Monday Morning Update 2/23/09

From Todd: "Re: Mass General. The Boston Globe reports that Mass General waited four days before alerting public health authorities that a wave of gastrointestinal illness was sweeping through one of their floors." Link. The hospital stopped admitting patients to the affected unit after nine patients and 18 employees came down with vomiting and diarrhea, but did not report the suspected disease outbreak immediately to the Boston Public Health Commission as city regulations require. The hospital says the "so-called delay" was necessary because they were collecting information for the commission.

Some readers posted comments ridiculing the idea that Epic is cutting back on staff, while others (some of whom have HR contacts at Epic) assure me it’s happening. Supposedly individual employees are being asked to resign, not exactly a layoff, but perhaps a quiet way to cut back while assuring employees there are no "layoffs." Someone who should know tells me the company’s benefits/departures team is overwhelmed. One reader says it’s the glut of 2004 hires now hitting their five-year mark (and earning additional benefits) who are leaving, maybe not voluntarily. All speculation, nothing verified.

A New York woman complains that she constantly receives PHI-containing faxes intended for the HIM department at Putnam Hospital Center, whose telephone exchange is one digit off from hers.

UPMC hires a big-bucks Hollywood PR agent to market itself, joining notables such as Paris Hilton, Hulk Hogan, and Wesley Snipes on his client roster. The $7 billion chain refused to say what it’s paying. When the newspaper asked the PR guy’s people about the deal, they gave a very non-PR answer: no comment.

The Friday post was a little bit abbreviated, as you may have noticed. Inga did, instantly e-mailing me, "Have a hot date?" She’s good: Mrs. HIStalk and I actually spent time together in in which we were (a) both awake, and (b) not eating, with me sitting at a live performance with her instead of being hunched over a smoldering keyboard (although I admit that I longed to be there a couple of times). I actually bought her flowers for Valentine’s Day as well, thus earning significant goodwill after her initial shock waned.

Kaiser Permanente’s executives are told to cut costs after the health system lost $800 million in investments last year: freezing salaries, limiting hires, laying off, cutting back on contractors, reducing travel, and spending aggressively on marketing and sales to get new members (as with most non-profit hospitals, it’s simply unthinkable to scale expenses to volume — the answer is always to fight harder to steal more sick people who are going elsewhere, thereby adding zero incremental value to the health system as a whole).

Listening: Tsunami Bomb, defunct female-led pop-punk.

Housekeeping reminders: the Subscribe to Updates box to your upper right is the lifeline between you and me since you won’t know about HIStalk updates unless you sign up. If you’re not getting e-mails when I write something new, check with your e-mail server people since the spam blockers are getting more aggressive these days. Also to the right is a Google search box for the nearly six years’ of HIStalk, an Email to a Friend button that will let you tell your compatriots about HIStalk, and some other cool stuff. Topside is the Archives link (at the very top of the page) where you can browse previous HIStalk articles and a link to the discussion forum, which is cool but rarely used, unfortunately. Please don’t forget about HIStalk Practice, where Inga and I (and our guest authors) write for the physician practice IT crowd (it has its own signup for updates, so what the heck, drop your e-mail in there, too). Also to the right is my version of the telethon tote board, that magic count of how many people have visited HIStalk since I started it in mid-2003. Will it hit the 2 million mark by HIMSS? Maybe — I’ll be watching it with great interest since we Web misfits have nothing to live for except our page hits. And related to that electronic narcissism, thanks to the folks who have signed up for the volunteer-created HIStalk Fan Club on LinkedIn, a veritable Who’s Who of the industry (and Inga and I will approve all LinkedIn connection requests to scratch your electronic back since you would do the same for us, wouldn’t you?). Thank you sincerely for reading and thanks to the sponsors who keep the keyboards clacking.

Peter Waegemann and Claudia Tessier have left what’s left of the Medical Records Institute and TEPR (not much, apparently), moving to their newly created non-profit cell phone organization mHealth Initiative. Waegemann defended MRI’s for-profit status in the "HIT Moment" I did with him a few weeks ago, but was apparently careful to make the new group seem less proprietary since the "non-profit" part is mentioned prominently (despite dues ranging from $500 per year for individuals to $9,500 for larger vendors). Tessier is listed as serving in all corporate roles in its Massachusetts corporate filing.

Speaking of mobile phones in healthcare, that was a hot topic at Mobile World Congress in Barcelona. Also mentioned was a new organization with a similar mission and name to the one Peter Waegemann chose: the non-profit mHealth Alliance, launched by the Rockefeller Foundation, the United Nations Foundation, and the Vodafone Foundation last week.

Lots has happened with Stanford International Bank, the primary owner of failed Emageon acquirer Health Systems Solutions. Billionaire owner Allen Stanford has been found and served, most of his enterprise has been frozen by the SEC, Antigua is having a run on banks including ones he doesn’t own (like Bank of Antigua above), liens have been placed on his US properties for the $104 million he owes in back taxes, and even pro jocks can’t pay their bills because their money is frozen in Stanford’s bank, earning twice the interest everyone else was paying (hmm …) Sir Allen (he earned himself an Antiguan knighthood for buying up the island) may have been located, but his bank’s claimed $8 billion in assets hasn’t. The New York Times says his wealth wasn’t built by admirable bootstrapping and shrewd Houston property investments as he says; instead, he took millions from his father and started offshore banks on loosely regulated Caribbean islands. Sounds like HSS just got stuck in the middle of the mess through no fault of its own, at least pending its resolution.

Staff at Genesis Medical Center East (IA) set up a Webcam so that a husband hospitalized for kidney stones could join his wife’s 80th birthday party virtually. Both the hospital and the site of the 250-guest celebration (a local bar) had wireless, so the guests dropped by the camera to send good wishes to the husband.

InterSystems Iberia wins a prize for the best technology effort for developing healthcare solutions in Spain.

Healthcare portal vendor MEDSEEK acquires Visibility Factor, whose technology it will use for search engine optimization projects.

Dubai News
By Ms. Adventure

Since there seems to be so much interest in what is happening over in Dubai, I thought I would let everyone know what the latest news is and the effects of the economic crisis in this country.

Many construction projects have been put on hold indefinitely. Yes, that includes many of the new hospital construction projects. In the Dubai Healthcare City, the University Hospital construction has been halted for a period of 18 months ( it might as well be indefinitely). With the halting of construction, 60 clinical planning and non-clinical projects employees were laid off, and only six were retained for management purposes (C-suite).

The new Epic Systems contract is also under investigation, as there are charges of corruption in the management and acquisition of University Hospital HIS system.

In other areas of the Healthcare City, over 100 people were laid off. In Dubai overall, 1,500 people per day are cancelling their visas and returning to their home country. As they are leaving, they are also leaving their debt behind.

So who is left in Dubai and where is all the excitement? Looks like Cerner is going strong, working on their project for the Ministry of Health (14 hospitals and 60 clinics) named Wareed. I had the pleasure of meeting a few of the project consultants demonstrating applications in the MOH booth at Arab Health ( I was shocked that Cerner actually had quality and seasoned people working on the project — looks like many of them came over from the States to live in Dubai). You could see that the relationship with MOH and Cerner is very good and that Love was in the air. I caught glimpses of the Cerner executives interacting with the UAE Minister of Health as he introduced them very happily to other Ministers of Health in the region (couldn’t hear which countries they were from).

I have been in this region over 10 years and sadly I will be returning home soon. I must say that in one short year things have changed so much, from a thriving and booming town to a town that may not have a tomorrow.

More About CCHIT

People still insist on posting absolute drivel about CCHIT for some reason, some of it so clearly wrong that I’ve heard that HIMSS has loosed its lawyers to ask (some have called it "threaten") bloggers to remove some of the more hysterical comments posted by the same, anonymous person (and often duplicated word for word on multiple sites). You know you need a twit filter when a major investigative point of contention is that Mark Leavitt and Mike Leavitt share the same last name even though they are not related.

For all the time the conspiracy theorists have spent writing up their imaginative speculation, you would think that maybe they could have done a little bit of research. The question about CCHIT’s incorporation status has been endlessly pontificated upon, with relevance unclear (Would be it be a travesty if they weren’t actually incorporated? Does anyone really lose sleep wondering in which state it’s incorporated)?

Well, all the Internet nimrods had to do was look. Within 60 seconds (literally) of deciding I’d look for myself, I had both CCHIT’s corporate records and their federal tax filings (from October) in front of me, maybe another indication that these aren’t exactly geniuses out there riding the comments trail.

I figured CCHIT was, like many organizations, probably incorporated in Delaware. Looked it up online, bingo. Incorporated as an LLC in 2004, reincorporated as a non-profit C-corporation in 2006. I e-mailed Sue Reber at CCHIT and she confirmed that the Illinois incorporation was accidentally allowed to lapse, which is why those records show "involuntary dissolution." OK, is everybody happy that they’re really incorporated? The only question I couldn’t answer is why they filed for domestic residency, which according to the Delaware department of state, means "this entity is domiciled in Delaware." I’m sure they have a registered agent in Delaware, so that may be adequate to claim that category. I find it hard to get excited about it one way or another. They’re legal, not a big shocker since they get government contracts and Uncle tends to check those things (unlike when paying Medicare claims).

On with the tax records. CCHIT’s address on the tax form is 200 S. Wacker Drive, Chicago, IL 60606. That’s a 41-story building that includes CCHIT’s Suite 3100, which is actually a Regus/HQ Business Center that will rent you a "virtual office" for $225 per month or a mail box for $80 per month. In other words, I could share a suite with CCHIT if wanted (along with about a zillion companies that use same suite number). I wouldn’t plan a field trip during the HIMSS conference since I’m pretty sure there won’t be any certification activities happening there, just some people sorting mail into roomful of boxes. It is a cool building, though — I bet I would get some good HIStalk writing inspiration there.

Anyway, here’s the money story: CCHIT took in $4.7 million in FY2007, spent $3.6 million of that, and banked $1.1 million, bringing its fund balance up to $2.7 million and total assets of $3.4 million (they’re running some pretty heavy AR at $750K, so someone’s not paying their bills on time).

Of the $4.7 million in income, $2 million was from certification fees, $2.7 million was from government contracts. CCHIT got an HHS contract in 2005 to develop and a certification program, which it says is "transitional" and will be followed by a self-sustaining model (all the more reason to bank some of its income). That’s dead on with earlier announcements that pegged the HHS award at $7.5 million over three years, plus a $1.4 million extension that runs through April 2009, so it would appear that CCHIT’s only income will very soon be from certification, which means it will need to do some cost-cutting (current spend $3.6 million, current income $2 million).

CCHIT’s biggest expense by far was for consulting – $1.9 million. There are some mildly interesting expenses there:

• ISIS Health Informatics Resource Group was paid $243K. That’s a Canadian company owned by Guy Paterson, who was previously CCHIT’s director of certification development according to his LinkedIn profile (although it also lists him as currently employed by CCHIT, so it’s not entirely clear). According to CCHIT meeting minutes, he left in July 2007. Perhaps he’s contracting back to CCHIT at a handsome rate.
• Public Communications, Inc. received $184K. That’s a Chicago PR company that also has HIMSS among its clients.
• Soloman Appavu was paid $166K. A Google search shows him as a former Stroger Hospital and Cook County employee who served on CCHIT’s security and reliability work group. He has also listed in his biography as being President of Center for Healthcare Automation Ltd. whose address appears to be a residence (he lists that employment for a HITSP article planned for a June printing by HIMSS) and whose Illinois corporation has been dissolved. He is listed on CCHIT documents as "staff."
• Reber Marketing got $157K. I assume that’s my contact Sue Reber, who is CCHIT’s marketing director.
• Merril Prager was paid $152K. Her LinkedIn profile shows her as an independent consultant specializing in helping organizations turn around their financial performance. She is listed on CCHIT documents as "staff." Her name is on the tax form as the contact for financial records.

Salaries totalled $356K for officers, $382K for staff. CCHIT reported having four employees. The highest paid non-officer made $110K with benefits, but that doesn’t count those folks above, I assume, since they are paid as contractors. Alisa Ray, executive director, made $192K.

CCHIT reported $866K transferred to AHIMA in a category that includes sharing of equipment, facilities, or employees. HIMSS received $196K for a category that includes performance of membership services.

The tax records indicate that CCHIT chair Mark Leavitt is still a HIMSS employee, "on leave from his position as HIMSS’ Chief Medical Officer while serving as Chair of CCHIT. CCHIT pays HIMSS an hourly rate for Dr. Leavitt’s services that is intended to cover the portion of his salary and benefits allocable to those hours." That’s at odds with both his CCHIT bio and his LinkedIn write-up, which say he’s finished with HIMSS and working full-time for CCHIT (he put on LinkedIn that he left HIMSS in September 2005). I don’t know which is correct, but he is shown as being paid $164K for 40 hours a week at CCHIT and I would bet he’s making more than that.

I’m not finding any smoking guns here. Everything looks entirely above-board, although Mark Leavitt’s employment status probably should be clarified by CCHIT.

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