Re: "Physicians are just about the only professionals who are expected to enter data into a computer system while doing…
News 3/30/11
Top News
From Quilmes Boy: “Re: Google Health. Just heard a rumor that they are not pursuing development or sales.” Unverified, but strongly suggested by the Wall Street Journal as CEO Eric Schmidt steps aside as CEO to make way for co-founder Larry Page. If they back out of Google Health, that ought to have a major effect on … well, nobody. PHRs are the consumer versions of EHRs — potentially useful technologies that, rightly or wrongly, aren’t all that attractive to their target audience in their current form.
MedQuist (MEDQ) announces that it will voluntarily delist its stock from Nasdaq in April, saying MedQuist Holdings (MEDH, the former Cbay) has bought up 97% of the shares anyway. I suppose it’s just a way to cut the administrative cost involved with keeping two publicly traded entities going.
Reader Comments
From John’s Boy: “Re: Partners HealthCare. Announced today that acting CIO Jim Noga, formerly CIO for Mass General and its physician organization, will be promoted to CIO.” Unverified, but John’s Boy helpfully included what looks like an internal e-mail announcement to that effect.
From Duke_ACC_Champs: “Re: another champion coming to Duke. Warrior Art Glasgow takes the health system CIO position.” Unverified. He is CTO for Ingenix.
From Siouxsie: “Re: Costco. You can buy everything there, even an EHR." Next time at Costco, I can pick up a set of tires, a five-pound bag of shredded mozzarella, a hot dog, and a copy of Allscripts MyWay (via Etransmedia). In fact, since they already have a pharmacy and a contracted optometrist, I’m surprised they haven’t stuck a doctor back there by the cigarettes and beer.
From GearShifter: “Re: browser. In our IT shop, we’d love to run IE9, we’d settle for IE8, but a couple of HIT application vendors require that we run the older versions of IE for their app to be supported or in some instances run correctly. Don’t always assume it’s IT keeping you down — sometimes it’s that shiny app someone selected.” Good point. I remember fighting those battles over Windows versions – one vendor requires the latest and greatest, while another refuses to certify its application on anything developed in the last five years. Even though the major browsers assume you will always want the newest version, you would think there would be a way to have multiple versions co-exist for situations like these (or to use Citrix or some kind of virtual desktop instead). I can understand requiring IE for official work use since it’s free and ubiquitous. As long as the desktops aren’t locked down, users can always grab their own copy of Firefox or Chrome to steer clear of interfering with the standard browser. And I’ll timidly suggest this: Apple doesn’t have that problem since it controls its entire proprietary hardware and software package. If you want that kind of Apple-like hospital system where there’s only one call to make and one neck to wring, your only choice is Meditech.
From Kid Rock: “Re: Allscripts. There are many things to look at when looking at the value of corporation (and earnings is just one of them – bear in mind that free cash flows and the determination of what should and shouldn’t be discounts are judgment decisions as well). Allscripts had a big investment year. Should the cost of goodwill and capital investment in buying Eclipsys be held against them? I’m not so ready to discount Allscripts.” I said pretty much the same thing. The best time to micro-analyze current financials to predict the future isn’t a few scant months after completing a big acquisition and a skillfully led untangling from a not very competent foreign parent company.
From Alhambra: “Re: your poll on who owns patient information. Unfortunately, that may be one of the major reasons we will have difficulty in attaining true record interoperability. The financial industry has made much more movement in the use of technology without any concern of data ownership.” I was thinking after the poll that people often don’t own all the information that pertains to them. Companies buy and sell e-mail addresses and detailed demographic information from those fake “registration cards” that everybody fills in after buying something that clearly doesn’t need to be registered, like a blender. Nobody complains about companies profiting from selling that information, which isn’t even de-identified. Ample precedent seems to exist that just because information pertains to you doesn’t mean you own it – school transcripts, driver’s license records, criminal history, credit history, etc. I’d be surprised if the lawsuit against Walgreens is successful for that reason. I think they have little to fear as long as there’s something in their Notice of Privacy Practices that covers that situation under the super-broad “treatment, payment and operations” blanket (which technically isn’t even necessary for de-identified data), which doesn’t even require them to give you an accounting of disclosures if you ask. Plus, how can a patient prove their de-identified information was sold?
From All Hat No Cattle: “Re: this paper. Interested whether you think the issues raised will generate much discussion.” Only the abstract is free, but from that, I’d say maybe a little. The “unanswered questions” about EMRs include clinician liability for reviewing a glut of electronic information and overrriding alerts, the lack of a way to report EMR software problems, and the lack of alignment of who pays for EMRs (in both money and time) vs. who benefits from their use. Neither the questions nor the lack of answers are new, but the further the practice of medicine moves up the food chain from small practices to bureaucratic government, insurance companies, and mega-corporations (both for-profit and not-for-profit), the less anybody’s going to worry about the individual clinician who’s on the wrong end of these issues. Unless you’ve gone off the grid with a cash-only practice, your soul has already been sold and resistance of many kinds (EMR among them) is futile. He who provides the tools makes the rules, and let’s face it – patient benefit aside, organizations love EMRs because they allow the executives to monitor and enforce compliance with corporate policies that may or may not be in the best interests of patients and providers. I’d like to be more positive, but medicine seems to be turning into one big 1990s-style HMO where nobody’s happy except big companies and their Wall Street investors romping happily through big profits fueled by delivering as little care as possible. What everybody doesn’t like about EMRs is no more than a symptom of the underlying problem.
From American_Idle: “Re: St. Raphael’s. Due to happen, surprised it took this long. Major Epic consolidation will result in many redundancies. St. Raphael’s HIS is very patchwork.” Yale New Haven Hospital considers buying its neighbor, Hospital of Saint Raphael.
HIStalk Announcements and Requests
My talented offshore programmer/DBA developed an elegant workaround to the bug that was causing some readers to have problems viewing this site using old versions of Internet Explorer, like IE6. Everything should be working correctly now.
Ed Marx has added an updated to his Leadership Equations post from last week.
Acquisitions, Funding, Business, and Stock
Physicians from Cleveland Clinic will provide updates and reviews of medical content for First Consult as part of a strategic relationship between Cleveland Clinic and Elsevier. Elsevier offers First Consult as an evidence-based resource tool for providers at the point of care.
Elsevier also just announced free access to both First Consultant and MD Consult from all IPs originating from Japan. Elsevier wants to make the resources easily accessible to clinicians caring for earthquake and tsunami victims.
Charge capture vendor Ingenious Med gets $3.25 million in funding from Council Ventures, which assigned the resulting board seat to HMS co-founder Tom Givens.
Sales
Amerinet selects 4medica as a healthcare IT supplier. Members of the purchasing organization are eligible for preferred pricing for 4Medica’s inpatient and ambulatory EHR products.
Emerson Hospital (MA) purchases the Pinpoint RX system from Centice, which chemically analyzes prescription drugs and automatically links to the relevant Medi-Span drug information.
University of Michigan Health System’s new C.S. Mott Children’s Hospital and Von Voigtlander Women’s Hospital, opening in November, will implement GetWell Town, the interactive patient care solution for pediatrics from GetWellNetwork. The system has been installed in over 20 pediatric hospitals. Also new from GetWellNetwork: Carroll Hospital Center (MD) chooses its interactive patient care solution, which will integrate with the hospital’s patient management, CPOE, pharmacy, nutritional, and other systems to handle patient education, service requests, and patient-clinician communication.
People
Lake Regional Health System (MO) promotes Scott Poest to CIO.
Announcements and Implementations
Rutland Regional Medical Center (VT) goes live on its $15 million EHR system March 1, which it hopes will qualify it for $5-$6 million in EHR stimulus incentives.
Government and Politics
The government of South Australia is cutting 100 healthcare IT jobs as it consolidates hospital IT functions into a centralized statewide structure.
Poor-performing VA hospitals are shaping up after the Department of Veterans Affairs starts publicly posting outcomes data.
Innovation and Research
Kaiser hoped its contest for ideas of how to build 100-bed hospitals of high quality (“innovative use of technology and facility design to improve access to care and foster collaboration and team care while remaining efficient and affordable.”) would generate 25 solid entries, but they’ve received nearly 400 so far from 21 countries.
Technology
Apple says it sold out its annual developers conference in under 12 hours. Tickets for the June 6-10 conference went for $1,599 each and are now selling as high as $4,599 on eBay and Craigslist. Crazy.
Other
Thomson Reuters names its 100 Top Hospital award winners, based on outcomes. The top four teaching hospitals are in Chicagoland: NorthShore University, Advocate Illinois Masonic, Advocate Lutheran General, and Northwestern Memorial.
Above is the next installment in Vince Ciotti’s look-back series called HIS-tory.
HIMSS Analytics says Meditech owns the largest chunk of the hospital EMR market, with its 25.5% share (1,212 installations) beating Cerner (13%), McKesson (12%), Epic (9%), and Siemens (8%).
Another benefit of EMR: speeding the pace and cost of clinical trials. Medical centers and pharma companies recognize that EMRs provide better tools to quickly and accurately find qualified patients to recruit. With EMR, recruiting the required number of patients for large trials can be reduced from years to weeks.
NextGen Healthcare and its parent company Quality Systems, Inc., recently challenged their employees and clients to raise $20,000 for The St. Baldrick’s Foundation to fund childhood cancer research. They exceeded their goal, raising $28,000. As a result, 15 NextGen/QSI leaders have shaved their heads, including QSI President Pat Cline. Personally, I think bald is hot.
I got an e-mail blast from LinkedIn celebrating its 100 millionth member and noting that I (as real me, not as Mr. H) was among the first million people to join (in fact, I was around #100,000). I also noted while checking that out that the LinkedIn HIStalk Fan Club that Dann started is up to almost 1,500 very cool members.
Flush with being recognized by LinkedIn as an early adopter, I signed up for Amazon’s just-announced Cloud Drive. You get 5 gigabytes of free cloud storage for files (documents, MP3, video) and unlimited access from any computer, including a Cloud Player. Buy one Amazon MP3 album and they’ll raise your free capacity to 20 GB for the first year.
Sponsor Updates
- PatientKeeper appoints Chris Stakutis , previously with Computer Associates and IBM/Tivoli, as VP of engineering.
- Wheaton Franciscan Healthcare (WI) picks CareTech Solutions to provide SEO services for its www.mywheaton.org website. CareTech also announces that it has added two new Web Content Management System. CareWorks Fundamentals and CareWorks Fundamentals Amped are lower-cost, standardized packages for hospitals with limited marketing budgets.
- Ozarks Medical Center (MO) picks ProVation Order Sets as its electronic order set solution.
- CynergisTek earns Gold partner status from FairWarning Inc., for its commitment to providing expertise and value to the healthcare community and for its consistent sales success.
- GE Healthcare introduces Centricity Research, a clinical research management solution.
- Wayne Memorial Hospital (NC) is implementing Ingenix’s LifeCode computer-assisted coding solutions, which apply NLP capabilities to identify diagnoses and suggest appropriate medical codes.
- Medical Society of Virginia will offer its members PM/EHR software and services from Sage Healthcare, which will include discounts, certification guarantees, and free upgrades.
- HT Systems signs two new customers for its PatientSecure palm vein scanning system: Altoona Regional Health System (PA) and El Centro Regional Medical Center (CA).
Contacts
Mr. H, Inga, Dr. Jayne, Dr. Gregg.
I disagree that Google backing out of Google Health affects nobody, That’s basically granting a monopoly in PHR to HealthVault… and THAT’s good news for well, nobody (exept MS shareholders).
When you send in the registration card for the blender you don’t have to worry that by doing so some life or health insurance company is going to refuse coverage or raise your rates to penury. A little too flip H. Healthcare data is not like financial data and never should be.
Whatever you did with the IE version changes, it now takes HISTALK ten times as long to load. Not sure if that indicates “Improvement”.
If a PHR vendor falls in the woods does anyone but another PHR vendor care?
The article citing the top ten hospital EMR vendors incorrectly reports the number of EMR installations. If you add up the top ten’s total installations, that comes to 4,621 total EMR installations. Well, if that’s the case then almost every hospital has an EMR installed. The article even says that only a small number of hospitals have EMRs installed that will meet stage 1 MU.
The list looks more like the number of total core system clients to me.
Yeah I have to agree registration cards are not like health insurance at all. Registration cards make you send in a copy of your reciept and the original UPC. I don’t want to send in my UPC everytime I go into the doctors.
But if do not send the registration card in quick enough you do get a PFD(Past Filing Deadline) rejection. So they do have that in common.
[From Mr. HIStalk] My point is that people don’t worry about companies selling their identifiable information sold with no compensation to them. They opt in by filling out the card or registering on the website with language clearly indicating that this will happen, knowing they’re going to get telemarketed and spammed. That’s why I don’t think the lawsuit against Walgreens will hold — there is precedent that companies can buy and sell your information with your permission and by giving them that permission, you’re giving up your right for a piece of the action. Not to mention that what Walgreens sells is de-identified (for whatever level of confidence that gives you) and you don’t get personally contacted like you do with most lists.
I hate that you fixed the IE problem. I had enjoyed reading the past 6-8 weeks with no “problems” other than the fact the sponsor ads no longer showed up.
[From Mr. HIStalk] It wasn’t just the ads — for some readers, the page wouldn’t come up at all (probably related to how they had their IE’s error reporting options set). But as I always recommend to the ad haters, you can always click the View/Print Text Only link at the bottom of the page for a “clean” reading experience, albeit without the pictures and video.
The EMR vendors ranking can easily mislead. As Reed points out, the total installations adds up to something like 90% of the hospitals in America. They state in the notes that this counts contracts that have been signed even if implementation hasn’t started, which explains part of it. Does the list also include non-US hospitals?
What I’d like to see next is a ranking of vendors by number of beds, not hospitals.
I hate to say this…but somebody must.
I have ALWAYS had a big problem with the HIMSS Analytics data – even more so when ol’ Shelly ran it. They way they count things, the way they categorize things, etc, is at best arbitrary. You never repeat..NEVER.. will be able to reconclie the survey data to reality. IMHO anyone that pays the big bucks for that data should call me ASAP as I have a bridge I need to sell…
@Jonathan
who cares how many beds are on each EMR? Worried that beloved Epic didn’t make it to the top? Like it or not, Meditech is an original and still the largest EMR vendor. They fill a lot of need. Besides, who cares how many beds? Contracts are signed by hospitals and health systems, not by beds. The EMR for a 500 bed hospital doesn’t cost twice as much as that for a 250 bed hospital. If a vendor is focused primarily on beds, they’ll miss their dollars.
Re: registration cards
The point in the Walgreen’s case is that the plaintiffs are claiming that the selling of data is causing them loss and injury since it enables detailing by drug reps which increase cost of care, endanger patients and interfere with patient-doctor relationship. This is a very novel approach. It’s not about privacy at all.
see more here: http://thehealthcareblog.com/blog/2011/03/21/unjust-enrichment/
If injury cannot be established, you are right Mr. H., they will not prevail (Smith v. Chase Manhattan Bank), but if injury and loss are established and the court awards $1.50 or whatever to each plaintiff in the class, it will stop this despicable practice and it will make for a lovely precedent….
Here is the link to Duke’s announcement that Glasgow will be new CIO.
http://www.dukehealth.org/health_library/news/health-care-it-leader-art-glasgow-named-cio-for-duke-medicine
Here is the team of people he will be working with
http://dhts.duke.edu/modules/dhts_management/index.php?id=1
Perhaps an initial strategy for energizing informatics at Duke will be to improve the web presence of the department.
To wit – Notice: no announcement of his pending arrival from this site linking to the news.
Godspeed, Mr. Glasgow