Monday Morning Update 7/9/12

From Gob Bluth II: “Re: Health Information Partnership for Tennessee (HIP TN). HIP RIP. Another HIE bites the dust.” Verified. Gob forwarded the e-mail that went out to stakeholders on Friday, along with a copy of the official announcement that will be released Monday. The three-year-old state network says officials decided to pursue a simpler strategy of using the DIRECT system as a HIP replacement. HIP TN chose Optum’s Elysium Exchange (the former Axolotl) in October 2010 and now it’s going to the Greek mythology version of Elysium, the afterlife of the chosen.

From Data Birth: “Re: Consumer Reports hospital safety rankings. I’ll wager the reason the data were inconsistent or missing is because hospitals don’t want this particular information to reach the eye of regulators or the public. You would think this would be available through Joint Commission inspections.” In my experience, the Joint is good for two things: (a) reacting to headlines by setting big-picture goals and ever-moving standards that never result in hospitals getting punished, and (b) clearing the hallways of carts and getting storage boxes away from the fire sprinklers, which happens only when their inspectors are on site. Hospitals in the past have been given a clean bill of health by Joint Commission, only to be threatened with shutdown immediately afterwards by inspectors from the state or CMS over egregious patient safety problems. I’m not casting implications on the Joint’s motivations since I’d much rather have them than not, but they’re making nice coin by not only selling inspections but also the tools and services that help hospitals pass them, and sometimes I think they struggle with the balance of being both a regulator and a vendor (like other similar organizations.) I think they see their role as more consultative than punitive, while sometimes the latter seems more appropriate.

From Max Payne UK: “Re: NHS and Epic. Epic doesn’t have a UK localised product and Cerner is installed in several Trusts. Reportedly, Cerner was cheaper than Epic. So how did Epic wind up being the winner? What consulting company or consultant advised the Trust on this decision?” Hospitals often choose Epic for non-financial reasons: perceived honesty, a near-perfect track record of going live on time, general polish on issues like training and documentation, and lack of Wall Street pressure that could shift their focus quarter by quarter. Not to mention that the big price tags mentioned for Epic projects are all-inclusive of even internal labor, which other vendors don’t include to the later discomfort of their customer. If you’ve seen the actual contracts (and I have), Epic isn’t always more expensive than arguably inferior alternatives. With regard to localization, they have over 5,000 employees and have learned from the mistakes made by others, so the have a leg up on the pioneers before them who crawled back with arrows in their backs. You bring up a good point – do organizations buy Epic because consultants recommend it, or do consultants even get involved with Epic decisions? And as one last thought, Epic (and Meditech) are big enough to command UK attention, but emerged unsullied by the NPfIT meltdown since they weren’t players, so that’s a plus for them. I would hope that those who made the Epic decision talked to the Cerner-using trusts first.

From Konrad: “Re: job stress. I often wonder if part of the fear of EMR and Obamacare is tracking of stressful of employers, like cancer centers. One place I worked actually did that for employees.” The former CEO of France Telecom is released on bail after being questioned by government officials about the suicide of more than 30 company employees in the two years just before he quit. He says the suicide rate was similar to that of non-employees and blames pressure brought on by the economy and the company’s minority shareholder (the French government), but did say he wishes he had paid attention to the warnings of doctors that the company’s massive layoffs and unreasonable performance targets were causing employee health issues.

From BitesTheDust: “Re: John Muir. Epic must have gotten another major McKesson account – this time John Muir in California. Looks like the CIO (Eric Saff) is already gone too as an executive firm looks for his replacement and prefers Epic experience.” They chose Epic awhile back, I think. I had run a rumor here (without naming the hospital) that Epic had originally declined to work with John Muir over some perceived conflict with its IT department and told the hospital’s board as such. I think this may happen more often that we know – the Epic train rolls right over the CIO during selection or implementation when Epic’s way isn’t warmly embraced by IT.

From HR Guy: “Re: stack ranking of employees. Epic does stack ranking as well, with about the same results, combined with the slow hire/quick fire mentality it’s been pretty deadly.” An article about Microsoft’s lack of agility and its fall from swaggering innovator to bean-counting market follower blames stack ranking, the practice that requires a fixed percentage of employees to be identified as great, adequate, or poor, with the great getting promotions and the poor getting shown the door. It concludes, based on Microsoft employee interviews, that everybody spent more time stabbing each others’ backs and sucking up to those who might review them instead of worrying about how Apple was beating them like a drum. Steve Ballmer gets a lot of the blame (honestly, what does Microsoft see in that guy that nobody else does?) but the damage was well underway when Bill Gates was still running the show. A former marketing manager concludes, “I see Microsoft as technology’s answer to Sears. In the 40s, 50s, and 60s, Sears had it nailed. It was top-notch, but now it’s just a barren wasteland. And that’s Microsoft. The company just isn’t cool any more.” Epic does apparently follow the same practice of quickly categorizing employees based on feedback from managers and co-workers who may barely even know them. I like the practice in theory, but as in most aspects of life and business, execution is everything.  

Welcome to new HIStalk Platinum sponsor Visage Imaging. The San Diego company is a global provider of enterprise and advanced visualization solutions that make slow, trickily deployed client-server and Web-based PACS approaches obsolete. No more reconstructions at the modality console while the radiologist twiddles his or her thumbs waiting on digital mammography or PET/CT — Visage 7 makes even the largest multi-slice datasets completely navigable in seconds via an intelligent thin-client viewer displaying server-rendered 2D, 3D, 4D, and advanced visualization imagery on a single desktop (in plain language, huge images don’t need to be pushed painfully and slowly from the hospital data center to the radiologist’s workstation – the server does the work and interpretation gets underway faster no matter where the radiologist is sitting.) Its platform enables enterprise viewing and interpretation and image enablement of EMRs, VNAs, HIEs, and RIS/PACS. You can use it on smart phones and even on Macs. Thanks to Visage Imaging for supporting HIStalk.

I headed over to YouTube to see if Visage Imaging had anything there, and lo and behold, here’s a brand new video on Visage 7 that includes some cool product video (though being a non-radiologist, anything with lots of movement and color seems cool to me).

Clearing out my “Listening” box for now: Phideaux, interesting “psychedelic progressive gothic rock” led by TV soap opera director Phideaux Xavier. Think Jethro Tull, Kansas, and Renaissance rolled into a more modern package with bigger production. It’s really good, especially coming from a guy who directs General Hospital as his day job. I’m playing it loud enough for Mrs. HIStalk to ask me what I’m listening to, though her tone suggests an interest that doesn’t necessarily involve my loading it to her Nano.

Inga and I are coincidentally both traveling this week (not together, just to be clear) so we may be occasionally tardy in our responses and terse in our writing as we take rare simultaneous vacations. Let me know if anything really important comes up this week that I might otherwise miss since I’m hoping to spend a few more hours than usual not working.

Thanks to the following sponsors, new and renewing, that supported HIStalk, HIStalk Mobile, and HIStalk Practice in June. Click a logo for more information as you ponder with me the illogicality of respected, successful companies backing a shoot-from-the-lip journalistic ne’er-do-well who nonetheless appreciates their support in forms that often extend beyond financial to personal. There hasn’t been a day in the nine years I’ve been writing HIStalk that I didn’t marvel at how cool it is to live my Mr. H alter ego even though it’s purely imaginary.

PPACA pretty much splits us as taxpayers, but we apparently like it fine as healthcare IT people. New poll to your right: which group would you target first to reduce healthcare costs? Obviously it’s a simplistic question with limited answer choices, so the poll accepts comments for your further elucidation.

A Physician’s First Watch poll on the Affordable Care Act drew similar results, with 65% of respondents (presumably mostly doctors) saying they like the Supreme Court’s decision (which presumably means they like PPACA).

CapSite releases its 2012 Laboratory Information Systems study. By the numbers, the dominant vendors are Meditech, Cerner, and Sunquest, and 81% of respondents say they won’t be replacing their system within two years. I like reading CapSite’s reports because they’re formatted as PowerPoints saved as PDFs and they get right to the point with charts. I had forgotten until I read the graphic above that Allscripts offers a LIS, which I assume is the former Sysware that it acquired in 2006. I also noticed that Epic’s Beaker is moving up the LIS ladder even though it’s not quite there yet, but probably will be by the time its newly implementing customers are ready to take another look at lab systems.

For the stats-obsessed among us (not me, but maybe Inga, and surely that one person who always e-mails me to ask), June’s readership numbers were really good given the annual summer slowdown: 102,849 visits and 191,515 page views, up a bunch from last year.

Weird News Andy finds the comments left on the Physicians’ Declaration of Independence interesting.

Here’s why e-MDs CEO Michael Stearns is  no longer with the company, as explained to its customers via e-mail. Grizzled Veteran provided that rumor last week. Founder and board chair David Winn has replaced Stearns as CEO.

This might be the first time that a hospital is acquired primarily for the value of its expected Meaningful Use payout. Cookeville Regional Medical Center (TN) will hold back $700K of its $6.7 million acquisition price for Cumberland River Hospital until that hospital gets its $4 million in Meaningful Use money. CRMC’s CEO said, “Part of the viability of this acquisition is the fact the Meaningful Use dollars are tied to it. That’s why it’s vital to have those dollars. That’s why we were adamant to have a hold-back of $700,000 so that we wouldn’t close the deal and they would stop working if they have a chunk of money held out there to comply with the purchase."

Vince continues his HIS-tory this week with HMS, having connected with co-founder Tom Givens to get a first-hand account of those heady days. I suspect many of you who are enjoying Vince’s series lived the experience first-hand in some of the 1970s-80s companies he has mentioned (and those he’ll be mentioning down the road). If so, Vince could use your old pictures and papers for future installments, but most of all, your anecdotes of what it was like back in the day.

E-mail Mr. H.