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Monday Morning Update 4/25/11

April 24, 2011 News 13 Comments

4-24-2011 7-17-59 PM

From A Friend: “Re: McKesson. Did you see they lost their appeal for patent infringement to Epic? The products affected are what is now called RelayClinical Communicator vs. MyChart.” I did see that, although the verdict was filled with a lot of legalese and dissenting opinions, which probably means the fat lawyer hasn’t sung yet. McKesson’s original patent was for putting visit-specific information on a Web page for patients, including offering online scheduling and refill requests. The judge found that Epic doesn’t make those capabilities directly available in MyChart, which requires patients to request the service and physicians to approve their request. On that basis, Epic is off the hook – for now. The ruling doesn’t really hurt MCK all that much since it only prevents them from insisting that Epic pay up.

From Cantankerous: “Re: videos on HIStalk. Is there a way to view them on the iPad?” I don’t think so. Apple refuses to work with Flash, which is how YouTube videos stream. You could use the YouTube app that’s included in the OS, but I don’t think you can do that without searching for the video all over again from YouTube. All of that’s good news for companies selling Android-based phones and tablets.

From Ishmael: “Re: Meditech 6.0. I was hoping for something that would improve my workflow, but all I got was a new graphical front end to the exact same functionality as 3.0 and 4.0 except that it now takes 50% longer to do it. Time is all I have and anything that takes it away without compensating me for it is my enemy. It’s not helping me, the doc who has to use it, and it’s taking nurses away from my patients so they can spend more time staring at a screen.”

From Outside Insider: “Re: iPad not being revolutionary. The device weighs just over a pound, you can access your network and systems, you don’t need an input device other than your fingers, and your developers can write apps that will let you access your data any way you want. Would you be as comfortable carrying around a laptop or rolling a PC on a cart? Those who don’t recognize the advantages to change are typically the last to implement and are behind the curve in realizing the benefits.” My iPad has a great screen and very cool apps written specifically for it, but I’ve found the iPod Touch to be the real game-changer since I don’t carry an iPhone. It’s always on and has a huge battery life and quick recharge time, so I check e-mail, CNN, and the weather last thing before bed and first thing in the morning. Sometimes I stream Netflix over it while sitting outside or in the kitchen. For both devices, the key to my satisfaction was to buy a cheap non-USB charger so I could top off the batteries quickly from a wall socket anywhere. The Touch costs only around $200 and carries no recurring expense since it hops happily onto the WiFi at home or work. My record still stands: I use the Touch all the time, and even though it’s primarily a music player, I’ve yet to play an MP3 on it.

4-24-2011 4-55-38 PM

From The PACS Designer: “Re: Microsoft Office 365 beta. Now that Microsoft has launched its online version of Office, those of you who could enhance your business practices by incorporating Office can contribute to further refinement of the Office 365 release by participating in the improvement process for this product, and also possibly improve your day to day operations for the future.” It starts at $6 per user per month, which is $6 per user per month more than Google Docs (although to be fair, you’d have to pay Google $4 per user per month for Google Apps for Business to get the uptime guarantee that’s probably not needed anyway). The Microsoft offering includes stripped down versions of Word, Excel, PowerPoint, Outlook, OneNote, and parts of SharePoint. Personally, I find Microsoft’s offerings confusing: there’s also Windows Live SkyDrive (free)and Office Web Apps, all to replace Office 2010 (which you can buy in a three-user license pack for $120 and with no stripping down or need for Web connectivity). I find Google Docs to be pretty clunky and not all that intuitive, so maybe that’s a market for whatever Microsoft ends up releasing. It should be most attractive to small business that haven’t already bought Office and don’t want to manage servers. Maybe I’m naive, but I just don’t see the average user needing to collaborate to an extent that e-mail doc swap doesn’t address, so I personally wouldn’t use either service enough to justify paying for it.

4-24-2011 5-24-26 PM

From GoTooSlow: “Re: Valley Medical Center, Renton, WA. Has signed with Epic to replace many modules.” Verified, apparently, since I found the above in the minutes from the hospital board’s December 13, 2010 meeting. It seems to me (without any hard data to prove it) that McKesson is losing more Horizon Clinicals customers to Epic as a percentage than any other vendor, which might have been expected given that those customers were the only ones with significant doubts that their vendor and product would get them ready for MU requirements in some survey I recall from a few months back.

From Lucy Gucci: “Re: Epic. They gave me a great start in healthcare IT (I didn’t exactly have recruiters pounding on my door as a fresh liberal arts graduate), but it’s truly a sweatshop for most people because of 70-80 hour weeks, lack of work-life balance, and travel. I got sick during a Monday-Saturday work trip and had to go to urgent care. The PA there said they see Epic staff constantly because they travel during normal appointment hours and need antibiotics since they can’t take time off to recover. In our March 2011 staff meeting, Judy spent five minutes going over the HIStalk awards and seemed to be tickled pink with her ‘industry figure with whom you’d most like to have a few beers’ award, although she said the would have to drink a chocolate milkshake since she doesn’t drink – at corporate events, we have ‘mocktails.’ As is obvious, sales are through the roof and we dread hearing the wedding music playing over the PA to indicate a new sale since Epic truly does not have the experienced implementation staff to support all the new customers. Experienced employees used to have two customers, now 3-4 are the norm. Please keep me anonymous – Judy warns us every single month at the staff meeting not to post anything about Epic to blogs.”

This weekend was an almost-first: I whisked Mrs. H away to a beach mini-vacation and didn’t touch the laptop until we got home. There was mango sangria, walking in the surf, watching a horrible Burt Reynolds movie (was that redundant? – well, it was Stroker Ace, which is bad even by low Burt standards, but I couldn’t look away given the mammoth thespian talents of Jim Nabors) while drinking wine in front of the TV with the sea breeze wafting in, and eating some excellent fish tacos and goat cheese with mango salsa (it was a two-mango weekend). I’m sunburned, behind in my work, and not a bit regretful about either. 

4-24-2011 6-05-54 PM

The feds aren’t exactly wowing those of us in the industry with their Medicare and Medicaid fraud-fighting record, with 95% of respondents saying they’re doing something less than a good job. New poll to your right: will the Meaningful Use requirements significantly improve patient outcomes and patient safety?

My Time Capsule editorial from 2006: Joe Sixpack’s Concerns About Privacy and Security Need to be Taken Seriously. A snip: “Odd, isn’t it, that a physical break-in seldom reflects poorly on the company being victimized, but an electronic one immediately triggers outrage and disbelief?”

4-24-2011 3-41-54 PM

Cerner COO Mike Valentine resigns the job he’s held for three years for unstated reasons, although the company claims it has nothing to do with its upcoming earnings announcement. He will be replaced by Mike Nill, EVP and chief engineering officer, who oversees the company’s solutions and technology management. Nill, who joined Cerner in 1996, holds a bachelor’s degree in computer information systems from Rockhurst University and was previously with Andersen Consulting.

4-24-2011 3-55-47 PM

In addition to the COO change, Cerner also announces that SVP Zane Burke has been promoted to EVP over the client organization that covers the Americas and the Pacific Rim. He joined Cerner in 1996.

More HIStory from Vince Ciotti.

The New Mexico REC accepts Sage Intergy Meaningful Use Edition as a qualified product.

Adena Health System (OH) chooses MedsTracker 5.0 from Design Clinicals for medication reconciliation.

4-24-2011 5-13-32 PM

The CDC-funded Lab Interoperability Cooperative is recruiting hospitals to participate in a program that will connect their labs with public health agencies as required by ONC’s Meaningful Use criteria. LIC will provide educational and technical assistance to at least 500 hospitals help them electronically transmit lab results. The underlying technology is the Surescripts Network for Clinical Interoperability. Participants include AHA, the College of American Pathologists (and CAP-STS – SNOMED Terminology Solutions), and Surescripts. A readiness checklist is here.

MedPlus puts a cool green bus on the road to demo its Care360 EHR. I should tag along since it’s as close to a rock star tour as we’ll get in this industry, although there was no mention of groupies or trashing hotel rooms.

Big Boston physician groups Atrius Health and Fallon Clinic are in talks to merge, with their common software platforms for EHR, PM, and patient scheduling being cited as a reason that action makes sense.

Banner Health and Poudre Valley Health System will participate in the Colorado RHIO, which awkwardly calls itself the CORHIO HIE since a substantial part of its name came from a fad that has already become passé.

Stupid: a former Ohio neonatologist pleads guilty to signing up for a child pornography Web site using a hospital computer. He has surrendered his Ohio medical license, was fired from his most recent job as a Massachusetts researcher, and will serve 27 months in prison.

E-mail Mr. H.

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Currently there are "13 comments" on this Article:

  1. Wow. Great news for Epic, winning that lawsuit with McKesson. Those patent lawsuits are terrible wastes of money. McKesson should invest their resources in their product, instead of their patent attorneys.

  2. Regarding showing YouTube videos on Apple iOs devices: If you use the “iframe” method for embedding videos (now actually the default method offered by YouTube) they will play without Flash. For more information, see the following guide at Google support:


    Having said that, I sure wish Apple would reconsider their rejection of Flash — it is used for a lot more than showing video, including making eLearning more than an exercise in boring page turning. Apple has a way of pushing us into moving ahead with new technology (e.g. ditching the floppy drive, adopting usb), but I have a feeling their rejection of Flash is also a lot about having more control over what games you can play online.

  3. you need to take a closer look at the mychart lawsuit. it was a 3 judge panel that found 2-1 in epic’s favor. however, the swing vote actually voted in epic’s favor only because of precedent, while actually saying that he disagreed with precedent. the key term in there is en banc. not sure if it will affect this specific case, but this case may cause all the appeals judges to get together and decide if their precedent actually needs to change to account for modern technology. alot of things have to happen to make it a reality, but if the judges decide to re-interpret the precedent, it’ll have a big impact throughout the technology patent world.

  4. While I really do love Vince Ciotti’s history lessons having lived some of it forces me to clarify – the IBM 1401 was not a “card sorter” – it was a full blown, stored program computer with 4k of memory, a console, and the ability to attach to DASD, a card reader/punch, and 1403 printer. It did not have an OS so it could only run one program at a time.

    I wrote my first program on a 1401 (in machine language).

    Now get off my lawn you young whippersnappers!

  5. @NotQuite: What a ridiculous thing to say. Patent infringement is a serious problem; lawsuits to enforce patent law are not a waste of time or money. Why should any person or company invent something, then just allow everyone else to steal it without consequences?

    @MrH: Might have missed the recent KLAS report that shows McKesson rated highest among community hospitals in confidence to reach MU. McKesson and Meditech are long-time HIT providers, and have a large and diverse community hospital customer base, so a few of them switching vendors isn’t really big news. I think a better question to ask would be why Epic has been hammering Cerner, even though they’re both similar EMR systems and Cerner has a much broader offering. Also interested to hear your thoughts on why several large Eclipsys/Allscripts accounts have switched to Epic recently.

  6. “Those who don’t recognize the advantages to change are typically the last to implement and are behind the curve in realizing the benefits.” Oh I agree completely. I’m just skeptical that so many people think they are so good at recognizing the advantages to change. Marketteers get paid to make you believe otherwise of course, but gathering and analyzing data is hard – like designing something that is useful and not just cool. But you’re right that there is a benefit to early adopters. I just wonder if all these people touting the revolutionary ipads have closets full of palm pilots, tablet PCs, Palmtop PCs, Apple Newtons, etc, etc. Maybe iPads will be different. Maybe. As for me, i’m picking up a nice Macbook Air. Which is clearly not revolutionary. But top of its class.

  7. RE: Ipod touch “Sometimes I stream Netflix over it while sitting outside or in the kitchen.”

    OMG… When do you find the time???

    [From Mr. HIStalk] I admit that it’s usually for maybe 2-3 minutes before I have to go get some work done, but a little bit of Larry Sanders, Veronica Mars, or Twilight Zone (new to Netflix – all episodes!) is a nice break. Maybe I should get a waterproof cover so I can watch it in the shower!

  8. Hey, Burt did some good work as well–Deliverance, Longest Yard, Boogie Nights. And I gotta defend Cannonball Run cuz it’s just funny in a 1970s (even though released in 81, the humor is a throwback) slapstick kinda way. I would also argue that Smokey and the Bandit gets a positive nod for Sally Field and Jackie Gleason. Let’s say Burt was elevated by those around him.

  9. Wow…Did anyone else catch this in the item from Lucy Gucci…The part about the PA at the Urgent Care Center saying that Epic employees “need antibiotics since they can’t take time off to recover”?

    WTF? Since when is the deciding factor as to whether or not to prescribe antibiotics the amount of time the patient has to recover??? If the patient has a condition for which antibiotics are not indicated (viral URIs, so-called “acute bronchitis”, non-GAS pharyngitis), then prescribing them won’t make the patient get better faster, they will have no effect…other than giving the patient diarrhea, maybe a yeast infection if they’re a woman, and increasing their likelihood of developing resistant infections. Geez…I thought we were past this!

  10. Mckesson suing Epic for online access of patient info is like Microsoft suing Google for Gmail. Whatever happened to competing in the marketplace through some good old innovation?

  11. “Whatever happened to competing in the marketplace through some good old innovation?”

    It went the way of health systems purchasing systems based on a thorough evaluation vs. narrowing down to the handful of “market leaders” and asking buddies at other systems who they chose…

  12. Increase Productivity is essential so that we can spend more time with the patient and taking care of there needs. I hope Meditech reads this blog and get there workflow together

  13. Is it really fair to say Epic is a sweatshop? Last I heard, a sweatshop describes long hours, poor wages, and poor working conditions. My Epic acquaintances have never hurt for money and their working conditions are pretty above-average.

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