From Your Name Here: “Re: Community Health Systems. Medicity wins VOC, beating out RelayHealth.” Unverified.
From Scotty B: “Re: ACE. I guess you scared the cardboard Mr. HIStalk into hiding today.” The vendor who misappropriated my Smoking Doc logo at the Allscripts user meeting demonstrated at least a little bit of creativity in acknowledging their transgression. Two readers with what I assume are tongues in cheeks are urging me to sue them.
From Lem Hewitt: “Re: ACE. I wish you would go to Epic’s UGM and do a similar report.” Now that would be interesting — I’m kind of embarrassed that I’ve never thought of doing that. Lem generously offered to cover the hotel costs using his Marriott points. I’d have to swing some time off from the hospital and probably find a customer willing to let me pose as their fake employee. Something to think about although there’s not much time left.
From Dirk Squarejaw: “Re: speakers. Do you know of any dynamite speakers for a CIO-type crowd?” I get asked this question a lot, so I’m appealing to readers to suggest outstanding speakers they’ve heard. The criteria: (a) inspiring; (b) unbiased; (c) not the HIMSS semi-celebrity types who charge thousands of dollars, like the guy who sawed his own arm off or Dana Carvey; (d) not just canned speech-readers riding the rubber chicken circuit. Ideas? I should disclose that I’ve been asked a couple of times to do keynotes, but I always decline – I have nothing insightful left to say that I don’t say right here, so I’m leaving it all on the field, as the jocks say.
From Ollie: “Re: mobile healthcare. I was getting blood drawn at Emory Midtown and saw an infectious disease MD tapping away on an iPad in the Starbucks line. I asked how he liked it using his Cerner PowerChart EMR that way. He said it loves it, it runs great, he places orders, does documentation, etc. He was happy to share and smiling when he said it. An MD reviewing an EMR, maybe even placing orders, while in line to get coffee … what is the world coming to?” That’s pretty cool. As much as we debate software usability, mobile device capabilities are right up there when it comes to physician satisfaction — just like it is in the consumer world, where the same old e-mail app takes on another dimension when you can use it untethered.
From Geri: “Re: objectivity. How do we know that an anonymous Mr. HIStalk doesn’t have interest that conflict with those of his readers? I’m not accusing, just asking.” Here’s how I would judge anyone running a site like HIStalk: (a) do they have a hidden agenda, like owning stock in a particular company or profiting in some undisclosed way? I have no way of proving it, but I don’t. (b) are they pitching their own profitable endeavors such as consulting, speaking, or landing a board gig? (c) do they shill out every possible revenue source, such as spamming readers with sponsored e-mail blasts? (d) have they ever actually worked in the field, particularly on the non-profit side, or did they just cruise in and hang out a shingle proclaiming to be an expert? and (e) does the author try to use his or her readership to make themselves more famous and influential? Feel free to judge me on any of the above — you have seven years’ worth of evidence to review. Staying anonymous keeps me honest — there’s no way to cash in even if I was tempted, i.e. there’s no such thing as an anonymous celebrity. It’s a fair question, though, and there’s more information on my About HIStalk page.
Listening: new from the highly regarded Arcade Fire.
It appears that we remain collectively unconvinced that HIEs can figure out how to support themselves financially, like trust fund babies who struggle when daddy’s money (or Uncle’s in this case) is gone. New poll to your right: if you were seeking hospital care, would you care whether a hospital is on the Most Wired list or not?
Tucson Medical Center’s CEO talks a lot about its Epic implementation in her blog entry about upcoming layoffs that were triggered by a 10% drop in inpatient volumes. One the one hand, “While costly, the investment was worth it because, as we were told by Epic last week, we are far ahead of other hospitals in terms of system optimization,” but reading between the lines, she seems to say that the labor needed to implement it caused the hospital to miss its productivity goals.
Kaiser reports Q2 numbers: $11 billion in revenue and $313 million in operating income. They, too, talk a lot about Epic / HealthConnect, saying that members exchanged 5.3 million messages with their providers in the first six months of the year.
Looks like the Sunny Sanyal rumor was on the money. He’s at T-System now. Thanks to You’ll Know Who for the original rumor and Mark for telling me about Sunny’s updated LinkedIn profile (done since my original report, apparently, since I checked it originally and it was unchanged).
Somebody breaks into a Texas allergy clinic and steals four PCs containing PHI, although as one of the docs said, “We’re an allergy clinic, so I don’t think there was anything embarrassing taken.” The clinic complains that it cost them $15,000 to send the mandatory breach notification letters to its 25,000 patients, more than the cost of replacing the computers.
A reader sent over a note about the death of Christopher Heller, MD, FACS, a co-founder of hospital software vendor MIDAS+. Condolences can be sent to his family via this e-mail address or left on the obituary page.
Encore Health Resources announces its EHRight solution, which helps map EHR technology to the MU requirements, match clinical data elements to quality measures, and assess EHRs.
Medicare’s fraud contractors, which cost taxpayers more than $100 million per year, come under the gun of Senator Chuck Grassley, whose investigation finds that they take six months to send their cases to law enforcement and only seven percent of the suspicious billing they identify is recovered. Also noted: the Program Safeguard Contractors are poor at identifying new fraud trends. The Obama administration, of course, says it will fix everything, with the only announced change so far being to give the groups a new name.
The travel habits of athenahealth CEO Jonathan Bush are profiled in the Watertown section of the Boston paper. “I literally rent [an] airplane every Tuesday morning, and I hit five cities by Thursday night, every week. I’m cold calling . . . That’s my life now. It’s like any government fiscal stimulus thing — it’s a gold rush.”
Sharp Community Medical Group signs up for the just-announced Collaborative Care Solution jointly sold by IBM and Aetna. I’m not entirely clear on exactly what it is, but it sounds like analytics. I’m always skeptical about IBM’s healthcare intentions even when insurance companies aren’t involved, so I’ll assume it’s a repackaging of a hodgepodge of its existing technologies that will tap into insurance company billing data for clinical purposes (always questionable), with a key motivator being getting stimulus money. Reference is made to HIE-type services as well. They say it will cost less than $1,000 per doctor.
The Milwaukee paper writes up AskHermes, software developed by University of Wisconsin-Milwaukee researchers that uses natural language processing and artificial intelligence to review medical case descriptions to recommend treatments.
A study looks at telepsychiatry, in which patients are interviewed on camera with the resulting video analyzed later by psychiatrists. I found that of minimal interest, but that announcement (and a couple of unrelated ones that talked about video recordings of patient encounters, including remote ICU monitoring) suggest that the multimedia EMR is finally at hand.
Oracle’s punishment if found guilty of defrauding the government by overcharging it for software could reach $1 billion. Imagine being the former Oracle employee who is the sole whistleblower in the case.
Ingenix releases a version of its CareTracker PM/EHR with specific functionality for Federally Qualified Health Centers.
Incoming medical students at the UC Irvine School of Medicine will receive an iPad preloaded with mandatory course materials and hundreds of medical applications. Interesting: they’re ditching the sage-on-the-stage lecture model in favor of student-controlled learning. That’s the big announcement if you ask me.
MedAptus announces GA of the new version of its Intelligent Charge Capture system, which runs in the iPhone and iPad.
MEDecision releases Alineo 3.0, the new version of its case, disease, and utilization management system.
eHealth Insider reports that NPfIT is about to be scuttled as part of its decentralization, even losing the Connecting for Health name in a program to cut its massive costs. The government is putting CSC on the hook to reduce its costs dramatically and the Microsoft enterprise licensing deal has already been cancelled.
Odd lawsuit: the widow of comedian Bernie Mac sues his dermatologist for not recognizing his symptoms of respiratory failure. The doctor says he told him to get to a hospital and he did.
Final Thoughts – Allscripts Client Experience 2010
I have to say that I enjoyed ACE a lot, although I can’t pinpoint what I liked about it specifically. I think it may have been that, unlike HIMSS, the attendees had modest egos. I saw no one pontificating, traveling with a sycophantic entourage, or working their pectorals with a foot-long string of “I Love Me” badge ribbons. These are mostly frontline people from practices and hospitals, i.e. my kind of folks. I liked the Allscripts people, too. The logistics were manageable, the lunches and opening reception held in the Hub with vendors was a smart idea, and there were plenty of essentials at hand (restrooms, break-time snacks, and entertainment).
One more full disclosure item: I take my “everyman” role seriously, so I turned down an e-mailed company invitation to meet personally with Glen Tullman. I appreciated the offer, but it wouldn’t be right to claim to be objectively reporting “from the ground” and while meeting personally with the CEO. I came and went anonymously.
Friday’s sessions may have appeased the person I talked to who felt the conference wasn’t detailed enough. In looking back, Thursday’s meetings were heavy focused (intentionally, I’m sure, to accommodate one-day attendees) on Meaningful Use and product roadmaps. Friday moved into deeper topics at a product level. My favorite was one from ColumbiaDoctors on their Enterprise implementation — it was candid and informative about the challenges of changing the culture of a huge organization that is quite set in its ways (one of the more interesting presentations I’ve ever attended, actually). They used the classic commercial above, which even though I’d seen it before, made me inadvertently laugh disturbingly loudly a couple of times, probably jolting the adjoining attendees into thinking a psycho had crashed the session. I think I was overly caffeinated from the readily available soda from the break.
Most impressive to me, however, was that Glen made good on his promise to fix the breakfast line problem. It was gone Friday morning. I had a feeling he was serious when he announced in the opening session that he had designated a team to make it happen. Now if only he had a similar chance to re-do the Friday night bash, which involved moving from a huge line to get into the House of Blues to multiple huge lines to get food and more huge lines to get drinks (guaranteeing that either your drink was warm or your food cold in your unsuccessful quest to enjoy them simultaneously as they raced from opposite directions toward room temperature). The house band was OK if you like Top 40 covers (I abhor them, but these guys were adequate) and they had karaoke (I’m not a fan, but that Chris dude who knocked out a deadpan but flawless “Baby Got Back” with beer in hand might have changed my attitude). It was fun, just a little too packed.
I checked out a demo of the patient portal (Allscripts / Medfusion / Intuit). Well, sort of — they were running screen shots instead of a live demo, which I hate with a passion (I always assume that either the demo people or the product are untrustworthy when they aren’t willing to risk showing it live). It looked good in the screen shots, anyway, showing functions for patient communication, scheduling and charging for online consultations, pulling EMR data into notes for patients, scheduling appointments, and placing incoming patient communication into the chart. I’m a little surprised that Allscripts is trusting another company to provide such an important part of its offerings. I’m just guessing, but I bet Allscripts had a strong interest in acquiring Medfusion before deep-pocketed Intuit came along to push the price into the stratosphere so they could latch onto the financial transaction possibilities it creates.
I saw Enterprise running on an iPad in the Innovation booth. It was really cool — clearly the iPad is just the right size to balance portability with screen real estate. I still can’t figure out how I’d comfortably hold the thing for extended periods, though.
A complaint I heard more than once from both Enterprise and Professional users: Allscripts has experience in implementing all kinds of specialties, yet each implementation starts over from scratch. The plea was to use the content and knowledge from one implementation to expedite future implementations. I’ve complained to vendors about that before — as long as a new client is willing to take the risk of using someone else’s ideas and the old client doesn’t mind, it sure would be nice to start with a non-blank slate and piggyback on their experience.
I talked to an Enterprise customer who was not only happy with the product, but very satisfied with Allscripts support. She said the case backlog was ridiculous at one point, but the company brought in some new leadership and added resources to the point where she’s getting quick callbacks from people who know what they’re doing.
Funny, but even though the presentations talked a lot about Meaningful Use, I didn’t hear it mentioned much by the attendees. Either there’s just no collective experience to make it worth discussing or practices aren’t all that interested in it. I’m almost concluding that it’s (b). Those of us in the industry who talk about it knowledgably and constantly may be overestimating the HITECH knowledge and interest level that’s out there in the real world. And these are the practices astute enough to send people to a national user meeting, not the average small-practice customer.
I wandered into the area where sessions for users of Allscripts hospital products were meeting. I had to wonder if they felt like orphans since so much of the emphasis was on practice-based PM/EMR. I didn’t connect with any of them to ask. I don’t know if the Eclipsys users will be rolled into the next meeting, assuming the acquisition goes through.
Las Vegas is my least-favorite city. It’s sleazy, tacky, and not even cheap any more. Fake beaches in the middle of dull desert moonscape, fake cleavage, fake celebrity chef restaurants (think your local mall’s food court at 10 times the price), and shows that (as Mrs. HIStalk points out) mostly involve aged celebrity tweeners too passe’ for Hollywood and a only a small step above Branson. I caught the 5 a.m. shuttle and even then the casino had plenty of people (families with small children, two-fisted drinkers, and groups of scantily clad women whose motivations were not clear, making for an interesting but depressing mix). The airport was a madhouse, although kudos for having free WiFi good enough for me to stream Better Off Ted while waiting for my flight. I’ve been to meetings there maybe 4-5 times and am always happy to leave. It was a good setting for ACE, though, since the deals were good and the logistics were outstanding.
When it comes to Allscripts, it came across as a bigger and more polished company than I anticipated. It’s growing fast, maybe a little too fast to stay connected with its customers in the same ways, but scaling well in general and trying to add technology to replace some of the “just call me directly” type of contact that’s no longer feasible. I don’t know how a salesperson would figure out which of the many overlapping EMR products to push at a prospect, a situation that will be more confusing when those from Eclipsys are brought into the fold.
Customers seem to be adapting to the idea that their vendor has changed since they signed up, which is always a challenge (it’s like getting married, only to have your new spouse gain weight, join a cult, and start sleeping around). Unless someone like Oracle buys the company, Allscripts seems early in a lofty trajectory given its ambitions and footprint and it appears to be executing pretty well, with the Eclipsys acquisition being a crucial test. Thanks to the folks there for inviting me to attend without even asking to influence what I might say.