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Monday Morning Update 8/13/12

August 11, 2012 News 8 Comments

From The PACS Designer: “Re: big data mining. One of the challenges facing healthcare is how to collect, manage, and view data that can improve outcomes. Some interest is brewing in the open source community to help with the challenge. An open source solution drawing this interest is Hortonworks with Apache Hadoop 1.0. While it’s still relatively new, the chances of HortonWorks being production ready in the next year or two are high, and it could show up in healthcare settings in several years.” The post also quoted EMC’s CTO, who listed some healthcare big data opportunities: (a) always-on end user query capability for all data sources; (b) data collection from real-time medical instrumentation; (c) in-memory capabilities for fast decision-making in the ED; and (d) real-time health scoring as is done in ICUs. Above is a nicely done overview of the Hortonworks Data Platform that should get tech geeks salivating.

8-9-2012 6-58-06 PM

From A Curious Reader: “Re: Meditech’s KLAS numbers. The 16 customer losses in 2011 are from the C/S platform, while the 14 are from Magic. The C/S losses are a mix of v.5.x and v.6. KLAS issued an trend alert in July reporting that 35% of over 50 hospital respondents said they wouldn’t buy v.6 again because of product immaturity and usability issues. Of the non-IT respondents, more than half said they wouldn’t buy it again. According to a CIO quoted, ‘Some of the applications have been developed in the new v.6 language and some applications are in the old NPR language. Because of that, the new v.6 platform requires a million connections, and from a management and monitoring standpoint, the transfer of data is very complicated.’” Just to address the counterpoints: (a) Meditech has a ton of hospital customers, so their percentage loss is probably tiny; (b) Magic is ancient and upgrading is almost like a re-install, so it’s not surprising that those clients would explore and sometimes choose alternatives; (c) Meditech hospitals tend to be small and thus more likely to be acquired and subjected to a forced system replacement, assuming those are counted by KLAS as “losses” (which would likewise give Epic an inflated count of wins.) The customer comments about v.6 are indeed troubling, however.

Listening: First Aid Kit, a pair of amazing sisters from Sweden who covered a Fleet Foxes tune with their camcorder running in a Swedish forest when they were 17 and 14, making them a modest YouTube sensation. That was five years ago and they’re still putting out mature, bittersweet harmonies that could be pegged somewhere between indie pop and American country-folk. They use talent, not studio tricks – check out this rather stunning video that was shot as they sing and play memorably while walking down a public street in Paris right before their show, with cars and people milling around them. They’re doing several US dates in September and October.

8-11-2012 5-28-27 AM

Two-thirds of us would be disappointed if we went straight from a routine doctor’s appointment to the hospital, which would have no record of our just-concluded ambulatory visit. New poll to your right: how has Meditech’s market position changed in the past year?

As I was creating the poll, I struggle as I always do with whether I should write Meditech (my usual) or MEDITECH (like everybody else does). It struck me that I should check the “AP Stylebook” (the Bible of news writing) that’s two feet from my chair, which says all-capital company names aren’t used unless the letters are individually pronounced. It’s OK for IBM or GE, but not Nasdaq or Meditech. That leaves me puzzled about HIMSS (Himss?) since it’s always sounded out. I also learned that characters are not used in a company name (so it’s MModal, not M*Modal), periods go outside parentheses unless what’s inside is a full sentence (so it’s outside this set), and the first word of a sentence is always capitalized no matter what (so it’s Athenahealth, not athenahealth, if it’s the first word of the sentence).

8-11-2012 2-55-32 PM

Speaking of MModal, the company agrees to release the projections its financial advisors used to determine that JP Morgan’s $1.1. billion buyout offer was fair. The disclosure is one of the terms in a settlement agreement the company reached with shareholders who felt the offer price was too low, representing just an 8.3% premium over current market share price and 18% less than a competing bid from Nuance that MModal’s directors rejected. Meanwhile, the company reports Q2 results: revenue up 7%, adjusted EPS $0.21 vs. $0.31, missing expectations on both but maybe backing up the board’s arguments that the buyout price is fair.

Bond ratings company Fitch warns bond investors that HITECH payments can hide the “otherwise anemic revenue growth” of hospitals given that it’s a one-shot payment that doesn’t even cover the IT costs required to earn it in many cases. They also say that the need to implement IT is helping drive hospital consolidation.

Presidential candidate Mitt Romney names Rep. Paul Ryan (R-WI) as his running mate. Ryan’s healthcare IT connections: (a) he wants to overhaul Medicare and Medicaid, saying the country can’t afford the cost; (b)  he was #1 on the “100 Most Influential People in Healthcare” for 2011; (c) he co-sponsored a bill in 2008 that would have established independent health record trusts that would allow consumers to manage their own health records, force EMR vendors to link to those trusts, and split the proceeds from de-identified data sales between the patient and the trust to fund the operation; and (d) he and four other Wisconsin politicians tried to influence the VA and DoD to buy systems from home-state vendor Epic instead of writing their own. My favorite trivia items about him: he was voted prom king and “Biggest Brown-Noser” as a high school senior and he worked a college summer job at Oscar Mayer and was allowed to drive the Wienermobile once (both irrelevant factoids courtesy of warring Wikipedia edits by fans and foes).

Allscripts chooses Symedical Server from Clinical Architecture to address clinical terminology requirements for its entire product line.

E.J. Noble Hospital (NY) hires a new CFO mostly for his IT experience, saying an unnamed system it installed in 2010 works OK for patient care, but isn’t user-friendly for the finance people. That system would be Meditech, according to noted healthcare IT expert Mr. Google. UPDATE: they aren’t Meditech, even though their job application asks about Meditech experience. Folks are suggesting they are using CPSI.

8-11-2012 4-26-28 PM

St. Luke’s Hospital (NC) goes live on McKesson Paragon after what it said was a 3,000-man-hour, $2.5 million project.

General Dynamics is awarded a five-year, $20.6 million contract to connect the Indian Health Service’s EMR system (an offshoot of the VA’s VistA called RPMS) to the Nationwide Health Information Network.

Former Awarepoint CEO Jason Howe is named president and CEO of Vaporstream, which offers a secure digital messaging channel for executive communication that prevents legal discovery.

Personal health records systems haven’t done much of anything, but that doesn’t keep everybody and his brother from cranking out low-rent versions sold cheap on the Internet or burned onto flash drives. Here’s a new $35 one from from “a local Mom” that runs on your PC and requires printing out your manually entered information in advance. The local mom even made a TV commercial. I couldn’t find a screen shot or example of the printed report anywhere. At least the local mom identifies herself as “Owner/Founder” on the site, unlike most spare bedroom part-time moguls who grandly label themselves as CEO like that’s going to fool someone into thinking they’re running multinational conglomerate.

8-11-2012 4-29-46 PM

This story about over-capacity Yale-New Haven Hospital buying the money-losing Hospital of Saint Raphael, also in New Haven, CT, illustrates how political the hospital business is. The YNHH people had to brief city aldermen whose constituents have been pestering them about their fear of losing their jobs or benefits. YNHH said only one group would definitely lose their jobs: the estimated 60 people on HSR’s payroll that Yale had previously fired, raising the ire of one alderwoman who said, “Just because Yale fired them they can’t work? You’re not willing to give them a second chance?” YNHH was also questioned about whether it would dismantle the Teamsters union at HSR; it said it wouldn’t. Maybe it’s no mystery why HSR needs a bailout given that it hires previously fired employees, has to deal with the Teamsters, and pays so much that employees are afraid of a gravy train derailment after being taken over by a university, a group collectively known (as are hospitals) for overpaying masses of marginally competent people who will never be fired or demoted for anything short of a felony committed on company time. Hospitals are like NASA: the science is sometimes questionable, the lack of value is inarguable, but nobody can touch them because they create a lot of jobs and political allies.

Bizarre: a new mom who agreed to appear in an instructional video for breastfeeding is horrified when Googling her own name to find a slew of porn links and explicit YouTube videos. The video company said it’s not their fault that somebody spliced the breastfeeding scenes into a porn video featuring graphic footage of someone who resembles the woman performing acts much less innocent than breastfeeding, but they don’t deny that the video displays the woman’s full name on the screen. She’s suing, of course.

Weird News Andy finds the story of this former law student inspiring (“Tough as Nails,” he labels it). Experts can’t figure out her skin disease, in which fingernails are growing out of hair follicles all over her body. She was referred to Johns Hopkins, where she’s racked up $500,000 in medical bills that her insurance won’t pay because it’s an out-of-state provider. She takes 25 medicines, of which insurance pays for five.

Vince responded to a reader’s request to have all of his HIS-tory episodes available in one place. All 50+ of them have been loaded to his company’s site, where I intended to take a quick look but got wrapped up in reviewing them all over again. This week’s edition is an introduction to the series, why he’s doing it, some folks he fondly remembers, and a plea for material for future episodes from those who lived the HIS-tory he writes about.

Sponsor Updates

  • Certify Data Systems, which offers the HealthDock intelligent interoperability appliance, is named as a "Major Player” in HIE technology.
  • A White Plume blog post observes that physicians seem to prefer to code E/M visits manually even though most EHRs can do it automatically.
  • A HealthCare Anytime fact sheet describes its patient portal, which offers online bill pay, appointment requests, refills, messaging, and a PHR.
  • Henry Elliott & Company’s hot position openings include Cache’ developers, MUMPS programmers, and several other technical jobs.
  • Eastern Health goes live with the disease screening solution of NexJ Systems, which offers next-generation customer relationship management systems for healthcare.
  • Besler Consulting provides an overview of CMS’s Hospital Readmission Reduction Program.
  • Southern Oregon Orthopedics (OR) chooses SRS after de-installing its legacy EHR product that it says had tedious drop-downs, wasn’t meeting transcription needs, and wasn’t getting them to Meaningful use.
  • Shareable Ink customer Sheridan Healthcare (FL) describes its use of the company’s “digital pen and paper” system.
  • Current opportunities at Executive Search Recruiting include consulting VP, IS director, consulting partner, and certified consultants for Meditech and Epic.
  • API Healthcare offers a free August 14 Webinar called “Will You Ever Love Your Patient Classification System? Embracing PCS with Evidence and Persistence.”
  • Health Data Specialists, which offers consulting services for Cerner, Epic, Meditech, and Siemens, will exhibit at Siemens Innovations this week in Baltimore.
  • TrustHCS, which offers coding, compliance, and ICD-10 solutions, will speak about ICD-10 readiness at the AHIMA convention October 1-3 in Chicago.
  • OTTR Chronic Care Solutions will host its user conference September 17-19 in Omaha. The $485 registration fee includes 2 1/2 days of discussions, Q&A sessions, networking, lunch, and a half day of small group workshop training.

The “Future” is Now “Today!”
By Dr. Gregg

There’s a true labor of love that I do each year for the American Academy of Pediatrics – National Conference & Exhibition (AAP-NCE) which used to be called the Pediatric Office of the Future. This non-profit event began as a demonstration of how technology could improve a pediatrician’s office practice. It now showcases technology in all areas of practice – office-based, hospital-based, and mobile / social / telemedicine. It has grown from just seven sponsors and a 900-square-foot booth in 2007 to more than 30 sponsors in a 4,500-square-foot space last year.

It’s a huge volunteer effort. We work hard every year to give our attendees greater informative value and our exhibitors greater ROI. Big changes this year include:

  • No more “sponsors.” Every vendor in our exhibit is a true “exhibitor” who gets better signage, sales conversations, and individual lead capture for a single exhibitor fee.
  • The event itself is now an exhibitor, allowing us to offer short and sweet exhibit hall-style educational offerings as long as we clearly label them as non-CME.
  • We (COCIT — Council On Clinical Information Technology, which runs the event) control the marketing. If we can fund it, we can do it.

We’ve rebranded the exhibit as the “Pediatric Office of Today!” to make it clear that what we are showcasing are tools that can help today instead of in the future.

The non-CME educational offerings will build on last year’s Tech Talk Theater, adding the TIP Stop Video Booth (“How do you put “Technology In Pediatrics?”) and a Meet The Experts area where, during the MTE sessions, attendees can chat one on one with pediatric informaticists, telemedicine pros, REC reps, MU and ePrescribing experts, and even high-level ONC folks. (there’s a rumor that “The Farzad” might drop by.)

The media area of our new site will contain an ongoing record of these sessions, along with audio and video recordings from past years and professional video from this year. It will become our virtual pediatric tech library.

The Pediatric Office of Today! is all about having some fun as we promote advanced technology for delivering better pediatric care, improving bottom lines, and enhancing life and work styles. As the pediatric HIT market’s potential is just starting to take off, it’s exciting to help it take wing. To all our volunteers, AAP support staff, and each and every vendor who has helped or will help support our project: thanks for helping turn the “Future” into “Today!”

(And a special thanks to Mr. H for graciously letting me share the word here about my little pet project.)

8-11-2012 2-37-50 PM

Dr. Gregg Alexander, a grunt in the trenches pediatrician at Madison Pediatrics, is Chief Medical Officer for Health Nuts Media, directs the Pediatric Office of Today! exhibit for the American Academy of Pediatrics, and sits on the board of directors of the Ohio Health Information Partnership (OHIP).

E-mail Mr. H.

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Currently there are "8 comments" on this Article:

  1. Well, you violated your capitalization rule with HITECH so I guess every rule has it’s exception.

    [From Mr. H] I know — I’m struggling with HITECH, HIMSS, AHRQ, RHIO, etc. since we healthcare people sound out everything even when it makes no sense like calling the former JCAHO “Jayco.” Surgical Information Systems sounds out SIS, but it would be weird to refer to them as Sis.

  2. For both balance and truth, it would have been nice to see the President’s response to the confusing figures and mathematical machinations of Mr. Ryan’s analysis. I grant that it is hard to know exactly what the future will bring as far as cost is concerned, but I am not aware of any plan that can grant access and hold down cost more effectively than the current ACA. Something has to give.

    The ACA is consistent with long standing AMA policy, hardly a liberal organization. That policy was developed with input from the Heritage Foundation among others.

    Republicans embraced that policy until it was introduced by the President.

    RomneyCare in Massachusetts is working quite well and is embraced by all the stakeholders. It is the same basic priciple of the ACA.

  3. Imagine how difficult it was not to laugh when GEMS (GE Medical Systems) went into the healthcare IT (HIT) business and came up with the monicker GEMSHIT. GE Healthcare flowed off the tongue easier.

  4. What is most interesting about Ryan’s concern about the national budget is his failure to consider the $ billions being spent on HIT systems that have neither improved outcomes or reduced costs of medical care, according to all published research on the topic. Just wondering what $$$$$ contributions Epic has made to his campaigns and devoted to lobbying him. Does anyone know?

  5. @ Not Tired…

    You obviously don’t know Judy. I can guarantee her money is not going toward any Republicans any time soon.

  6. @NTSuzy, RN – Yep…there is no research done that creating an electronic medical record has not improved outcomes. The only thing it has done is allowed for us to track for the first time anything in health care. Technology is a TOOL and will never replace clinicians…so to quantify an EMR directly with outcomes is like comparing a pencil with a novel.

    I am sure if you were around at these epic moments in mankind, this would have been your stance: “The earth is still flat!” “Pff…the wheel is never going to do anything for mankind.” “Thomas Edison wasted his time with that light bulb…fire is better!”

    Common sense prevails…instead of “fighting”, figure out how to influence your health system to use technology wisely and not trying to adapt it to broken paper processes. With rising costs in health care, the last thing we need is to stick to paper that is crippling our national health system & adding costs…but at the same time, we shouldn’t go for the latest fad that costs 3-4 times more than any other viable option out there.

  7. Find it bizarre, sad and ultimately telling that big defense contractors (e.g., General Dynamics) who build systems to maim and kill are now positioning themselves as healthcare IT consultants and winning big federal contracts. Guess that is why they are called beltway bandits.

    Also, found your comment on NASA somewhat disturbing as it demonstrates a level of ignorance as to the value of basic research. Decades ago there were similar views on federal funding of fruit fly research, research that became the foundation of genetics research. Try to keep an open mind Tim as much of the research we support today will indeed prove valuable in the future.

  8. Lockheed Martin created the first CPOE system, so they’re not all bad. The defense contractors have some bright engineers at their disposal.

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