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Monday Morning Update 5/23/11

May 21, 2011 News 7 Comments

From The PACS Designer: “Re: SlideRocket. Microsoft PowerPoint has been the dominate force in the presentation arena for business applications, but there are new ideas surfacing that could challenge their market share.  One is a Web-based application called SlideRocket, acquired by VMware last month. You can try it by importing an existing PowerPoint presentation to see what a Web-based format can do to enhance your creative abilities.”

From Little Birdie: “Re: [SVP name omitted]. Fired from Ingenix last week.” I’m leaving the name off since nobody likes seeing themselves in unflattering headlines, but the source is a good one.

5-21-2011 8-16-09 PM

From Lawdy Mama: “Re: Ford’s in-car medical monitoring. The target is much larger. Truckers include a large population of diabetics and, since they live on the road, have problems managing their disease. It can also be dangerous for diabetics to drive while suffering dizziness or other symptoms.” I’m always fascinated by trucker health since I talked to a guy once who runs a company that provides healthcare services from truck stops – it was truly fascinating to hear about their particular risk factors and the challenges of delivering healthcare services to them when every minute off the road costs them money. I guess I can see the value there, although Ford didn’t mention trucks in their announcement. As long as the built-in device doesn’t require drives to interact with it (or drivers exercise reasonable caution by pulling over when doing so), then there may be some medical value.

My Time Capsule editorial this time deals with missing clinical information, even in supposedly advanced IT systems. A snip: “I can think of only two reasons: (a) command and control is so fragmented within our episode-based system of revolving door specialists that everyone assumes that someone else is watching the big picture, or (b) providers are too busy to do anything more than patch and mend, buried in piles of disjointed facts that are difficult to comprehend and act upon.”

I got a nice e-mail that I need to anonymize quite a bit, but here’s the gist. The author said reading HIStalk for years taught him/her two major lessons that he/she will use directly in his/her new vendor leadership role: (a) move your products up the value chain via application and technology integration, and (b) if your product enhances expensive hospital information systems, then price it accordingly based on the value it delivers. The conclusion: “Your blog sure cut down my learning curve for many things healthcare. I thank Dr. Jayne the newcomer, Inga, and yourself for your commitment to the industry.” I really appreciate that.

5-21-2011 5-10-43 PM

CMS may not show a lot of confidence in providers, but the feeling is apparently mutual. New poll to your right, for providers: are you confident that your employer’s security practices will keep your medical records private?

I found this installment of Vince Ciotti’s HIStory to be his most interesting so far, in which he also mentions the EMR that’s 40 years old and still running today (and it’s not Meditech).

5-21-2011 5-42-08 PM

Welcome to new HIStalk Platinum Sponsor Kony Solutions of Orlando, FL. They help companies (more than 35 Fortune 500 ones, in fact) get their message out to every mobile device that’s out there, providing a highly configurable out-of-the-box solution that allow companies to put mobile-rich apps (smart phone, mobile web SMS, etc.) in the hands of consumers in as little as a few weeks and at a lower cost than any other solution. These are not cookie cutter templates. Healthcare examples of what they can do: generate outbreak alerts, manage appointments, do prescription refills, and create provider-finder apps. Like their ad says, just putting an iPhone app out there is missing a bunch of consumers who use other technologies. I interviewed Aaron Kaufman, VP of the company’s healthcare and life sciences solutions division, just a few weeks back. Thanks to Kony Solutions and Kony Healthcare for supporting HIStalk.

5-21-2011 8-18-32 PM

Thanks to the readers who sent over new Annals of Internal Medicine articles on RHIOs and EMRs. Talking points: (a) only 13 of 179 RHIOs reported that they could meet Stage 1 Meaningful Use requirements, and (b) two-thirds of RHIOs won’t survive financially once their grant money runs out. The RHIO article points out that it’s not surprising that RHIOs can’t wean themselves off the taxpayer teat since free-flowing HITECH money encourages them to start up, but nobody wants to pay for information exchange except for directly beneficial transactions such as lab results. It also mentions that RHIOs are being held back by low EHR adoption (the accompanying editorial says RHIOs struggle “in exactly the same way as a cable company would if no one owned television sets.”) Here’s all you need to know about the article, which comes from its summary: “No RHIO in the nation met our expert-derived criteria for the comprehensive HIE needed to substantially improve care quality and efficiency.” The article had some unintentional humor in the footnotes: the authors who concluded that RHIOs are pretty much a failure were, like the RHIOs themselves, supported by ONC grant money. Doh!

Even Epic’s contractors get big new buildings. The company working on Epic’s never-ending construction projects figure they’re never going to be finished at this rate, so they build a 22,000 square foot building to hold their 65 on-site professionals that oversee several hundred construction workers. The construction company says they will have up to 700 people on site next year as they ramp up work on Epicenter 2, a second on-campus Epic auditorium that will seat up to 13,000 people.

5-21-2011 7-31-11 PM

A book detailing the 2004 murder of Cerner nurse Julie Keown by her husband (he poisoned her Gatorade with antifreeze), has been published.

A study finds that hospitals are over-promoting their robotic surgery gadgets and, in 73% of their Web sites, are using word-for-word questionable information provided to them from the manufacturer who sold them the equipment. According to the Hopkins surgeon who led the study, “To me, this is exactly what is wrong with American health care.  We are adopting technology without being up front about the outcomes to consumers. And we adopt technology before we properly evaluate it.”

Bizarre lawsuit: a woman sues an Ohio hospital, claiming it mailed her picture of her premature baby who died there. She says she received 154 pictures of her dead baby propped into a variety of poses, including some of his body being held by an unknown hospital employee, even though the mother told the hospital she didn’t want pictures taken.

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Currently there are "7 comments" on this Article:

  1. I have been a slide rocket subscriber for about a year. But, the pricing is ridiculous (over $200 per year, versus $86.86 for all of MS Office). Also, I find it much cumbersome than PowerPoint.

    I would love to find a web based alternative to PowerPoint, but for me, this isn’t it – yet.

    I like Prezi. You can do some cool things with Prezi that are out of the box, but it is time consuming to create a good Prezi.

  2. I get skewered by the informatics glitterati every time I criticize the business model of state and federally funded RHIOs. But the wisdom of my aunt sums it up nicely: When money gets tight, good will takes flight. There is zero natural economic incentive in today’s US healthcare system to encourage the sustainability of RHIOs. Even those that are not funded primarily by state and federal funds are going to go under in the next few years if the US economic model for healthcare doesn’t change. RHIOs are CHINs version 2. Double CHINs. 🙂

  3. My daughter has Type 1 diabetes and has a history of low blood sugars. She tests her glucose levels often which involves a finger poke to draw a drop of blood onto a test strip. I wonder if she and other type-1 diabetics test while driving, at stops lights for instance.
    A passive monitoring system that would alert the driver to low blood sugar level would makes the roads safer. Now that is amazing technology.

  4. I never understood why RHIO’s didn’t just attach a fee for “medical records” every time a patient saw a provider. That solves the funding problem. The fee probably wouldn’t have to be that large.

    States usually have all sorts of fees for other services, why not RHIO’s? Collecting user fees and running the RHIO as a public utility is a far better model then letting providers or insurance companies run the show.

  5. I don’t understand any of the questions or criticisms re: HIEs not reaching MU Stage 1. MU is something that eligible providers (EPs) would need to achieve within their own EMRs. HIEs are just for exchanging data between EPs’ EMRs. Similarly, why would an HIE be expected to do e-prescribing as has been questioned before? That would need to be done from within an EMR (that might attach to an exchange). Unless the HIE is also providing an EMR itself, but again, that would be up to the EMR to reach MU, not the exchange. Or, have I just missed something here?

  6. The Ford monitoring technology sounds great. However, raises the question of whether truckers or anyone else would really want someone monitoring them besides at a very basic safety level (alert if glucose too low, for example). Sort of a general topic for in-home monitoring – how much is too much?

  7. RG said: “Collecting user fees and running the RHIO as a public utility is a far better model then letting providers or insurance companies run the show.”

    This speaks to a fundamental question regarding HIEs: Are they public utilities (i.e. for the good / use of all in a community like roads, fire departments, bridges, sewers, electrical, postal service, etc.) or are they entities expected to develop a business plan to be self-sustaining (profitable)?

    As public utilities, HIEs hold the promise of supporting the reduction of health disparities and improving community health…while the latter risks widening them.


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