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January 12, 2010 News 11 Comments

From rx4change: “Re: dialog. This is a very interesting dialog at the President’s Council of Advisors on Science and Technology two days ago. Atul Gawande and Google CEO Eric Schmidt talk health technology and policy.” Schmidt should have kept his mouth shut, but instead expounded his unoriginal thought that practicing medicine should be a simple as having a doctor type in symptoms and then review the resulting computer list of best practices. Gawande gently sets him straight, mentioning the doctors have 15 minutes to manage six problems instead of plowing through reams of computer-generated junk. The problem with computer people is that when all you have is a hammer, everything looks like a nail. As nice as it would be if patients simply got better because of computer algorithms that matched Symptom A to Government-Approved Treatment B, that doesn’t work. I say let Schmidt find a doctor who practices that way and commit to seeing him or her for the next five years and then report back.


From Computer Historian: “Re: first real microcomputer. This article says the first real microcomputer, three years before the Altair, was built to handle medical records.” That’s pretty cool. The article says the computer was built at Sacramento State University in 1972 specifically to manage medical records. Of course, Meditech had been in business for several years by then, but this refers to an actual PC built expressly for healthcare use. The only surprise is that some hospital isn’t still running it.

From The PACS Designer: “Re: Google Wave.TPD has alerted HIStalkers about the beta called Google Wave. Now, InformationWeek has some interesting comments on what Google Wave is trying to convey to users.” Its major problem seems to be that no one can explain what it is or what problems it solves. I guess it has passed the Peak of Inflated Expectations and moved on to the Trough of Disillusionment.

From Cryovac: “Re: Bill O’Connor. The former McKesson doc who was in charge of clinical sales support is now SVP of marketing at Eclipsys. He was connected with Jay Deady at McKesson, so I am sure McKesson is not happy about his move.”


From Sylvester: “Re: wikibook. Here’s a compendium of wikipedia articles on informatics. The standard textbook is Shortliffe’s Biomedical Informatics. I don’t know how they compare, although this one is favorable on price!”

An insider says that the allegedly upcoming Apple tablet will be aimed at healthcare, not the consumer market. He makes the good point that the Intel C5, the hottest thing at HIMSS a few years back, has been pretty much a dud, now wildly overweight and overpriced. Of course, tablets haven’t exactly lit up the night skies of healthcare either, but Apple wasn’t involved.

I like to report on my personal technology experiments every now and then for you fellow geeks out there. Here are two winners: Dragon Naturally Speaking and SugarSync. I bought DNS Standard for $55 and it is truly amazing, deadly accurate straight out of the box and a very polite application on my modestly powered PC. I’m using it to reply to e-mails since my fingers tend to get tired after the third or fourth hour of typing after a full day doing exactly the same thing at work. SugarSync is an online backup application, of which I had tried Mozy and Carbonite without much satisfaction. SugarSync is fast, easy, and free with up to 2 GB of storage. It’s a real-time backup and has a Web interface that allows you to use or view your files from any PC or mobile device. I recommend both from my limited experience so far.

Allscripts announces Q2 numbers: revenue up 32%, EPS $0.10 vs. -$0.05. Showing how little I know about stock-picking, some analysts were disappointed despite what looked like gangbuster numbers to me. Market cap is at $2.8 billion. The company also announces its EHR certification guarantee, an EHR financing program requiring no payments for the first six months, and a faster implementation program. I also noticed that Glen Tullman mentioned HIStalk in the investor conference call.

Vince Kuraitis has a useful resource list for the proposed Meaningful Use rules.

Speaking of Meaningful Use, I like to think HIStalk is nimble in getting information to you faster. For that reason, I’m proud of Inga’s series on HIStalk Practice in which she connected with several industry executives to get their thoughts on the proposed regulations. She asked our 10 executive collaborators whether the proposed criteria were a surprise and whether they will have problems meeting them in Part 1. In Part 2, we find out what difficulties they expect physicians to have in meeting the proposed requirements. Thanks to our participants.

Our pen pal Janeen Cook, a former RelayHealth marketing VP now at graduate nursing school at Vanderbilt, says she’s torn between using her student discount or her AARP discount to attend HIMSS (funny). She’s doing a little marketing on the side, so that’s her Killer Marketing Collaborators text ad to your right. She’s trying to convince me to let people bid to sponsor her schooling in return for clinician and marketing services afterward. Sounds fun to me.

An internal Kaiser memo says that starting next week, patients will be able to securely e-mail images to their Kaiser doctors, giving patients an alternative to follow-up visits. Suggested uses are for post-operative wounds, lesions, acne, and rash. Their pilot project showed that 90% of received images were useful in making clinical decisions. Smart.

Gerard Livaudais MD, MPH, formerly of Kaiser-Hawaii, is named EVP of product management for Quantros.

Tim Adams, chief investment officer at Constitution Medical Investors, is named SVP and CFO of athenahealth, replacing the recently retired Carl Byers.


Athens Regional Medical Center (GA), chooses Eclipsys PeakPractice PM/EMR.


Cerner’s CareAware iBus receives FDA pre-marketing clearance, making it generally available. It provides data exchange between EMR systems and medical devices.

It’s a Weird News Andy field day. A new blood test finds that 80% of people previously thought to be allergic to peanuts really aren’t. Expectant but absent fathers can see live videos of their unborn child on their iPhone. A British TV show seeks a terminally ill volunteer to be mummified Egyptian style. And a professional singer who hiccupped 20 million times over three years is cured by brain surgery.

The judge in Charlie McCall’s HBOC securities fraud trial freezes his assets and raises his bond to $4 million, uncomfortable with the ease that Charlie could hightail it in his yacht. He also denies the defense a new trial and soothes the concerns of his attorney that Charlie can’t pay him if his assets are frozen. Charlie got off on a solicitation charge in 2006 when the undercover officer’s tape recording was of poor quality. According to statements, he asked the female vice officer about “various options” and offered her $100 to accompany him back to his hotel.

ONCHIT is advertising for a vendor to attempt to re-identify a de-identified database, linking the data elements to individual patients.

Flagstaff Bone and Joint chooses the SRS hybrid EMR.

The National eHealth Collaborative posts its preliminary slate of board candidates for public comment.


The Houston business paper does a writeup on Encore Health Resources, highlighting its growth from 10 employees a year ago to 41 currently with 10 new folks coming on board each month. The company is sponsoring the HIStalk event at HIMSS, which I appreciate. For all the experience Ivo and Dana have in consulting, they have obvious deep domain expertise in the bartender-to-guest metric, as evidenced by their wildly popular reception at the last HIMSS conference. I’m pretty sure a good time will be had by all.

The entire 26-member EMR team at Royal Berkshire Hospital is canned as part of its UPMC implementation partnership. Also in the UK, Charles Gutteridge is appointed as the first national clinical director for informatics.

A New York Times article mentions an upcoming study that concludes that the Danish HIT system is the most efficient in the world, saving doctors 50 minutes per day and the country $120 million per year. They have advantages for that kind of adoption, however: high taxes, free medical care, and different attitudes toward privacy. Not mentioned is the prevailing Scandinavian model of not having healthcare be a rampant playground for greedy capitalist enterprises. You get the feeling that their healthcare isn’t run by MBAs and multimillion dollar CEOs.

MediConnect Global acquires PHR vendor PassportMD.

The state of California establishes the use of open source software as an acceptable practice. The CEO of Red Hat notes that economic conditions are pushing companies to consider open source to offset budget shortfalls.

E-mail me.

HERtalk by Inga

From UB40: “Re: ambulatory physician eligibility for ARRA. I know there has been some fuzziness about MDs who work for hospitals, like pathologists, radiologists, anesthesiologists, ED docs, etc. Obviously, the object of the ruling was that if the EMR was bought and paid for by the hospital and the MD was working exclusively in a hospital setting, then he shouldn’t reap the benefit of the work the hospital did.” UB40 is referring to an upcoming conference call hosted by The Health Management Academy, to discuss the exclusion of “thousands of physicians practicing in hospital-owned ambulatory clinics or facilities, whether or not the physicians are employed by the hospital or health system.” Reading over the latest documents, the wording does indicate that hospital-based EPs are not eligible for the Medicare or Medicaid incentive payments. A hospital-based EP is defined as one who furnishes substantially all (90% or more) of his or her Medicare-covered professional services in a hospital setting  (inpatient and/or outpatient) through the use of the hospital’s facilities and equipment, including the hospital’s qualified EHR. In other words, if a provider performs 90% or more of his/her services under place of service codes 21, 22, or 23, regardless of the provider’s employer, he/she would not be eligible for stimulus funds. The assumption is that a provider providing 90% or more of his/her services in the hospital are not likely to expend significant resources related to EHRs in other, non-hospital settings. OHCHIT is looking for feedback on whether or not this assumption is correct. I admit their assumptions sound reasonable to me.

Rome Memorial Hospital (NY) selects McKesson to provide the software for its $7 million EHR investment. Last month Mr. H mentioned that a Congressman helped the hospital obtain $250,000 to help fund the effort.

Meditech and Zynx Health partner to provide Meditech Magic and C/S customers the Zynx Health portfolio of evidence-based order sets.

cdc ehr

The results of this new EMR usage survey indicate that 43.9% of physicians use an EMR, at least partially. However, only 6.4% utilize the full functionality of their systems. The survey used a self-reporting methodology, so the results may not be the most statistically valid. Regardless, adoption is clearly on the rise.

Thomson Reuters names Raymond Fabius, MD, FAAP, FACPE as chief medical officer of its Healthcare & Science business.

Frimley Park Hospital NHS Foundation Trust goes live with Picis in surgery and critical care.


Bronx Lebanon Hospital Center is now live on Sunrise Emergency Care in it ER and Ambulatory Care at a 40-doctor practice. The hospital plans to deploy the the Ambulatory Care solution to all it 27 outpatient clinics in 2010. Eclipsys also announces that New York Downtown Hospital (NY) is adding Sunrise Acute Care, Pharmacy, and Emergency Care applications.

University Medical Center at Princeton, a 10-year client of QuadraMed’s, plans to offer e-MDs to its affiliated physician practices. I was curious what would happen with the QuadraMed/e-MDs partnership now that QuadraMed is owned by Francisco Partners. Looks like the alliance is not dead yet.

Michael Martens takes over as Mediware’s new CFO. Martens replaces Mark Williams, who announced his retirement last fall. Martens’ previous employers include Euronet Worldwide and Cerner.

Geisinger Health System is implementing RelayHealth’s RevRunner solution for eligibility and benefits verification.

southeast alabama

Southeast Alabama Medical Center selects Wolters Kluwer Health to deploy Provation Order Sets, powered by UpToDate Decision Support. Fort Worth Endoscopy Center also contracts with Wolters Kluwer Health for ProVation MD for procedure documentation and coding and ProVation EHR for patient charting.

CliniComp says four military treatment facilities went live with Essentris inpatient documentation solution during Q4.

Florida Hospital, an eight-location system with 2,188 beds, deploys HealthPort’s release of information technology, alongside Cerner Millennium.

VirtualHealth Technologies announces plans to sell its Secure eHealth messaging division to Wound Management Technologies.

Now that the holiday season is behind us, I’m beginning to feel that pre-HIMSS excitement. I love opening my mailbox each day to discover all the informative junk mail from vendors. Mr. H and I have been so busy lately that we have yet to talk much about details. I am sure he’d like to hire a dozen fake Ingas in low-cut blouses to sashay about the exhibit floor. And for the last three years I’ve asked him to hire a Mr. H look-a-like — that would be someone looking a lot like George Clooney — to provide foot massages. If you have any suggestions on how we can make HIMSS more fun and/or informative, let us know.


E-mail Inga.

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Currently there are "11 comments" on this Article:

  1. Thanks for the link to our Houston Press article. True to the article, we are already at 50 employees as we enter 2010. We are excited about sponsoring the HISTalk event this year, and it is the ultimate compliment to be told you know how to throw a good party…which we do, and will be evident in Atlanta! Can’t wait to see everyone there!

  2. To comment on the issue of hospital-based providers being excluded from meaningful use incentive payments: As I read the rule, independent providers that do not pay for their EMR system because the local hospital provides it via a safe harbor provision remain eligible for incentive payments, while, for instance, faculty practice plans associated with delivery systems often do not. That seems very inconsistent with the principle of “incentive”. After all, this is not being promoted as a “compensation” mechanism, and many here may agree with me that the heavy lifting on the journey is really done by physicians that must adapt their practice to the use of these tools.

  3. Allscripts “stimulus certification guarantee”, like the others I’ve seen, is not much of a guarantee at all … 12 months maintenance … we still have to pay for their overpriced software and implementation. And their “stimulus finance” package is nothing more than what they’ve been offering for years … 6 months delayed payment while interest still accrues. Sounds like a lot more hype than substance …

  4. In response to Sylvester’s comment on the Apple tablet (arguably the most hyped piece of yet-to-be-confirmed hardware ever):

    Given Apple’s recent history, it is likely that the company will be mainly targeting consumers with the Apple Tablet. However, there are some practical applications in hospitals.

    One example would be enabling a mobile electronic forms solution, that would allow nurses to pull up a patient’s forms (such as a consent) on the tablet, iSlate or whatever Apple calls it. The patient could then apply an electronic signature at the bedside, and the form/s would be interfaced directly into the EMR. That’s just one fast, easy, paperless example.

    Such processes are not exclusive to the Apple device – there are other, hospital-focused tablets that already have this capability, and e-forms solutions that integrate with it. Hospitals are already using these to great effect.

    There’s a lot of hype surrounding the consumer applications of the Apple tablet and the majority of sales will be to Apple-philes, but it and other such devices could potentially have more impact in a healthcare setting, if they’re deployed intelligently.

  5. “The entire 26-member EMR team at Royal Berkshire Hospital is canned as part of its UPMC implementation partnership.”

    I am sure we will learn of all of the adverse events now and that MHRA will be informed of all defects.

  6. Argument by extreme is a lame position, akin to disparaging autopilot because “6 different problems” can be going on… but without the consideration that in normally operating systems, autopilot seems to work just fine.
    From my casual perspective, it would seem that a system run by doctors may not be performing up to expectations. Although a government bailout is the resolution de-jure, I would personally prefer automation to quickly and accurately get services that were otherwise suceptible to overpricing, inaccuracy and inefficiency. But I’m no doctor and I’m often unaware of exactly who’s kidding whom.
    Anybody notice that EHR sounds like “ier”, as in HealthEHR? Perhaps professionals could discover a betEHR way of doing things that matter and refrain from framing arguments around things that don’t. Doctors are critical for certain complexities (I wouldn’t trade my neurosurgeon for automation), but I suspect professional contributions aren’t that significant for things like medical marijuana authorization.
    Ultimately, if a fix to healthcare is forthcoming, I’d put my bet on Google over medical doctors for betEHR results.

  7. Re: PC built for medical records.

    The reason no hospital still has it is probably that the company was acquired by someone else (HBOC?), who promptly sunsetted it.

  8. There is an informative piece on Health Care Renewal blog: “Office of the national coordinator a one man show?” I agree with Silverstein, where is the HHS staff? Where is the transparency in government?

    I also read the comments on his blog:

    1. So is John Glaser’s six-month stint as advisor to David Blumenthal over? Glaser is FHIMSS, and VP and CIO of Partners HealthCare in Boston.

    Glaser is also listed as HIMSS VP of Government Relations David W. Robert’s “friend” in Facebook (as well as John Halamka). Maybe that is how HIMSS was able to get David Blumenthal as a keynote speaker at HIMSS10.

    Maybe there are no permanent positions at HHS, only temporary contractors. Still, there should be transparency in listing these contractors.

    Perhaps that is why there has been so many closed-door meetings at HHS. Blumenthal is calling ALL the shots.

    2. It appears that HIMSS is trying to influence HHS again. HIMSS is sending out its employees (yes, including Mark Leavitt who still appears to take direction from his boss H. Stephen Lieber) and use its influence with John Halamka) to speak at HIMSS Kansas Chapter. See schedule for Jan and Feb 2010. This just happens to be Kathleen Sebelius’ home state, where she was former governor of Kansas.

    With HIMSS’ previous connection to David Brailer, perhaps HIMSS is hoping (praying) Kathleen Sebelius throws out a life line to CCHIT!

    HIStalk, I’ve noted Glaser writes on your blog from time to time. Do you know the answer to the first question?

    I checked the link to the second comment on his blog. This is so obvious to anyone in the HIT industry, that HIMSS is trying to influence Kathleen Sebelius! I wonder if she, or one of her assistants, will attend any or all of these Keynote speaker events at the Kansas HIMSS Chapter. I was very surprised to see Mark Leavitt and John Halamka joining forces to deliver information on CCHIT. Is Halamka being groomed to be the next CCHIT Chair?

    I also noted that Lisa Gallagher, HIMSS Sr. Dr. of Privacy and Security, is speaking on Feb 3 at the Kansas Chapter. Maybe she can explain how privacy and security was breached within HIMSS own headquarters. There are complaints on file with HHS against HIMSS and a Chicago doctor’s office. Three HIMSS staff medical records were stolen from a doctor’s office and given to HIMSS executive staff. HIMSS self-insures!

    It is a conflict of interest for HIMSS to speak about privacy and security when they cannot guarantee privacy and security within their own organization.

    Read Dr. Al Borges website:

  9. Re: first microcomputer

    Very interesting. Way ahead of its time.

    The first “personal computer” – not a micro but not that much physically larger, at least the CPU – may have been the DEC PDP-8/S, 1965. It was available off the shelf with 4K memory for $10K, fit on a desk, and with an ASR-33 teletype was probably more powerful than an 8008 based machine. http://slinberg.net/sfl-ahl-computer.jpg . (Full disclosure; I’m biased because I learned about computing on the PDP-8/S.)

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