News 7/30/08

From: Esther. “Re: Picis. FYI – Just got notification from Picis that they have re-evaluated their offerings and are stopping enhancement on the nutrition services applications. From the letter – ‘Our decision regarding the direction for Dietary Manager is that it will continue to be fully supported, but we will no longer be actively enhancing the product.’ I’m sure that we’ll see more of this with the current state of the economy.” I checked in with Ann Joyal, Director of Corporate Communications at Picis and here is her response: “At Picis our focus is on delivering results in the high-acuity areas of the hospital (emergency department, surgery and ICU). In a recent evaluation of our product portfolio, we made the decision to de-emphasize our non-high-acuity products, including our dietary management product line. Even though we do not plan further enhancements, we believe these products continue to provide high value to the current customer base, and we will continue to support those current customers.”

From: Art Vandelay. “Wal-mart in Telemedicine – Hat tip = Health Populi. I saw the following on Health Populi. Wal-mart has now made a step towards telemedicine with University of Texas Medical Branch at Galveston. This touches upon two guesses in a post from nearly a year ago. I guess health care may start moving at Wal-mart speed. In the Health Populi link, be sure to check-out the ‘retail world is flat.’ If we can have data centers in containers, why not doctor’s offices?”

From: Trace Gal. “Re: HERSS. HERSS could stand for: Highly effective & remarkable sister systems OR Highly effective & remarkable superior systems.”

From: Music Guru. “Re: Inga Radio. I love your eclectic musical taste, Inga! Mr. H trips me up with all his “listening to” Eveel Kaneeveel– 70’s throwback with heavy influences from Echo and the Bunnymen, and BurkaBurka – Mongolian Rolling Stones tribute band (former screamer lead man from Your Yurt or Mine.) Does he actually listen to all that or does he just have a bad Indie music generator!???” I guess Mr. H really listens to his recommendations. Then again maybe he is making up all those funny bad names to see if anyone is paying attention. (In fairness, I think HIStalk Radio has many fans. Inga Radio is just more mainstream, I suppose.)

From: Hotstix. “Re: Inga Radio. I have listened to Pandora for about a year, and never could find that right eclectic mix of music . . . until YOU! I find myself listening to this constantly. Great music for the summer! I particularly like your selection of Alison Kraus.”

Virtual Radiologic announces their first international contract, a multi-year agreement with Lion City Radiology in Singapore to provide preliminary interpretations of CT and MRI studies for imaging centers affiliated with Lion City Radiology in Singapore and United Arab Emirates.

On Monday Virtual Radiologic also released it Q2 results, highlighted by a 22% increase in revenue from the same period last year. Adjusted EBITDA and adjusted income were both up 27% and 70% respectively. Net income was $.12/share. The market’s response was an 18% decline in the stock price.

The 38-physician, 12-location Crescent City Physicians (LA) has selected Sage’s Intergy EHR and PM solution.

British-based E-Health Insider obtains records that detail Milton Keynes Hospital’s Cerner Millennium deployment. The article outlines the numerous product and implementation difficulties throughout the two year project.  Though it sounds like a mess, I wonder if the situation is that much worse than situations we’ve seen here (with a variety of vendors.)

Premise names John Hannon as its new CFO/COO. Hannon served in a similar role at Mangrove Systems and was a GM/VP with Ascend’s Broadband Access group. The appointment coincides with Premise receiving $2 million in Series B funding.

The Healthcare Growth Partners folks have published a Q2 2008 Healthcare IT transaction report. The document provides an excellent overview of the capital markets and M&A activity. Despite a gloomy economy, the HCIT world seems to be faring better than most.

Eclipsys reports they now have more than 1000 trained pharmacists and technicians using Sunrise Pharmacy.

Several Nuance products received high rankings in KLAS’s new Speech Recognition report. PowerScribe for Radiology and RadWhere for Radiology took the top spots for front-end speech recognition category; eScription and Dictaphone Enterprise Express Speech System claimed two of the three top spots for back-end speech recognition vendors.

Business intelligence and patient outreach solution provider MedVentive names  Nancy  J.  Ham  as  president  and  a  member  of  the  Board  of  Directors.  Ham formerly served as president of both Sentillion and Proxymed. The appointment coincides with the closing  an  additional  $3.55M  Series  B  investment  from  existing  investors.     

3M and Sonitor are teaming up to provide Sonitor’s Track and Trace RTLS technology to 3M’s customer base.

For about 400,000 yen ($3,700) you can buy a Japanese “Intelligence Toilet” that allows you to stand at your bathroom sink to measure and record your blood pressure, blood-sugar, weight, and body-fat. Clearly the coolest thing about the product has to be its name.

Healthcare analytics company MedeFinance has secured $50 million in funding, led by Bain Capital Ventures. Mede plans to fund new growth initiatives and acquisition opportunities.

The Military Health System awards General Dynamics a contract worth a potential $5 billion. The 10-year “indefinite delivery, indefinite quality” agreement is for planning and management services. I don’t understand what indefinite delivery, indefinite quality means but it sounds like I need to include that term in my next employment agreement.

I’m happy to report that Mr. H should be back any day now!  My stint has been made perfect after receiving this long-awaited love sonnet (of sorts) from Wompa1.  It’s a masterpiece.

Ode to Inga

Prosperous and informative laid the Blogdom,

Mr. H, sometimes jaded, leader of thought,

Glanced at his site tracker,

And smiled at what he wrought.

Then they came in numbers too great,

Asking for more, too much more of him,

Mrs. H never saw him,

He said “enough! I’m almost dead Jim!”

He sounded the electronic call

Throughout the Blogdom went the story, (okay not really)

“I can’t report it all,” he said,

Is there one who will cover ambulatory?

He clings to hope,

Who will answer his cry,

Golden locks flying,

She stands and calls: “I.”

She stood tall and bold,

The German princess, the mystery,

All we see

Is Angelina Jolie.

The golden maiden brought

A true golden age,

Like Mr. H.,

She too was a sage.

Brave the maiden Inga,

Ready to don the crown,

When Mr. H.,

And Mrs H. find themselves out of town.

Endless toiling,

Searching the news,

Pausing but seldom,

To shop for new shoes.

O but heavy is the head,

Power feeds the need for more,

First the HIMSS doubles,

Dare we wonder what’s in store?

As the pendulum swings too far

The temptation too great as such,

HIS becomes HERs

The chance to seize it; too much.

But she is steadfast and trusty,

The king’s lands will not burn,

The watchful warden holds

The keys ‘till his return.

HIStalk Guest Writer: Frank L. Poggio and The Ten Commandments of Healthcare Information Technology

Since joining HIStalk, I’ve  been surprised numerous times by our readers’ impressive credentials.  Looking over the subscribers list is a bit like reviewing a Who’s Who List of HIT leaders.  Today’s guest writer has is right up there with the best of them.

Today Frank is President of the Kelzon Group, a firm specializing in healthcare information systems consulting.  Over the years, he was GM of Mediware’s Blood Bank Division, President of Citation Computer Systems, and founder of Health Micro Data Systems (the developers of the first client/server-based system for healthcare organizations that later merged with CITATION and was  subsequently acquired by Cerner.)

Have fun reading!

– Inga

The Ten Commandments of Healthcare Information Technology

(or, What Moses downloaded while on the mountaintop!)

It is a little known fact that Moses was not only a prophet, but also a hospital CIO. That fact should be self evident when you think about it. Prophets communicate critical information from a unique source to the rest of the organization. What the organization does with that information is beyond the control of the prophet. The prophet can neither require the masses to listen to it, nor does he have the power to require the masses act on it. Sounds pretty much like today’s CIO!

So, thousands of years ago when Moses went to the mountain top what did he download into his ‘Blockberry’? Fortunately, Moses was big on backups and he would routinely transfer his electronic files to stone carvings. Recently while excavating in a cave in the middle-east I came across his backup tablets, which included Moses’ original annotations!

HIT – Commandment 1

Thou shall never have enough project time.

Annotation: Actual project development always takes at least three times longer than planned. God created the world in six days. That was the first and last project ever completed on time, which is why s/he could rest on Sunday, and you can’t.

HIT – Commandment 2:

Thou shall never have enough resources.

Annotation: All projects will exceed budget by at least a factor of two. God made man a wasteful and inefficient being. Hence, there can never be enough resources.

HIT – Commandment 3:

Thou clinical users shall constantly and continuously change requirements and medical protocols.

Annotation: Medical requirements will always be changing and usually at the worst possible time. God created nature to be in constant change so why shouldn’t user requirements?

HIT – Commandment 4:

Thou shall always upgrade when least convenient and unprepared.

Annotation: New version will always set you back a month and reverse all previous fixes. Failure to install new versions will bring seven years of famine.

HIT – Commandment 5:

Thou shall sunset immediately.

Annotation: As the sun rises, so does the sun set. And clinical system vendors know this and therefore will sunset their products immediately after sunrise (a.k.a. go live).

HIT – Commandment 6:

Thou shall forever run legacy systems.

Annotation: Once a system is installed and running it must live forever. To ignore this commandment will bring a plague of bugs, glitches and gremlins on your hospital and all that work there.

HIT – Commandment 7:

Thou shall not worship newer technologies.

Annotation: There is only one technology and there will be no technology after it. True believers know the next best technology never is, and cannot be. To believe otherwise is blasphemy and all who do will be destined to spend all eternity in the hell of constant upgrades.

HIT – Commandment 8:

Thou shall not idolize the demo.

Annotation: The demo is Satan. To believe in the demo is the ultimate sin.

HIT – Commandment 9:

Thou shall never be trained.

Annotation: Your staff will never get enough training, the vendor will never deliver enough training hours, and even if he did you could not afford to pay for them.

HIT – Commandment 10:

Thou shall never have enough support.

Annotation: Vendor support will always be insufficient, and if it ever is sufficient, the vendor will quickly install a new release (see Commandments 4 & 5).

In our archeological diggings we could see that there were more stone tablets but the erosion from weather and wind exposure made them all unreadable. I am sure most CIOs can guess at what they said.

News 7/25/08

From: Dr. John. “Re: Purkinje. EMR vendor Purkinje is going to focus on its Medicare Advantage insurance and cut/reduce is EMR software sales business. Guess they see the insurance business being more profitable than the EMR software business….duh. Unfortunately, they let go some really talented folks!” I reached out to the Purkinje folks but didn’t hear a response back, so currently unconfirmed.

From: Steve McGarrett. “Re: Hawaii. The situation in Hawaii is a mess, especially the Neighbor Islands. The North Hawaii Community Hospital situation is a bit different since that’s a private hospital as opposed to Kona which is part of the state system. If you can believe it NHCH even kicked Earl Bakken to the curb. Something is wrong when that happens to the guy who developed the wearable pacemaker, especially when you consider that he helped found the hospital a dozen years ago. If you want more info regarding the situation both Big Island papers have run numerous articles. The Kona paper is at www.westhawaiitoday.com and the Hilo paper is at www.hawaiitribune-herald.com. Keep up the good work while Mr. H is away.”

From: HERbie. “Re:  HERtalk. Hi Inga – the acronym is fine as is. Whenever you try to type ‘EHR’ in an MS Office document, spell check auto changes it to HER. I’m sure I’ve sent dozens of emails with ‘HER’ instead of ‘EHR’ thanks to the spell checker (Of course I could always go to the custom dictionary and fix it once and for all.) The story could be that you tried to create the blog as EHRTalk but spell checker changed it to HER.”  That makes perfect sense to me, especially since I’ve never figured out how to make the custom dictionary not auto correct HER (see – it just did it again.)

From: ElsieEHR. “Re: This and That. HERtalk — Simple: HER = Healthcare Electronic Records… Especially since any time you type "EHR" in MS Word, the AutoCorrect option changes it to HER. Hospital Layoffs — UMDNJ may cut 300 jobs, according to today’s Star Ledger (Newark, NJ). You say tomato — C-C-H-I-T vs. C-CHIT; H-I-S-talk vs. HIStalk. I always sort of slurred the name, saying H-I-S-stalk (as in ‘stalker,’ but I guess it could have other meanings as well).”

From: HERcules. “Re: I wonder, while you’re busy changing HIStalk to HERtalk, whether you want to send up any test balloons on changer HIMSS to HERSS. What on earth would THAT acronym stand for? Love your blog. Keep up the good work in Mr. H’s absence.”  I’ve been working on this one all day and nothing yet, so creative assistance appreciated.

From: Mountain Man. “Re: Layoffs – What does all this mean? It means that margins are razor thin, that reimbursement is down, expenses are up. Healthcare is not immune to the economic strife that the rest of the country is in. Starbucks closed stores, GM and Ford can’t make it and your small business owner is closing at alarming rates. We have to do more with less. This my friends is where we are all so important to the solution. The solutions we provide to the end user, will help us deliver better quality care at an overall lower unit cost. Technology is the only way Healthcare can be delivered in a more efficient way that is safer for the patient. The use of Technology to drive real change will be the salvation of healthcare as we know it today. These layoffs are treating the symptoms of rising costs. The cure is to be more efficient and the magic pill is technology.”  I am afraid Mountain Man (LOVE that name) is right.  Healthcare institutions are cutting back, as well as the vendors.  Look for more sales reps to become more virtual because companies can’t afford to send them to every last hospital and doctor’s office. Which will lead to more competition for those post-cheerleaders wanting to become drug reps.

From: Angela. “Re: Microsoft’s Health Solutions Group. I recently sat through a support presentation with Microsofts Health Solutions Group. I left confused. They keep referring to themselves as NOT Microsoft? One of the value propositions for us is that they ARE Microsoft and we can assume the same quality care and support that we are used to getting. The speaker made it sound like they had their own support group and infrastructure. Needless to say this was a huge turnoff for most of the staff. Granted Microsoft’s support had some issues in the past, but our Premier contract ensures that we get the help we need when we need it. I am really puzzled by this. Can anyone out there confirm that the Healthcare group is starting their own support organization? I mean when you have a world class support structure why in the world would you re-invent the wheel? Not a very strong selling point. We are still discussing the opportunity but someone needs to tell the healthcare group that coming across as a stand-alone company does nothing to enhance the sales process.” I was able to connect with Bill Crounse, Senior Director for Microsoft Worldwide Health. His comment: “Thanks for drawing this to my attention. I think the speaker from HSG was misunderstood. While our Health Solutions Group is developing their own sales and support channels, they are very much a part of Microsoft. If anything, their desire is to exceed the service levels people have come to expect from Microsoft.”

Yesterday’s Guest Writer was athenahealth’s Jonathan Bush, who raised questions about what can be done to encourage small groups to use EMR. No one seems to have a reasonable model that addresses the true effect of EMR, especially in a small office. Jonathan closed his post saying, “One of the core reasons I like Mr. HISTalk, Inga and this blog so much is that it has emerged as a disruptive presence in how folks in our industry get their news and discuss topics and trends. So let’s discuss this…maybe we can get an actual dialogue started here that will begin to disrupt our industry’s stagnant approach to the small physician market.” The dialogue has clearly started with many folks weighing in. The only consensus so far is that the issue is complex, and, that the smaller the office, the more the human factors affect the project’s success or failure.  I wonder if there are any doctors out there in small practices that want to brag about all the extra money in his/her pocket because of a great EMR install.

Misys announces its preliminary annual earnings for the fiscal year ending May 31. Overall revenues were up 6% and operating profits 37%. In the healthcare division, both revenue and total order intake were up 2%, though ILF revenue declined 2%. Maintenance and Payerpath revenue seem to be sustaining the group with revenues up 6% and 4% respectively. An 85% increase in operating profit from 11% to 20% indicates all the cost-cutting activity has had an impact.

McKesson announces their Q2 earnings (flat,) though profits rose 9%. Actual profits were $.03/share less than analysts’ predictions, coming in at $.77/share. McKesson raised its full year earnings prediction to $4-4.15/share.

Hayes Management Consulting and InterSystems are partnering to provide InterSystems Ensemble to the global healthcare IT market. Hayes plans to develop solutions to integrate disparate healthcare systems for business and clinical end users.

For those of you missing Mr. H’s music recommendations, give Inga Radio a try, though I should point out tastes are definitely different than Mr. H’s HIStalk Radio. Some recent favorites: Jon Nolan, Keb’ Mo’, Andrew Lipke, and Etta James.

Medavant (aka Proxymed) has had numerous troubles over the last year or so, including upper management turnover, a troubling auditor’s report, sell-offs of multiple assets, and major revenue declines. When Medavant filed for an extension on their 10-Q in May, Mr. H noted that it "wasn’t a good sign." This week Nasdaq issued a notification that the stock price had failed to maintain a minimum $1 stock price for more than 30 days. The fact the company filed for Chapter 11 bankruptcy protection Wednesday is thus not much of a  surprise. With problems going back so many months I don’t believe you can simply blame the situation on a softening economy. However, it does make one fearful that over the next few months we’ll see more HIT vendors struggling to their keep their lights on.

Coming soon: a new online source for deciphering your elderly mother’s various medications or determining if your itchy skin is poison ivy (and not some sort of skin-eating strep.) Medpedia, the world’s largest collaborative online medical encyclopedia is launching at the end of the year. The Wikipedia-like project is a big collaborative effort between multiple healthcare institutions and all the contributors either PhD’s or MD’s.

The Illinois Primary Health Care Association is implementing NextGen products in five affiliated health centers and potentially 25 more in later phases.

If you are bound for Epicland, you’ll be happy to read about plans for a number of boutique-style hotels in Madison, Wisconsin. All are being designed with the tech-savvy traveler in mind and promise to be swank, hip, and priced in the mid-range.

Blue Ridge Medical Management (TN/VA) expands their investment in Misys products, adding 125 new Vision licenses. Blue Ridge bought an additional 250 Vision and 325 Misys EMR licenses to provide hosting for East TN State University College of Medicine.

Kudos to the 700 GE Healthcare employees from South Burlington (VT) who helped Habitat for Humanity build five homes for people in need.

HIMSS announces new officers and board members.  Charles E. Christian and Liz Johnson are the incoming chair and vice chair along with eight other board members who officially started July 1.

Thanks for all the encouraging notes, by the way. I know everyone is missing Mr. H’s expert commentary and amazing wit, so I am thankful you are sticking with the under-card in his absence.  I’m feeling the love, though I’m still waiting for those love sonnets to come my way.  Email me.

HIStalk Guest Writer: Jonathan Bush and Getting Small Groups to use EMRs…with no Cash Promise

I met Jonathan Bush right after the HIStalk/Healthia cocktail party at this year’s HIMSS conference.  As a HISsie winner in every category he or his company was nominated, athenahealth CEO, President, and co-founder Jonathan Bush was gracious enough to receive his honors in person and then entertain the crowd with his commentaries on HIMSS, the industry, and boat shows.  After the festivities, I went to whisper in his ear that I was "Inga" and he thought I was trying to give him a peck on the cheek.  Of course in return he gave me a little air kiss – and then a big laugh when he realized I was just trying to tell him my secret (it was so very cute.) 

Besides being cute, Jonathan has proved to be an innovative and successful leader, leading his company to last year’s most successful IPO. And he is big HIStalk fan (I think he and Mr. H are tight.)  We appreciate and thank him for taking the time to share his wit and wisdom with other HIStalk readers!

– Inga

About 50% of doctors practice medicine in small groups. The vast majority of them don’t use EMRs. Why not?

For the past 5 years, we have seen a huge uptick in the buzz around the adoption of EMRs and what it will mean for healthcare. EMR software companies issue press releases on new functionality or new versions and the prospect of a paperless delivery system. With all this innovation by software companies, and HIT conferences popping up every month to discuss "interoperability" and "standards," why on earth haven’t more doctors in small groups adopted EMRs?

Better yet, why do the small-doc practices that have EMRs resist using them to their fullest advantage?

The other day I was on the phone with a Wall Street Journal technology reporter, discussing the lack of adoption of EMRs by physicians practicing in small groups. I was glad this got the attention of a journalist who doesn’t normally cover healthcare. A little over 8% of 1-3 doctor practices have some kind of EMR…and the actual usage of "fully functional" EMR technology stands under 5% (data from MGH’s Institute for Health Policy). Earlier, more optimistic estimates were closer to 15-20%, but so far, no go.

The problem is, EMRs are usually tools, not services, I explained. If they were services that docs could use properly while increasing cash flow, they’d be flying off the shelf.

So the journalist asked a reasonable question: How much cash flow does athenahealth’s EMR service provide for physicians?

And I had a totally unreasonable answer: "Uh…"

The fact is, I don’t know! Here’s what I do know: Our EMR increases cash flow by removing paper from the process. Unlike old school EMRs, our athenaClinicals service handles all of the documents that enter our clients’ office as part of the service.  So far, that’s more than 60 documents every day per FTE physician — 68% of which would have to be handled manually by the client. This means that even if they had traditional EMR tools, our clients would still be handling a large portion of their documents manually. But how much was it costing them to handle those manual documents before they got onto the athenahealth network?? Not the foggiest clue. What about if they got some consultant or custom programmer to build a bunch of interfaces and maintain them every time something changed at the lab?  Not sure, but it sounds ugly and expensive to me.

What’s the solution? Actually, I’m not sure. What do you guys think? Invest in a time study? Wait for real P4P payments to kick in before the REAL docs out in the community adopt or let the academics with endowments lead the adoption wave?

So I will stop my post here, because one of the core reasons I like Mr. HISTalk, Inga and this blog so much is that it has emerged as a disruptive presence in how folks in our industry get their news and discuss topics and trends.  So let’s discuss this…maybe we can get an actual dialogue started here that will begin to disrupt our industry’s stagnant approach to the small physician market.

News 7/23/08

From: Susie Q. "Re: CCHIT. I recently sat in on a CCHIT workgroup and was amused by how much time was spent emphasizing that the correct pronunciation is ‘C-C-H-I-T’ and not ‘C-CHIT.’ I can’t figure out what the big deal is. As if this branding distinction is a) going to work and b) be meaningful if it does. It’s notable, if simply funny, that this is what they are worried about.” Too bad Mr. H is gone because this would have been the perfect opportunity for him to remind readers this blog’s name is “H-I-S-talk” and not “HIStalk” (as I always and still call it.) The rebel that I am I’m sticking with C-CHIT.

From: Eclipsys Observer. “Re: Bob Elson. Inga, I just heard Bob Elson is no longer with Eclipsys for about 2 weeks now. Any thoughts on why or where he went?” I was able to track down Dr. Elson and he confirmed that he is the “former” CMO for Eclipsys. Says Elson: “I left Eclipsys on July 1st to pursue other interests.” The only other thing he mentioned in his note is that he is a “big” HIStalk fan.

From: What Happens at Eclipsys Stays at Eclipsys. “Re: Changes. There are lots of changes going on. There is a huge push to increase our KLAS scores, everything is now tied to those (perf evals, bonuses, etc…) Services impact that the most, hence the changes in Stearns and Wagner.” Eclipsys is announcing second quarter earnings on the 30^th so we will see soon enough if financial considerations play any part in the changes.

From: Wondering. “Re: Kevin Smith. I heard an unconfirmed rumor that Kevin Smith, head of the GE/IHC partnership at IHC is gone.” Anyone?

From: Dyan Cannon. "Re: Hospital Layoffs. Good Samaritan Hospital in Suffern – 80 employees, union & nonunion. This follows a layoff of 57 in February.  North Hawaii Community Hospital – 59 employees (~13% staff reduction.) Kona Community Hospital – 55 employees (looks like Hawaii has seen better days!) Ingham Regional Medical Center – 100 employees.  St. Peter Regional Treatment Center – 32 employees, possibly up to 100 total by September." That’s almost 400 people. I will defer to you industry experts to explain what it all means.

The Military Health Systems claims no decision has yet been made about what EMR could replace the VA’s Vista. The MHS press release contained a bit of an update on for work on the AHLTA system and the VA’s VISTA electronic health record.  No clear indication if the plan is to update/converge/replace. Posters on the MHS site are expressing dismay at the billions already spent, at suggestions of a piecemeal option, and at the current usability limitations with the products today.

Cerner announces Q2 earnings, beating analyst projections by $.01 per share. Profits were $.10 a share higher than last year and Cerner predicts full year revenue growth to be about 10%.

Loftware announces the official debut of its new healthcare specific blog, designed to promote product identification and labeling in the healthcare industry.  The Loftware Blog on GS1 and Healthcare is found here.  While checking out their site I noticed that the Premier healthcare alliance has become the first group purchasing organization to endorse GS1(R) supply chain standards, requiring all their contracted medical device manufacturers to commit to the standards.

DATATRAK International has retained Healthcare Growth Partners to explore a possible sale or merger. DATATRAK provides eClinical solutions for the clinical trials industry.

Arnot Health is replacing their Mediware perioperative solution in light of Mediware’s announcement to no longer invest in operating room software products. SIS Essentials from Surgical Information Systems is the replacement product.

HHS predicts Medicare will save up to $156 million between 2009 and 2014 as physicians migrate to eRX solutions. The savings are attributed to the avoidance of 1.5 million adverse drug events.

The lovely Gwen Darling of “Healthcare IT Jobs” fame (details to your right) pointed out that in light of Mr. H’s extended leave, I should take the liberty of renaming the blog HERtalk. We separately spent time drinking wine with girlfriends over the weekend and attempted to come up with the perfect name to match the acronym. My working name is Healthcare Estrogen-Reflected Talk but email me with any other creative suggestions.

HIMSS and the Electronic Health Records Vendors Association (EHRVA) announce the election of a new chairman, vice chairman, and six executive committee members. Greenway VP Justin Barnes will lead the group and McKesson Physician Practice Solution chief medical officer Dr. Andy Urdy takes the vice chair spot. The new members include Michele McGlynn (Siemens,) Charles Parisot (GE Healthcare,) Charlie Jarvis (NextGen,) Rick Reeves (CPSI,) Don Shoen (MediNotes,) and Steve Tolle (Allscripts.)

The Barbara Ann Karmanos Cancer Institute (MI) has contracted with Eclipsys for the deployment of its Sunrise clinical/revenue cycle solutions.

McKesson recognizes six healthcare organizations for vision, innovation, and results-driven performance using McKesson and RelayHealth solutions. Here for the list of 2007 VIP Award winners, each of whom wins a  $10,000 grant to their foundation or charity of choice (I like that part.)

A Florida bookkeeper is accused of setting up phony corporations with names like “Cardinal” and “McKesson” to steal several million dollars from her oncologist employer. Over the least eight years, she created checks payable to her non-existent entities, often instead of paying the real pharmaceutical companies.

Siemens has formed a strategic partnership with Imprivata to market their OneSign SSO solution to its customer base.

Opus Healthcare Solutions introduces its OpusLaboratorySuite solution which includes remote reporting, allowing clinicians to view results on a smart phone or PDA via a cell phone network or hospital Wi-Fi connection. The product works with most major HIS products.

I was giddy seeing all the comments in response to John Glaser’s guest posting.  I promise we will have an equally entertaining guest writer tomorrow. Send juicy news my way and thanks for reading!

HIStalk Guest Writer: John P. Glaser and The Top 10 Cool Things About Being a CIO

When Mr. H started making his vacation plans, he determined only an elite group of HIT superstars could fill his shoes. Or, perhaps he concluded only a few people would want to contribute to an obscure blog. In any case, Mr. H asked but a handful of experts to provide guest columns in his absence. Partners HealthCare Systems VP and CIO John Glaser was definitely on his short list.

Mr. H and I were thrilled he agreed to participate because he is a funny guy. And, John’s credentials are certainly pretty stout as well. He is the former IS VP at Brigham and Women’s, was CHIME’s founding chair, and was a past HIMSS president. Additionally, he is a PhD, a HIMSS, CHIME, and American College of Medical Informatics fellow. Plus now a published HIStalk Guest Writer.  Enjoy!

– Inga

I have been a CIO for a really, really long time – over 20 years. And while I wasn’t sure about the role at first, after a while it kind of grew on me.

I was asked – what are the top 10 cool things about being a CIO? There are 10 things that I like but I could only remember 7 (this job does nothing for your memory or intelligence).

You get to go to lots of meetings. I realize that most meetings are pretty boring. But they can hardly be called hard work or dangerous work. All you have to do is be able to sit for long periods of time, avoid dozing off and be able to make up facts should a question come your way.

How hard can this be? You don’t have to actually do anything substantive like write code, support users or write documentation – you just have to show up at the right meeting at the right time and keep your eyes open.

You get to go to lots of conferences and events. In order to “stay on top of the industry,” “develop a valuable network of colleagues” and “engage in meaningful dialogue with vendors and consultants” you have to go to multiple conferences and events. Usually these are held in nice places, give you time to play golf, result in your being fed well and provide you the opportunity to wear a badge with colored ribbons.

Your staff are back at the ranch slaving away while it is snowing outside. You, on the other hand, are advancing the organization’s strategic IT agenda as you toss down a couple of cold ones with industry movers and shakers – pool side.

You get to give lots of presentations. The board wants to know the IT strategy. The organization’s leadership wants to understand that projects for next year. Your staff want to hear about efforts to improve the effectiveness of the IT department. As a result, you will need to give lots of presentations. Presentations give you opportunities to show really cool moving bullets, present graphs that build, play video clips, listen to audio clips and, if you’re really good, leverage a hologram or two.

Don’t worry about substance. That isn’t the point of presentations. Entertainment and high tech wizardry are the point.

You get free publications. To get free industry publications all you have to do is fill out the qualification card that says that you approve every IT decision in the organization and that you have installed every technology ever made and that your organization is going to be engaged in major buying decisions in the next year. You may not know what some of this equipment does. You may not know if you really have this hardware or that operating system installed. And you may not have a clue what the IT purchasing plans are in the year ahead.

This doesn’t matter. The publication doesn’t really care whether your responses are accurate or not. They just want to show advertisers that they have important readers so that they can charge top dollar for a full page ad. Once you get the publications you don’t have to read them other than to scan them to see if there is a picture of someone you know. You should however keep big stacks of these publications in your office. This helps to create the aura that you are well informed – see next section on pronouncements.

You get to issue official pronouncements. Every now and then you are expected to make important decisions. Which vendor should we choose? Should we participate in a RHIO or not? Where should we make budget cuts?

You might be worried about the pressure to make the right decision. Relax. All you have to do is decide. You don’t have to be right or wrong – you just have to decide, announce your decision and deliver that decision with a tone of voice and a body posture that indicates that this decision is well considered.

If you want help in deciding you can use the Magic Eight Ball or Rock-Scissors-Paper. Don’t let the rest of the organization see you do this – it has a way of diminishing the appearance of the decision being well considered.

And if someone points out “That decision you made last year didn’t work out so well. What happened?” All you have to say is, “Overcome by events.”

You get a nice office. Being a CIO generally means that the organization gives you an office in the same area as the other muckety-mucks. This office is usually large, has plush carpeting, is appointed with a big desk and a mini-conference table and has a really big screen to go with your ultra-fast computer. Plus there is free coffee nearby.

You may wonder – why do I need all of this space? And why do I need the space to be this luxurious? You need the luxury so that you can appear important. It is important that you appear important when you make official pronouncements. The key part of the space is to have enough room, on the carpet, to lie down and take a nap. Being a CIO can be tiring.

You get free doo-dads and trinkets. Conference exhibit halls (particularly HIMSS) have dozens of opportunities to stock up on pens, key chains, little flashlights, coffee mugs, note pads, bags and lots of other quality merchandise. Vendors, in an effort to grab your attention, will mail you golf balls, radio controlled cars without the radio controls, umbrellas, kaleidoscopes, back scratchers and shirts. And you get all of this because you are top of the IT heap (and you filled out your qualification card as I instructed above).

You have family presents for all of the major holidays and life events for the rest of your life. You can use the shelves in your spacious office to exhibit your loot. While you have meetings in your office you can invite the attendees to play with the doo-dad of their choice helping you to avoid a conversation that you’d rather not have.

These doo-dads and trinkets show you that, while the rest of the organization thinks you should be shot, your vendors and consultants care enough about you to send you presents.

My CHIME colleagues may not admit it. But the above reasons are the real reasons that we are all glad to be healthcare CIOs.

News 7/18/08

From Dr. Bob: "Re: The origin of Johns Hopkins name. Oh Inga, spelling Johns Hopkins without the ‘s’ is like spelling Wahington or Pittburgh. :-)) Wikipedia  explains the origin of Johns Hopkins’ name. ‘The peculiar first name of philanthropist Johns Hopkins is the surname of his great-grandmother, Margaret Johns, who married Gerard Hopkins. They named their son Johns Hopkins, and his name was passed on to his grandson, the university’s founder (1795-1873).’ Also, at the end of the Wikipedia entry there is a humorous piece about Mark Twain and John(s) Hopkins.” Ug. Mr. H. hadn’t even closed his suitcase yet and I committed a major sin! I’m blaming it on my post-vacation fuzzy head. I loved this history lesson, though, and Mr. H says the Mark Twain reference is a must read.

From Rosemary Thyme: “Re: Sage Software Restructuring Response. She’s right. Sage Healthcare is not a callous company. Her quote, on the other hand, was callous. More so now that she’s confirmed there wasn’t a misquote. In context or out of context, reporter or no reporter, sensitivity matters in situations like this. It matters to those that are leaving and to those that are left. Sage shouldn’t have sent the SVP of sales in to publicly represent management’s decision to be open about employee lay offs. They reported that the cuts to sales and other "customer facing jobs" were minimal. So why send sales and marketing in to comment on such a strategic corporate action?? We should’ve heard from someone closer to it. Sales should be selling. There are 1400 employees left that are counting on the revenue. Calling it a PR mistake and moving on.” Ms. Thyme is referring to the recent HIStalk comment from Sage sales VP Sharon Howard.

From Dyan Cannon: "King-Harbor Hospital in LA just can’t stay out of trouble. The hospital made headlines in 2007 when it left a dying patient on the ER floor for 45 minutes, going so far as to “mop around her.”  Shortly thereafter, the hospital lost huge amounts of funding and limited to outpatient care.  Now, after talks of trying to breathe new life into the hospital by UC, King-Harbor has fallen under public scrutiny yet again.  Following a company wide background check, 16 employees have been suspended for undisclosed criminal convictions, one of which includes rape.  This, coupled with reports earlier this month that 22 former employees connected with the closure of the hospital are still employed by the county as a result of a ‘computer glitch,’ simply adds mileage to the already lengthy rapsheet they’ve developed.  I’d be curious as to the burnout rate of their Human Resources and Public Relations departments."

From Who Knew: “Re: Medsphere. Medsphere is moving offices to Carlsbad. Downsizing? Upsizing? Better surfing further south?” I asked Medsphere COO Rick Jung and he said the company is indeed packing their bags (no mention of surfboards, however.) “I can confirm Medsphere is indeed moving as the rapid expansion of our Company has required we more than double our physical space. Our new offices are in Carlsbad, CA.”

Medsphere, by the way, also just announced a new partnership with WebReach, Inc. The agreement provides Medsphere with comprehensive support for WebReach’s healthcare messaging integration engine which facilitates interfaces and data exchange within the Open Vista EHR.

GE names John Dineen president and CEO of its $17 billion healthcare division. Dineen moves from GE Transportation where he held a similar role. Dineen is a 22-year GE employee, though this appears to be his first stint in healthcare. Will his healthcare deficiency help or hurt the division?

TeraMedica and Hyland Software team up to create faster physician access to medical images and other types of clinical digital content through healthcare organizations’ existing EMR systems.

PatientKeeper announces its MEDITECH customer base now includes over 200 hospitals.

Mr. H’s parting words to me included a request that readers send us updates on their summer vacations. Creating your own essay entitled “What I Did on My Summer Vacation” is sure to remind you of the first day of school, new clothes, and searching for your locker.

WiFiMed Holdings, the parent company for EncounterPRO Healthcare Resources and CyberMedx Medical Systems, is expanding into the European market. The company signed a Memorandum of Understanding to purchase UK-based Integrated Telecare and Position System Limited.

iMedica announces that Blue Cliff Partner will resell their Patient Relationship Manger and EMR products in Hawaii.

Now that Congress has approved the Medicare eRx incentives, will more physicians jump on the electronic bandwagon? The highest payment rate is 2% in fiscal 2009 and 2010, drops to 1% the next two years and then 0.5% in 2013. Beginning in 2012, payments to physicians will be reduced by 1%, then 1.5% in 2013 and 2% in subsequent years. Are the incentives/penalties adequate to affect change? eRx vendor Allscripts was quick to announce their pleasure over the act.

The 1105 Government Information Group is looking for bands for their third annual GIT Rockin’ Battle of the Bands. Participant bands must consist of at least two members of the government IT community (government and/or vendor executives.) Five bands will be selected to perform at an October 16^th event in DC. I told Mr. H he should volunteer to be a judge but he thinks we need our own HIStalk Battle of the Bands with winners getting the chance to perform at HIMSS. Any takers?

McKesson adds another product to its portfolio with the acquisition of EN-Chart Scanning Program. EN-Chart provides computer-assisted facility coding and compliance solutions for the ED and McKesson has already been reselling the product for a couple of years. Though the product can be used stand-alone or integrated with other EDIS products, McKesson obviously favors connections with their own Horizon Emergency Care solution.

Healthvision expands northwards to Canada with the acquisition of MediSolution’s Healthcare Products & Service’s division. The $49 million purchase gives Healthvision a bigger installed base to sell its interoperability solutions, plus provides them an EHR and a variety of clinical solutions to market to new and existing customers. Given the soft RHIO market, a bit of product diversification is probably not a bad idea.

Medical Present Value’s purchase of TeraHealth sounds like a good fit. MPV specializes in providing financial tools for managing payor contracts and ensuring maximum re-imbursements. TeraHealth (which is changing its name to MPV) offers electronic insurance and benefit verification tools to ensure accurate reimbursement on the front end.

With its decision to offer LodgeNet Healthcare’s Interactive Patient Television System, will Brigham and Women’s Hospital feel more like a hotel? No mention of whether or not patients will have an option to use the TV to review their charges and check-out.

HHS slaps Providence Health & Services with a $100,000 fine for "potential" HIPAA violations related to Providence’s loss of electronic backup media and laptop computers with identifiable health information in 2005 and 2006.

Thanks to Dyan Cannon for keeping me up to date on a few odd lawsuits.  First, a woman is suing Lake Chelan Community Hospital in Chelan, WA, alleging that in June 2007, while in the hospital’s inpatient alcohol-treatment program, a nurse fondled her.  My favorite was the Virtua Memorial Hospital surgeon who is being sued by a patient for placing a temporary tattoo on her abdomen following back surgery.  He claims it was to lift her spirits, and that past “recipients” have only had positive responses.  She claims it was sexual misconduct and voyeurism.  I think it’s funny. Thoughts? 

If you are reading this it means that I figured out how to do the posting without crashing the HIStalk servers. Mr. H intends to ignore email for almost two weeks so if you use the green Rumor Report then chances are we won’t see it.  So, email me directly with any dirt, encouragement, love sonnets, etc.