the left hates.

    One of the main problems with this whole HC reform thing is that too many limp wristed liberals actually think this is all about HC reform.

    Anytime someone with a spine speaks up…they are labled and accused of ‘unconstructive’ or ‘inflamatory’ remarks.

    Buck up bra!

  14. inotroped Said:
    “Who is teaching the doctors?”

    The nurses will of course. Why upset the balance?

    Seriously though, Nursing Informatics is a mature and recognized body of knowledge, so it makes sense to have all nursing students get exposure to EMR right from the start like this. Contemporary technology makes it simple to connect remotely, so why not?

    Cleveland Clinic Nursing should be commended for being progressive and keeping their nurses from ever being labeled as laggards.

  15. SameOldDistortion Says:

    “Suzie RN – thinking the FDA is going to help is quite a stretch. They can’t seem to keep the peanut butter safe, prevent raw sewage from showing up on you salad or keeping unsafe drugs off the market.”

    Sheer fallacy. FDA actions, while far from perfect, have led to many unsafe medications and medical devices being pulled, for example by FDA official David Graham.

    Sen. Grassley has acted to improve the FDA, e.g., March 2009:

    … Senator Charles Grassley asked the Acting Commissioner of the Food and Drug Administration to clarify the Agency’s position on the rights of employees to communicate with Congress and the Inspector General. Grassley was responding to a memo issued last week that warned FDA employees about releasing information. In the letter, Grassley stated, ““Federal laws protect whistleblowers and allow people who work in the federal bureaucracy to discuss what’s happening inside an agency with other officials.

    SameOldDistortion Also Says:

    “You’re clearly on a mission, must have been abused as a healthcare worker, and are actively retaliating for something. The beauty of being anonymous to allow you to hide your history.”

    The beauty of anonymity also allows SameOldDistortion to hide his/her lack of understanding of medical ethics. I suggest they review the Hippocratic Oath.

  16. Correction:

    The beauty of anonymity also allows SameOldDistortion to proffer his/her lack of understanding of medical ethics, without accountability. I suggest they review the Hippocratic Oath.

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