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Monday Morning Update 1/21/13

January 19, 2013 News 10 Comments

From Jean Valjean “Re: Vendor shake-up. A major EHR vendor plans to dismiss between 10 and 20 percent of its workforce aimed at development, product management, marketing, and testing groupings. Employees also say the organization is taking initial measures to remove all personal days and compelling employees to use vacation time. Morale is very low and several key employees are leaving on their own. Issues stem from the recent appointment of a key executive whose management style is unknown.” This email contained just enough details (which I removed) to identify the company. However, the accusations are incredibly vague, though if any of it is true, employees may recognize their employer. If you can identify the company and want to share some verifiable details, drop me a note.

1-19-2013 6-06-01 PM

A dozen health systems earn a spot on Fortune’s 100 Best Companies to Work For 2013, including Southern Ohio Medical Center (29), Meridian Health (39) , and Mayo Clinic (41). I liked the perk offered by Methodist Hospital System (67): every employee received a $200 debit card to recognize their efforts and to promote the hospital’s ICare philosophy.

1-19-2013 8-47-01 PM

inga Speaking of great employers, Mr. H is taking a few days off so I am flying solo. I’m not sure whether he is sitting on a beach with an umbrella drink or skiing down a mountain, but I am sure he is putting together a few new Spotify playlists for your music diehards. I don’t have a playlist to share, but I can recommend Lincoln and Zero Dark Thirty if are interested in hitting the movie theater.  Especially Zero Dark Thirty, which stars Jessica Chastain as a very smart, tough, and attractive CIA operative committed to finding Osama Bin Laden. Really, who doesn’t love a smart, tough, attractive woman? I’ll also mention for the HIMSS-attending fun seekers that we will be sharing details of HIStalkapalooza this week, including a link to request an invite.

United Airlines did not make the Best Companies list, but offers a nice perk by providing free health services at several of its hubs, including a just-opened employee health clinic at Chicago’s O’Hare airport. It’s one of five Walgreens-managed facilities available for all employees.

1-19-2013 8-53-00 PM

athenahealth announces it will offer an anesthesia-specific billing solution for hospitals and independent practices.  MedOasis will provide the capabilities for anesthesia coding, charge-entry, contract management, and compliance.

The VA again awards HP Enterprise Services a $543 million contract for RTLS, three months after IBM contested the original award granted in July. The GAO upheld the protest, saying the VA had made several prejudicial errors in evaluating the original offers from HP, IBM, and four other vendors. The VA re-opened the bid process in October and again selected HP to equip 152 medical centers.

1-19-2013 8-57-54 PM

Audax Health, which recently signed a strategic alliance with Cigna to develop a digital engagement platform, raises $21 million through a mix of debt, options, and other securities. The company also names four new executives including Optum alums Doug Celebi, MD (SVP of informatics) and Brian Dolan (chief customer solutions officer).

1-19-2013 8-58-46 PM

Saint Anthony’s Health Center (IL) will offer emergency tele-neurological services in partnership with Specialists On Call.

1-19-2013 9-01-36 PM

The local business journal profiles UCSF Medical Center and its $160 million Epic EMR, which went live in June. The reporter includes a few details that UCSF would likely rather forget, such as the project taking a year longer than originally estimated and costing $100 million more.


Mr. H, Inga, Dr. Jayne, Dr. Gregg, Lt. Dan, Dr. Travis.

More news: HIStalk Practice, HIStalk Connect.

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Currently there are "10 comments" on this Article:

  1. At UCSF, a $160 million Epic EMR that took a year longer than originally estimated and costing $100 million more than the original budget. That number is astounding and is consistent with the RAND report, and, this has nothing to do with doctors not “re-engineering” their work flows to enable HIT to do its thing. How do you spell F-A-R-C-E? One can not help but ask the question, where was the accountability, transparency, and integrity of those in charge and of the vendor?


  2. It’s it starting to get laughable about these EMR projects and their true costs versus budgets. While EPIC continues to maximize it’s revenues from the EMR hype, healthcare providers are spending huge amounts of dollars to implement these systems, then they have to optimize them and spend more because they are installed in a boiler plate way. Then on top of it all they have expand their IT budget to maintain the systems. At some point, if you look at healthcare providers that have spent millions of implementing EPIC within 30 miles of each other, at some point someone has to ask the question, can’t we just all get along and share?

    There will never be a true ROI on any of this and if you believe that there will be, you must be the one creating the original implementation budget for these organizations. This game is a big farce, and as a taxpayer I look at all of this hype and spending as another government boondoggle.

  3. Re: Vendor Shake-up — Well, you have had to been under a rock these past months because I would be totally shocked if it wasn’t Allscripts.

  4. I hope that these new devices save many lives, reduce errors, shorten hospital stays, reduce readmissions, and otherwise transform and automate health care as it is practiced at UCSF, because the number to treat to break even on this $$$$$$$ outlay and the ongoing costs of training and maintenance is a bit more than a dozen. I would have used that money for pills and care of the indigent and the homeless.

  5. As a tax payer, resident of CA, and a UC alumni I am angered by UCSF’s and Epic’s negligent implementation. I understand 10% over, even 25%–but 150% over budget requires an official state inquiry. ( I know I know, state inquiry sounds like another cash drain) Are they aware UC tuition has been raised 8 years in a row? Epic implementation budget busters are a norm not exception. Perhaps UCSF should look to their anteater brothers/sister over at UCI and see how Allscripts Sunrise has worked, on budget, for them.

    Hmm was Allscripts’ CEO Glen Tullman onto something regarding NYC’s incorrect assessment of how much it would cost to implement Epic? Tullman’s claim of Epic costing more than 300 million more than what Epic claims it would cost doesn’t sound so unreasonable after all. NYC officials have an absolute duty to examine the tax payer’s investment with the utmost due diligence. Anything less would mean, at best, they are not fit for civic duty, at worse, criminal negligence with tax payer money.

    How will all of these CEOs, CIOs, CFOs look after they’ve paid millions for a closed system that doesn’t connect to anyone else? Executives flocking to Epic is sheep mentality at it’s finest.

  6. What isn’t clear with the Epic install at UCSF is if those additional costs were truly in scope of the original work, or found to be needed to make the solution work as expected.

    For example, there may have been some unknown infrastructure costs that weren’t considered in the original planning, but were found to be needed. Another ‘hidden’ cost could be documentation devices for clinicians and infrastructure to support them in areas where they had not been used before.

    All that said, consultant travel expenses, backfill support for the UCSF team and other expenses of this type may have been minimized by the planning team. However, a delay in schedule of a year could easily have cost them $100,000 per month. Bottom line, without more detail on the cost overrun, it’s impossible to armchair quarterback the causes.

  7. ummm PJ, 1 year delay at $100K a month is still only $1.2 million. Where did the other $98.8 million go? It’s really hard to blow that kind of money. It’s a public institution, operated with public funds, and should be held accountable. Any other state agency that blows $100 million extra would have to account for it.
    Best quote in the article: “Still, ‘the implementation is substantially complete,’ COO Ken Jones said in a Jan. 15 interview.”
    i.e., that’s not a final number…….

  8. I am staggered by some of these implementation costs. The inefficiency of one-off builds is staggering. I am reminded of the mainframe world before PCs came along. It would appear some places are spending more on initiatives to get MU money than the potential return of MU incentive dollars. And what money is then left to do all the niche things a giant single-vendor solution cannot do?
    I am convinced that, going forward, enormously expensive single-vendor systems are an unsustainable model; neither nimble enough nor cost-effective enough to be the future paradigm for healthcare software.

  9. OGMD, no taxpayer or tuition funds would have been used for UCSF’s Epic project. UCSF Medical Center, like all University of California medical centers must be self-supporting. Regarding the dollar amount, I wonder if that included costs for their failed IDX project. Regardless, many IT projects go way over budget–there are so many unknowns and incidental expenses–so I am not surprised. You refer to UC Irvine’s Sunrise project but that had many bumps and delays as well and it’s not even an integrated system; they’re still using Invision for patient accounting and TDS 7000 for some functionality as well. Your statement that Epic is a closed system that doesn’t connect to anyone is just plain wrong–they have more out of the box interfaces than anyone I know of and their software is customizeable to a fault (in fact, we have both client and server side source code and Epic offers programmer training to customers). Like Clint Eastwood’s Obama chair, I have no idea what you’re thinking. We’re not talking about iPhone customers waiting outside Apple Stores; the people who make these purchasing decisions have to provide substantial justification and documentation (and they don’t get anything out of it; Epic doesn’t wine and dine executives like other vendors).

  10. @ Quite One

    Sheep says: “baaaaaahhhh” and “Epic”.

    We both have very genralized claims, but being 150% over budget (not 50% a whole 150%) cannot be marked up to “unforeseen” events.

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