News 5/21/08

From Mr. Green Jeans: "Re: retail clinics. They are partnering with local health systems, like Wal-Mart with Memorial Hermann and Bon Secour. I believe CVS is doing the same in some markets. The slower uptake is due to the challenge they face in becoming profitable and having secure operational infrastructure in place to handle self-pay and the commercial carriers, which many are now accepting. This is why, in my opinion, you saw CVS/MinuteClinic (which has over 50% of the retail clinic market) select athenahealth to handle PM and billing a few weeks ago. Getting paid and not have billing nightmares for patients is key. The EMR play here is small, as they only conduct a finite number of procedures. The billing and back-office operations are critical to shorten the time between opening a clinic and it becoming viable. The big boys (WM and CVS) are figuring this out."

From K.K. Kallenbach: "Re: comments. Where do the comments in HIStalk come from?" Since this is your comment, now you know! Readers e-mail me or use the Rumor Report (to your right) to send news, rumors, comments, documents, pictures, etc. If they’re good, I run them here (anonymized, of course). Some folks click the Comment link at the end of an article and post their own comments (click the same Comments link at the end of an entry to show them). A very few messages are posted in HIStalk Discussion (usually idiot foreign spammers selling electronics whose messages I have to delete), but we always wish more folks would post there since reading and replying are easier.

From Dr. BeanTown: "Re: Google Health. Dr. Halamka has moved BIDMC live. Curious what your thoughts are." If PHRs have a chance of succeeding, it will be because hospitals allow patients to populate PHRs with their reliable data without it being burdensome (patient-entered data is not worth much in most cases). I like BIDMC’s willingness to lead the pack and I would trust Halamka more than almost anyone to be the patient’s advocate and to be honest in assessing how well it works. It’s slightly odd to use a patient-controlled technology as an intermediary between sophisticated practitioner IT systems (i.e., the patient as the interface engine), but maybe that will serve as a good privacy tollbooth (and Halamka seems thoughtful about privacy as well). With a few big places jumping on board, PHRs will either sink or swim quickly, I would think. If patients aren’t interested, expect the former, so part of BIDMC’s job, I’m guessing, is promoting it. It’s an Internet technology, so a quick market share grab is the main strategy.

From CareGuy: "Re: RHIO. Vermont’s only RHIO failing?" Link. State government wants Vermont Information Technology Leaders to reduce the size of its 21-member board, hire a CEO, and speed up its work. The state tacked on a medical claims fee that will give the private VITL $27 million over seven years, so they’re getting more involved. Doesn’t sound like they’re failing, though.

From Poo Flinging Monkeys: "Re: Misys. Layoffs Monday, almost a dozen folks in implementation, most with a least 10 years." Unverified, but reported by at least four readers.

From Madrigal: "Re: MEDITECH. Their new Southcoast office opened Tuesday in Fall River, MA. Picture attached." Thanks for the pic – nice building!

Listening: Under the Flood, hard-rocking newcomers from Charlottesville, VA.

Say hello to new HIStalk Platinum Sponsor Loftware of Portsmouth, NH. Its products include technologies to manage label printing, barcodes, RFID labels, and retail labels. They have a nice case study from Johns Hopkins on their site involving a lab management system for tracking research samples. Their VP of marketing has a strong healthcare IT background, including as a Health Language, Inc. co-founder and member of HIMSS, AMIA, and AMA. The company is the world’s second largest employer of RFID-certified staff. Welcome to Loftware and thanks for supporting HIStalk and its readers.

Tanya Townsend has been named shared services CIO at St. Mary’s Hospital Medical Center and St. Vincent Hospital (WI). She was at St. Clare’s when I interviewed her in November. Maybe HIStalk made her famous!

Shafiq Rab is named VP/CIO of Orange Regional Medical Center (NY).

Jobs: EMR Developer (FL), Clinical Applications Analyst Lab (WA), Senior Web Developer (DC), Pharmaceutical Informaticist (TX). You can sign up for a weekly e-mail since there’s too many jobs to list here.

San Francisco’s city attorney and a local health plan for low-income residents file suit against McKesson, alleging price fixing. It’s related the Massachusetts suit from 2005 involving average wholesale price of prescription drugs.

Wireless asset tracking vendor InfoLogix acquires Aware Interweave, a provider of mobile information applications for SAP users.

Quality Systems Inc. (NextGen) will acquire revenue management company Healthcare Strategic Initiatives of St. Louis, MO to augment its NextGen Practice Solutions revenue cycle management services business.

VISICU (aka Philips) announces the results of a 156-hospital remote ICU monitoring study: the mortality rate was 9.6% vs. 13.5% nationally, supposedly representing over 7,000 saved lives in the sample.

An Erlanger Hospital (TN) board member and former Tennessee senator walks out of a meeting of the board’s finance committee over an outsourcing proposal from PHNS. The CIO says IT employees favor the move (I’d be surprised if so) but another board member says the contract doesn’t adequately address their future. Says the hospital’s data center will be shifted to the one PHNS runs, which sounds great until the hospital decides to end the outsourcing arrangement (which nearly always happens) and they don’t have a data center or the capital to build one. Perot was also a contender for the business.

An e-mail making the rounds in Kansas City claims "a friend" became sick on soup from a local restaurant, which was analyzed (by a hospital … riiiiight) and found to contain body fluids. It’s surely an urban legend, of course, since hospitals don’t test soup for diseases. What’s interesting, though, is that the newspaper’s original version of the story (cached on Google) included this snip: "The e-mail chain lists smiles@cerner as one of the originators, but a spokeswoman for North Kansas City-based Cerner Corp. said it was not a valid Cerner e-mail address and the name of the e-mailer was not a Cerner employee," but the story was changed afterward – the current version is missing that sentence. That e-mail address may not be valid at this moment (or at all, actually, since it was missing the .com at the end) but the brochure (warning: PDF) for Cerner’s 2008 user conference lists that e-mail address (with the .com) and the employee’s name it belonged to — it was the contact person for canceling exhibit space. None of this matters one iota except I thought the changed story seemed sinister.

The Shared Health statewide information exchange in Tennessee will use software agent technology from Novo Innovations for integration.

Sentillion announces new Q1 customers that include Baptist Birmingham, Hawaii Pacific, UNC Health System, and University of Chicago.

Hey, thanks a lot for reading, e-mailing me, and recommending HIStalk to others. It means a lot to me. Without you, I’d just be downstairs pretending to be interested in watching Kristi Yamaguchi dance.

E-mail me.

Inga’s Update

I have been reading the comments bashing privacy advocate Dr. Deborah Peel and decided it was time to weigh in. I have talked to Dr. Peel a couple of times and was actually surprised she was not the crazy zealot I expected. Instead, she is passionate, well-spoken, and makes some good arguments. She is not against PHRs or using data for medical and genetic studies. She believes that health data belongs to the patient and they should decide who gets it. In other words, it is my decision whether or not everyone may look at all my information, or, whether no one can access my mental health records. Peel is a psychiatrist and became an advocate after having many patients pay for services in cash because they didn’t want their employers to know they were under psychiatric care. Peel also advocates a “break the glass” option should you end up in the ED. I understand that if patients must provide approval before anyone accesses their information (de-identified or not) then it complicates many things, but I can’t say I disagree that I should own my own medical information. I also agree with Matthew Holt and his suggestion that we should also be looking harder at banning discrimination based on health information—especially with regard to insurance coverage.

Speaking of privacy, I played with the new Google Health site and it seems quite friendly and easy to use. However, when you sign up you must agree to give Google “a license to use and distribute (your information) in connection with Google Health and other Google services.” The disclosure also reminds users that HIPAA rules don’t apply to them. I decided I need more warm fuzzies than that before sharing all my medical secrets.

I’ve been amused by how many readers have mentioned they share my shoe passion and have gotten some great tips for places to buy shoes! For example, Saturday morning I got this note from Marlo Thomas: “I thought about you on Friday afternoon. I was the new DSW at Cascade Station, down the street from the Portland airport. Other great DSW stores: San Fran, the store just off Union Square, and Cincinnati, the Rookwood location. Both these are multi-story facilities with ‘better than average’ brands and selection.” I must confess the e-mail sent me into deep shoe envy and I had to go to my nearby DSW to purchase this very sexy pair of black strappy sandals. I was going to take a picture of them to post but I decided Mr. H wouldn’t go for it since he is a sensible shoe kind of guy.

The Detroit News reports that Wayne State University Physician Group is cutting 80 clerical positions following its outsourcing agreement with athenahealth.

eClinicalworks announces a sale to Georgia’s second-largest GI group.

Collaborative Software Initiative (CSI) announces it has released the first open source, web-based infectious disease reporting and management system. The State of Utah Department of Health is piloting.

A federal appeals court upholds a previous ruling that a North Texas IPA engaged in unlawful price-fixing in its negotiations with various health insurers.

Compuware announces its Q4 and fiscal year earnings (ending March 31.) For the year, revenues were flat and income was down 15%. The better news was a 38% increase in software license revenues for Q4 and the overall better than projected Q4 numbers.

Tennessee Medicaid contracts with ACS for a five-year, $156 million deal to manage its data and ongoing systems operations.

Several people have indicated TEPR is on its last leg, but nonetheless, it has announced its 2008 Outstanding HealthIT solutions. Winners include CapMed (Best PHR), MediNotes Clinician Supply Chain Manager (Hot Products), and Doctations and eMedicalFiles (tie – EMR Systems Best Meeting Medicolegal Requirements). Does anyone select an EMR product because it best meets medicolegal requirements?

Valley Baptist Medical Center in Brownsville claims its cardiology and radiology departments are saving $28,000 a month since replacing film with digitized images on EMC systems.

UPMC CEO Jeffrey Romoff was paid $3.95 million in 2007, which is 20% higher than the year before. Not-for-profit UPMC actually paid 11 people more than $1 million last year. All I can say is that these numbers are staggering. Mothers, the time has passed for urging your daughter to find a nice doctor to marry – the real money is in administration.

On a not-totally-unrelated note, check out the results from Health Imaging’s 2008 HIT salary survey. Not surprisingly, CIOs earn the most ($180-200K) and system administrators the least ($40-50K). Interesting statistic: you could hire 100 system administrators or one Jeffrey Romoff for the same money!

E-mail Inga.