Giving a patient medications in the ER, having them pop positive on a test, and then withholding further medications because…
News 1/25/08
From Kevin Gnapoor: “Re: HIMSS Analytics mention of HIStalk. It came off better than you reported. Of surveyed healthcare IT execs, 65% reported reading a technology blog in the last year. When asked to mention specific blogs read, 13% identified HIStalk, whereas no other blog was mentioned more than once.” Glad to hear that, although I’d like think I can compete well with mainstream publications and not just blogs. It makes Inga happy to be anonymously famous.
From Cady Heron: “Re: Misys. Misys will have a big roll-out of an SaaS solution. athenahealth may start feeling some heat if Misys can overcome its current dismal perception in the market. As my contact stated, athenahealth is nothing more than a service operation for handling billing with a software front-end.”
From Broadway Joe: “Re: Keane. We run their RCM product and some clinical apps and we were happy to see there recent press releases with some new deals. I know they are actively installing new business in the NY/NJ area. I think the CHS move was a provider acquisition that is causing the move away from Keane.”
From Gretchen Wieners: “Re: Leapfrog. I agree Leapfrog has become irrelevant, but they started with the realization that employers held the purse strings in many cases and had motive for lower cost and better quality of care and better negotiating power given their role. So they analytically looked at what would have the biggest impact on medication errors and chose them. That included CPOE, which can play a key role if the system is designed for clinical decision support. The others were also no-brainers, e.g. the intensivists. But, they never used their clout and their demands were unfunded. Once the MDs balked, they caved.”
From The PACS Designer: “Re: Oracle VM. Virtualization has been mentioned in past posts by TPD. Oracle has a new software offering called Oracle VM, which makes it easier to implement virtualization within the institution at a relative low cost for both Oracle and non-Oracle applications. Edward Screven, Oracle’s chief corporate architect, states ‘Oracle is the only software vendor that combines the benefits of server clustering and server virtualization technologies to deliver integrated clustering, virtualization, storage, and management for grid computing’.” Link.
From Cliff Pantone: “Re: AMIA. This job posting on the American Medical Informatics Association website nearlymade me spurt my morning coffee over the screen: ‘Applicants should have experienced first-hand the creation and rollout of a commercial software product, or else should possess a good sense of humor.’ Too true, too true…”
From Jerry Aldini: “Re: Cerner in the Middle East. I wonder if Cerner will sue IBA since the hospital IBA supposedly took from them was never in the Cerner-Health Authority contract? Also, I have heard that the delayed go-live is mainly due to data center delays. In the Middle East, there is NO experience on the client side when it comes to projects of this magnitude. If a data center is not ready, PCs are not ordered, or end users are not trained, it’s the vendor’s default.”
From Lazlo Hollyfield: “Re: Cerner. It’s funny how an organization supposedly trying to improve healthcare treats its own employees poorly in health benefits and policies. Cerner offers only high-deductible health plans. It created its own TPA (whose medical director was a Cerner associate) to handle employee healthcare claims and Cerner employees manage precertifications, claims, and medical records, meaning the company is looking at the medical records of its own employees. HealtheExchange uses a second-tier provider network that leaves major metro areas uncovered, so if an associate falls seriously ill while working at a client site where the plan has no in-network providers, the associate gets stuck with the bill for any charges over the usual and customary amount, typically 60-75% of the provider’s claim.” I’ll just jump in to disclaim that I don’t know this officially, so you’ll have to take Lazlo’s word for it unless somebody wants to second his emotion.
From Charles Bronson: “Re: RevolutionHealth. They already have a PHR, soon to be CCD-structured.”
From Dr. Lisa Cutty: “Re: Cerner. We get rumors from Asia about Oracle buying Cerner. I know they are interested in the company since 2004 and Cerner is using Oracle’s platform, but are there any new developments?” None I’ve heard. The floor is yours if you have.
MedStar Health, the Baltimore/Washington system in which Azyxxi was created, chooses Cerner Millennium for all seven of its hospitals, although not all apps. A couple of people e-mailed me wondering if that means anything beyond the obvious. I’m guessing no. From Art Vandelay: “I wonder if they used the funds from the sale of Azyxxi to pay for Cerner? Ironic … at least there was no mention of replacing the ED module. Do you really still need your own CDR/Viewer if you are going away from a best-of-breed strategy?”
This must have been embarrassing. HealthTrio is working with CMS in a PHR pilot, which requires going through a security audit. Auditors connected their equipment to power in a server rack and blew a power circuit. That was fixed, but somehow the connector on the server’s RAID controller card was broken. They failed over and were up again within a couple of hours, but this morning went down again due to DNS problems. It’s running, although not very well, and another outage this evening is needed to catch up the primary server.
I’m guessing that Sumter Regional Hospital won the MRI since the Sumter folks sent me an invitation to attend a joint Siemens-SRH announcement tomorrow morning. Good for them. Unusually smart marketing by Siemens, too.
Inga and I finished the first of several new HIStech Report interviews, this one with Stratus Technologies. Pretty interesting stuff. We’re proud of how cool our reprint format (warning: PDF) looks considering we’re moonlighting amateurs.
Jobs in cities: Nashville, Chicago, Denver, Los Angeles. I see we now have 230 jobs listed.
Meditech’s Magic 5.6 is now CCHIT certified.
Premise had a 260% increase in revenue in 2007 (2,265% over five years). I interviewed CEO Eric Rosow in November about hospital throughput.
Ann Carey of St. Vincent’s HealthCare (FL) is promoted to VP/CIO.
Suffolk RHIO in New York chooses HealthUnity.
Last chance for HISsies voting.
Former State of California CIO J. Clark Kelso replaces the receiver of the state’s prison system. I had to look up what that meant: California’s prisons provided such bad medical care that the federal government seized the system in 2005, calling conditions deplorable despite annual medical costs of over $1 billion. The guy in charge is the receiver.
Cleveland Clinic is a big sponsor of Arab Health Congress and CIO Martin Harris will speak. Mr. HIStalk was not invited to attend as a guest of the countries he so richly supports through his regular gasoline purchases, so he sends his regrets. Dubai seems pretty cool.
MedAvant’s shareholders approve the sale of its preferred provider network for $23.5 million.
Wal-Mart starts an employee pilot of its Dossia PHR system, a quick rollout considering it wasn’t long ago (September 2007) that Omnimedix was replaced with Children’s Boston as the technology supplier.
Busted: a Massachusetts doctor is reprimanded for reviewing the electronic medical records of a nurse he was dating. The hospital caught him in an audit and gave him a written warning, but the medical board fined him. Another employee found that the doctor had checked out her OB/GYN records, so she’s suing the him and hospital for $250,000.
The Massachusetts Attorney General is investigating the $16.4 million parting gift that “nonprofit” (despite a $157 million “surplus” in one year) BCBS of Massachusetts gave its retiring CEO this month.
Varian Medical Systems announces Q1 numbers: revenue up 18%, EPS $0.43 vs. $0.37.
The government is anguishing over those five acronyms that are holding the industry at bay due to imprecise definitions, but there’s another mammoth problem that’s keeping Uncle Sam awake at night: the job descriptions of HIT employees. HHS secretary Mike Leavitt asks AHIC to come up with job descriptions and their required credentials in the next year. It is mentioned that the shortage of trained HIT experts is getting critical and not just in the US.
Inga’s Update
Misys PLC announces its interim results from the first six months of their fiscal year. While overall revenue for the company (including banking and financial services) was up about 3%, healthcare saw only a slight revenue rise and order intake was up only 1% over the same period last year. One of the most painful numbers has to be the 34% decrease in initial license fees. No doubt they are hoping MyWay will turn things around for the rest of the year.
Medcomsoft signs a $750K agreement to put EMR in Puerto Rico’s largest owned drug store chain. The deal includes licenses for 100 physicians.
Just the other day I was wondering if I should consider a health savings account and if anyone really used them. Well, according to HSA Bank (warning: PDF), quite a few folks are using them, given the bank’s status as the first HSA administrator to surpass $500K in HSA deposits.
Revenue cycle management provider Accuro Healthcare Solutions files a registration for an IPO to raise up to $144M.
McKesson adds Intel executive Andy Bryant to their board. Bryant is an Intel executive vice president and chief administrative officer.
HIMSS announces that registration for this year’s conference is up 17% over this time last year and more top-level execs than ever are attending. Mr. H swears it’s because I’ll be at the Healthia/HIStalk soiree, but I think he’s just saying that to get me to wear some fancy ball gown.
Read about Meriter Hospital and details on its $30 million all-digital hospital in Madison, WI. Epic is called the “centerpiece” of their showcase for the latest in healthcare technology for patients with cardiovascular disease.
E-mail Inga.
(Apologies for earlier, perhaps repetitive, entries: I accidentally leaned on the Enter key.)
Generalizing from Leapfrog, aligning incentives is key. Most entities in the healthcare system actually benefit from bad health. For example, hospitals and doctors get more business from bad health. Payers get a percentage of a bigger financial flow if people have bad health. The exceptions to this rule are individuals and employers. Two problems seem to prevent individuals from optimizing their health. First, the indiscriminate nature of employer-based insurance programs means that individuals do not suffer the financial penalties of bad health behaviors. Second, the long delay and probabilistic connection between bad health behavior and the resulting bad health consequences means that too few people are stimulated to adopt healthier behaviors. Employers, however, have an incentive to get health behaviors right on a population basis, and are in a position to invest in near-term incentives to improve near-term health behaviors which will result in long-term savings from better health. The Institute for Health and Productivity Management is leading thought in this direction, and a company called Triveris has developed an interesting patient dashboard called Health Insight Now that empowers and rewards patients to engage in behaviors that increase early detection of potentially serious problems, prevent the development of chronic disease, and reduce the expensive complications of chronic illness. Leapfrog provided more evidence that incentives are misaligned in most of the healthcare system. An approach that helps the employer to empower the individual to their mutual benefit is much more likely to succeed.