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Monday Morning Update 1/25/10

January 23, 2010 News 11 Comments

From Cannondale Guy: “Re: ACS. Xerox buys ACS. Xerox headquarters are in Connecticut. Hospital of Central Connecticut dumps ACS. Not a good way to start, I’d say.”

I’ve closed the HISsies, so if you voted, thanks. Winners will be announced at the HIStalk reception at HIMSS. I’ve invited some of the winners to speak, but history has prepared me for rejection.


Thanks to CynergisTek for joining our happy little band as an HIStalk Platinum Sponsor. The Austin, TX company offers general and healthcare-specific security services that include audit, compliance, information security, and infrastructure services. Some of their specific offerings that would make a good first step include vulnerability and penetration testing, Web security assessments, security tool selection, independent risk assessment, disaster recovery testing, and business continuity planning. Check out the experience of the executive team (I think I may have run across COO/CTO Mike Mathews, PhD at some point when he was CSO of Parkland). Thanks to CynergisTek for supporting HIStalk and its readers.


I guess this is one of those “kissing your sister” results that satisfies nobody. New poll to your right, triggered by Steve Ballmer’s visit to Nashville: when you think of Microsoft’s involvement in healthcare, is your overall impression positive or negative?

An Oregon psychiatric hospital will spend $25 million on a new computer system from Netsmart Technologies.

You vendor types will like this reader-recommended video on the consumer equivalent of contract negotiation. My favorite line: “We can do this!” The follow-up video on marketing people designing a stop sign is also funny, especially the perky but clueless blonde.

Albany area hospitals weigh in on ARRA in the local business paper. Their concerns: penalties are just five years away, implementation takes time, insurance companies are not ready for electronic eligibility checking, and the requirements are all or none.


Inga figured out how to view the comments that have been left so far about the proposed Meaningful Use criteria on HHS’s site. Only a couple of dozen have been posted, although that’s just one method of sending feedback to HHS. One I liked came from Christine Sinsky, MD, who previously wrote an AAFP opinion letter advocating technology, but not necessarily the current generation of EMRs:

I am concerned that the current emphasis, promoting adoption of existing EHRs, with little focus on the need to make EHRs better, will ultimately slow innovation. Subsidization of the EHR industry and allowing vendors to lock up the EHR marketplace with existing products will set us back in the long run. With six years experience using an EHR in both the inpatient and outpatient settings as a primary care physician I have trouble reconciling the high expectations for improved patient care and physician efficiency with my own experience. Usability is the Achilles heel of current EHRs. An EHR may meet all of the functionality requirements and yet be so burdensome to use that patient care is made more difficult. At this point we don’t need more EHRs, we need better EHRs.

Janeen Cook, our pen pal HIT marketing VP turned nursing student, is in a class contest for getting YouTube hits. You can help the “old lady in the class” (as she calls herself) “look cool to all the 20-some-year-olds” by watching her video on “Why Nursing is the Career for You”. 

Syed Tirmizi, MD, a VA physician and informatics expert, joins Quantros as VP of international business development and government relations.


IP5280 Communications acquires Denver-based CEWest Consulting, Inc., a vendor of data and voice over IP services to healthcare organizations using hosted EMRs, telemedicine, and videoconferencing.

GE Healthcare announces Q4 results: revenue down 2%, earnings down 3%, but Jeff Immelt says it was the strongest quarter since Q3 2008. GE itself had a 19% drop in Q4 earnings, but gave an upbeat forecast.

Sen. Charles Grassley, interviewed by an Iowa radio station, is asked about his letter to hospitals regarding technology:

There’s two reasons for doing it. One is, $19 billion is a lot of money, and that’s probably not all we’re going to spend on it. Some hospitals have had some experience in information technology on their own initiative without federal law and without federal money. And we want to know how it’s going, learn from any mistakes that are being made, so when we continue to spend more money and expand this program, we know that — that we can learn from the mistakes of the past. The other one is to check to see on the wise use of money, and then I suppose I’d better add a third one, and probably a third one is as important as the first two, because we’ve had some questions about interoperability of various software and systems set up. So if you’re going to have a medical technology information system, so when you’re in Algona in the — in the summer and you need a doctor, but you’re in, let’s say, Arizona in the winter, and you have a different doctor down in Arizona, but you want full access by both doctors to whatever’s done to you in the respective places, that that information is — is available. So it ought to be available wherever you are with whatever doctor or hospital you’re involved in and that you give them permission to use this information to know more about you, how you’ve been treated elsewhere. So if it’s not interoperable, that’s a problem. So we’re just generally trying to be ahead of the curve as we get further into more medical information gathering and computerization of it.

VC firms invested $7.73 billion in healthcare companies in 2009, including a jump in healthcare IT investments from $363 million in 2008 to $498 million.

Expect more of this as HITECH money pushes doctors into buying software for which they are not prepared. Several Florida physicians, lured by a reseller’s promise of ARRA-funded billing software, complain of unauthorized charges and a training session that lasted only one day. The reseller says the doctors “are all in a clique together” and sends cease-and-desist letters to prevent them from going public with their gripes. His trainer says the doctors didn’t know how to use computers and seemed scared to use a mouse. Even one doctor whose got everything free because she’s a former TV reporter was so unimpressed that her promised product endorsement wasn’t enthusiastic enough for the reseller, so he denied her access to her patient records on his server and sent her a software bill. Maybe Chuck Grassley should talk to them.

A hospital in Scotland suspends a nurse after colleagues spot Facebook pictures of patients undergoing surgery.

David Blumenthal is interviewed by InformationWeek. What he said: (a) he wants to see lots of comments on the proposed Meaningful Use criteria; (b) ONCHIT will be considering recommendations to simplify NHIN so that less tech-savvy providers can use it; (c) ONCHIT’s focus now is on creating a certification process, setting up NHIN governance, and finishing the Meaningful Use criteria; (d) on CCHIT, he said, “We’ll have to see what the regulation actually is and see where CCHIT fits in. CCHIT is clearly going to have the option to participate in certification going forward, but I can’t tell you what role exactly it will play.”;  (e) he suggests that reported shortages of healthcare-trained IT people can be mitigated by bringing in technical people with no healthcare exposure.

Strange: the former mistress of a high-ranking Oracle executive goes public in a big way, buying a three-story sign in Times Square and two other cities featuring a photo of the pair and the inscription, “You are my soul mate forever.” The potential successor to Larry Ellison, who made $20 million in 2009 and owns $80 million in Oracle stock, admits his indiscretion with the “writer and actress”.

United Health Group’s Q4 numbers: revenue up 6.5%, EPS $0.81 vs. $0.60.

I write regular editorials for Inside Healthcare Computing’s electronic news update, visible to subscribers only. The publisher really liked this latest one and suggest running it on HIStalk.

Marry in Haste, Repent at Leisure: Choose your EMR Soul Mate Carefully 
By Mr. HIStalk

Too much Meaningful Use has led me to Meaningless Musing. Here’s where it took me: the same handful of wrong reasons that convince people to marry unwisely also convince them to buy EMRs that will make them unhappy. 

Let’s start with lust. A good-looking partner often leads to hasty and ill-advised EMR marriages. Providers swoon over the slick, sexy sales demo of an EMR that seems cool and popular. They can’t wait to get legally hitched and embark on a lifetime of what they expect to be never-ending passion and soul-mating, flinging themselves at each other several times a day.

Once the vows are said and the papers signed, the romantically foggy lens they’ve been looking through clears shockingly. In the unforgiving harsh light of day, the sultry enigma turns into an endlessly argumentative pest, or maybe a hot mess looking for company in their downward slide. Your new EMR is Bobby Brown to your Whitney Houston.

The most in-vogue reason to marry an EMR is cold, hard cash. Certified EMRs come with a taxpayer-funded dowry. Golddiggers rationalize that it’s just as easy to marry someone rich as it is someone poor. You are Anna Nicole-Smith, trying to work up lustful yearnings for a billionaire who is 63 years your senior. And like Anna, EMR users may not live long enough to enjoy the fruits of their connubial labors. Once your $44,000 has been spent, you still have to enter orders and pay larcenous tech support rates for hardware maintenance.

There’s also the shotgun wedding, although that’s a hopelessly dated concept now that society’s moral linkage between parenthood and marriage has been fully disengaged. Still, HITECH-seeking hospitals and practices are sure to push doctors and EMRs together despite their inherent incompatibilities, unwilling to take no for an answer when ARRA money is on the line.

My college roommate’s mom had wise advice, triggered by his ill-disguised lust for all things female and fearing he would sully the family home by marrying the pregnant, drug-using dropout that he found endlessly fascinating (she even had a tattoo, unheard of back then). His mom told him to picture a person who is horribly disfigured and wheelchair-bound after being burned in a fire, requiring his constant care and attention. Would he still be happy to spend the rest of his days with that person? If not, she isn’t the one. She wasn’t, apparently.

If the sweet young thing of an EMR that’s catching your eye becomes old, cranky, or unreliable, would it still be attractive once the money is gone?

Doctors should not be shamed into EMR marriage because of societal pressure (all the other doctors are getting hitched), age (being an EMR spinster isn’t all that shameful), or lust (you can get free milk without buying the cow by messing around with computers as a hobby instead of actually using them in practice, i.e., like informatics doctors do).  

Ditto getting EMR betrothed because you want a big wedding (the vendor’s celebratory dinner) or to rebound from a bad previous marriage (the EMR you de-installed because the vendor was unresponsive).

Breakups are ugly. They involve a lot of ill will, money, and wasted time and energy. Like they say, marry in haste, repent at leisure.

The right reasons to get EMR nuptialized is that you’ve finally found that special lifetime companion with whom you want to spend every waking minute, the one you admire, that special person with whom you will grow together, and that soul mate with whom you will share intimate thoughts through good times and bad. For better or for worse, for rich or for poor, till death (or vendor insolvency) do you part.

I bet my roommate’s ever-practical mom would add one last item: just on the off-chance that you’ve chosen unwisely, get an ironclad pre-nup.

E-mail me.

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Currently there are "11 comments" on this Article:

  1. I’d add one comment to Mr HIStalk’s wonderful essay on EMRs and marriage:

    If there are no suitable brides out there, don’t jump into a bad marriage. Making due with available and uncommitted girlfriends for a while is a more reasonable strategy than a life of committed pain. Eventually, the right one will emerge. And you’ll be a more knowledgeable consumer.

  2. From the Comment on Meaningful Use and as related to the relevant well written marriage metaphor: “An EHR may meet all of the functionality requirements and yet be so burdensome to use that patient care is made more difficult. At this point we don’t need more EHRs, we need better EHRs.”

    Does this equate to an attractive but frigid bride with venereal disease? Health, safety, and functionality do count. Blumenthal’s ideas are overly influenced by his advisors from HIMSS.

    Additionally, why is Kaiser Health News covering the HIT sales spat in Florida? Appears that the doctors married the bride described above, they are displeased with the matchmaker (?pimp), and are seeking an annulment.

  3. $$$$$ONC Chief : he suggests that reported shortages of healthcare-trained IT people can be mitigated by bringing in technical people with no healthcare exposure.

    You gotta be kidding me. Why not bring in automechanics to work on the space shuttle?

  4. How can GE Healthcare be down 2-3% this quarter, yet have it be their best quarter since 2008? That doesn’t make sense.

    I decided to RTFA and this is the salient quote, I believe:

    “For the full year, revenues for the healthcare segment were $16 billion, down 8 percent from the $17.4 billion recorded during 2008. The 2009 segment profits of $2.4 billion marked a $118 million, or 15 percent, decline from $2.8 billion in profits at GE Healthcare in 2008. ”

    They may have “rebounded” a bit in 2009, but the bottom line is that they ended 2009 8%/15% off of 2008. Not good.

    You nailed it on the essay, though. Here’s some math every provider should do: how many visits is that ARRA money worth? If you gain $45K over 5 years yet you lose even 1% of your productivity…aren’t you losing money?!

  5. Blumenthal suggests that reported shortages of healthcare-trained IT people can be mitigated by bringing in technical people with no healthcare exposure?

    No wonder Mr. Obama lost Massachusetts. His people talk trash.

  6. On the other hand: the article says this:

    Blumenthal: We’re going to be training a lot of these professionals, and I hope we get them out in time. We’re going to get them out as fast as we can. Professional organizations indicate there are shortages. I think people who are IT trained are potential candidates for these jobs, but they need to … understand the challenges of healthcare, the problems, the kind of cultures of healthcare delivery. Those are the kinds of people we’d want to attract into healthcare, but we also want to attract people who might not be IT professionals but have knowledge of healthcare and see this as an interesting area for them. Our training programs for community colleges will provide a lot of the necessary skills, we hope.

    It appears Dr Blumenthal was misquoted.

  7. I always get annoyed by “reported shortages” of workers. Hey, for the record there are MASSIVE SHORTAGES of Ferraris when you’re only willing to pay $1000. …I stole that analogy, don’t remember where, it fits though.

    Offer more, and maybe the IT-savvy clinical folk will be more willing to take an IT role?

    Also inotroped, insinuating non-clinical IT people are grease monkeys compared to the almighty NASA engineers of clinical IT folk is insulting, even if partly true.

  8. No problems with IE8 when I voted.

    ” find it mildly amusing that IE8 crashed when I tried to vote in your MS poll. Um, yeah, my vote is a negative”

  9. I’ve worked with your so called mighty NASA engineers in real time and I watched how they lost an entire days work for the radiology suite with the push of a button. OOPS, aint no tea leaves gonna bring back those images.

    I have also seen the EHR industry put on the white coats like they are physicians providing care and that’s the sick part of this thing, they don’t know how to fix their computers so how are they supposed to fix a human being?
    Humm, i guess it doesn’t matter that much anyway so long as they get paid. Untrained people can hurt us just as well the trained ones we have now in the EHR industry except they might talk to reporters…OOPS again, thats where indoctrination or a ride on the rectifier train comes in.

    Now that Blumenthal guy – he’s one scary dude taking it over the cliff. Isn’t that what they call a “Crash Captain”.

    Don’t worry , we have comments coming for you Captain…

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