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Monday Morning Update 12/6/10

December 4, 2010 News 16 Comments

From Mighty: “Re: CMS. They’ve apparently again changed the MU denominator for the ED.” The FAQ is updated to say that providers must use the same denominator for all measures, either the Observation Services method (ED admissions plus those treated in observation units) or All ED Visits (all patients).

12-4-2010 9-13-04 AM

From Catatonia: “Re: UCLA going Epic. LA County is QuadraMed’s biggest client. Not sure if that includes UCLA, but if so, QuadraMed will lose a huge customer just as they are struggling with implementations. Rumor is that the company’s HIM and MPI business will go to Ingenix.” I tapped a key UCLA contact and HIStalk reader, who explained that only UCLA proper is going Epic. LA County is working on requirements for their EHR selection, with the obvious potential bidders being Cerner (already being used in the county’s 200-bed jail hospital), QuadraMed (they’re still running QuadraMed Affinity – not QCPR – in all DHS facilities), and Epic (if they would really want to take on a complex client like LA County). I appreciate that update. I hadn’t heard the Ingenix rumor.

From Wildcat Well: “Re: NJ. The NJ Physicians Group web site enrolls 1,500 docs and receives $350,000 for a EMR selection process while reviewing, in depth, about four out of 200 EMR systems. NJPG has stepped out quicker than the Colts left Baltimore. Now the NJ HIT REC has endorsed ITelagen as the EMR of choice. Will NJ back room deals never stop?”

From Cliff: “Re: sales. I’m working in HIT and would like to move into direct sales. What tips can you offer and who would you consider to be the top 5-10 companies to sell for?” I told Cliff that I have zero sales experience but would open the floor to readers, so feel free to add a comment to this post to help Cliff out, for which I’m sure he’d be grateful.

From RegularReader: “Re: MedAssets / Broadlane. Let the synergy begin! I don’t know if the acquisition has closed, but the layoffs have begun. Many people in the St. Louis office have been given their walking papers and in some cases a personal escort out the door. Happy Holidays! As you say, Mr. H, my condolences to those that have lost their jobs.” I hate to see employees have their jobs taken away, but I’m also aware that nobody wrings their hands for employers when key employees voluntarily walk for a better opportunity. That’s the hazard of employment at-will. Ed Marx said you have to “go to grow” and I believe that, even though for some people they don’t make the “go” decision but still benefit from it in the long run (most of the people I’ve known who were laid off ended up better off). Still, Christmas is always a lousy time to be shown the door.

Listening: reader-recommended Kristy Lee, an undiscovered folksy blues singer-songwriter from Mobile who sounds to me like a cross between Johnette Napolitano of Concrete Blonde and Tina Turner (meaning she has a BIG voice). She’s not a pretty, choreographed lip-syncher – it’s real music that she could play in your living room unprepared if you had a guitar in the corner, which is kind of what music is supposed to be.

12-4-2010 7-09-03 AM

The “who’s an informaticist” poll was close, but the winning answer is “clinicians who learned on the job and who have no formal credentials.” A commenter pointed out that the academic and certification programs are new enough that they aren’t common yet. It’s still a divisive topic: 23% of respondents think someone can be an informaticist without either education or clinical experience. New poll to your right, requested by a reader: if you work in a hospital, who does your CIO report to?

12-4-2010 7-46-17 AM

Joe Heins PharmD, former Eclipsys SVP and DocuSys COO, joins First DataBank as global product management and marketing VP. I remember him from his Cerner days, where he ran some of its pharmacy systems business. He gets extra points for being in the 1,229-member HIStalk Fan Club on LinkedIn (I’m sending every one of you a Christmas card, so if you don’t get yours, I’m calling that darned post office).

Inga got clarification from RTLS vendor Awarepoint: Jay Deady was named president and CEO last week, but Brad Weinert is still there as COO.

12-4-2010 9-10-04 AM

Ashe Memorial Hospital (NC) chooses PatientKeeper’s CPOE, physician portal, and mobile results solutions. Pretty slick stuff for a 25-bed hospital. I’ve been to Jefferson, NC several times and love it — canoeing the New River there up in the mountains is fun, not that that has anything to do with the hospital unless I fall out next time and crush my skull on a rock, in which case I’ll provide a first-hand PatientKeeper update.

Meditech Magic version 5.6.4 earns ONC-ATCB certification from Drummond Group. 

Want to earn your EHR (Esteemed HIStalk Reader) incentive? Here’s the roadmap: (a) put your e-mail in the Subscribe to Updates box to your right, since even if you’re a casual visitor, I guarantee you’ll miss something useful if you just wander over whenever you think about it; (b) Friend or Like Inga and me on Facebook since it’s a publicly visible barometer of our tortured, anonymous existence; (c) send me your news, rumors, pictures, or guest articles about anything HIT related; (d) show some sponsor love by reading and clicking the ads to your left, which will confirm to them that I wasn’t lying when I claimed I had readers; and (e) shake your right hand with your left, pretending it’s Inga and me thanking you for supporting HIStalk even though we may not meet face to face.

12-4-2010 5-39-37 PM

The Eye Care Institute (KY) implements the ophthalmology EHR from Medflow, which is an ONC-ATCB certified complete EHR. It’s pretty slick-looking, although some of the screens are unbelievably busy.

A hospital reader from Switzerland sent over a Huffington Post article called Don’t Repeat the UK’s Electronic Health Records Failure. It points out that the UK’s NPfIT, being dismantled after mixed results and colossal expense, is similar to what’s being done here. The reasons it failed, according to the article: it was too ambitious and it was overly dependent in several for-profit companies implementing proprietary systems while offering too little support to clinician users. Their conclusion: HITECH should be slowed down, penalties should be eliminated, and thorough studies should be conducted before mandating EHR use. “Simply following the lead of ‘IT Believers’ and salesmen without the requisite evidence will repeat the UK’s failures.” All valid criticisms, but the big problem is with out Bailout Central: ARRA is stimulus money, so the idea is to just throw the money out there and hope for the best. The real coup for vendors is that providers have to spend money quickly on EHRs to (possibly) earn money quickly via HITECH, which will goose sales a lot more than thoughtful studies.

Marty Mercer sent over the results of a little survey he did of 25 senior HIT sales types (this is for a class he’s teaching). Factoids from it:

  • The #1 CXO strategic issue is MU/ARRA, closely followed by access to capital and ACOs.
  • The worst things a salesperson can do is to not listen, show up unprepared, make assumptions, and bash competitors.
  • The #1 information source was, by far, HIStalk and HIStalk Practice. (thanks!)
  • Top pearls of wisdom: prepare before making contact, focus on care quality and not IT stuff, and be patient since HIT sales cycles are long.

Memorial Hospital (CA) uses Skype to conduct virtual visits between moms and their newborn babies that require ICN admission, hoping to reduce separation anxiety. They also use it to let far-flung family members check out the new addition.

12-4-2010 9-45-03 AM

A UK hospital says it will save $400K per year by using a privately developed dictation system that will send letters electronically between clinics and physicians. It uses WinVoicePro to create letters and other documents, including progress tracking and countersigning, that are then sent through the hospital’s data transfer service.

12-4-2010 9-52-47 AM

Patty Lavely, SVP/CIO of Memorial University Medical Center (GA) will serve as commencement speaker for Georgia Southern’s fall commencement ceremonies at 9:00 a.m. this Friday.

University of Chicago Medical Center chooses Sun SPARC servers and the Solaris OS (both now owned by Oracle) to run Epic.

I’m fascinated for some reason by pictures taken of abandoned amusement parks and formerly famous places, so this video someone took while prowling around the former Mansour Hospital in Jeanette, PA (just outside of Pittsburgh and home to the excellent DeLallo Foods) is both creepy and interesting. The hospital was shut down in 2006 and the bank is trying to sell the buildings.

The Street runs a really good overview of athenahealth and CEO Jonathan Bush. He comments specifically on the risk to his business as hospitals buy up practices that might have become athena customers: “Our job is to be an information infrastructure between various models. Certainly, hospitals have not been our historic wheelhouse, but if you think about it rationally, the cloud-based solution can lower business risk for the hospital CEO. The hospital CEO is taking a multi-$100 million business risk depending on standard health care information software applications … There’s no question that some of these marriages will work, but others, when rates do come down and hospitals can’t subsidize doctors at these levels, will fail. There’s a $100,000 subsidy to a primary care doctor for selling out to a hospital, and for a specialist it’s even higher. How many primary care physicians will bring in one million dollars in business each year for a business like a hospital, with an operating margin of 3%?”

Bizarre: a former hospital receiving clerk is indicted on charges that he stole $4 million from Memorial-Sloan Kettering Hospital by ordering $3.8 million in printer toner cartridges and reselling them. The $37K per year employee lived in Trump Tower (!), with neighbors wondering where he was getting his “his car, his jewelry, and his women.”  Imagine what he could have done with drug ordering.

So how do you work this into the healthcare cost equation? Partners HealthCare makes a $195 million profit for the fiscal year (much of that from your taxpayer dollars in the form of stimulus money for research) even as other Boston-area hospitals struggle to keep their doors open.

A high school basketball coach who saves his star center’s life by performing CPR on him after the boy collapses in practice credits a $1.99 iPhone app. The coach had purchased the app the night before and went through it as a refresher. It includes pictures, voice instructions, single-button 911 dialing, and other first aid advice.

E-mail me.

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Currently there are "16 comments" on this Article:

  1. Re: From Cliff. Cliffy, I do believe you started your new career search at the right place. Mr. H might not consider himself a sales guy, but he’s got 78 companies listed to your left (I just counted) paying him slightly more than $1 for the privilege of being part of this HISTalk experience. Not so bad for someone with zero sales experience, and perhaps that is the key. If you want a successful sales career, in front of you is the perfect roadmap: be an expert on something, communicate your expertise in a trusted manner; make it interesting & fun. The top 5-10 companies for you to consider joining should be the ones where you can walk in as an expert, engender trust with your peers and prospects, and believe in what you are doing.
    You don’t know the power of the Dark Side!

  2. In terms of UCLA Health System, I believe the system they will be replacing is a system from a niche vendor called CliniComp…

  3. What was UCLA on prior to moving to Epic? Any insight on their decision to switch, and why it took them so long, since HITECH Stage I is already on the horizon? It will take them some time to implement everything. UCLA has absolutely no influence over LA County, so I’m not surprised there’s no insight on their choice. I doubt they’ll go Epic or Cerner, and probably don’t have the cash to buy any system right now.

    On a different note, I’m always amused by the obscure bits of Epic news that always manage to make it on this blog. No hometown newspaper or random press release mentioning Epic slips past this blog. Is it any wonder that someone living in Madison, WI runs a blog that is so pro-Epic it should just be called EpicTalk? I fully accept that blogs are opinion, not fact, and the blog author has the right to post whatever he/she wants; let’s just put those biases out there to keep some semblance of transparency, though.

    [From Mr. HIStalk] I don’t really live in Wisconsin — I just put that on my LinkedIn profile as a joke. I have nothing to do with Epic, so my interest is strictly because they’re a dominant company that doesn’t issue press releases or do interviews. Any mention they get here, which is nearly always from the Wisconsin press for that reason, is better than nothing at all (you’ve noted that I always run comments about Epic for the same reason — there’s nothing official available). I usually do the same for the other companies that are purely HIT, like Cerner and Allscripts (not McKesson or Siemens).

  4. On the Partners profit, Blue Cross is coming up to bat with a new insurance plan that encourages employers and employees not to visit 15 specific hospitals in the Boston area and of course there are financial incentives to encourage this to work and I don’t know if any of the others have something like this in the works, but interesting along with their own interests ,they have taken note of what hospitals are getting paid at a higher rate after a ton of claim payments I’m sure:) Partners owns Massachusetts General Hospital and Brigham and Women’s Hospital and they are on the “do not use” listing with this new insurance policy called the Hospital Choice Cost Sharing plan.


  5. Give credit where credit is due/ Was it not MiMD who stated something similar to the quote at Huff Po ““Simply following the lead of ‘IT Believers’ and salesmen without the requisite evidence will repeat the UK’s failures.”

    At least some one else understands the horlicks our government is a fixin.

    One interesting ingredient in this horlicks is the variable meaningful use denominator in your lead story, a sprinkling of ipecac on the government’s horlicks.

    Partner’s has done pretty well at the money trough. One would think that its care would be so much better that Highmark would want its subscribers to go there. Don’t you?

  6. Mr. H, you are soooo RIGHT when you say “The real coup for vendors is that providers have to spend money quickly on EHRs to (possibly) earn money quickly via HITECH, which will goose sales a lot more than thoughtful studies. ”

    Comparing the UK to the US merits concern in view of the failure of the Deficit Committee to address the boatloads of cash exiting the pockets of the taxpayers and supporting the multi million dollar compensation packages of the CEOs of the HIT vendors, without any thought ful studies.

    I am waitting for any sudy that shows improved outcomes, fewer errors, and reduced costs from the current generation of care managing HIT softwares in hospitals.

  7. Great to see that Meditech Magic got its certification. It has to be the most widely used HCIS in America today,so that’s a great piece of news for alot of hospitals.

  8. Cliffy oh Cliffy,

    please articulate why a top 5 HIT company would want to hire someone with no experience in sales?
    Especially with so many senior veterans winning deals right now?

    Answer to this question is key to your getting an interview.

    Good luck hermano!

  9. ummm Mr. H, what’s funny about being from Wisconsin?

    [From Mr. HIStalk] Probably lots of things if it’s like any other state, but the one I had in mind was the idea that I work for Epic. That’s why I put Madison as my location. Although either could be true.

    how come no love for the companies like McKesson and Siemens – and GE, United Health, Microsoft, Google, Oracle and Accenture for that matter? they do a lot for HIT, even if they do other stuff too

    [From Mr. HIStalk] The question was why I mention all the local folksy bits about Epic and my answer was that since they don’t do an press, that’s all I had to work with. Somehow I doubt readers would be fascinated that some Siemens manufacturing employee in Stuttgart started a blog or the quirky statue in the lobby of a GE Capital office in Mexico City.

  10. ‘it’s real music that she could play in your living room unprepared if you had a guitar in the corner, which is kind of what music is supposed to be’

    I guess what anything is supposed to be is relative. If you where part of the underground acid house scene in the UK during the late 80’s you may think that music is supposed to be comprised of a 4/4 kick drum, arpeggiated synth lines and inane repeating diva-esque vocal samples. Having said that though, these days you can always fire up programs like Ableton Live and jam out electronically, kind of like the guitar in the corner analogy.

  11. Cliff – RE: Sales for HIT

    Top 5 companies are only hiring reps with a minimum of 2 years successful Sales EMR/PM experience. The water is faster, deeper, and colder for those without that piece in your resume.

    Good Luck.

  12. hjtarpons at#6,

    Indeed, I said many similar things over the years to the two professors who wrote the HuffPo piece.

    By the way, what are “horlicks?”

    (Maybe it’s better I don’t ask.)

  13. Cliff,

    Are you interested in selling a solution or the work?

    Depending on your background; network and ENERGY LEVEL you can be successful…

    The Top 5 companies “FOR YOU” to sell for will depend on this…

    Mr. H feel free to share my email privately.

  14. Re: “who’s an informaticist” poll

    Perhaps the definition of “who’s an informaticist” is moot. ONC has made recommendations as to who should be doing what based on a number of criteria. Education plays a prominent role as one goes up the ladder of leadership.

    See “Founding Opportunity Announcement: Program of Assistance for University-Based Training” at http://healthit.hhs.gov/portal/server.pt?open=512&objID=1428&mode=2 defining “Targeted Information Technology Professionals in Healthcare Roles.”

    I’ve brought out and highlighted the recommendations at “ONC Defines a Taxonomy of Robust Healthcare IT Leadership” to make them easier to read.

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