Giving a patient medications in the ER, having them pop positive on a test, and then withholding further medications because…
News 12/15/10
From Nasty Parts: “Re: InnerWireless. Their VC backers want their money. Look for it to be acquired soon.” Unverified. The Richardson, TX company offers wireless infrastructure. It struck me as odd that its board of directors has four members, all of them money guys from different VC companies.
From THRGuy: “Re: JPS Health Network, Fort Worth. The interim CIO, has been named CIO. So a complex hospital implementing a complex EMR hires a CIO who has never had that job before?” I thought maybe he’d been there a long time, but it’s just been a year. His LinkedIn profile indicates no college degree, either. But it’s the same argument that college football teams go through: do you pay huge dollars to bring in a big-name ringer who could fail or bail, or do you figure your chances are about as good going with a known quantity who seems capable? Especially when a successful EMR implementation shouldn’t be under the CIO’s control in the first place. I will say from the cheap seats it does seem like a puzzling choice, but I have to assume they have the knowledge and incentive to pick the best candidate. And like coaches, CIOs are replaceable if things don’t work out, even when it’s not their fault. UPDATE: Joe Venturelli e-mailed to say that he obtained a bachelor’s degree in design from School of Visual Arts, which I see he’s updated on his LinkedIn profile. He also notes that he was CIO for NewHope Bariatrics. Thanks for the update.
The IOM’s Committee on Patient Safety and Health Information Technology, which is conducting a year-long study on the safety of HIT, held its first meeting Tuesday, continuing through Wednesday. Tuesday’s presenters: Gail Warden (University of Michigan), David Blumenthal (ONCHIT, which is paying for the study), Peter Pronovost (Johns Hopkins), Lawrence Shulman (Dana-Farber), Rainu Kaushal (Cornell), Dean Sitting (University of Texas Health Science Center at Houston), Sumit Rana (Epic), Madhu Reddy (Penn State), Ben Schneiderman (University of Maryland), and folks from NQF, Geisinger, AHRQ, FDA, CMMS, and CCHIT. I’m not exactly sure why Epic had someone presenting (or CCHIT, for that matter – what about the other EHR certification bodies?) The key agenda item was the last one in Tuesday’s session – what is the government’s role in overseeing HIT safety?
David Blumenthal will deliver a keynote address at the eHealth Initiative’s annual conference in Washington, DC on January 19-20. He speaks at a lot of events, but I don’t ever see anything quotable, so I assume he sticks to the standard EMR stump speech.
Weird News Andy is intrigued that patients in England are raising huge amounts of money for US cancer treatments after being told by NHS that nothing can be done and being offered no financial help, only to find that the same treatment is actually being delivered in England as part of clinical trials. Some parents claim their kids were turned down for the trials because those running them didn’t want make their study look bad.
Cathy Bruno, CIO of Eastern Maine Healthcare, wins the CIO of the Year award from the New England HIMSS chapter.
Cerner opens an employee health and wellness center this week for Deffenbaugh Industries, a Kansas City trash company. I noticed that Liking Deffenbaugh on Facebook puts you in the running for a Stinky the Garbage Truck toy, just in case you haven’t chosen a Christmas gift yet for that special someone.
Federal CTO Aneesh Chopra, speaking at a Brookings Institute forum on Internet policy, talks up the healthcare data sharing platform Direct Project as an example of the government’s role as a convener to facilitate innovation.
The Tampa VA hospital launches a $3 million Smart Home project to rehabilitate veterans with traumatic brain injury. Apartments are set up to keep patients re-learn activities and to monitor their movement using a real-time location system.
Healthcare IT vendor Cegedim clarifies news reports suggesting that up to 4,000 French pharmacies rigged its software to underreport taxes due using a secret code, with authorities estimating revenue loss of up to $534 million over three years. The company says it highly doubts that the one known tax fraud case translates into 25% of all pharmacies in France, also pointing out that the change is traceable if they tried anything sneaky.
Massena Memorial Hospital (NY) gets a local newspaper mention for its use of Meditech’s bedside medication barcoding system.
A study published in Archives of Internal Medicine finds that patients who receive care from multiple hospitals and EDs have more medical errors, treatment delays, and duplicate testing, with the conclusion being that data-sharing technology might pay its way by improving that situation. At least what the (free) abstract says about the (not free) article. Sometimes I wonder why you still have to pay for medical journal articles in an age where publishing costs are close to nil, especially since much of the heavy lifting is done by unpaid peer reviewers anyway.
iSoft sells its financial management software group, trying to pay down debt and focus on its core clinical systems business.
The government of Ontario seizes Hôtel-Dieu Grace Hospital due to high executive turnover and a wrongful termination lawsuit. The hospital was under review for a series of pathology and surgery errors.
HERtalk by Inga
CHRISTUS Health plans a seven-state rollout of Medicity’s ProAccess Community and MediTrust Cloud Services, plus ambulatory order initiation, physician referral, and CCD exchange. They were already using Medicity’s Novo Grid technology.
Now on iTunes: Dragon Medical Mobile Recorder from Nuance Communications. The app allows users to dictate at the point of care via iPhones, which is then delivered to the eScription and Dictaphone Enterprise Speech platforms or to Nuance’s outsourced transcription services.
Moses Cone Health System (NC) implements Proficient Health’s Proficient Orders to streamline communication with local physicians and facilitate future participation in the North Carolina HIE.
Discovery Health Records Solutions completes a $2 million equity offering with the backing of Silverhawk Capital Partners.
CCHIT names three new members to its board of trustees and 11 commissioners to start terms on January 1.
Elliot Health System (NH) implements EMC and VMware solutions to virtualize and consolidate its IT infrastructure. EHS says the VMware vSphere platform eliminated the need to purchase 130 physical servers and resulted in a 50% reduction in data center power usage. EHS, which runs Epic EMR and McKesson financials, next plans to deploy a private cloud to deliver EMR services to physician practices.
MedVirginia announces that it’s the first community HIE to connect with the VA’s and DoD’s Virtual Lifetime Electronic Record (VLER). MedVirginia is leveraging its existing open source CONNECT gateway to the NHIN to enable clinical information exchange based on the CCD C32 format.
Surprising: almost 90% of providers are actively planning or piloting a PHR solution, according to a new KLAS report. Providers are trying to decide whether to partner with their EHR or HIE vendors or choose a free-standing, no-cost solution. Many providers are interested in free options because they can brand them as their own. Microsoft is the most-considered PHR vendor, followed closely by Epic and Google.
Also new from KLAS: satisfaction scores for ambulatory clearinghouses. Navicure, ZirMed, EDI Gateway, and Capario earn the top scores while Emdeon’s indirect product was noted as “most improved.” KLAS also points out that providers are willing to pay higher fees for more functionality if it can make practices significantly more efficient and shorten A/R cycles.
Community Memorial Health System (CA) chooses Wolters Kluwer Health’s ProVation Order Sets as its electronic order set solution.
The executive director of the 10-county Rochester RHIO says all 15 hospitals in its region are connected, as well as labs, elder care agencies, and health insurance companies. In addition, over 360,000 patients have signed consent forms to allow their doctors’ offices see their records online.
Salinas Valley Memorial Hospital (CA) sends a company-wide memo announcing that between 100 and 120 employees will lose their jobs by the end of the year as the hospital tries to trim operating costs. Affected workers include 40 nurses, unit assistants, clerical workers, housekeepers, and nutrition workers. The hospital has already eliminated 205 employees since July. I am pondering the exact wording on that memo. Perhaps, “Merry Christmas! You are Fired!”
MMRGlobal names Sunil Singhil EVP and adds two new members to its board of advisors. Singhil is a co-founder of Nihilent Technology and its former COO. Joining the board are Qualcomm VP Michael J. Finley and Spalding Surgical Center CEO John R. Seitz.
A Michigan pilot dupes the AMA, hospitals, and specialty colleges into believing that he is a physician. Apparently William Hamman attended medical school, but dropped out. At some point over the last 20 years he tweaked his resume to include a medical degree from the University of Wisconsin-Madison. He had spoken at meetings and universities since 1992 and for five years served as the co-director of Western Michigan University’s Center of Excellence for Simulation Research. He joined William Beaumont Hospital (MI) in 2009 as an educator and researcher. A routine background check by Beaumont eventually uncovered Hamman’s lack of credentials and he resigned. Nice job of vetting over the first 20 years.
Emergisoft partners with Crystal Cruises to implement EmergisoftMaritime, the first EHR designed specifically for cruise ship healthcare. I believe I must do a site visit in order to provide readers with a full product evaluation.
Sponsor Updates
- SCI Solutions wins an eHealthcare Leadership Gold Award recognizing its outstanding healthcare Web portals.
- CDW Healthcare signs up to be a channel partner for Greenway Medical Technologies, offering Greenway’s PrimeSUITE.
- Lower Bucks Hospital (PA) selects Wellsoft EDIS.
- Mindray signs a deal to become the sole distributor of iMDsoft’s MetaVision in China and will also make it available to customers in 10 other countries.
- Hopkins County Memorial Hospital (TX) chooses the Access Intelligent Forms Suite for printing barcoded and data-populated forms on demand.
- The Alaska eHealth Network picks Orion Health to provide its HIE solution in a hosted SaaS mode.
- Lisa McVey, VP and CIO for McKesson Provider Technology and RelayHealth’s provider and consumer business units, wins a Women in Technology award in the enterprise business category.
E-mail Inga, MD, PhD, FACP, CPA
“Re: JPS Health Network, Fort Worth. The interim CIO, has been named CIO. So a complex hospital implementing a complex EMR hires a CIO who has never had that job before?” I thought maybe he’d been there a long time, but it’s just been a year. His LinkedIn profile indicates no college degree, either.
May I suggest a new Histalk poll:
Do you believe a candidate for Chair of Medicine or Chair of Surgery could be someone who holds no college degree or experience running a complex clinical department?
– yes
– no
With regard to the IOM: I could not agree with you more about the conflicted presence of CCHIT and Epic people on this agenda.
As for the key item: “The key agenda item was the last one in Tuesday’s session – what is the government’s role in overseeing HIT safety?
”
We all know that Jeff Shuren’s presence is perfunctory since the FDA has already been marginalized by orders from the White House using the Sebelius conduit. What amazes me is who is on the Agenda with him to discuss that issue. Depreciating to the stature of Shuren.
At this time of year, i don’t think we are hearing enough eel stories.
I wondered if Inga had tried the soft but durable eel skin shoes?
http://www.eel.com/
not tired of suzy rn Says:
With regard to the IOM: I could not agree with you more about the conflicted presence of CCHIT and Epic people on this agenda.
I disagree. I think vendors should be allowed to participate. They are stakeholders in all this and should have a say.
That said, they should be held to scientific standards. If they deliver marketing-based spin, they should be called to present scientific evidence for their stance – and not just “positive” evidence. They should be made to refute “negative” evidence as well. not ignore it.
For instance, in the Dec. 13 NY Time article “Panel Set to Study Safety of Electronic Patient Data” by Milt Freudenheim, he quotes Carl Dvorak, executive vice president of Epic Systems as saying:
“The policing of design by a third party or agency, however well intended, will likely stifle innovation and inhibit the growth and development of electronic health records in the future.”
There is a lack of evidence supporting such a statement (e.g., pharma has been regulated for decades, as is its IT). The fact that NIST has just delivered Computer Science 101-level usability guidelines to the HIT industry in its recent report “NIST Guide to the Processes Approach for Improving the Usability of Electronic Health Records” to help solve the HIT unusability crisis also suggests that 30+ years of un-regulation did not impair ‘innovation.’
In fact unregulation appears to have led to prima facie innovation failure and paralysis as far as usability is concerned.
re: JPS CIO
I’ve known Joe for over a decade and hired him as my Director at JPS last year. He’s an excellent leader very deserving of the position he now holds. He has a degree from the School of Visual Arts and has previous CIO experience at Newhope Bariatrics. It would appear that THRguy didn’t get the job in favor of Joe.
Jamey Pennignton Says:
I’ve known Joe for over a decade and hired him as my Director at JPS last year. He’s an excellent leader very deserving of the position he now holds. He has a degree from the School of Visual Arts and has previous CIO experience at Newhope Bariatrics. It would appear that THRguy didn’t get the job in favor of Joe.
Perhaps THRguy was the #2 candidate, but the issue is much larger than that. HHS/ONC’s latest Opportunity Announcements call for domain expertise in both IT and medicine, especially in senior HIT leadership. See “ONC Defines a Taxonomy of Robust Healthcare IT Leadership.”
Eventually, I predict, hospitals that “do it their own way” will find their leadership choices harder to defend – in court.
re: eel shoes
You piqued my interest but alas when I went to the site I found the boots and shoes are “Currently Unavailable”. (sigh!)
Here is some indispensable information concerning eel skin wallets demagnetizing bank teller cards.
http://www.straightdope.com/columns/read/906/do-eelskin-wallets-demagnetize-bank-teller-cards
Is it Eel skin (two words) or Eelskin?
Eel skin wallets do not demagnetize cards.
http://mythbustersresults.com/episode3
Joe Venturelli will do a fantastic job. Congratulations Joe.
I find it more than a little disturbing that Epic seems to have such a heavy influence at ONC. As if it weren’t enough to have Judy Faulkner on the committee that brought us HITECH, it’s notable that Dr. Blumenthal/ONC specifically invited an Epic stooge to sit in on the IOM meetings.
I also find it ironic that after using a government mandate to make billions of dollars off customers looking for HITECH dollars, both Faulkner and Carl Dvorak are on record as saying they are against “prescriptive” government regulations for EHRs. Is that perhaps because the initial prescriptions mirrored closely the functionality of Epic’s systems, while later government prescriptions may not be so profoundly influenced by ONC alone?
The claim that regulation inhibits innovation is bovine waste.
The HIT being installed 2010, from what I am experiencing, has devolutionized the workflows of providing safe, expedient, and effective care to patients. These systems are ok for patients with simple diseases, but are outright impediments to care of patients with multiple comorbities.
It would appear that the commissioning of the IOM to investigate safety of devices that have already killed and injured many is window dressing for the ONC on to the White House. The infiltration of the committee by those known to hype HIT without scientific basis is consisten with the “window dressing” theory.
Until there is robust root cause assessment by an independent panel of clinicians of all premature deaths afflicting hospitalized patients, looking specifically at the altered workflows from HIT and HIT breakdowns as a potential culprit, the IOM report will be more HIT promoting fluff.
On the IOM meeting, my pithy and splenetic comments, as always, are at this link.
Once more on the topic of CIO’s and other health IT leaders lacking in solid healthcare informatics and clinical credentials (as a general problem, I am not singling anyone out), there’s this letter in today’s WSJ that I think says it all about complex technlological projects:
Manhattan Spirit for Cyber Defense
In “How to Fight and Win the Cyberwar” (op-ed, Dec. 6), Mortimer Zuckerman uses the analogy of the Manhattan Project to build the atomic bomb in World War II and suggests forming a “Cyber Defense Administration” (CDA).
We need to keep in mind how the Manhattan Project managed to succeed in achieving its objectives. The direction and top management of the project was by scientists like Robert Oppenheimer, who understood the scientific details of the project, and project director Gen. Leslie Groves, who made sure the scientists got what they wanted. This is not like any bureaucracy in the U.S. government today.
I would visualize a CDA more as a TSA- or EPA-type bureaucracy with a politically sensitive lawyer or bureaucrat at the top, and having to go down two or more administrative levels before you find the first Ph.D.-level computer scientists with a history of serious research and publications in computer/network security. The head of the CDA would probably be clueless about the computer science details and would have no basis for making rational decisions. This is a field where the devil is in the details, and to truly understand those details requires much more than bureaucratic and political skills.
Whoever created the Stuxnet worm that attacked Iran’s nuclear program’s computers probably was not managed by a bureaucrat, but by a team of very high-level scientists who clearly understood the details. Countries like China often have real experts running their organizations, not just politically smooth bureaucrats who go from job to job with a false theory that a “good manager can manage anything.”
In reality, especially in a field like cyber security, a good manager can only manage what he understands. Our bureaucrats will loose the cyberwar against scientists who understand the details.
Dallas Weaver
Huntington Beach, Calif.