October 29, 2010NewsComments Off on NTT Data To Acquire Keane
Japan-based IT provider NTT DATA corporation announced this morning that it will acquire IT services firm Keane, Inc. as part of its plans to expand to the US market. Terms were not disclosed, although sources indicate a price of $1.2 billion.
The president and CEO of NTT DATA, a quoted subsidiary of Nippon Telegraph and Telephone Corporation, said in the announcement, ““This transaction with Keane will allow us to provide comprehensive IT services including system development and management of mission critical systems in North America. Keane has a superior reputation in the area of application and infrastructure services, as well as deep industry expertise. I believe that this, combined with their unique global delivery model and our global scale, offers more cost-effective and higher value solutions to our customers.”
Keane’s healthcare offerings include IT services, revenue cycle, the Keane Optimum application suite, and the NetSolutions suite for long term care facilities.
Keane was sold three years ago for $854 million to a California outsourcing firm backed by a Citicorp private equity investment.
Rumor of the acquisition was posted on HIStalk last Friday after a tip from Broadway Joe.
From Domestic or Import?: "Re: this NEJM case study. Has Weird News Andy found this yet?” He has not. I’m sure there’s a fascinating story about how a full bottle of beer found its way into this inebriated man’s rectosigmoid colon, but I’m equally sure I’d rather not hear it.
From Man Up, MCK: “Re: most outrageous comment EVER. From the McKesson earnings call transcript, McKesson CFO Jeff Campbell claimed that nearly non-existent revenues for Horizon Enterprise Revenue Management were due to customers who aren’t buying anything except clinicals and are also pushing back their implementations (it’s the customers’ fault, in other words). He also mentions ‘new and latest requirements’ for HERM. What new requirements are causing them to basically stop all installs? The requirement that it work? I think you should ask the customers if it was really their choice to stop the installs. He said it was going to take ‘a number of quarters’ to meet those requirements — is it two, or three, or four? But the most outrageous comment ever is this: ‘… our customers are saying to us, we’re happy running that 20-year-old to 30-year-old software we bought from you 20 or 30 years ago.’ Are you kidding me? Their customers are happy to be on Star and Series, with no embedded contract engines, no professional charge billing capability, bolted-on claims scrubbing, no online bill pay, and no online registration? Customers just called up in the last few weeks to stop installs of a next-gen system that’s been touted for years and said, ‘That’s OK, we’re really happy running this old software, no rush from us?’” I actually do believe that to a certain extent – customers probably aren’t thrilled, but are used to McKesson’s deferred promises and have Meaningful Use to keep them busy short term (which will quite likely bite them long term when reform comes knocking). Also, the CFO’s reality is filtered through layers of corporate underlings like the president of the revenue cycle business they just fired, so maybe he really believed what he was told about how happy the customers are to wait and how impressive HERM will be … someday.
Listening: Atomic Tom, sounding great in the above video playing live on iPhones on the B-train of the New York subway (the video claims their instruments had been stolen, but they now admit that didn’t happen). A cool link sent by a reader, even if it does smack of an intentional viral campaign (multiple camera coverage, carefully mixed audio, and a convenient Apple tie-in).
Microsoft announces Q1 earnings after Thursday’s market close: revenue up 25%, EPS $0.62 vs. $0.40, beating estimates. The Windows, Office, and server software groups put up good numbers, while $527 million in ad revenue from the Bing search engine wasn’t much consolation for its $560 million loss. Still, these are good results and a nice bellwether for a hopefully-recovering economy.
Zynx Health announces a five-site pilot of its software and services solution that prepares hospitals for being involved in accountable care organizations. It will address clinical decision support in improving mortality rates, readmission rates, length of stay, and total costs.
Shore Memorial Hospital NJ) promotes Fred Banner from CIO to vice president, having worked his way up from PC specialist in his 20 years there.
A reader asked me if I knew of any possible candidates for a big health system corporate CIO job that requires CIO experience, but also a strong IT vision for healthcare’s future state (person-centric and involving wellness and not just care delivery). Send me your recommendations if you have any and I’ll pass them along.
University of Michigan Health System and 570 West Michigan doctors form Physicians Organization of Michigan, what they hope will be a statewide network of independent physicians. Benefits mentioned include EMRs and telemedicine.
To-dos for you: (a) drop your e-mail in the spam-proof Subscribe to Updates box to your right to get instant alerts when I post something new, allowing you to feel smug as you sprint down the hall like Paul Revere alerting everyone of some big HIT development, not because you want them to know, but because you want them to know that you knew first; (b) support HIStalk’s sponsors by checking out the ads to your left and clicking those that catch your eye as interesting; (c) Friend Inga and me or Like HIStalk on Facebook so that we can have the illusion of being BFFs; (d) make Inga happy by reading HIStalk Practice and signing up for the e-mail updates there (when Mama ain’t happy, ain’t nobody happy); (e) send me your rumors, news, and guest articles; and (f) tell people you know about HIStalk and the other sites since the ad budget is … well, zero. Thank you for reading.
Cerner just announced $65 million in quarterly profit, but it wants Kansas City to buy the computers for its new $63 million data center without charging it taxes, then lease them back to the company. That would save Cerner at least $3.7 million over 10 years even though it would create no new jobs, just the transfer of 11 existing positions from North Kansas City.
North Carolina public health agencies, free clinics, and community health centers will get broadband services from the initial phase of the NC Telehealth Network, with the $7.2 million cost paid out of a $12.1 million FCC Rural Healthcare pilot program. I couldn’t follow the confusing list of organizations, offices, and grants that were involved, so if you are really interested (I wasn’t), then you should probably read the announcement instead of relying on my impatient summary.
PinnacleHealth System (PA) chooses (warning: PDF) electronic documentation and charge capture solutions from Salar, Inc. I interviewed Todd Johnson, president of Salar, this past February. Sometimes my interviews are lame (usually because the person I’m interviewing is just not interesting or can’t quit pitching their product or themselves, so I rationalize) but this one’s good.
An investigative article from The Center for Public Integrity questions the effectiveness of having a 29-doctor AMA group recommend to CMS how much their profession should be paid for performing individual procedures. CMS accepts more than 94% of those recommendations, leading to “rubber stamp” criticism. Part of the group’s job is to deflate the times specialist groups claim it takes to the procedures they’re paid to perform. A former member of the group says specialists scratch each other’s back in the meetings, but everybody fights with the primary care docs (which the article says nearly always lose to the specialists who successfully get big payments for performing procedures). It was also noted that, even with major technology and efficiency breakthroughs, the group almost never recommends that work units be reduced.
Palomar Pomerado Health (CA) is chosen as a Pyxis development partner by CareFusion.
Curaspan says 354 hospitals and over 2,500 nursing homes use its Web-based discharge planning, referral, ride sharing, and transportation applications.
Ingenix forms an independent physician advisory board to guide its healthcare technology direction. Among them are Joseph Heyman (who was on some Health IT Policy Committee work groups), Salvatore Volpe (president of the New York State chapter of HIMSS), Martin Harris (his ubiquity precedes him), Gregory Reicks (an osteopath who is board president of an HIE), and Alice Loveys (a CMIO).
Charleston Area Medical Center (WV) cuts $40 million from its budget due to low reimbursement, high drug costs, and $16 million worth of software upgrades. They didn’t say which systems were being upgraded, although I seem to remember that they’re a Siemens shop.
The fired CEO of 15-employee, Indianapolis-based EMR vendor iSalus Healthcare sues the company for breach of contract. Mark Day says he was fired after telling the board chair that he was suspicious that employees were stealing software. The board’s termination letter said he was let go for telling a prospect that iSalus was in trouble and warning the customer of some of the company’s untrustworthy executives, also asking the prospect for a job if things went south there (I’ll hazard a guess that they didn’t sign on the line which was dotted). Day says that conversation was misinterpreted.
Boston-based MedNetworks is developing software based on Harvard-licensed technology that maps the social networks of people and clinicians. The startup plans to sell the information to drug companies, insurance companies, hospitals, and the government. It says that the influence of friends and colleagues may be more important than formal experts when it comes to changing healthcare behaviors or getting doctors to prescribe specific drugs. One of the founders is Harvard professor Nicholas Christakis, whose social network book landed him on Time’s 2009 list of the most influential people in the world. I might have to get a copy.
From Za:“Re: my McKesson rep. Said that while it has not been verified, Horizon is on life support. Pretty sure this is not news other than I am gloating a bit because when I got to my current hospital, they were looking at McKesson Horizon and I told them there is no way that mess would ever work. I like being right!” Unverified and purely conjecture, we’ll quickly disclaim, but it’s coming from a hospital CIO who’s usually right.
From Trinketeer:“Re: MGMA goodies. I know you like evaluating all the vendor freebies at trade shows. I brought home a bunch of stuff for my kids. My 10-year-old remarked that it was ‘the same old stuff’ and nothing very good.” Kids say the darnedest things. I have to agree with the 10-year old, except for my souvenir photo with the alligator (redacted for anonymity, of course). It supported alligator conservation, but as I said on HIStalk Practice, all I could think of was how nice his skin would look on a pair of pumps.
I am back from New Orleans and trying to find the bottom of my e-mail inbox. If you care to know what practice administrators are talking about and what vendors and pundits are telling them, we have three days of highlights on HIStalk Practice.
While at MGMA, I had a long conversation with an Allscripts executive. One of the topics discussed was the company’s decision to discontinue upgrades to the Peak Practice EHR. While I can understand how this decision is disturbing for end users, I must admit that Allscripts seems to be trying pretty hard to reduce the pain. A bit of background if you haven’t been following the story: Peak Practice is an EHR that Allscripts acquired in the Eclipsys purchase, which Eclipsys had acquired from developer Bond Medical. Apparently the Peak product has a number of functionality gaps and only 300 users. Allscripts has applied to have it ONC certified and won’t sunset it per se, but they won’t be releasing enhancements to it, either. They’ll offer Peak users free like-for-like MyWay licenses and perform the data conversion at no charge. Change is difficult, but I can’t fault Allscripts for making what is probably a good business decision and I commend the company for trying to make things as right as possible for the Peak Practice clients. An interesting side note: Bond Medical founder Travis Bond is now a MyWay reseller.
Another MGMA reflection: I asked several of the smaller vendors if they were going to obtain ONC-ACTB certification, and if so, through which certifying body. Those going the CCHIT route said it was easier since they were already CCHIT certified and/or they thought the CCHIT label was more prestigious. No one specifically named InfoGard as their certifying body. Those going with Drummond noted it was less expensive and faster. One vendor, interestingly, said they were “negotiating” with the certifying bodies to find the best price and suggested that more certifying bodies would soon be announced. And, I don’t recall a single EHR vendor saying they would not seek certification of their products.
HIMSS is hosting another virtual conference November 3-4. I “attended” the first one two or three years ago, mostly because I was curious about the virtual format. The conference is free for “qualified” participants and $99 for “non-qualified” HIMSS members. I can’t find anywhere on the HIMSS site that clarifies what it takes to be qualified, but I can say that when I tried to sign up for a conference a year ago, I didn’t have the secret requirements. I am mildly amused because my status must have recently changed, having received two separate invites from HIMSS this week. I should clarify that neither invite was for “Inga,” but for her counterpart in the “real” world. Since not much has changed on my end, I have to assume HIMSS is under pressure to boost attendance, probably to please its 25+ sponsors. If I have time, I’ll probably accept an invite and lurk around a bit.
Rush University Medical Center (IL) awards a five-year, $25 million contract to Siemens Medical Solutions for medical equipment and HIT consulting services. The press release does not provide a breakdown on equipment versus consulting services, but it does specify a whole bunch of hardware for its new facility opening January 2012. The HIT consulting services will focus on providing “a more efficient electronic infrastructure for managing patient information and services.” Rush, by the way, is in the process of implementing Epic.
GE Healthcare and UPMC announce that their imaging joint venture, Omnyx, is working to digitize the pathology process and eliminate the practice of pathologists using glass slides and microscopes. If glass slides and microscopes disappear, I wonder what schools will teach in seventh grade science class? So far GE and the non-profit UPMC have invested $40 million in the project.
Trustees for New Hanover Regional Medical Center (NC) approve a $56 million move to Epic (that will be another McKesson Horizon de-install). The investment in software, hardware, and implementation is only $15 million more than the $41 million than upgrades to their existing systems were going to cost.
Cerner announces third quarter results, which were up from last year. Revenue was up 13% to $462.7 million and earnings per share were $0.71 vs. $0.57, beating estimates excluding special items.
Northeast Hospital Corporation (MA) will deploy Merge Healthcare’s PACS and ECM systems.
Sponsor updates:
Advanced Pain Management (MD) selects the SRS Hybrid EMR. Which reminds me: while at MGMA, the SRSsoft folks told me they are working on an app store to be released early next year. It will give users a quick way to add innovative extras to the core application.
RelayHealth aligns with TransforMED to provide a communication tools that aids primary care providers by establishing patient-centered medical home models of cares.
EDIMS earns ONC-ATCB certification through CCHIT for its ED EHR product.
St. Paul Radiology (MN) says its accounts receivable days has decreased 35 to 40 percent since implementing ZirMed RCM tools.
CareTech Solutions and nine of its healthcare clients are recognized for excellence by the Web Marketing Association.
SCI Solutions, a provider of access management solutions, completes its fiscal year with 42 new customer contracts representing 86 hospitals.
Voalte is named a Mobile Health Expo 2010 award winner in the category of outstanding contribution to the growth and success of nursing and mobile health communications.
Mobile Health Expo also awards PatientKeeper for the best innovation in mobile health technology for patient safety.
Eastern Connecticut Health Network chooses Access Intelligent Forms Suite to auto-index patient forms in Meditech Scanning and Archiving.
From Southern Belle: “Re: Epic. I hear they’re thinking about changing their consultant non-compete agreement from one year to two.” Unverified.
From Blame the Dog: “Re: BlackBerry tablet. Here’s some video up of a demo of the eUnity PACS virtual workstation running quite seamlessly on the BlackBerry PlayBook through their fancy new QNX-based Tablet OS. I’m a big fan of the trend Apple has started with (finally) user friendly tablets, and there’s been a lot of interest in healthcare for the iPad so far because of the cost and usability factors, but I have a feeling there are more than a few healthcare CIOs out there collectively holding their breath for the PlayBook. Apple has some management tools for the iPad and I think they’re starting the realize the potential there, but they’re still nowhere near RIM on the enterprise, information security, and compliance management front. The PlayBook is going to be a BES-compliant device, meaning all those hospitals out there with existing BlackBerry infrastructure don’t have to do much to start putting the PlayBook into lab coat pockets early next year. No matter what, RIM, Google, and Apple are finally giving hospitals and practices simple and cost-effective devices that can integrate more comfortably into existing workflows. No more bulky notebooks posing as tablets, no more clumsy laptop carts, no more silly workstations in every exam room. Finally.”
From BCS Luv: “Re: Epic. Who’s implementing it in Boise?” I’d have to guess St. Luke’s since Saint Alphonsus just went up last week on an unnamed system (Cerner, I assume, since St. Al’s is a Trinity hospital and their Genesis Project runs Cerner, if I remember correctly).
Inga is posting live from MGMA on HIStalk Practice with our patented blend of news, rumors, booth critiques, and observations (she says she got hit in the head by a lady’s tossed beads, which I hope doesn’t mean that she flashed her, French Quarter-style). Check out her posts from today and yesterday.
Core Health Technologies releases its HL7 survey results (warning: PDF). Demand for HL7 expertise will increase, said 85% of CIOs. Respondents predicted that Cloverleaf will lead the integration engine market.
Cardinal Health signs a marketing agreement with Swisslog that will allow Cardinal to offer that company’s drug packaging and distribution technologies.
New York eHealth Collaborative plans to spend $129 million in state and federal money to create a statewide electronic medical records network.
UW Health (WI) is using palm scanning to positively identify patients and to reduce identity theft and insurance fraud. They spent $70,000 for 200 of the scanners.
McKesson announces Q2 numbers: revenue up 1%, EPS $1.25 vs. $1.11, missing on both revenue and earnings excluding a one-time asset sale. Revenue for Technology Solutions was down 3% (with some one-time adjustments), with the press release saying the reduced operating margin “was impacted by continued investment in our clinical and enterprise revenue management solutions.” The company also wrote off $72 million because of Horizon Enterprise Revenue Management, which readers have told us is in big trouble with high development costs and rumored missed deliverables. I looked up their term asset impairment charge and it means (in my non-accountant interpretation, anyway) that an asset’s value has declined even faster than it’s being depreciated and amortized, requiring one-time adjustment in value.
Disappointing perfomance in McKesson’s Technology Solutions business was surely the cause of Monday’s big McKesson reorg, which I mentioned on Facebook (actually the performance would have been great without the HERM charge). Clinical and revenue cycle groups will be combined to form Health Systems Enterprise Solutions (seems odd). The president of Revenue Cycle Solutions was let go. Several other products (workforce management, surgery, performance, analytics, HR, etc.) are being combined under Health Systems Performance Management. Enterprise Imaging will be made part of Medical Imaging. Sales teams will be integrated with their business lines. They seem to be focusing on differentiating Horizon vs. Paragon prospects.
Healthland promotes sales VP Angie Franks to CEO. Former Interim CEO John Trzeciak of Francisco Partners will keep his board seat.
Surescripts expands (warning: PDF) its e-prescribing network to become a “national backbone” that will allow exchange of clinical messages, expanding on its work with CVS’s MinuteClinic. The company is marketing itself as a trusted network, using messaging tools made possible by its investment in secure messaging vendor Kryptiq. Surescripts says it will follow standards for NHIN, HL7, CCD, CCR, etc. VA CIO Roger Baker was quoted as saying that the Surescripts network would help his organization connect with community providers. John Halamka was also quoted, although in a non-committal way (he doesn’t generally shill products, just ideas). This is a big announcement, both in length and in impact. Implementation dates: Net2Net connect to allow providers and vendors to connect outside their networks (December), Message Stream secure messaging (December), and Clinical Message Portal for providers who don’t have an EHR (January). I had to refresh my memory about who owns Surescripts: the founders, the National Association of Chain Drug Stores, the National Community Pharmacists Association, CVS Caremark, Express Scripts, and Medco.
Even Weird News Andy is speechless at this article (well, almost – he only said “wow”). In England, a quadriplegic home care patient, convinced that he was not receiving good nursing care, puts a bedside camera in his room. It caught an NHS agency nurse panicking after incorrectly adjusting his ventilator’s controls and setting off its alarm. The nurse, who says she was given no training on the ventilator, couldn’t get it restarted and didn’t know how to resuscitate him. It took paramedics 21 minutes to arrive and give him oxygen, but by then he had suffered major brain damage, reducing his mental capacity to that of a child. NHS says it’s sorry.
Panasonic invests in Houston-based CardioNexus, announcing its intention to become a global leader in personalized preventive medicine. CardioNexus, formed last year, is a product of Baylor College of Medicine’s commercialization organization and works with Texas Medical Center, which was already working with Panasonic. The company focuses on early detection of heart disease, which I assume means imaging.
Sage Intergy Meaningful Use Edition is ONC-ATCB certified by Drummond Group. Also earning certification, but from CCHIT: GE Centricity Practice Solution version 9.5.
AirStrip Technologies provided some clarification about its agreement with Sprint that I mentioned recently. Users can choose any mobile device (including Android-powered ones in the next couple of weeks, but 80% of their users are on iPhones so far). Those users generally use AirStrip on their personal smart phones (makes sense – they wouldn’t want to have to carry two). Sprint helps the hospital pay for AirStrip to encourage them to use more Sprint devices, but they help subsidize the cost for all users, not just those who choose Sprint smart phones. AirStrip gets what it says is better 4G performance from Sprint, which will allow it to eventually expanding its offerings to real-time video collaboration, imaging, and extended historical waveform data. Thanks to AirStrip for the clarification. I usually steer clear of proclaiming a company or technology as “hot” since I’m just a cheap seat observer, but I’m pretty sure they are.
Folks I know at Cedars-Sinai tell me that they’re up on Epic’s nurse documentation and care plans. They’ve also shut down CareVue now that they’re live on device integration and doing some physician documentation in the ICUs.
Our Lady of Lourdes (NY) chooses Allscripts EHR for its 16 employed medical groups. They’ll also implement Allscripts Remote, which allows physicians to access the system via the iPhone, iPod Touch, iPad, BlackBerry, Android, and Windows Mobile smart phones.
Martin Memorial Medical Center (FL) borrows $25 million for equipment they say is EMR and HITECH related, including smart pumps and patient monitors.
A prospective sponsor e-mailed me a question I’ve not been asked and couldn’t answer without digging through some stats. How many unique people read HIStalk each month? The answer: just over 19,000. I also noticed the countries they’re from: the US, of course (over 93%), then Canada, Australia, UK, India, Israel, Ukraine, UAE, China, and so on. All I see from this end is a blank screen that I have to fill each day while sitting in my inner sanctum and playing music at excessive volume levels, so it’s fun to occasionally be reminded that real people are on the other end.
Healthcare futurist Jeff Goldsmith says HIT adoption is lagging because there’s no return on investment. He says the payment system is largely at fault for piling tedious documentation requirements on doctors, made worse by new quality measures (I assume those prescribed by Meaningful Use are among them). He says he would have done Meaningful Use differently, offering providers an immediate malpractice shelter for following guidelines instead of a payoff down the road. He also thinks that hospitals buying practices will drive more HIT usage than Meaningful Use since the new owners will want them to communicate with each other (and will want to monitor and control their performance, which Jeff didn’t say but I will). His estimate of consumer influence on EHR adoption by doctors: “nearly zero” since people have stayed away from PHRs in droves and the improved communication that patients really want doesn’t require IT. Jeff’s an investor in some startups, which I’d love to do if I had the money (although I probably therefore wouldn’t have it for long since those rarely pay off).
Francisco Partners takes a majority stake in Quantros, which sells quality and risk applications. The private equity firm is no stranger to HIT, with investments in AdvancedMD, API Healthcare, Healthland, QuadraMed, and T-System. I interviewed Quantros CEO Sanjaya Kumar this past April. Worth a read (or re-read). I have to say that if your vendor is bought by someone, you should hope that it’s Francisco Partners since they appear to be the most patient, most HIT-savvy, least change-demanding acquirer out there. They seem to help the companies they invest in succeed instead of slashing and burning their way to a fast payoff.
A Modern Healthcare article says that the AMA is getting into the EMR business with its Amagine project, which will go live in 2011 after the current pilot in Michigan is finished. It will charge vendors to list their wares on a portal, then take a cut of the action. AMA will actually providing technical support and possibly implementation services. I’m having a rather strong reaction to this, but leave a comment at the bottom of this post and let’s hear what you think first.
Ever wonder how those frequent flier patients get to your ED? By ambulance, of course. One health commissioner said, “The misuse of ambulances speaks to our health system. If we had a place as user-friendly as an emergency room, people would likely use it. The fix is to have more primary care and a better way to get to it.” One New York patient called for a ride to the hospital 313 times in one year. Like the rest of healthcare and the country in general, relying on personal responsibility is a bad idea, especially with a government willing to subsidize stupid decisions by taking money away from those too responsible to make them.
HealthPartners launchesvirtuwell (annoying all lower case besides being a pun), an online MinuteClinic-type alternative to office visits that offers online nurse practitioners around the clock. Online users (only in Minnesota for now) get a diagnosis, treatment plan, and prescriptions for $40 or less, depending on insurance.
The Wisconsin State Health Information Network is named as the overseer of the statewide HIE, set to launch next year.The group is a non-profit with members Wisconsin Hospital Association, the Wisconsin Health Information Organization, the Wisconsin Collaborative for Health Care Quality and the Wisconsin Medical Society.
Sponsor Updates
All Children’s Hospital (FL) will use GetWell Town from GetWellNetwork as its interactive bedside TV system offering Internet browsing, games, movies, and behind-the-scenes clinical applications.
RelayHealth beats the mandatory 2012 date for complying with Version D.0 of the NCPDP pharmacy claim standard. The company’s prescription transaction solutions are compliant now.
RelayHealth also announces at MGMA its RelayAnalytics Financial Diagnostics, a visibility dashboard into claims and remittance information.
Revenue cycle vendor ZirMed announces that it has processed 750 million healthcare transactions and is doing 20 million per month. The company says its 39% annual growth rate required adding two executives: former Allscripts sales VP Kevin Weinstein as VP of marketing and Kraig Brown as sales VP.
MEDSEEK announces its Sprint to Meaningful Use solution, which will help organizations meet the MU goals involving patients and families.
From Polemic: “Re: Epic-certified resources. Only Epic knows and they’re not sharing. That leaves everyone else to make sense of what it means when someone claims to be Epic-certified (what module, what release, etc.) Tightly controlled certification keeps qualified people in high demand, but doesn’t seem to take into account the rate at which they are signing new accounts. One has to wonder whether the ‘we’re Epic, you’ll do it our way’ approach won’t perhaps come back to bite them someday.”
From Celling Yourself: “Re: AirStrip’s Sprint announcement. I don’t get this. AirStrip’s target customer carries an iPhone, which doesn’t work on Sprint.” It is interesting since the deal offers hospitals Sprint’s help creating an in-building Sprint infrastructure for running AirStrip’s apps on 4G smart phones, but AirStrip says it’s staying carrier agnostic. I can’t imagine docs giving up their iPhones (and thus AT&T now and possibly Verizon soon) or carrying a second Sprint-capable device only for on-property access. It sounds like little more than a targeted Sprint promo for its infrastructure business.
From Former McKessoner: “Re: long overdue. I’m one of the many departures from the McKesson senior sales ranks since the June 1 beginning of the fiscal year. It took over 10 years, but the Horizon undoing is coming fast. No new business, customers grudgingly upgrading.” Unverified. All I’ve seen is the recent KLAS report, which says Horizon lost more clients than it gained in 2009 (along with the other faders you might expect — QuadraMed, GE, and Eclipsys). The company has announced nothing pertaining to its Horizon strategy as far as I know, so unless a customer verifies they were told something officially (and those I’ve asked haven’t responded), I’d say it’s business as usual.
From Introspect: “Re: Houston hacker. Here’s an update with the hospital’s side of the story. I wish you had withheld judgment until at least hearing both sides of the story.” I agree, although I assumed the newspaper’s account was accurate and complete and I did hedge my bets by referencing the hospital’s “apparent” security incompetence. The original article said the hospital had to hire outside help to fix the problems the kid claimed he told them about. The CIO’s story is different, although he didn’t mention the problems the kid says he discovered. He says the 21-year-old had installed “back door” code on the hospital’s server that would have let him bypass security to log on at any time, which he accomplished by using a doctor’s password instead of actually penetrating the hospital’s security (I’m surprised he was able to do that with a doctor’s security privileges, which I assume means any doctor could do the same, but that’s not my area of expertise). As the CIO says, “He didn’t discover a breach, he was the breach.” The outside help was engaged to make sure the kid didn’t do anything else, the CIO told the newspaper.
At least most readers think their employer’s economic conditions are no worse than they were six months ago, although more say they’re unchanged than better New poll to your right: what’s your experience working for an employer that has won a “best place to work” award?
It’s easy to confuse patients about healthcare benefits. A non-profit clinic in California sends out ID cards to all its recent patients that include the patient’s name, medical record number, and doctor name. They wanted to speed up registration by giving staff information needed to look up patients in their new EMR. Puzzled patients seen at the clinic but not its regular patients are calling their providers and insurance companies demanding to know why they’ve been turfed off to a new clinic and doctor.
RemCare, fresh off $2.7 million in new financing, renames itself (warning: PDF) after its product, Care Team Connect. The Illinois company’s product helps hospital care managers by creating evidence-based discharge care plans and coordinating care, reducing readmissions.
Vanguard Communications, which offers the MedMarketLink marketing service for specialty practices, signs a partnership deal with Intuit Health to market its portal.
HP announces its Slate 500 would-be iPad competitor, which it will market to businesses (note the medical apps featured in the above promo). It’s more expensive (starting at $799) and runs Windows 7, meaning that unlike the iPad, it supports Flash. It comes with 2 GB of memory (which is needs since it’s running Windows), has a shorter battery life (Windows again), and does not support 3G (WiFi only). I’m guessing all of those facts led to the decision to steer a wide berth around the consumer market created and owned by Apple in the hopes that businesses are so pro-Windows they’ll pay more to get less. This will be problematic: all those users with iPhones, iPods, and iPads at home are not likely to be thrilled by their employer’s offering. Apple doesn’t make mistakes too often, but failure to reach detente over Flash is a big one since that’s one of few chinks in its armor and it involves all of its products as its competitors will tell you constantly.
Mobile Health Expo announces its 2010 award winners. HIStalk sponsors winning were PatientKeeper (best patient safety innovation) and Voalte (outstanding contribution to nurse communications).
Greenway acquires Visual MED’s PACS technology, which will power its PrimeIMAGE solution for its PrimeSUITE 2011 EHR.
The radiologist who founded teleradiology services vendor Virtual Radiologic launches an early stage venture fund that will invest in consumer, healthcare, and technology companies. Sean Casey was kicked out of the company, which he started and took public, with $68 million worth of stock. It was the subject of a private equity buyout for $294 million this past May.
HHS CTO Todd Park is added to the speaker lineup of the mHealth Summit next month, run by the NIH, its foundation, and the mHealth Alliance. Also speaking: Bill Gates, Ted Turner, and US CTO Aneesh Chopra. I’ll be filing daily reports from there as will HIStalk Mobile editor Dr. Travis Good.
The Austrian man who was the first person to use a mind-controlled robotic arm for driving dies in a single-car crash that may or may not have been related to the technology.
I can’t decide if HIMSS is clueless or evil with this announcement: attendees at the Orlando annual conference in February will be tracked by RFID for the benefit of exhibitors, who can “… derive a more accurate score of a visitor’s buying potential.” RSNA has been doing this, apparently, triggering specific booth ads to play based on who’s around (Philips is a happy customer cited in the above promo video). An RFID tag will be attached to conference badges that will let vendors track attendees by job and employer (and name if the conference allows it), ending the days of anonymous and obligation-free booth cruising. The technology will log booth visits and duration by product being viewed and will alert vendors in real-time when a “key prospect” is in the area (CIO alert! Ignore everyone else!) The conference keeps getting more similar to a cattle butchering operation: you’re herded into a holding pen (the exhibit hall) since the token educational offerings (getting less useful every year) intentionally go dark during major booth hours, you’re fed and watered in the exhibit hall with vendor snacks until it’s your turn with the the high-paying exhibitors, and now you’ll be tracked like livestock throughout the process. Let me just say that, as a paying attendee and member, I resent the hell out of this (I’m sure I can get info on how to cripple the RFID tag and I’ll run it here if so). I can imagine what was going through the minds of the HIMSS dim bulbs who approved this: hey, we can charge vendors even more by selling them the personal information of attendees, vendors can pounce like snakes when attendees identified by job title as a decision-maker enter their air space, companies can monitor whether competitors are encroaching into their proprietary neighborhood, and HIMSS can justify its exorbitant exhibiting costs by showing who dropped by. People seemed to be resigned to letting HIMSS do whatever it wants in the name of picking the pockets of its vendor members. I say it’s time for provider members to push back and make the conference theirs again. Being tracked as nothing more than a roving sales prospect is just insulting. HIMSS apparently doesn’t extend its claimed interest in patient privacy to its own paying customers in the Ladies Drink Free model in which it pimps access to low-paying providers to high-paying vendors.
AHRQ spends $26.5 million of its ARRA money to hire a high-powered PR agency. Ogilvy Washington will “market and promote” the findings of Patient-Centered Outcomes Research in a newly created Publicity Center. I didn’t volunteer to have my taxes used for wasteful economic stimulus projects, but if I had, I’m pretty sure dozens of millions for a HHS PR wouldn’t have been on my list even though the general idea of comparative effectiveness research is a good one (but hugely expensive – $1.1 billion in stimulus money).
Four NICU babies in a hospital in Canada are given insulin instead of heparin in their TPNs, killing one of them.
Shares in athenahealth jumped by 23% on Friday after good Q3 numbers that beat estimates.
From BeKind: “Re: the Senate Committee on Veterans’ Affairs testimony about MUMPS. This dialog occurred at 75:26 in the video.”
Senator Richard Burr: If you maintain MUMPS can the private sector have full access into the VA system, into the MUMPS system, for the exchange of electronic information?
Roger W. Baker, Assistant Secretary for Information and Technology, Department of Veterans Affairs: I would answer it this way, I believe just as much as if we implemented it in any other language because at the bottom it’s the data that’s important.
Senator Burr: Let me turn to Mr. Tullman if I can just simply because he’s out there. Now, let’s see what the limitation is.
Glen Tullman, Allscripts CEO: What I would say is again that you can extract data from any system. What we’re really talking about, and I don’t want to get too technical, is the native exchange of information. So you can pull information out of a mainframe system and put it into a PC if you want two people to talk to each other. The question is why would you do that when you could have two PCs that were talking with each other? So again we think MUMPS was the right decision to make when it was made. We think there’s a reason to carry it forward. We’re just saying as we go forward into the future we need to broaden the understanding of what systems to use, what architectures to use, and what the general reason we need these systems for and that is for communication and I think that’s this idea of this community is important and no one’s using MUMPS to build systems that communicate and exchange data efficiently today in anywhere else but the US government.
Wow, there’s a lot of interesting stuff in this video of the committee meeting, which runs two hours (meaning I didn’t listen to every word yet). The chair, bless his heart, leads off by reminding everybody that the VA and its contractors flopped big-time with CoreFLS and the projects it had to kill because they weren’t being managed well. Ed Meagher talks about the VistA Modernization Committee’s recommendation to put VistA on a stabilization program while developing its replacement. Glen criticizes MUMPS-based systems (meaning not just VistA, but his company’s competitors Epic, MEDITECH, QuadraMed, etc.) and saying the military’s evolution requires new EMR requirements for data sharing. He also says its replacement should be either Microsoft-based or open source (technically, VistA sort of open source, so I assume he means non-MUMPS open source). He says its time for the government to learn from the private sector.
Tom Munnecke, a former VA guy who helped build VistA, testifies at around the 61 minute mark. He credits the original VistA developers, all of whom were clinicians turned developers, for its success, starting it with “good enough” and then refining it from field experience instead of sitting around writing specs. He said MUMPS criticism isn’t new, going back to the beginning, but it works and has been stable. He likes the open source idea for a VistA replacement but cautions against throwing out the lessons learned from VistA. He also advocates additional forms of communication other than the EMR, saying that 25% of VistA’s use was the Mailman app used to simply communicate among professionals (comparing that to today’s social networking). He talks up personalization that can be delivered by cheap, easily implemented tools.
The chairman also asks VA CIO Roger Baker directly what assurances he can give that they won’t screw up again like they did with their replacement scheduling system. He cites the VA’s cancelled or retooled projects as proof that they’ll kill projects with minimal chance for success (the “fail fast” approach of identifying and killing the dog projects fast before they cost too much). Munnecke agrees, but says users need to scale back expectations and allow the software to develop instead of going for the gold-plated Cadillac upfront.
Munnecke: “Mr. Tullman’s comments have a number of technical issues that I think we need to talk about over coffee some time, but I probably largely agree with his conclusion. I don’t want to be characterized as pro-MUMPS. I do want to be characterized as having a very successful legacy system that has accomplished a lot and just going with the standards of the information technology industry and thinking we’re going to take the shiny new technologies and word on PowerPoint presentations and develop a successful system is not going to work.” When interrupted by Sen. Burr’s comment that he’s never heard anybody comment that DoD actually has working EMR software and wondering why it’s so hard to send DoD medical records to the VA, to which Munnecke replies, “I think you’d have to look at DoD actually throttling back CHCS and crippling the features that were design into it for communication in order to protect their bureaucratic stovepipes.”
Sen. Burr’s summation (in which he repeatedly refers to VistA as “the MUMS system”): “It is absolutely essential, in my estimation, that private sector companies buy in to what technology decisions you make at VA because of exactly what Mr. Tullman references, and that’s that this is no longer our population of people that we’re taking care of. They’re bouncing back and forth … if we want to reach the efficiencies long-term of private healthcare, as most have realized, then we’ve got to have this interoperability solved … if a company like Allscripts, a leader, is questioning whether they’ll be able to exchange through your system, I think we ought to pause for a minute and talk to those companies and find out what is your concern …”
Then came the comments BeKind mentioned above. Sen. Burr mentions that three people in the room have iPads, yet soldiers returning from the military hospital at Landstuhl have paper medical records taped to their chests, saying that the VA should collaborate with the private sector.
From Wee Man: “Re: [vendor name omitted]. The rumor you recently ran about halted implementations and delayed upgrades for [product name omitted] is true, I’m 95% certain. Also, the same company’s flagship clinical product line [product name omitted] is going to maintenance-only.” I’m chickening out in naming the company since this is big news if it’s true and I’d hate to get in trouble just in case it’s not. I’ll say just this: the non-anonymous source is a good one, this rumor fits with some earlier stories and customer survey results that I’ve run, and some mighty big hospital systems are going to be super PO’ed if it’s true. If you have confirming evidence, send it my way.
From FormuLarry: “Re: Micromedex. They’ve released free versions of their drug information application for the iPhone and iPod. It’s not as slick as Epocrates, but the price is right.”
From Stifler’s Mom: “Re: Epic certifications. Can anyone share the exact numbers of certified people out there for products like Prelude, Bridges, Beacon, Cadence and the year/version? Also whether they have clinical backgrounds?” I’m pretty sure there’s only one source for that information so I wouldn’t get my hopes up, but if anyone knows, send it over and I’ll forward to Stifler’s Mom (I gave this non-anonymous HIStalk pal that name years ago and she adores it, not to mention it makes me cackle every time because I have a puerile sense of humor).
From Broadway Joe: “Re: Keane. Being purchased by NTT Data for $1.2 billion.” Rumor is that the Japanese company (part of Nippon Telegraph & Telephone Corp.) is in advanced talks to buy Keane, which is half owned by Citigroup. The deal is imminent, Tokyo newspapers are saying. Keane offers application, BPO, and infrastructure services, not to mention its healthcare presence (Keane Healthcare Information Systems), which markets the Keane Optimum system and other products.
From Oops, Here: “Re: glitches. We are not aware that any of these patients were injured after death.” Errors in loading UK driver’s license organ donor information to the NHS databases cause the wrong organs to be removed from 25 donors. Nobody noticed until prospective donors (the ones not already dead, in other words) complained that their information was wrong.
From Matt Mucha: “Re: my blood pressure chart. I’m a Web developer from Krakow, Poland who also happens to have hypertension. I created a tool to let people keep records online and share them with a doctor. I know you’ve written healthcare apps in the past, so I hope you can relate :). Check out the video and forums. I’m not profiting from the site in any way.” It’s a pretty slick with a clean design. Nice job. Take a look.
From Greed Earns Justice, Eventually: “Re: McKesson/HBOC scandal. Sales SVP Dominick DeRosa pleaded guilty in 2000 to one count of aiding and abetting securities fraud by hiding side agreements to manipulate revenue recognition. This past April, the judge overrode the prosecution’s request for probation and sentenced him to a year in federal prison. While waiting 10 years for his sentence, he appears to have built quite a resume, serving as CEO of OneWeb Systems, VP of sales at Transcend Services, and executive VP of sales at CareMedic. Rumor is that he was at MedAssets before getting the bad news about jail. Mastermind and former president Al Bergonzi is apparently doing his 41 months in Atlanta after being given more time than the prosecution requested. He’ll get out Christmas Eve this year. He’s been doing consulting work for former friends and one of the many HBOC acquisitions he coordinated. CEO Charlie McCall, who almost got off, is due to be release in 2019. Controller Timothy Heyerdahl was released in 2008 and CFO Jay Gilbertson was released earlier this year. I wouldn’t be surprised if he’s still in HIT somewhere.” He didn’t even mention Jay Lapine, one of few corporate counsels to ever be indicted for securities fraud (he got off on criminal charges a year ago and then settled the civil case against him, barred by the SEC from involvement with publicly traded companies for five years). McKesson’s executives, desperate back in 1998 to prove they could run something sexier than drug warehouses, paid Charlie $14.5 billion for a company everybody knew was a house of cards ready to collapse if he couldn’t fast-talk some rubes into taking it off his hands in a hurry. He did, with the announcement of the accounting scandal just a few months later evaporating $9 billion in McKesson shareholder value in a single day (the stock went from around 90 to less than 20 and still hasn’t hit that level since). Not to mention that a lot of HBOC software was as crappy as their corporate books, also widely known by nearly everybody. It’s always ugly for the foot soldiers when greed meets stupidity. Sorry for the rant, but what those guys did to McKesson’s employees (many of them unfortunate conscripts due to HBOC acquisitions), their hospital customers, patients, and to the industry really ticks me off even after a decade.
Hosted pharmacy applications vendor MedKeeper announces its acquisition of DoseResponse from Keystone Therapeutics, a competitor in outpatient anticoagulation management software.
I mentioned the 21-year-old Georgia computer tech who was arrested for accessing a hospital’s computer system. I’m beginning to think he got a raw deal. He was working on a physician group’s hospital connectivity problems and documented seven problems with the hospital’s server, hoping to impress the hospital enough to land him a job. The hospital CIO and security person met with him, asked him for a copy of his resume and a list of the problems he found, and then came back in with police officers to arrest him. The kid’s been in jail since last week, with the hospital claiming he’s a danger to them since they can’t fix the problems he cited without outside help. Maybe the hospital should swallow its pride, admit its apparent security incompetence, and hire the kid cheap.
Acuitec announced its iCare mobile anesthesia apps for the iPhone, iPad, and iTouch at the American Society of Anesthesiologists conference in San Diego this week. Jessica sent me a press release that I can’t find online anywhere to link to, so you’ll have to take my word for it. The above is a shot of its Vigilance remote presence monitoring system running on an iPad, which I found while looking unsuccessfully for the press release. The Birmingham-based company is a joint venture with Vanderbilt University.
HIStalk pal Justen Deal sent over a position listing for “geek interns” at his Vieu Health startup that was a fun read (he’s a really good writer in a Joel On Software kind of way). I was hooked enough to read the whole thing. If you’re a techie and want to be underpaid (so Justen says), but live and ski free at a resort, get a MacBook Pro and a BlackBerry Torch, and work with “misfits, rebels, square pegs, and troublemakers,” you might want to connect with Justen. I have no idea what Vieu Health is building since they haven’t said yet, but it’s something to do with electronic health records and networks. Maybe I should follow his lead and get some interns myself since I always seem to be buried.
Former NaviNet SVP Tim Mills is named VP of sales and marketing of revenue cycle management company Avisena.
The Toronto newspaper profiles the involvement of Telus in Canada’s move toward digital healthcare. It mentions that Telus provided the software and technology behind The Ottawa Hospital’s plan to buy 3,000 iPads to run on the Telus-provided wireless network to access an aggregated database. That hospital’s CIO says the information needed by key staff members that is available electronically has gone from 30% in 2008 to 100% now. It also mentions the Oacis product, mentioned several times here previously. The healthcare division of Telus is bringing in $400 million a year. It’s a well-done article. Somehow Telus Health seems to come in under the radar in the US, but it’s an impressive operation run by a a large telecommunications company.
Cardinal Health Foundation will award $1 million in medication and OR safety grants in 2011 for the fourth consecutive year. Applications are due by December 3, 2010.
The Chicago Sun-Timescovers the local healthcare use of iPads: University of Chicago Medical Center will give iPads to all of its internal medicine residents, a plastic surgeon uses her to explain reconstructive surgery to breast cancer patients, and one hospital says at least half of its ED docs bought their own iPads once they found that they could use the EMR on them.
In Germany, CompuGroup Medical AG says it will invest $180 million in its software over the next five years, most of that to further develop its Software Assisted Medicine medical knowledge system.
Ontario’s health administration is slammed by an auditor’s report that found the same expensive practices previously found in eHealth Ontario scandal last year: single-source contracts, overpaid consultants, and excessive expense reimbursement. One temporary executive who was making $275K per year billed the hospital an extra $150K for helpers, $14K for bonuses, a Christmas lunch, and world-wide travel, including $500 in telephone charges in one hotel stay.
Q3 numbers for UnitedHealth Group, parent of Ingenix: revenue up 9% to $23.7 billion, with net earnings of $2.15 billion in earnings from operations, easily beating expectations on revenue and earnings. The company gave guidance of $94 billion in revenue for the fiscal year. Ingenix revenue was $592 million, up 23%, with $70 million in earnings from operations. The announcement also gave the cost of the Q3 acquisitions by Ingenix (Axolotl, Picis, and A-Life Medical, I assume) at $1.9 billion in cash. UnitedHealth market cap is $41 billion.
Odd lawsuit: a couple says a waiter at the local Steak ‘n Shake gave their child a bottle of Blair’s Mega Death hot sauce for his chili, causing him to break out in hives (assuming the child wasn’t hitting the restaurant on his own, maybe the parents should have intervened). They’re suing for $10,000 in compensation and $50,000 in punitive damages.
CMS incentive payments are taxable. That’s the opinion of Steven Waldren, director of AAFP’s Center for Health IT. I’d never really thought about it, but that hardly seems fair. Definitely not nice.
Cerner Ambulatory tops the list of a recent Ovum report entitled Selecting an Ambulatory EHR Vendor in the Healthcare Market. I mentioned this on HIStalk Practice yesterday, but it perplexes me so much that I’m also asking HIStalk readers to share their impressions. I don’t know much about Ovum (which is a division of DataMonitor) so I asked them to provide me more background on their research methodology. No response as of yet. Cerner, along with eClinicalWorks and GE Healthcare, make their short list of top vendors based on strong brand names “in the ambulatory market” and for demonstrating “market-leading positions.” The report also says Cerner is the “most versatile and multi-faceted” of all the vendors reviewed (which included Allscripts, Sage, NextGen, athenahealth, and Amazing Charts.) To be fair, I know Cerner ambulatory by reputation only, so for all I know Ovum is spot on. The Cerner folks have graciously offered to dispel my skepticism and asked me to stop by for a demonstration at MGMA next week.
Follow-up: back in March I mentioned the former MedAssets employee who was arrested after using a fake identity to get her job and stealing financial information on more than 1,200 patients. Katina Candrick was sentenced to 10 years and ordered to pay more than $163,000 in restitution. As I was looking for a photo of Candrick, I noticed that in 2008 she had been charged with fraud, falsifying identity, and fraudulent possession of a controlled substance after posing as a medical clinic employee and attempting to pick up prescription drugs at a CVS pharmacy.
HealthGrades says that overall hospitals are improving, but the gap between the best- and worst-performing hospitals is substantial. A typical patient would have a 72% lower risk of dying in a 5-star rated hospital compared to a 1-star rated hospital, and a 53% lower risk of dying by going to 5-star rated hospital compared to the US hospital average.
Baptist Health System (AL) contracts with Passport Health Communications for Passport’s IntelliSource software for revenue cycle management.
Virtual Radiologic is named the top-rated vendor in the KLAS Teleradiology Study 2010. KLAS notes that teleradiology contracts had historically been held by local radiology groups, but now hospitals and clinics have 40% of the contracts. Look for teleradiology volumes to rise in the next few years.
athenahealth posts a 33% in increase in third-quarter revenues ($63.1 million vs. $47.4 million). Excluding one-time items, the company’s net income doubled from last year, coming in at $6.4 million or 18 cents per share. Analysts were looking for a 27% increase in revenue and 13 cents share. Basically, a darn good performance. The always entertaining Jonathan Bush will provide more details at 8:45 a.m. Friday on CNN.
AirStrip Technologies collaborates with Sprint to offer a bundled solution that includes Sprint’s clinical grade in-building coverage and AirStrip services for hospitals agreeing to expand or extend an enterprise commitment to the Sprint network for more of their employees.
Thomson Reuters releases a new version of Clinical Xpert Navigator mobile for iPhone, iPod Touch, and iPad devices.
Lots of good stuff on HIStalk Practice this week: in addition to the usual posts, we feature several HIT Vendor Executives who shared their opinions on what attendees will be discussing next week at MGMA 2010 in New Orleans. We also published a handy vendor guide summarizing what each of our exhibiting sponsors will be highlighting at MGMA (you can download a PDF to print and take along). Do us a favor: stop by their booths, ask for a tour of their offerings, beg for a trinket, and tell them thanks for powering HIStalk and HIStalk Practice.
Sponsor Updates
Greenway introduces PrimeSPEECH, an integrated direct-to-EHR speech technology and PrimeIMAGE PACS solution. Both solutions are fully integrated with Greenway’s PrimeSUITE EHR and physician workflows.
MED3OOO acquires health benefits consulting firm Insurance Solutions Group.
Voalte partners with Meru Networks to extend its capacity in hospitals running the Voalte application. The company also announces a trial at Parkview General Hospital (IN).
For the third year, Vitalize Consulting Solutions earns a spot on the Philly 100 List, coming in as the 57th fastest growing privately held company in the greater Philadelphia area.
Bronx-Lebanon Hospital Center selects the Allscripts Care Management solution, which will integrate with the hospital’s existing Sunrise Clinical Manager system. Bronx-Lebanon also recently deployed Allscripts solutions in its ED and 40-physician multi-specialty practice.
SRSsoft is named to Deloitte’s Technology Fast 500, which lists the 500 fastest growing (by revenue increase) high-tech companies.
MedPlus parent company Quest Diagnostics releases its Q3 financials: revenues of $1.9 billion, down 1.7% from last year; net income rose to $198 million ($1.13/share) compared to $192.2 million ($1.02/share).
McKesson signs an exclusive agreement with MedVentive to offer that company’s SaaS-based Analytics Advisor analytics solution to the payor market, where it connects payors and providers transparently around clinical and financial performance metrics.
I’ll be traveling to New Orleans this weekend to attend the MGMA conference. I’ll be on the lookout for cool HIT stuff, collecting giveaways, and hopefully learning a few new things. Look for updates and photos.
From Buck Dharma: “Re: CIO salaries. Are you still keeping a list? Long time reader — appreciate the effort you take to keep this thing fresh.” I stopped running CIO salaries a few years ago when it became kind of a pain to dig them up from tax records, but I’ll try to do some every now and then when I have time (remind me or tell me the ones you want to know). Here are a few new ones for you: Partners Healthcare, $803K. Sentara, $692K. Memorial Hermann, $834K. Detroit Medical Center, $391K. Adventist Health System, $774K. Centura Health, $468K. Children’s Dallas, $635K. University of Maryland Medical System, $569K. Suddenly I’m feeling poor.
From A-Rod: “Re: Audax Health Solutions. One of few healthcare firms to be selected by Google to beta test a unique machine learning algorithm. Audax plans to use it to tag and sort healthcare content to predictively suggest it to the Careverge user.” I’ve read the buzzword-oozing About Us page for Audax and I still have no idea what exactly they do — something to do with social networking and benefit management (you would think they could be succinct being that they apparently worship Twitter and Facebook). Google or not, I ran out of interest before I ran out of prose.
From Elsie: “Re: UPMC. These are the folks whose $5 million CEO earlier this year closed the only hospital in Braddock, one of the nation’s most underserved cities, and are now rushing to demolish the building. UPMC rationalizes saying they want to turn the site over to Allegheny County for ‘future development’. Anybody who’s seen Braddock, the embodiment of poverty and urban decay in America, knows it’s just block after block of boarded-up storefronts and empty lots. Taking away that community’s only healthcare facility is the antithesis of humanitarian.”
From K-Rod: “Re: anesthesiologists. I agree that they are on the edge for patient safety. Wonder when (or if) surgeons will get there? What you may not know is that these talented nurse anesthetists can sing!” I’ve mentioned these amazing guys before — The Laryngospasms. They’d make great entertainment for an HIStalk event, right?
From WillOurSoftwareEverWork: “Re: McKesson Horizon Enterprise Revenue Management. Implementations have been suspended and Release 2.0 is delayed until next year.” Unverified. I e-mailed a CIO who should know and I think Inga tried an informal company contact, but we haven’t heard anything so far. Consider this false until someone confirms.
From Careener: “Re: DHIN. I don’t know if you saw this Delaware dust-up (no, not former witches as US Senate candidates). The Republican candidate for US Representative took a shot at his opponent over the Delaware Health Information Network, saying it is ‘mismanaged … with no tangible benefit.” I was involved with DHIN as a provider and it was, and is, an unqualified success, with Delaware being the first state to have statewide results delivery, HIE to EMR integration, and public health integration for pandemic and reportable results reporting. It is the model other stares are following. Love reading your updates, please keep up the good work.”
From Lady Pharmacist: “Re: National Hospital and Health-System Pharmacy Week, October 17-23. It’s that time of year again. Can you kindly give a shout-out to pharmacists and pharmacy technicians? If you’re thinking that hospital pharmacists and pharmacy techs are like the drugstore ones that Jerry Seinfeld makes fun of above, you couldn’t be any more wrong. Imagine a small group of professionals who handle with virtually 100% accuracy the thousands of medication-related orders generated in a hospital each day, except unlike lab and diagnostic radiology orders, any one of those orders could kill a patient because of an incorrectly prescribed dose, method of administration, allergy, or conflicting therapy. Pharmacists and techs prevent untold errors every day as unchallenged medication experts whose only interest is patient safety. The hospital pharmacy is a complex, demanding environment involving drug procurement and distribution, clinical monitoring, professional consultation, heavy duty informatics, significant clinical and research work, and careful monitoring of the use of high-risk meds that cure when used correctly and kill when not. I’ve worked in hospitals for quite a few years and watched the transition of hospital pharmacists and techs from the lick-and-stick pill pushers that Jerry skewers to professionals adding indisputable value to patient care with their brains and not just their hands, quietly and unassumingly preventing innumerable bad outcomes without much glory. If you look at the most tragic medication errors (see: Quaid babies), you will nearly always find a situation where doctors and nurses mishandled drugs without pharmacy involvement. My hospital is featuring Pharmacy Week in the lobby display case, so maybe yours is, too.
Listening: Bad Religion, prototypical SoCal punk for over 30 years. Strong harmonies, angry but literate lyrics (the lead singer is a Cornell PhD and UCLA college professor), and a hard rock edge make them better than the Ramones if you ask me. I played a few seconds of two songs from Stranger than Fiction and instantly bought it for my gym iPod. Love it.
Encore Health Resources is named to Modern Healthcare’s 2010 Best Places to Work in Healthcare, which I’m sharing since they sponsored last year’s HIStalk reception at HIMSS. They just hired their 100th employee. That’s Dana and Ivo above, of course. HIStalk sponsors making the list: maxIT Healthcare and MEDecision.
ThinIdentity changes its name to Aventura. They need to learn to write more disciplined press releases — this one prattles on without giving even a hint at what they sell until the final “About” paragraph (answer: some kind of logon/logoff tool). Their Web site is much better at using the few precious seconds of the average Web attention span to get to the damned point.
Grady Memorial Hospital (GA) chooses Apollo Health Street to convert its legacy patient accounts to a new PA system.
How do you tell when a CEO is lying? (no, smart aleck, not when his or her lips are moving). According to a researcher’s algorithm, lying CEOs tend to overuse words like we and our team to refer to the company in presentations, also showing fake exuberance with words like fabulous, fantastic, and extraordinary. Honest ones say I, me, or mine to indicate that they take ownership of their claims. That’s until this article came out, of course, which will tip off CEO media handlers to coach their lying executives better.
Cerner will become a reseller of address checking and patient classification software from SearchAmerica, which is part of mammoth credit scoring vendor Experian.
Former Cerner LifeSciences CMO Robert Dubois MD, PhD is named chief science officer of the National Pharmaceutical Council. Their mission statement sounds noble, but based on their sponsors (drug companies) and their emphasis on innovation and value (the “we have enough scientists to sort of prove that our unbelievably expensive drugs are actually a good value” approach), I’m guessing the scientific aspect mostly involves marketing.
Illinois Bone & Joint Institute chooses the SRS Hybrid EMR for its 242 Chicago-area providers.
Weird News Andy awakens from apparent dormancy with this offering, which he titles “Smurfitis?” Police in the Baltimore area are called to check on an 89-year-old woman, who they find blue, motionless, and smelling of decomposition on her bathroom floor. Instead of checking for a pulse, they call up her son and tell him she’s dead. Three hours later, a guy sent over from the State Anatomy Board to transport her body for use as a medical cadaver notices that she’s breathing. She is rushed to the hospital and discharged to hospice a couple of weeks later, where she died for real shortly afterward. The police chief says the case is “deeply disturbing.”
A Claremont Graduate University research team introduces the HealthATM, designed to give low-income health clinic patients access to their health information anywhere. It can be used to schedule appointments, request prescriptions, look up lab results, and review medical content. Community clinics enrolled up to 100% of their patients, 75% of whom wanted to use it regularly. What a fantastic idea – not everybody has Internet access and PC knowledge.
Lake Health (OH) introduces digital way-finding to its all-digital TriPoint Medical Center. It offers visitors a kiosk-based virtual guide that helps them locate their destinations, including the ability to have directions sent by text message. That makes me reflect on the odd design of hospitals compared to other public buildings, where visitors (many of them first-timers) are expected to traipse around back hallways and through multiple buildings to find lab, radiology, registration, and all kinds of other departments, often within a single visit and involving visitor-unfriendly jarring architectural change along the way since hospitals are often expanded patchwork over decades without any obvious continuity (“take the Red Zone elevator to seventh floor and then follow the blue stripe, then make the first left through the closed double doors marked ICU Waiting …” Clearly the unspoken paradigm is: you may be our customer, but it’s your job to come to us, no matter how hard we make that task. I confess that I can and do easily get lost in my own sprawling hospital campus, hoping that nobody notices my backtracking and frequent “where the heck am I” cognitive dissonance pauses until I finally give up and ask whoever’s at the nearest nursing station.
In Canada, Queen Elizabeth Hospital (PEI) warns of ED delays due to the implementation of Cerner’s FirstNet and PowerNote, which the assistant medical director says have a steep learning curve.
Bartron Medical Imaging wins FDA approval for its medical imaging software, which uses image segmentation algorithms developed by NASA for analyzing satellite images to find abnormalities in diagnostic images, such as those for mammography. I snagged the knee slice above from the company’s sample image database (you can log in as user guest and password guest).
The FDA issues urgent Class I warnings for the recalled CareFusion Alaris PC 8015 smart IV pump, saying its intermittent wireless network lockups prevent nurses from making programming changes, with the resulting runaway pump potentially causing serious patient injury or death in some circumstances.
A 21-year-old computer technician hired to fix a Georgia doctor’s computer uses the doctor’s password to sign on to a hospital’s computer system. He’s arrested and charged with computer theft, computer forgery, password disclosure, and “theft by taking.” The hospital’s HR VP says he thinks the man was trying to show off his computer knowledge to get a hospital job offer. Doh!
Doctors in Taiwan say their counterparts in China want to work with them on telemedicine and preventive medicine programs via cloud computing, given Taiwan’s superior capabilities in IT and medicine.
An investigative article by ProPublica finds that hundreds of doctors shilling drug company products have been accused of professional misconduct, have been disciplined, or don’t have adequate credentials. They created an online database that lets you look up any doctor to see if they’ve been paid promotional fees for any of seven big drugmakers.
In the UK, the Cambridge University Hospitals trust will take a pass on the defunct NPfIT’s Cerner Millennium or iSoft Lorenzo offerings, choosing instead to do their own system selection.
East Tennessee Children’s Hospital releases its iPhone app, which offers hospital information, maps, directions, parking information, health articles, and a place to store medical information.
David Blumenthal calls on HIT vendors to “include providers who serve minority communities in their sales and marketing efforts,” expressing his concern that EHR adoption rates are lower among providers serving Hispanic or Latino patients who are uninsured or rely upon Medicaid. Having once made my living making sales, I can assure Dr. Blumenthal that salespeople (and their bosses) are happy to sell their EHRs to just about anyone who will buy them. If this segment of providers isn’t buying EHRs, I doubt it is because vendors aren’t knocking on their door, but because these doctors don’t have the money. These are the physicians who have forgone the bigger incomes to treat the uninsured/underinsured and who rely on reimbursements from Medicaid, not the higher-paying commercial carriers.
Philips Healthcare posts a 14% increase in revenues to $2.67 billion for the third quarter. North American sales grew 11%.
Emdeon wins a subcontract from CSC to perform IT services for the Department of Defense Pharmacy Operations Directorate. As part of the 51-month contract, Emdeon will develop interfaces for immunization tracking and lab systems.
Nebraska Medical Center subscribes to the CapSite database to improve its capital expenditure process.
Marion General Hospital (OH) pays a $1.2 million fine for self-reported Stark law violations that occurred between 2003 and 2009. The hospital’s president says it failed to do the proper paperwork for several physician-related matters, including payments to to independent physicians who saw indigent patients and provided emergency room call. The hospital also did not properly document providing office space and services at below-market rates. If I didn’t know better, I would think the US attorney handling the case is running for re-election. In a statement that seems to ignore the fact that the case was self-reported, he remarks, “This is a significant victory for taxpayers and another step in our efforts to protect the Medicare Trust Fund.”
Texas Health Resources and Alliance HealthCare Services (CA) contract with Sy.Med to provide credentialing software.
Union Hospital of Cecil County (MD) selects Wolters Kluwer Health’s ProVation Order Sets as its electronic order set solution.
The Scarborough Hospital in Toronto picks Access Intelligent Forms Suite to integrate with MEDITECH Magic. The Access product will improve forms management by pre-filling forms with patient information and auto-index barcode forms into the EHR.
Audax Health Solutions appoints Henry DePhillips MD as president of healthcare operations. He was previously with McKinsey and was chief medical officer of MEDecision.
RCM software provider Avisena hires Timothy Mills as VP of sales and marketing. He’s worked at NaviNet, Spheris, and CareScience.
Healthcare and financial transaction provider TransEngen appoints Mike Pileggi as EVP of sales. He was previously in sales roles with mPay Gateway and Misys Healthcare Systems.
Shareable Ink launches Shareable Ink Analytics for Anesthesia, a business intelligence module of its anesthesia record.
The American Hospital Association extends its exclusive endorsement of AT&T’s HIE services. AT&T Healthcare Community Online enables the secure exchange and sharing of patient data across multiple health systems. AHA also endorses AT&T’s voice and data networking services and wireless services.
Management Health Solutions, a provider of supply chain software for healthcare, acquires Hospital Inventory Specialists, which offers inventory management solutions and analytical services.
Eight of Minnesota’s largest healthcare organizations connect their Epic systems to electronically share patient data. All are members of the Minnesota Epic User Group using Epic’s Care Everywhere software. The network includes access to estimated 3.6 million patients, or 75% of Minnesotans.
The CDC awards CACI International a 10-year contract to support the CDC’s IT infrastructure. The contract has a ceiling value of $1 billion.
The board of directors of the Perkins County Hospital District (NE) approves a $1.5 million allocation to implement an EHR at the 20-bed Perkins County Community Hospital.
Xerox expands its healthcare footprint with the acquisition of pharma tele-services company TM Health.
KLAS reports that vendors offering integrated workforce management solutions are winning more deals than companies offering standalone staff scheduling products, even though providers prefer the functionality of stand-alone products. The top rated vendor was McKesson, followed by Clairvia, Concerro, API, and Kronos.
Evangelical Community Hospital (PA) commissions Keane Optimum as its financial, clinical, and EHR solution.
A reader sent me a note last week, noting that my avatar depicted “a very sweet young lady worthy of my attention strictly in a fatherly way.” A lovely and I am sure well-intentioned comment. A question to my fellow female HIT-types: why do you suppose that that statement leaves me disappointed and reminiscent of my early teens, when only the Ted The Geek-type boys noticed my existence?
From Improper Setting, Here: “Re: CVS is caught stocking meth labs.” A $75 million software bug? Drug chain CVS is fined that amount for illegally selling pseudoephedrine (generic Sudafed) from its stores in California and Nevada. The congestion remedy had been moved to behind-the-counter sales since it’s used to manufacture methamphetamine. Meth makers found that they could simply make repeated buying trips to CVS to accumulate enough of the drug, made possible by a CVS software bug that couldn’t detect repeat sales. The apparent personal best: one customer bought the drug 10 times in 53 minutes from a single CVS store.
From Alicia: “Re: IntraNexus and biometrics. A big piece missing in medical device integration is patient identification, where this might be useful to bind patient ID to medical devices, especially if what they say about vein print is true. Right now you need a myriad of systems such as RFID and/or bar code and it’s usually done indirectly by bed number association.” The shots above from Fujitsu’s PalmSecure illustrate the concept.
From The Purple Computer: “Re: UPMC. Say it and people will come. How many nurses are they giving up?” UPMC rolls out a $16 million “branding campaign” centered around bold, humanitarian healthcare thinking — a purple logo (“fresh and progressive, yet warm and feminine … distinguishes us from the sea of blue in the academic medical center and health insurance space.”) Obviously they’ve let the marketing people run wild. Non-profit hospitals have gone over the edge when they start throwing around terms like “space” to refer to healthcare delivery. If their hospitals aren’t already full, I doubt there are enough patients will switch just because they’re tired of the blue-logo places. Maybe their competitors (if any are left other than West Penn) should run their own UPMC ads during Unemployment TV hours (daytime judge, talk, and soap programs) to dump more uninsured patients onto the newly purpled.
From Jailbreak: “Re: EMR vendor VP. I wrote you before about a sales VP with a criminal record and am amazed his new EMR employer didn’t check references. Here’s a threat to me from the VP, who can’t even write.” I’ve omitted names and details, but the purported e-mail from the VP, nearly unintelligible, is kind of fun in an illiterate, ransom note kind of way: “Why are you such a [genitalia synonym omitted] and hide you indenty .. Law suit coming … You dam well i never stole nothing from you … I will make sure I get on EVERY doctor website (EMRUPDATE) for example to let them know how bad and far back the [company name omitted] technology is … will not even get a whiff of 2011 cchit and over the EMR SUCKS The statements will come from various doctors … NOMATTER what you do I survive.”
From DyingToKnow: “Re: HCA. Persistent rumor in KC this week – HCA is switching from Meditech to Cerner. What’s the real scoop?” I mentioned from a sound inside source that HCA is doing a small Cerner pilot, facing an extensive effort and cost to move to Meditech 6.0 and figuring they might as well explore their options. I think that’s the limit of HCA’s commitment so far.
From Volare, WoOh: “Re: Moses Cone. They had a 1.5 hour recorded demo of Epic on their physician page, but it looks like it’s been taken down. There is also a CEO video talking about the $80-120 million Epic investment over the next five years.”
From Yosemite Sam: “Re: Most Wired award. I heard that AHA is discontinuing it. Maybe the commentary on HIStalk made them see the light.” Unverified. It can’t be because the award is pointless since that’s always been the case, so I’ll go with the obvious: with Meaningful Use, who cares about a phony award sponsored by skin-in-the-game HIT vendors and magazines trying (but failing) to perpetuate the myth that more HIT is always better? If the rumor is true, the CIO dilemma begins: should you leave the Most Wired vanity entry on your resume once the award is sunsetted? Here’s the award that actually means something: use IT to improve patient outcomes and/or reduce your costs, in which case your reputation will precede you without your having to wave flimsy evidence of it around. Too bad there’s no profit involved in that to attract the interest of AHA, HHN, CHIME, McKesson, and the other Most Wired conspicuous HIT consumption cheerleaders.
From HIT Geek: “Re: Siemens layoffs. The timing of Siemens layoffs follows the fiscal calendar. They are often announced on or shortly before the fiscal year-end (9/30). This year’s round is no exception. It is numbers-driven, with no concern for holidays or employee morale.” You would think well-educated MBA-type VPs could use their legendary quantitative skills to look forward more than one quarter, but that never seems to happen with any company. It’s like, holy crap it’s year end and the numbers suck, so start dumping people.
From Hogs Get Slaughtered: “Re: Cerner and Ingenix. Gonna take on 3M’s monopoly and crazy, hostage-style pricing.” Cerner will integrate coding and PPS solutions from Ingenix with Millennium.
From Kay: “Re: patient estimation tools. Patients want to know what the cost of the service will be and how much they will owe. The time of ‘wait and see’ is over — not just what it costs, but how much they will have to pay. Thirty states require the hospital to provide cost information. Vendors that provide a quick and easy 270/271 transaction code check based upon the hospital’s charge master cost for the service and the patient’s insurance plan would be able to provide the most accurate estimate for the patient. A cost estimate at time of scheduling, pre-reg, or registration will meet state requirements and help the hospital compete. Time-of-service collection of the accurate out-of-pocket balance reduces collection expense and bad debt. These tools also allow checking addresses and creditworthiness. With medical identify theft on the rise, being able to immediately know that the ID provided by the patient may be associated with ID theft protects the hospital from lost revenue and also prevents the contamination of the EMR.” Kay works for Iatric Systems, which offers this kind of solution.
From ePatient Advocate: “Re: PracticeFusion. The ad-supported vendor said at Health 2.0 that they are the largest and fastest-growing EHR. No breakdown on how many are getting ‘free’ (aka pharma ad-sponsored version) and if patients want their docs to be getting drug rep visits via their EHR.” There’s an overview and demo above, just in case you’re interested. I didn’t watch it all, but ads and patient data sales didn’t seem to be emphasized.
I’m back from a break. Thanks to Inga for capably covering while I was away. I’m sure I’ll inadvertently repeat some of what she wrote about last week, but I’ll catch up eventually. That wasn’t really me in the picture she ran, by the way — that was just some sly Inga impishness. And thank God she didn’t sent out minute-by-minute Chilean miner updates since apparently the entire world had two full days to ignore pressing problems while watching feel-good bios of oppressed miners now turned instant but probably short-lived superstars (the most interesting aspect of that story is that the mining company is too broke to even pay their wages, much less the dozens of millions it cost a previously safety-indifferent government to get them out to create the mother of all political photo opportunities).
I bet not many people can say they couldn’t wait for vacation to be over to get back to their jobs, but I can (especially my HIStalk “job”, but I even missed my hospital one). I missed seeing people in scrubs and white coats, feeling the on-campus energy, and doing geeky IT stuff.
Readers don’t have a lot of confidence in the ability of Windows Phone 7 to compete with iPhone and Droid, it seems. New poll to your right — another economy check. From your employer’s perspective, how is the economy doing compared to six months ago? All I know is that my IRA value went up 10% last month, which is nearly as fast as it was going down for the past several.
Chuck Christian (Good Samaritan Hospital) and Judy Kirby (Kirby Partners) win the CHIME Collaboration Award for writing the IT internal marketing book that I’ve mentioned here previously. Chuck co-wrote it with Kirby VP Steve Bennett.
Yuma Regional Medical Center (AZ) names pediatrician Bart Bernstein, MD as its CMIO. He will lead the 333-bed hospital’s Epic implementation, which is costing $73 million. I noticed that the hospital has put up a website hoping to recruit candidates for its 40 newly open Epic-related positions. For some reason, they spell Epic as EPIC, which I see often but don’t understand since even Epic doesn’t go all-caps (unlike Meditech or MEDITECH, whichever is correct since I can’t figure that out at all). My rule is that only acronyms get capitalized and neither Epic nor Meditech is an acronym. It‘s usually those UPMC-style run-amok marketeers that demand to capitalize words against all logic or to stick annoying symbols on them like a proud rancher branding his steers.
Getting a local paper Epic mention: University of Colorado Hospital, spending $67 million.
Listening: the brand new debut album from The Band Perry, three young siblings cranking out polished country pop that sounds more genuine than the usual Disney-style, photogenic and overproduced hat-wearing faux cowboys/cowgirls pretending to know who George Jones and Ralph Stanley are but whose impeccable makeup might melt at the sight of an actual mandolin or pedal steel guitar. They’re from one of my favorite small towns: Greeneville, TN.
Stuff you can do if you want: (a) add your item free to the HIStalk Events Calendar; (b) click the Like button on the Facebook widget to your right or friend Inga or me; (c) search the amazingly deep HIStalk archives using the Search All HIStalk Sites box to your right; (d) send me rumors, news, or a Readers Write article; (e) check out the other sites, HIStalk Practice and HIStalk Mobile; (f) support my sponsors by perusing the ads to your left and clicking any of interest to see what’s new with the folks who keep the virtual printing presses running here at HIStalk; (g) thank yourself on my behalf for reading and for telling others about HIStalk.
It’s American Idol, EMR style. Intellect Resources, looking to quickly hire 90 short-term Epic trainers for Mount Sinai Medical Center, is running a one-day audition in New York on November 5. The job pays a fixed rate of $20 per hour and lasts for a maximum of 24 weeks.
The Milwaukee newspaper profiles Epic with some interesting facts, with the most interesting one being confirmation of our June report that Aurora is dumping its $150 million Cerner system for Epic, which will cost them an additional $100 million. A quarter billion dollars seems like a lot for an EMR considering that Aurora showed a $50 million loss two years ago and a $116 million loss last year. For that performance, the CEO was paid $2.3 million last year (including a million-dollar bonus), the COO made $2.2 million (another million-dollar bonus), two other VPs made more than $1 million (both with >$500K bonuses), and the CIO took home $739K (including a $250K bonus). All while laying people off, of course.
That article about Epic values the company at $2.6 billion, or just 3.3 times revenues. That seems about right given that Cerner’s market cap is just over 4x sales and is better diversified, although Cerner is probably less profitable for the same reason.
Gary York, the founder of patient visibility vendor Awarix that was bought by McKesson in 2007 (and who was also founder of imaging vendor Emageon, since acquired by Merge Healthcare) is named board chair of Emergency CallWorx, an Alabama-based 911 and incident management software vendor.
A Florida business paper does a nice profile on nurse communication system vendor Voalte, mentioning its rapid growth (20 clients expected by the end of 2011) and its legendary pink pants. Trey Lauderdale told me that Inga gets some credit for those since he asked us for advice before the company’s first HIMSS exhibit awhile back and joked about needing to stand out among the larger and better located ($$$) booths. I don’t recall the details, but Inga either dared them to wear pink pants or picked up on Trey’s joke that they were thinking about it and she ran it in HIStalk before he could change his mind. The rest is history, as the pink represents the company’s fresh culture. Shockingly, we don’t get asked for advice all that often despite having other colors on reserve for those occasions.
GE reports bad Q3 numbers as it tries to shed its GE Capital baggage. Net income dropped 18% and sales fell short of estimates, although Jeff Immelt says orders are picking up (I’m always wary when the audited numbers are bad but the unaudited anecdotes are rosy). GE says its performance was dragged down by the $1.1 billion it had to pump into a Japanese finance division. GE Healthcare’s performance was the only bright spot, with revenue up 4% and profits up 14%.
Speaking of GE Healthcare, it announces a CCD-powered tool for Centricity that allows exchanging basic patient information with non-GE EMRs.
A veteran is denied his request to return to active duty in Afghanistan when a Pentagon doctor using DoD’s AHLTA EMR sees his post-traumatic stress treatment records from the VA’s VistA system. The VA is treating the incident as a data breach since the AHLTA-VistA interface isn’t supposed to exchange information of that type. VA CIO Roger Baker actually suggested that doctors not enter progress notes into VistA if they can’t figure out how to keep it from being viewed in AHLTA. On the other hand, the VA wants to rewrite/replace VistA at huge taxpayer expense, so that kind of warning would help the argument, I’m just saying.
Speaking of DoD, the GAO says the $2 billion AHLTA EMR (double that cost by many accounts, up to $20 billion by some estimates) is mediocre at best (limited capabilities and performance problems) and will be replaced by 2015 with something called "EHR Way Ahead,” with $302 million requested for FY2011. Northrop Grumman got billions to develop and maintain AHLTA (the EMR formerly known as CHCS II before it was rebranded in a PR-company led attempt to hide its many warts), so I’m sure they consider themselves an obvious choice to take a second uber-expensive swing at the ball. In any case, regional droughts are being relieved by vendor and fat cat contractor salivation. I love these AHLTA comments from student doctors:
My favorite are the contractors who keep explaining how much easier it is to use than a real chart. I wonder how much medicine they practice.
They tell you that all you need to do to fix the system, is keep sending trouble tickets in. since when did software testing get added to my job description? i want out, and as far away from AHLTA as possible.
I remember watching the PGUI instructor (similar to AHLTA) show us how "wonderful" that system was. He pretended the pt was there for an asthma appt. I kept track of the time it took just for him (the specialist) to enter the info and the time the computer was "thinking" (hourglass sign). It took 7 1/2 minutes.
I was the last holdout and management basically had to come down and hold a pistol to my head to get me to stop writing 600s. I still order things in CHCS and document it later in AHLTA when I get around to finishing notes in the evening. This is the biggest turd of a program I’ve ever seen.
I haven’t met an AHLTA contractor yet that I would hire to help anybody program their VCR.
For new users, if you’re trying to add a consult and it keeps kicking it out, 95% of the time you can fix it by adding a med first (I like rectal Tylenol), then adding the consult, then go and delete the med. Ha ha of course the fact that I have to do this to work around the bug lets you know how screwed up AHLTA is in the first place.
What I hate is that, while psych notes are require a "break the glass" thing to access, the actual psych/counseling diagnoses appear on the front of every note created. Thus some poor kid talks to a social worker about problems with his wife, and every subsequent note has "MARITAL PROBLEMS" plastered to the top of it.
It’s funny, I think AHLTA is the most universally despised part of military medicine. Anything else: GMOs, Base Locations, volume of procedures, whatever, you’ll find someone who had a good experience. AHLTA the opinions just seem to vary between ‘it’s pretty bad’ and ‘I’m armed and hiding outside the programmer’s house’.
When anesthesiologists talk about patient safety, I listen, because that group is the only one of all medical disciplines that admitted their own problems and went off on their own to reduce surgery-related mortality by a huge percentage (see: Peter Pronovost). The Anesthesia Patient Safety Foundation has new recommendations (warning: PDF) for medication safety in the OR, indicating its willingness to surrender anesthesiologist independence in the interests of patient safety: (a) put pharmacists in the OR; (b) use high-alert drugs only as premixed products and administered by smart pump; (c) bar code check meds before administration and with decision support and documentation built in; (d) use case kits whenever possible and do not let providers prepare their own drug doses; and (e) establish a just culture for error reporting. Not to perpetuate a stereotype, but if surgeons weren’t collectively such pouting egotistical cowboys, they might save more patients instead of arrogantly standing in the huge patient safety shadow cast by their anesthesiologist colleagues.
Verizon expands its Medical Data Exchange beyond simple dictated notes to include images and lab results. It also announces new partnerships: MD-IT for applications, Alert Notification for communication, Amaji for clinical documentation, Tolven for applications, NLP for natural language processing, ZyDoc Medical Transcription for transcription. I’ve never heard of MD-IT, but I was interested that one of its founders and board chair is an MD/PhD who founded the company that claims to have developed the first antivirus software, later sold to Symantec to become Norton Antivirus. He also founded Cybertrust, which Verizon Business bought in 2007. I guess he didn’t need to practice medicine.
Nurses at Children’s Hospital of Oakland go on strike after management makes them pay 15% of the cost of their healthcare benefits, which have risen 80% in the past five years. The hospital says the nurses all make at least $136K per year and the benefits will cost them only $4,000. Can they really be paying staff nurses $136K?
From: JimmyJoe “Re: UW Warning on Cut and Paste. In my prior life I became increasingly concerned about the quality and safety ramifications of mindless cutting and pasting. The practice also causes progress notes to grow and grow (due to cut and paste and add), making the record increasingly unwieldy and less useful. I informally polled a number of people in my position and all of them were equally concerned. None of them had an answer other than policies around not doing it without paying attention. It is important to remember that cutting and pasting is not really an EHR function, it is a Windows function.What to do, what to do?” I don’t have an answer either but it’s good to know you can always blame Bill Gates, should an auditor raise concerns about cutting and pasting in your EHR.
From: Bama Bubba “Re: RFID tracked hospital workers. I wonder if RFID-tracked hospital workers feel like cattle, too. Personally, I never bought the ‘inventory tracking’ rationale (excuse) for tagging workers.” Two Houston-area school districts, hoping to monitor the whereabouts of their students, implement “the same technology used to track cattle.” Despite parental concerns about potential health risks, administrators are pleased attendance is up.
From: Weird News Andy“Re: Medicare fraud-biggest ever. Leads me to wonder. . . Medicare get hits with fraud ALL THE TIME. Do private firms get hit with fraud as often and we just don’t hear about it, or is there something about people looking out after their own money that makes them more vigilant?” WNA asks a compelling question, prompted by news of a $100 million Medicare fraud case. In reading details on this case, it sounds as if the art of cheating Medicare isn’t rocket science. Maybe it’s not as easy in the private sector.
When I first read details of this same Medicare fraud case, I thought it had the bones for the perfect modern day Godfather saga. Federal prosecutors have charged a band of 40+ Armenian-American gangsters for billing Medicare over $100 million in fraudulent claims (Medicare paid $35 million of them.) The enterprise has been led by Armen Kazarian, whose role is similar to a Mafia godfather. He came to the US in 1996 and was granted political asylum based on a fabricated story that involved his father being doused with gasoline and burned to death.The fraud operations started with the identity theft of doctors, including their medical license numbers. The accused group then stole the identity of Medicare patients. From there, gangsters created 118 fake clinics across 25 states and began churning out fake claims. In most cases, Medicare was happy to pay. The story includes plenty of infighting, threats of violence for not paying debts, and untraceable money transfers back to Armenia. The US attorney handling the case calls it the “single largest Medicare fraud ever perpetrated by a single criminal enterprise.”
Not a moment too soon: HHS awards TerraMedica a contract to assess fraud, waste, and abuse in Medicare claims using predictive modeling technology.
The St. Charles Health System (OR) selects Allscripts EHR and PM solutions for its employed and affiliated physicians. The Oregon Community Health Information Network’s (OCHIN) REC will provide implementation and training support for independent physicians. Allscripts, by the way, also announces its 2010 President’s and Circle of Excellence Hospital awards, which recognizes customers with documented strategies and superior outcomes using Allscripts technology.
eHealth Ontario awards CGI Group a $46.2 million contract to develop a new chronic disease management system. The solution will operate on AxSys Technology’s Excelicare platform. AxSys, by the way, also just secured contracts with North American Management California and MSO of Puerto Rico to develop HIEs running on the Excelicare platform.
The Denver paper highlights the University of Colorado Hospital’s migration to Epic. The hospital says data integration is one of the major benefits of the $67 million project, which is expected to be completed mid-2012.
Halfpenny Technologies, which recently secured $2.6 million in VC funding, appoints four new execs to its management team, including Mitch Fry as EVP of business development, Daniel O’Brien as CFO, Roger W. Newbury, Jr. as SVP of sales, and Jim Sheils as VP of sales. Individually the group has worked for such employers as Sunquest, Misys, TELCOR, Touchstone Health, United Healthcare Group, US Laboratory and Radiology, and dbMotion.
DB Technology and BridgeHead Software partner to offer a joint content and storage management solution. The combined solution leverages DB Technology’s document imaging component and BridgeHead’s data and storage management tools.
MEDecision earns accreditation from URAC for meeting URAC’s Vendor Disease Management, Vendor Case Management, and Health Content Provider standards.
Vocera Communications acquires voice technology vendors Clinical Health Communications (makers of OptiVox) and Integrated Voice Solutions (maker of VoiceCare.) Vocera also reports a 39% y/y growth for the third quarter.
Catholic Health Partners (OH) claims its saved over $8 million using Kronos’s time and attendance and productivity solutions. CHP attributes the savings to reduced agency and overtime use.
A reader tells me that Advocate Healthcare (IL) is now live on SAPPHIRE for patient registration and accounting in all nine of their facilities.
A class-action lawsuit filed in Arkansas accuses HealthPort of charging patients an illegal fee when requesting copies of their medical records. The lawsuit is not challenging the legality of HealthPort’s basic charge to retrieve/copy/send medical records. However, the lawsuit contends that the $1.71 sales tax imposed by HealthPort is illegal and in-state providers do charge sales tax for similar services.
St. Barnabas Medical Center (NJ) picks Merge’s AIMS, medication management, and patient portal solutions.
UMass Memorial Health Care announces plans to eliminate 350 jobs, or almost 2.6% of its workforce. The seven facility system expects to lay off 130 workers, freeze another 120 vacant jobs, and eliminate the equivalent of 100 jobs by reducing overtime and move employees from full to part time.
Hiring: the Cincinnati Business Courier reports that healthcare systems in tri-state area expect to add more than 100 people to help set up various EMR systems.
Verizon releases plans to expand its Medical Data Exchange platform beyond its core transcription exchange services; members will soon be able to share X-rays, lab results, and other digital records. Verizon will also begin offering IT consulting services for its Exchange members.
This week on HIStalk Practice: KLAS publishes a new report rating ambulatory EMRs by specialty; the Rhode Island Quality Institute picks several pre-qualified EHR and technology vendors for its REC; Ohio State Medical Association publishes a new social media toolkit for providers.
API Healthcare says it’s recently signed up more than 30 healthcare clients for its workforce management technology.
The Chesapeake Regional Information System for our Patients (CRISP) announces its statewide HIE is now live.
Pemiscot Memorial Health Systems (MO) selects Prognosis Health Information Systems’ ChartAccess EHR.
Despite taking some well-deserved vacation, Mr. H did manage to check in with me a couple times this week. Mrs. H apparently took this shot of him taking a moment to ensure the HIT world was still on track. Maybe he’ll post a few more pics when he posts the Monday Morning Update this weekend.
From: Penny Chenery“Data Innovations.” Data Innovations is taking on a huge amount of capital from an unknown venture capitalist. It is either an outright sale, or a large infusion of cash.” Investment firm Battery Ventures announces it just purchased the maker of software for managing clinical lab data for an undisclosed sum. Data Innovations also appoints former Lawson VP Mike Epplen as the company’s new CEO.
From: WALL-E“Re: Most Wired. I heard AHA is discontinuing the Most Wired award. Maybe all the commentary on HIStalk made them see the light.” Unconfirmed but I am sure that just reading the rumor will make Mr. H smile for a second or two. WALL-E wasn’t clear if AHA is no longer going to be associated with Most Wired or if the Most Wired award as a whole is going away. Send a note if you know.
From: Bertha Lindau“Re: Moses Cone. In case you’re interested, here’s a PDF where the Moses Cone COO talks about replacing GE with Epic.” The internal newsletter includes details from a brown bag lunch with COO Terry Akin, who has a number of interesting things to say about the transition. He points out that the health systems was unable to develop a fully integrated health record after their “big investment with GE” five or six years ago. Akin calls Epic the “one company that has emerged head and shoulders above the rest” and claims that 99% of their physicians were favorably impressed with the Epic demo.
As WisconsinBiker shared June 23rd, Aurora Health Care (WI) is replacing its 15-year old Cerner system with a $100 million Epic solution. Aurora CIO Philip Loftus says that one the biggest advantages of Epic over Cerner is Epic’s fully integrated solution for both hospitals and clinics. Epic, by the way, is expected to end the year with $780 million in revenue, compared to $650 million last year and has an estimated market value of $2.6 billion.
Cerner may not be feeling the love from Aurora, but I bet the Kansas City Convention & Visitors Associates are big fans. This week’s Cerner Health Conference will generate $4.5 million for hotels, food, fuel, and related expenses as 6,000 users descend upon the city. Cerner took advantage of the event to announce several new alliances:
A reseller agreement with SearchAmerica that includes the integration of Cerner’s revenue cycle offering with SearchAmerica’s financial services
An alliance with Ingenix to integrate Ingenix’s medical coding and prospective payment system (PPS) solutions into Cerner’s Millennium product
A reseller agreement with MedAssets to market MedAssets’ web-based revenue cycle services
Here was an odd observation from one of the local papers: Cerner closed many of the leadership forum sessions to the media. Of course now the whole HIT world wants to know what Cerner was hiding.
Also meeting this week: nearly 1,500 Sunrise Enterprise users in San Diego. Attendees had a chance to see the new Sunrise Mobile MD iPhone application, which enables physician to access the Sunrise system. Allscripts also introduced Allscripts Developer Program, which allows clients and third parties to natively integrate their applications with Allscripts’ solutions. In December, clients will be able to search the Allscripts Application Store & Exchange to select or share applications developed through the Developer Program.
QuadraMed’s former SVP of corporate development Steven V. Russell joins digital pathology vendor Aperio as VP of corporate development.
A longtime HIStalk reader asked us to mention the upcoming HIT Leadership Summit in Atlanta November 9th. Silicon Valley venture capitalist Bob Bozeman (of Google fame) is keynoting the event, which aims to highlight Georgia’s leadership in HIT, plus drive statewide HIT revenue and job growth. There’s a pretty impressive list of HIT companies, universities, and medical schools participating in the event hosted by the Technology Association of Georgia (TAG), the Georgia Department of Economic Development, and the Metro Atlanta Chamber. I am happy to make the mention for Marty Mercer, who is on the TAG advisory board and a faithful reader. Plus I have a soft spot for attractive bald men.
So, Mr. H is vacationing this week, leaving me solo. I’m sure I have left out some earth-shattering HIT news, so give me a break and shoot me an email if you have some juicy news to share.
The Camden HIE (PA) goes live this week, connecting Cooper University Hospital, Lourdes Health System, and Virtua Health. Each of the three health systems is contributing $50,000 a year, plus the Merck Company Foundation is donating $50,000.
Vincent Marin joins Huron Consulting Group as CIO following 16 years with McKinsey & Company. Marin most recently served as director of IT services for the Americas region.
Novella Clinical hires Charles Lambert as its new CFO. Lambert had previously served as CFO for RCM provider Capario and Misys Healthcare before that.
Sponsor Updates
CynergisTek CEO Mac McMillan, who also serves as Chair of the HIMSS Privacy and Security Steering Committee, will be a presenter at the Midwest HIMSS 2010 Fall Technology Conference next week in Minneapolis.
e-MDs is playing an integral role in the creation of the HIT Certification program at the University of Texas. e-MDs’ CEO Dr. Michael Stearns serves on the curriculum committee and the company has donated their Solution Series EHR/PM system. Of the 34 students eligible for employment from the first graduating class, 21 have secured HIT jobs and seven have been hired by e-MDs.
Medical Hills Internal Medicine and Pediatrics (IL) selects SRS Hybrid EMR for its 14 provider practice.
Healthcare Coalition of Texas awards EDCO Group a contract to give its 17 healthcare system members to EDCO’s document management solutions.
Sunquest Information Systems expands its international operations with the hiring of Dr. David Rossitter as director of customer operations in Norwich, UK. Rossitter most recently served as Interim Head of Operations for Astron Clinica.
Frisbie Memorial Hospital (NH) contracts with Voalte for its integrated communication solution for the iPhone.
Lourdes Hospital (KY) is working with Informatics Corporation of America (ICA) and Ulrich Medical Concepts to provide a bi-directional CCR for providers. Lourdes providers currently have access to the ICAare Clinical Portal; bi-directional capabilities are being introduced for practices utilizing the Ulrich Medical EMR.
PatientKeeper reports that its customers are processing more than 10 million physician charges annually with its Charge Capture application. PatientKeeper also just added US Memorial Health System (IL) as a new client and expanded agreements with Alegent Health (NE), Boston Medical Center, and the Robert Wood Johnson Medical Group (NJ).
University Health System (TX) signs an agreement with iSirona to use iSirona’s technology to automate the delivery of patient medical devices to to the hospital’s EMR.
Memorial Hospital (IL) selects Access Intelligent Forms Suite to complement its MEDITECH 6.0 Advanced Clinical/EMR system.
How does this happen: a Pennsylvania paramedic is charged with multiple counts of felony theft for stealing and re-selling as many as 15 ultrasound machines. Over the past few years, Juan Torres worked for a private ambulance companies and several ERs where various ultrasounds equipment was reported stolen. The units, some valued at around $35,000 each, were being offered on eBay for under $7,000.
I attended my second Health 2.0 conference in San Francisco last week and find myself suffering from multiple personality disorder as a result. My multiples (only 2) are the geeky, health policy, propeller-head Ben; and the Investor Chair Ben. Allow me to share both views.
What an amazing ecosystem (or is it an incubator)!:
Health 2.0 is easily the most forward-thinking conference I attend, and the sense of energy and excitement there amazes me. I even started following a Twitter feed for the first time! Yes, it’s a bit like the Internet conferences I attended in the dotcom days, but there’s much more of a focus on empowering patients, improving decision making and making healthcare better.
Unlike the e-health conferences of yore, while investors do attend, they’re not throwing money around. With over 1,000 attendees and close to 50 sponsors this year, the conference is clearly a success. Kudos to Matthew and Indu (who I actually think might be the best entrepreneurs in the room) for putting it together and creating a bit of a sandbox in which people can play.
Another industry veteran and I were musing that it has a similar feel (albeit smaller scale and way hipper) to the Microsoft Healthcare Users Group (MS-HUG) conferences we used to attend about a decade ago. That is to say, it’s an outstanding networking and business development venue. Yes, the term ecosystem was way overused, but there’s a degree of earnestness that I find alternately annoying and endearing.
As expected given the 2.0 theme, many of the “companies” are focusing on social networking and “user generated healthcare”. I’m not sure if tweeting what I eat or posting how many steps I take will change my behavior, but a number of the other attendees seemed to think so.
Bottom line for this Ben is, as a very smart entrepreneur turned venture capitalist observed, “Health 2.0 is a great chance to catch the vibe and see what people are thinking about five years out.” He went on, however, to say he’d likely invest elsewhere for the next few years as he waited for the market to catch up. This brings us to what did Investor Chair Ben think.
Let the Angels Sing (Because the VCs Aren’t Likely To)
All of the above notwithstanding, I saw few, if any, investing opportunities.
Yes, some of the sessions had interesting ideas, but I couldn’t shake the 90s Internet conference feel. Too many companies were more into showcasing how edgy and disruptive they were, then how lucrative, proprietary or sustainable they were. There’s this tone of self-congratulation that I find off-putting (but maybe I’m just old!).
While I wasn’t able to attend the DC to VC conference the day before (another part of Health Innovations Week), chatting with some folks from a major publisher who did, I was told that none of the pitches they heard talked about a business model or how they’d make money. Of the companies I saw or spoke with that did have a business model, as with last year, too many were focused on advertising revenue or were just too small in scale to attain institutional financing. That, perhaps, is part of the appeal and charm of Web 2.0 in general. It allows someone to develop a website or app in their loft or garage and perhaps make a few hundred thousand dollars a year doing it, quit their day jobs working for the Man and, best of all, in this case, improve the health status of a sizable number of people in the process.
This shoestring/boot strap ability is great and exciting, but it typically does not create something an institutional investor who wants to generate returns for their funds’ investors (and themselves) is likely to care about, hence my conflicting viewpoints. Did I see a few companies that were likely institutionally backable? Yes, but with the criteria of having reasonably high entry barriers and/or capable of generating $10-20 million in EBITDA (earnings before interest, taxes, depreciation and amortization – a key financial metric used by investors), I’d say less than five. It not being a venture forum event, I will decline to name them, but I’d be surprised if they were EMRs solely for iPads (how long will it take NextGen, Sage or AdvancedMD to develop their own?) or a service that allows me to get a text message of my last STD status to prove I’m healthy before I hook up (though the founder of Qpid.me did a great pitch).
Trying to integrate my two personalities, I’ll observe the following about Health 2.0 and its eponymous conference:
Health 2.0 is real and becoming mainstream. Sponsors included Cerner, RelayHealth (aka McKesson), OptumHealth (part of United, sister of Ingenix), and Sage (fka Medical Manager). These aren’t companies jumping on the bandwagon or trying for some gloss either; for the most part they have a commitment.
Part of the power and excitement are the low entry barriers and the ability to bootstrap on a shoestring (Inga, just which is the right footwear metaphor here?) For minimal cost and time, a developer or entrepreneur can make a difference in people’s health status/quality/access…
…but raising capital will be a challenge and a home run (or even a triple) exit isn’t a likely outcome.
There were some innovative ideas and great, exciting and high energy people…
…but more features and products than companies.
I’ll close with a link to a very worthwhile Forbes article written by some of the best HCIT VCs in the business. In addition to athenahealth, they’re currently invested in four private companies that I personally find fascinating. Their lessons learned are well worth noting.
Ben Rooks spent ten years as a sell-side equity analyst covering HCIT and related sectors before spending six years as an investment banker where he closed transactions ranging from $40 to 365 million. Seeking to make an honest living, he then founded ST Advisors, LLC where he works with healthcare companies and their sponsors, most often on issues around strategy, financing, and outcomes/exit planning. After all this time, he still can’t wait for HIMSS!
From The PACS Designer: “Re: Windows Phone 7 launch. Microsoft has scheduled the Windows Phone 7 launch for October 11. If Windows Phone 7 is as good as Win 7 in combination with Bing, then we’ll see some interesting apps that could start to be used by healthcare providers and patients.” I’m not a big fan of the name for sure, and I don’t know how many people care about the Zune Hub. The Windows Phone Live cloud service seems cool. Overall, I don’t think it’s exaggerating to say that lines of would-be purchasers Monday morning (or lack of them) will tell you a lot about the odds that Microsoft will return to innovation relevance. I can’t imagine anyone giving up a recently purchased iPhone or Droid to get one — they’ll have to energize the fence-sitters. You don’t want to be slow to a market involving long-term contracts.
From Five Grand, Here: “Re: Harvard. Capitalizing on fear and anxiety, they’re going to the bank after promoting them. Even with a visit to the Harvard Faculty Club, am I the only one who thinks this is a rip-off?” The Harvard School of Public Health offers two-week program on HIT leadership for $4,995, not including hotel and dinners. Faculty includes Glaser, Halamka, and Middleton. Hospital people are so insecure and indecisive that I’m sure the mid-levelers with budget money show up (and probably add an intentionally vague note about their new Harvard “education” on their resume, which is part of what the $5K buys in their minds, I’d bet). The site says the attendee satisfaction is high. I’ll reserve judgment until someone who has been tells me their outcome, i.e. everything else aside, did their employer, who is likely quite different from Harvard, get their money’s worth in sending them? Sometimes expensive is worth it.
From Paisano: “Re: GE. I heard they’ve restructured the sales force. Any insights?” I don’t usually follow sales force restructurings, but anyone who wants to chime in can. I’m bored easily by endless territory realignments, new management bringing in recycled ideas already tried and failed elsewhere, and messing around with the sales function instead of fixing the real problem of underperforming products or executive management.
From Mark Wagner: “Re: HIStalk article EMR: One Size Does Not Fit All. Evan Steele made some accurate observations in his recent physician practice EMR post. There are many variables that influence the eventual success or failure of an EMR deployment at a practice. Practice specialty is absolutely one of them. Since HIMSS10, KLAS has been compiling a report that drills down on EMR vendor performance by specialty. As the need for more information by specialty was raised in this forum, it seems appropriate to also announce here that KLAS is releasing a first-of-its-kind ambulatory EMR specialty report on Tuesday. Beginning October 12, providers will be able to download a complimentary copy of the KLAS EMR specialty report and vendors can purchase a copy of the report. Mr. Steele correctly points out that KLAS only accepts evaluations from live users of a system. KLAS feels that live users are best equipped to report on current release quality, vendor responsiveness. and the level of customer support. Former users often share comments about failed experiences and KLAS reports that feedback when it is offered. KLAS welcomes research topic suggestions and questions about what we do and how we do it. Please contact us at info@KLASresearch.com.” Mark is the director of ambulatory research at KLAS.
From Mark: “Re: Meditech’s history. I love telling this story. Beverly Hospital was the beta when Meditech was introducing color terminals. Their controller and CIO went to visit Neil in the development building in Cambridge, which was actually two buildings, one old and one new, joined on a few floors. When you walked from the second floor of one to the second floor of the other, there was still a step because the floors weren’t the same height from the street. They went into the room where Neil was putting the final touches on the EPROM that was going to become the master for the new color terminals. All that was left to do was to pick out the colors that would be used for certain menus and pop-ups. Neil let the people from Beverly choose the color palette for hundreds of thousands of color terminal users.”
From John Smith: “Re: Ingenix. Layoffs in the payer and government group (the division that acquired AIM Healthcare). Rumor is about 100 people this past Wednesday.” Unverified.
HIE vendor Halfpenny Technologies gets $2.6 million in VC funding.
Thanks and welcome to North Highland, supporting HIStalk as a Gold Sponsor. The company, based in Atlanta but with 45 offices all over the US and elsewhere, does things differently. Instead of flying consultants out from a central location at the client’s expense, they have experienced consultants who work out of the same cities as their clients, or as they say, “Our consultants trade hotel rooms and security checkpoints for dinner at home and Little League practice.” Their results are real and measurable and their work is guaranteed. Thanks to North Highland for supporting HIStalk.
I was thinking about the impending Siemens layoffs, scheduled to start in early December. I know the Thanksgiving to New Year’s holiday season is long (15% of the year, basically), but companies could at least appear to be more humane by whacking their previously valued associates after January 1 instead of during the holidays. Cutting people loose right before Christmas means executives either don’t care or have let the situation become so desperate that the only answer they have for their own poor planning is to decisively overreact.
Carol from RelayHealth, who describes her specialty as “all-around-helping-providers-get-paid products”, offers a new white paper for readers interested in the point-of-service payment question asked earlier. You can download it here.
It seems that the IS department is going to be doing the Meaningful Use attestation work in most hospitals, although many clearly haven’t decided for sure. New poll to your right: how well will the Windows 7 phone compete against the iPhone and Droid?
If you’re an HIStalk sponsor and didn’t get your invitation from Inga for out little get-together in Orlando at HIMSS, e-mail her. We look forward to seeing you there.
Nuance and IBM are collaborating to develop Clinical Language Understanding, a healthcare-specific natural language tool to extract discrete data from clinician narrative.
Bon Secours Health System will use medical error tracking tools from Quantros.
BCBS of Nebraska chooses NaviNet’s provider communications portal for real-time eligibility checking and claims status and remittance.
I’ll leave you with one of the many amazing moments (this one from 1987) from St. Elsewhere, the best hospital drama ever. This is the memorable scene where Dr. Westphall expresses his opinion of the hospital administrator sent in by Ecumena, its new for-profit owner.
From Rickie in the Shadowlands: “Re: Siemens layoffs. 475 jobs in Managed Services and Professional Services (including Soarian support) will be transitioned to India and Romania, with the first wave of layoffs 60 days from last Thursday. The VP emphasized that no job is safe.” Rickie included the internal e-mails from both the VP (I don’t know his name) and from CEO John Glaser (still feels funny to think of him as vendor CEO and not hospital CIO). John’s seemed sincere and personal. The VP used every contrived buzzword and trite phrase known to man, coming across as smug in leading off with the “clarity and applicability” of his memo, moving to “evolve our delivery model,” “drive value to our customers and position for mutual success,” and finally in artfully finding a soothing phrase to describe trucking off 500 American jobs overseas, “introducing additional geographic diversity.” It’s bad enough to lose your job without having to hear brain-numbing Management Muzak as the soundtrack.
From Hot Nurse: “Re: nurses. The IOM released a report Wednesday recommending that nurses take leadership roles in healthcare redesign as physician partners. Within hours, the AMA issued a rebuttal, saying that nurses don’t have the education and training that doctors have and they should not assume an equal role. The IOM had science in its hand in saying that nurse practitioners have outcomes equal to or better than MDs. Seriously, the best they can come up with is ‘nurses aren’t our equals?’ In fact, physicians don’t want this low-paid work and we can’t recruit enough primary doctors anyway. The physician image has gone from gods to captains of ships to pathetic in my career. They have not supported IOM’s patient safety initiatives (checklists, handwashing) or embraced IT. They don’t want to do primary care, but don’t want anyone else to, either, and they have no plan for the coming tsunami. Nurses excel at patient engagement, communications, and education, which MDs avoid since they can’t bill for it. Their last big proclamation was that they won’t read PHRs for patient histories because nobody will pay them to do it. The poor economy is bringing out the worst in them.”
From Capitulator: “Re: Meditech’s database. We have a data repository, but given the latency in populating it, would like to access Meditech’s database in real time. Can you enumerate the companies that provide tools to do this? I gather that Blue Elm is one of these but we were hoping for something less expensive.” I need some help from Meditech experts on this one. If you have some advice, click the Add Comment link at the bottom of this post and fire away. Thanks.
From Dr. Love: “Re: patient estimation tools or eligibility software used by hospitals. Would you consider this as a topic for the future? We are interested in products that we can use in our application with simple imports and exports.” I’ll have to punt on this question, too. Little help?
From Picka Penny: “Re: Iowa HIE announcement. The scope was changed by the state to 40 hospitals, meaning ACS’s winning bid is less than $3,000 per hospital per month. I don’t see how they can even buy hardware and pay the expenses of the employees who will have to work free.” Unverified.
From Beantown MD: “Re: your list of reasons that hospitals buying physician practices won’t work this time around, either. You are absolutely correct. It will not work for the reasons you describe, which were the same reasons for the failure in the 1990s. Since then I have not seen any real change in how doctors view this issue. And for the record, these reasons are about the same for why Disease Management works so poorly.” Thanks, Doc (he really is a doc – I just didn’t give his name).
Listening: new from Canadian grunge rockers Finger Eleven, a little softer than their older stuff, so I went back to The Bluest of Gray Skies. All of it’s good, though.
I’ll be mostly incommunicado next week as I take a slightly-deserved hiatus with Mrs. HIStalk in a tropical locale, so the fabulous Inga will be wo-manning the helm in my absence. I’m hoping for none of those “it was better without you” comments when I come back.
My pal Lyndsey from Nuesoft (she friended me on Facebook and Liked HIStalk, so that makes her my pal) sent over some pictures of their sales folk at AAP last week, dressed in vintage clothing representing client-server technology compared to today’s cloud computing. That’s one hideous leisure suit (I’m having disturbing Mr. Furley flashbacks) and a couple of cute Trekkie outfits. You have to be fearless to be in sales, evidently.
Adobe wins the Blue Button Developer Challenge, sponsored by Markle Foundation and the Robert Wood Johnson Foundation. The challenge was to create a Web-based tool that downloads information from the VA or Medicare to help patients manage and improve health. Adobe’s Blue Button Health Assistant extracts immunizations, allergies, meds, health history, labs, and military service histories.
Terry Ketchersid MD, VP and chief medical officer of Health IT Services Group, suggests the 2010 book above in response to the reader’s interest in a book about HIT and the future. I see chapters by familiar names Don Berwick, Don Detmer, Bill Stead, and Jon Perlin. Terry’s company sells the Acumen EHR for nephrologists (a very small group, apparently) and they produce an EHR blog for them, including Meaningful Use information. Terry also marvels that I have time to write HIStalk, which was exactly what I was thinking Tuesday evening when I came home from work, ate in approximately 120 seconds, and didn’t leave the chair for the next five hours until I was finished writing Tuesday’s post. Tonight was a breeze at just 4.5 hours.
Voalte gets a writeup in their local Sarasota paper for implementing its iPhone-powered voice, alarm, and text system at Wahiawa General Hospital (HI).
Inga mentioned the new Allscripts Homecare Mobile. Above are a screen shots I found on their site. It will run on Windows Phone 7-based smart phones.
The VA puts its previously mothballed pharmacy re-engineering IT project back on track after redesigning the project structure.
The Technology Association of Georgia and other groups are sponsoring an all-day HIT Leadership Summit on November 9 at the Fox Theatre in Atlanta. I had to dig and scroll to find pricing, but it looks like $39 for members and $59 otherwise.
IntraNexus will integrate PatientSecure biometric patient identification into its SAPPHIRE Patient Access Manager and Advanced Clinical Manager solutions. Registration or clinical staff will direct the patient to place their palm over a scanning sensor, which will retrieve their records if they’ve been seen previously. My first thoughts were addressed in the fourth paragraph: it can be used to identify John Doe patients and can validate the bearer of an insurance card.
Stockholm-based Elekta boasts of the #1 KLAS rating of its MOSAIQ Radiation Oncology/MOSAIQ Medical Oncology systems among oncology information systems. You may recall that the company acquired IMPAC Medical Systems in 2005, making it the world’s largest oncology software vendor.
Both Davies Award winners in the ambulatory category are e-MDs clients, the company says. I like this: The Diabetes Center of Ocean Springs, MS is the first non-physician provider to win the Davies — it’s a nurse practitioner clinic. I’m shocked that Inga offered no commentary about their attire, which I think is quite fetching and possibly deserving of an award in the clinical couture category.
I like this: Meditech quietly supports the Lesley University New Teacher Community. They got Neil Pappalardo, Larry Polimeno, and Howard Messing to talk about teachers who made a different in their lives and took the great pic above, which I’m appropriating with full credit to their site because I think it’s an excellent shot of some pretty amazing guys. Sounds like a man crush, I know, but you cannot believe the business accomplishments and social contributions made by the Meditech founders and executives over the years. Neil Pappalardo’s story would be a Hollywood hit, I’m convinced. I’ll willing to write it.
Among the Phoenix-area companies presenting at a December investor conference: ClearData Networks (healthcare cloud hosting) and WebPT (a Web-based EMR for physical therapy clinics). I figured I’d give them a shout out just to be nice.
A Microsoft executive proposes that PCs be blocked from connecting to the Internet if they don’t have a health certificate, drawing an analogy to vaccinations. A security expert, referring to Microsoft’s endless security updates, said, “There may be some who would say that Microsoft shouldn’t be on the internet until they get their own house in order.” I think Microsoft is right in identifying a need to protect the Internet a bit better, although the devil is in the details.
This might be a record: 24 laptops are stolen in a Troy, MI pain clinic break-in.
An MIT graduate student develops a health monitoring system that uses a webcam built into a mirror to determine heart rate. It measures variations in facial brightness, a technique that the student thinks will also work to determine respiration and blood oxygen levels.
A free Internet tool developed by a UK-based non-profit research group predicts the drug regimen response of AIDS and HIV patients with 80% accuracy, better than any other method.
Former national coordinator (back when the government wasn’t spending much on HIT) David Brailer is elected to the board of Walgreens. I will have to drop him a note to recognize my local store, where I stopped the other day to buy Halloween candy and found a delightfully garish and well-made Hawaiian shirt perfect for vacation for $6.99. That’s healthcare in America: the same store that sells prescriptions and medical supplies also carries heavily discounted Hawaiian shirts, cigarettes, and motorized Halloween skeletons.
Robert Wood Johnson University Hospital (NJ) selects ProVation Medical MD software for gastroenterology procedure documentation at is ambulatory surgery center.
Medicity secures contractual commitments with five new health systems representing 12 hospitals.
RemCare, developer of a care coordination software product, raises an additional $1.9 million in equity and warrants, bringing its current round funding to $3.3 million. RemCare’s CEO is Ben Albert, a former VP of client services for PatientKeeper.
The Health Information Partnership for Tennessee selects Axolotl’s Elysium Exchange platform for its state HIE project.
RelayHealth introduces MedGift, which sounds like a cool departure from its typical RCM and HIE connectivity services. MedGift is a patient gift registry and social network that facilitates communication between patients and their friends and family members. In addition to providing communication tools, MedGift allows patients to register for personal needs, wants, and wishes based on their individual circumstances. MedGift was actually founded by a cancer survivor is a free service for patients and their families.
AT&T partners with eCario machine-to-machine wireless data and mobile connectivity for near real-time, remote monitoring of cardiac patients.
The Ohio State University Medical Center names Phyllis Teater CIO. She’s been serving as interim CIO since January.
Starting this weekend, downtown Kansas city will be packed with 6,000 Cerner health conference attendees. If you are one of them, send us a picture or a report from the front lines.
iMDsoft introduces MVdashboard, an ICU tool that displays clinical and administrative metrics graphically.
Emmi Solutions, a provider of Web-based patient communication tools, names David Pearah CTO and SVP of product management. He was previously VP of the e-prescribing business unit of Allscripts and the former director of product management at Nuance-Dictaphone.
Trey Lauderdale of Voalte sent me a note this week saying he’d be presenting at the DC to VC: Investing in Healthcare IT Summit. Even though US CTO Aneesh Chopra and HHS CTO Todd Park were featured speakers, I told him it probably wasn’t worth a mention — unless he could get a picture with one of those guys in the (in)famous Voalte pink pants. Todd Park obviously has a sense of humor.
Halfpenny Technologies secures $2.6 million in VC funding, which it will use to deliver its Lab Hub platform.
A compliance analyst at UW Medicine Compliance warns providers of these patient documentation shortcuts in EHRs that might raise concerns during an audit: (a) cloning (cutting and pasting) form previous encounters; (b) templates that include pre-filled “negative” terms for each organ system, and (c) macros. CMS is especially concerned when they suspect templates are doing the bulk of the documentation.
Ninety percent of CHIME CIOs participating in a recent survey believe their organization will qualify for Stage 1 stimulus funds by September 30, 2012. They expressed concerns, however, that staffing deficiencies could affect their chances at implementing an EHR and receiving stimulus funding. The release of the survey results coincides with CHIME’s annual Fall Forum. Now what will be really interesting is to revisit these same issues over the next couple of years.
Speaking of the CHIME meeting, Ed Marx tells me he won the CHIME Charity 5k. Ed also sent over this photo of David Blumenthal, who spoke in front of 600 attendees and stressed the need for the government and healthcare providers to address consumers’ privacy and security concerns.
When reality is crazier than TV: Actor Brando Eaton files a suit against a prop company, charging it failed to inform actors that a defibrillator on set was a “real working device.” A fellow actor on Miami Medical (a show I’ve never heard of, but that Mr. H says he’s seen filming at Warner Brothers in Burbank) applied the defibrillator to Eaton’s chest during a scene and it sent electrical charges through his body. Eaton was taken to the hospital and later needed treatment and counseling for “anxiety, flashbacks, and apprehension.”
Several employees at a Michigan hospital are reprimanded over a photo taken during a break and later posted on Facebook. One picture was of a nurse removing a splinter for another nurse while in an empty operating room. The pair were part of a group written up for “unprofessional” behavior. Unless I am missing something (like patients were left unattended or a patient’s photo was posted), I’m thinking we are getting a bit overly sensitive about policing social media.
From StateHIECoordinator: “Re: Iowa. The state has issued a Notice of Intent to Award to ACS for the Iowa Statewide Health Information Exchange.” SHIEC sent over the award letter that went out to the eight bidders. It includes technical scoring and prices, but I’m not sure if I should run that since it may not be public information. The selection went down to frontrunners ACS and Medicity in the “best and final offer” round, with ACS winning on price.
From Maladroit: “Re: book. You mentioned a book on healthcare IT and the future sometime in the last ear. I don’t remember much about it except it seemed like a great book to help me understand a CIO’s perspective as he/she thinks about maturing their tech org. Do you remember the book?” Hmm. I’ve mentioned a few books, but I don’t remember this one particular. It might have been Ed Marx, too, since he’s well read. Readers, if you know the book or have others to recommend on that topic, let me know and I’ll run a list.
From Wax On: “Re: medical transcription acquisitions. The big buzz among the MT community at the recent AHIMA convention in Orlando was about Nuance acquiring both OSi and Encompass Medical Transcription. And in another deal, Keystrokes acquired Chartnet.” I’m appreciating the irony that the hottest technologies in healthcare IT appear to involve transcription. Voice and paper are hard to kill for good reason.
From Ex-Employee: “Re: CareTech Web Division. All sales staff let go last week. Management plans to eliminate the Web division and focus solely on outsourcing.” Inga contacted the company for a response:
On the heels of significant growth in its Web products and services segment, CareTech made the decision to adjust its go-to market approach for the Web business with an emphasis on balancing its growth with providing the best delivery service. The decision involved a shift in resources, including a reduction in the area of Sales, and an increase in technical resources for the Web Development and Account Management areas. The company remains committed to its Web products and services business, and is especially looking forward to the opportunity to see current customers and meet new ones at the 14th Annual Healthcare Internet Conference where CareTech will have an exhibit and speaking engagement.
From Long Time Reader, First Time Writer: “Re: MU. Several CIOs I work with are gnashing their teeth because their vendors are telling them they’ll only apply to have their latest software version certified. Clients on the now-current version will have to pay the vendor for an upgrade and service fee to get on a ‘certified EHR’. Some have said they are being quoted months to get the upgrade because customers that signed lucrative contracts with the vendor’s service arm are moving to the head of the line. Love the blog BTW.” I guess I’m seeing it through the vendor’s eyes – ONC made them jump through hoops to get their products certified and to get them implemented by a firm date, so somebody has to pay and not every customer can be the first to go live. I’d blame the government for trying to tie something as complex as EHR adoption to something as desperately made up on the fly as economic stimulus. But if you have a particularly egregious vendor example, tell me since I’m sure some are milking it hard.
Ingham Regional Medical Center (MI) helped start and fund the Capital Area RHIO, but won’t participate in it. The hospital and its parent company will instead join Michigan Health Connect, explaining that, “A lot of the larger systems decided to go that route so they wouldn’t have to participate in different RHIOs and repeat the investment over and over again.”
Inga trumped Weird News Andy on this article, although she kept it at arms’ length when she sent it my way, saying it’s “a bit icky for my taste.” It’s a little raw for me too, but if you’re fascinated to know the “Strangest Foreign Bodies Removed From Patients”, many of which seem to involve unusual sexual practices, feel free to check it out. I did, but I think I regret it now.
The Government of Queensland will implement (warning: PDF) the MetaVision Clinical Information System from iMDsoft in the ICUs of 14 hospitals.
Blessing Health System (IL) will implement Patient Condition Tracker from Rothman Healthcare Corporation within Allscripts Sunrise Clinical Manager. Their nursing school will also participate in research studies involving the system, which turns 26 measurements and observations from the EMR into a single number called The Rothman Index that allows early detection of patients going bad. I’ll have an interview with the co-founder up shortly.
Jack Kowitt, SVP/CIO of Parkland Health & Hospital System, e-mailed to say he was happy that I was puzzled by an ARRA comment attributed to him by the Dallas business paper since he was misquoted. The article said the hospital “won’t seek federal stimulus funds because its electronic records upgrades started before the stimulus bill was passed,” which I thought was odd since HITECH payments aren’t linked to spending. I indicated probable reporter error, which was the case according to Jack: “The question was whether we were using any stimulus funds to implement the EMR. The response was, since we have already implemented, we would not. It wasn’t about MU money, which we are aggressively pursuing.”
It appears that CCHIT’s initial press release that listed certified products was incorrect. ChartAccess from Prognosis Health Information Systems was listed under EHR Modules in the hospital domain, but the current product list shows it as a certified complete EHR in the hospital domain, the only one other than EpicCare.
I got an e-mail blast from a seemingly desperate free HIT magazine today, urging me to post five comments to their online articles to be eligible for a giveaway (so much for highfalutin’ journalistic integrity – what’s The New York Times paying for sending in letters to the editor these days?) Since it mentioned their expert bloggers, I thought I’d check out the competition for the first time. All the blog entries I saw except one seemed to come from other sites – they’re just reprinting them on their own site like they were written for the dead tree people. Maybe I’m an amateur purist, but both the comment bribe and the reposted blogs strike me the wrong way.
Inga contacted the folks at Infogard to get pricing information for their ONC-ATCB certification services. Drummond and CCHIT are pretty transparent about what they charge and were very nice to give Inga the information so she could put a comparison together for readers. Infogard sent her a curt reply: “Unfortunately, we will not be able to provide our price list.” We’ll make sure to help keep their secrets when their press releases come out by not mentioning them.
A Forbes blog riffs on a New York Times article about EMR vendor ClearPractice, which I didn’t realize was run by big-time VC guy John Doerr (Google, Amazon) and his brother. They also oversee a Medicare Advantage insurance plan. The Forbes writer isn’t impressed with ClearPractice or its iPad version called Nimble, although he’s focusing on the business success and not the innovation or potential:
While electronic medical records are a promising tool, the piece lacks context. For a company like Dr. Doerr’s to have been around for a decade and only have 500 doctors using the software basically means it’s failed. Check out this list of EMR vendors by market share based on physician usage. In a rapidly consolidating market there are at least 10 and probably 50 different vendors with more than 500 licenses. The idea that the Apple iPad will somehow, with an assist from stimulus funds, revive the fortunes on an individual EMR company is optimistic to say the least … The other thing that struck me is that the piece made no mention of the history of hubris when Silicon Valley tries to cure health care’s ills. Remember when Netscape founder Jim Clark devised Healtheon on a piece of paper? Or AOL founder Steve Case’s mostly expired Revolution Health?
Meditech got specific about its expansion plans Monday, announcing its intent to purchase 135 acres in a Freetown, MA business park and to build a 180,000 square foot office building for 800 new employees. A local politician estimates the company’s investment there at up to $100 million.
The University of Louisville School of Nursing gets a $792K HHS grant to develop nursing informatics education. They’ll buy simulation lab equipment that includes a patient simulator, iPads, and EHR simulators.
Interesting: a company uses Salesforce.com to deliver and analyze patient EEGs, looking for similarities in a database of known EEG irregularities to suggest psychotropic medications to doctors treating mental illness.
MedAssets is holding its Business & Technology Forum this week in Orlando.
Weird News Andy’s contribution this time around: “1/3 off healthcare ‘reform’ … I wish.” A report (warning: PDF) finds that HHS has already missed a third of the deadlines mandated by the Patient Protection and Affordable Care Act, with another 29 coming due in the next three months.
And speaking of government efficiency, health insurance premiums for 8 million federal workers will go up 7.2% in 2011, which the government spins by saying that’s less than increases in the private sector because of savvy negotiating.
A company brings social networking to crutches, allowing Facebook friends of the injured to create custom “skins” for their crutches. The company will offer advertising materials in the ED and expects to co-brand with healthcare systems.
The Institute for Healthcare Improvement releases a white paper to help hospitals manage serious clinical adverse events.
An interesting analysis: hospitals are buying up primary care practices to prepare themselves to become Accountable Care Organizations, which could be the end of the line for small, independent practices. Hospitals are looking at increasing PCP salaries like a Wall Street analyst looks at price-to-earnings ratios, knowing that internists and family practitioners generate hospital revenues at nine times their average salaries, while expensive specialists generate a multiple of only five times their salary. For industry noobs, it’s time for hospitals to get taken to those 1990s cleaners all over again, because:
Docs sell out precisely because they don’t want to work as hard for their new hospital employer as they did for themselves (duh).
Hospitals are notoriously bureaucratic and inefficient managers, making them particularly unsuited for running a low-overhead medical practice in every way from EMRs to personnel policies to regulatory compliance.
Private practice docs hate and distrust everything about hospitals except the money they have and don’t usually change their opinions or behaviors just because they sell them their practices.
Doctors resent taking orders and being told how to practice medicine, especially from suit-wearing hospital MBA-types who fancy themselves business experts despite always having worked for a paycheck instead of themselves, making it likely all these deals will fall apart in 4-5 years like they did last time around, with the docs scrambling to start up new practices without the benefit of a location, an EMR, or patients that they sold away to the local hospital in a frenzy of co-opetition.
Patients aren’t much more enthused about hospitals than doctors are, so they aren’t exactly thrilled to see the big sign go up over their friendly little doctor’s office knowing it’s the same folks with ED waits, bad cafeteria food, and terrible parking.
From RDU Dude: “Word on the street is that Vern Davenport has left Allscripts.”Portly Gentleman sent us a note on October 1 suggesting Allscripts would soon announce some executive changes. He named names (Vern’s being one of two), but we didn’t run them since it didn’t seem right until it actually happened. The company confirms that the former Misys president and Allscripts exec has indeed moved on.
Over 50 practices in Tenet Healthcare markets select MED3OOO’s InteGreat PM and EHR as part of a Tenet/MED3OOO community-based EHR partnership.
Hearst Corporation appoints Gregory H. Dorn MD, MPH president of drug database provider First DataBank. He most recently served as EVP at another Hearst company, Zynx Health, and replaces Donald M. Nielsen, MD, who becomes chairman of the First DataBank Advisory Board.
Omnicell acquires Pandora Data Systems, a provider of analytical software for medication management. The Pandora solution is used by several HIT companies, including CareFusion, McKesson, Cerner, and will continue to be operate as a stand-alone product. Omnicell’s comparable product is about twice as expensive, so there goes your cheaper alternative, most likely.
Epic wins a five-year, $14 million EHR contract from the US Coast Guard, replacing a version of the Department of Defense system. That could be a notable Epic foothold in government down the road.
Penn State Hershey claims its use of CareAware technology has contributed to a 90% decrease in manual charting during surgical procedures. Providers now average one minute of charting during surgery, compared to 10 minutes before the CareAware implementation.
I love and appreciate all our sponsors, but this is funny. I received a note from one today (someone in accounting who has probably never heard of HIStalk) asking us to re-issue an invoice. The reason: they had asked to pay their sponsorship over several invoices, so dividing the total led to a per-invoice amount of xxx.1666 (infinite decimal). We invoiced xxx.17. They’re asking to correct the remaining invoices to xxx.16 so that the yearly total hits the amount exactly instead of being four cents over. Who else wonders how that accounting department handles client issues?
The Institute for Health Technology Transformation publishes a new report that examines the current EHR landscape. I can’t say I gleaned much new information, but was struck by the authors’ comment that the EHR “landscape” is still in its “infancy.” Given that I was selling EHRs (or EMRs as we called them in the old days) years ago, I’m thinking there must be some inverse relationship between EHR-years and dog-years.
North Kansas City Hospital deploys Cerner’s P2Sentinel auditing solution to address the hospital’s Meaningful Use Stage 1 access requirement.
Miami Children’s Hospital will spend $67 million to implement Cerner Millennium. The hospital will also extend a 50% discount to community physicians who wish to implement PowerWorks EHR in their offices. The hospital expects the government to provide $7-$8 million in stimulus funds once Millennium is fully operational.
Here is some not-so-pleasant news: at the current rate, 2010 could be one of the worst years ever recorded for mass hospital layoffs. Blame the increased demand for charity cases, the decline in reimbursements, and a reduction in elective procedures. As of August, 8,233 employees lost jobs in 102 separate layoffs, according to the Bureau of Labor Statistics. At the current rate, 12,349 jobs would be cut by December 31st, compared to 11,757 last year.
Six Texas pharmacies file a lawsuit alleging CVS Caremark of violating patient privacy laws and unfairly competing with its rivals. The complaint highlights Caremark’s plans to establish a data warehouse that includes the names, demographics, and drug histories of patients, plus Caremark’s Rx Review program that is designed to use patient data for direct marketing to patients and physicians.
Sponsor Updates:
Allscripts introduces Mobile Homecare, a smart phone application for physical therapists, nurse assistants, and other clinicians caring for patients in their homes.
API Healthcare signs up Halton Healthcare Services as its first Canadian client.
Quest Diagnostic partners with HP to offer a preconfigured solution that includes Quest’s Care360 EHR and HP hardware, services, and financing.
Wahiawa General becomes the first facility in Hawaii to implement Voalte’s iPhone solution.
Detroit Medical Center selects the iDoc document imaging system from CareTech Solutions for its eight facilities.
The Nashville Chamber of Commerce names Informatics Corporation of America to its Future 50 Award list for the third consecutive year. The award is presented to the 50 fastest growing companies in Tennessee.
Catholic Health Initiatives expands its partnership with Allscripts to include Allscripts EHR and PM for all of its 1,200 employed physicians and 7,000 affiliated physicians. CHI is also adding Sunrise EPSi Performance Management solution for its 73 hospitals and will develop its own HIE with the Allscripts Community Exchange solution.
PatientKeeper deploys its new physician documentation product, PatientKeeper NoteWriter, to Mercy Medical Center (IA) and Alegent Health (NE).
Equifax announced after the market close Monday that it has acquired authentication management vendor Anakam. The San Diego-based Anakam has a significant healthcare presence, with products addressing online identify verification, credentialing, two-factor authentication, inoperability authentication, and secure collaboration. Former HHS privacy and security advisor Bill Braithwaite MD PhD is the company’s chief medical officer.
Equifax had chosen Anakam this past January to provide authentication for its I-Card product. Anakam’s solution was chosen last month by Buffalo-based HEALTHeLINK as part of HHS Beacon Community demonstration project.
The Atlanta-based Equifax says it will market Anakam’s Identity Suite with its IDverifier service as a single, integrated two-factor authentication solution. Rajib Roy, President, Equifax Technology and Analytical Services was quoted in the announcement as saying, “With Anakam, Equifax will become a premier provider of cloud-based authentication solutions.”
From D.B. Platypus: “Re: ACO. The NorCal HIMSS chapter sponsored a CIO forum on October 1. A speaker showed this video. It had everyone rolling on the floor in a fit of hysteria.” I like it, although someone sent Inga a similar video that we posted on HIStalkTV that I like even better. My newest oft-repeated monotonic mantra from that one involving orthopods: “There is a fracture. I need to fix it.”
From CPAhole: “Re: Allscripts/KLAS. I’ve worked with numerous Allscripts/A4 reps and they did as they were instructed, sitting next to their clients as they completed the survey. KLAS outed the company. Of course Allscripts will take the high road and say they have a better system, but what else would they say?” Unverified.
From Lemmy: “Re: another stolen unencrypted laptop. Here’s the CIO’s internal e-mail from Harvard Vanguard Medical Associates.” I don’t recall seeing this previously, but the purported e-mail says that a vendor-owned laptop containing urodynamic testing data was stolen on August 3. It contained minimal information (name, date of birth, physician, MRN, and testing data). Massachusetts law required encryption starting March 1, 2010 as I understand it, so that might be a problem.
From Elaine: “Re: HIEs. I’m a new HIE manager within our health system and am interested in any data sources regarding interoperability discussions or lessons learned.” I’m sure people are reading who know a lot more than me, so add a comment to the bottom of this post if you can help Elaine.
From The PACS Designer: “Re: iPad’s little sister. Apple is working on a smaller 7" iPad for release early next year. This little sister iPad weighs only 1.1 pounds and will have front- and back-facing cameras. This smaller sized iPad may be of interest to our heathcare colleagues if they can produce it with a case that can be disinfected.”
Listening: Delain, female-led Dutch symphonic metal. Also, reader-recommended Pretty Lights, Boulder-based electronica (two guys doing something between DJing and playing) with some impressive live performances that mix several genres, mostly hip-hop and and synthesizer. Not something I usually like, but it sounds good (probably even better as a soundtrack to romance, I’m thinking without much credibility).
Meditech says it will expand again, adding hundreds of new jobs to be housed in newly built Fall River buildings. Sales in 2009 were $234 million, up 38% from the year before.
This week’s internal e-mail blast from Kaiser chairman and CEO George Halvorson says the company has donated its internally developed clinical terminology translation engine to the US government, accepted by HHS Secretary Sebelius, CTO Chopra, and National Coordinator Blumenthal. From the example he gave,the Convergent Medical Terminology utility can convert 75,000 terms back and forth, for example between ICD-9, ICD-10, and SNOMED. It will be distributed as open source by the National Library of Medicine.
Drummond Group issued the first ONC-ATCB EHR certifications, but CCHIT trumps them on quantity, announcing Friday that it has certified 33 EHR products (19 complete systems, 14 modules) in the 10 days since its program started. I’m not sure that will instill confidence in folks who have always questioned the rigor involved since they can apparently crank out three per day including weekends, but there you go. HIStalk sponsors that have newly certified products are Allscripts, NextGen, eClinicalWorks, T-System, and Wellsoft.
Transcription service outsourcer iMedX acquires FORE Transcriptions. And transcription software and services vendor MedQuist gets $310 million in financing, mostly from GE Capital, with the resulting announced dividend causing shares to hit a three-year high (strictly by investors looking to get the dividend – otherwise, borrowing money to pay a dividend isn’t exactly a robust growth engine). What’s with all the sudden interest in transcription companies?
Nearly two-thirds of respondents say KLAS reviews aren’t useful to providers, although I’m sure many of those respondents work for vendors ranked by KLAS as lower than #1. New poll to your right, requested by a reader: providers, which department will conduct and submit your Meaningful Use self-attestations?
Longmont United Hospital (CO) says VHA’s PriceLYNX vendor price comparison tool paid for itself immediately when a vendor was caught overcharging the hospital by $120K and returned the money. The materials manager says the software will allow him to negotiate price reductions of 8-20%, saving the hospital up to $4 million over the life of the contract.
This BBC article on real-time computing is interesting and scary. It says 50 to 70% of banks use it to perform algorithm-based trading of stocks and complex financial instruments. The example given is in trading stocks of two oil companies whose share prices usually follow each other closely. The software can check prices every 10 seconds and blindly buy Stock A shares if Stock B moves up even a tenth of a point. SAP says that kind of situational analysis may be useful in medicine, such as in monitoring the blood glucose of diabetics. Let’s hope the medical application is dissimilar from that of the money changers, whose computer-assisted self-destruction may yet take us all down with them.
Speaking of SAP, HP and “The Most Inept Board in America” choose the former CEO of SAP to be HP’s next CEO. SAP fired the Germany-born Leo Apotheker after a disastrous seven months as CEO, although some say he was the scapegoat for a terrible company strategy that predated him. HP is paying him like he’s a star: $1.2 million in salary, incentives of 200-500% of that with $2.4 million guaranteed, $72 million in options, a $4 million signing bonus, and $4.6 million in moving expenses (that’s a lot of U-Hauls). I’ll go with the summary of Oracle CEO Larry Ellison: “I’m speechless. HP had several good internal candidates…but instead they pick a guy who was recently fired because he did such a bad job of running SAP.” Their pre-Hurd CEO pick was an ultra-expensive termination, too: HP’s value dropped in half after Carly Fiorina orchestrated the company’s merger with Compaq. She was let go in an ugly fight about the time the company admitted that it spied on the personal phone records of journalists and its own board members trying to find out who was leaking information about its strategy.
The Dallas Business Journal summarizes the “long, expensive, and full of twists” EMR implementation projects of local hospitals. The hospital costs and associated taxpayer-funded EMR bribes: Texas Health Resources, $200 million, $70 million; Baylor, $200 million, $45 million; Parkland, $70 million and no stimulus funds. Parkland said they won’t go after ARRA money because their upgrades were underway before ARRA was passed, which seems puzzling since HITECH money doesn’t require spending anything, just demonstrating Meaningful Use (unless the reporter or I misinterpreted).
University of Virginia Medical Center goes live with Epic in its 140 clinics, with the big house going up in the spring. Cost: $122 million.
You, looking at the monitor – sign up for e-mail updates, Friend or Like us on Facebook, send me rumors. That would make me happy.
The VA will test 20,000 thin client devices using desktop virtualization, hoping to reduce maintenance and energy costs of its 325,000 PCs.
In Spain, Andalusia will require hospitals to record birth records electronically within the first 24 hours of life, giving the child full health benefits that are independent of the mother and allowing pediatricians immediate access to the records. The centrally maintained information will support monitoring of infant morbidity and prenatal mortality.
The Canadian Medical Association says the $500 million that the Canadian government will give Canada Health Infoway in 2010 to goose EMR adoption isn’t enough. CMA wants another $423 million, which it says will increase adoption to 100%, apparent embarrassed over the high EMR adoption rates of other countries (Netherlands 99%, UK 95%, Australia 95%). I guess they weren’t consoled by US adoption, which comes in at anywhere from 4% to 40% depending on whose definition and survey you like.
My Health Care Manager gets a $1.2 million NIH grant to develop a search engine for geriatric health issues.
The bailout-happy federal government agrees to throw taxpayer money in the general direction of Massachusetts hospitals, especially Boston Medical Center, giving them $335 million. Cynics like me might point out that Massachusetts leads the nation in healthcare (percentage of insured citizens, use of electronic medical records, fancy hospital buildings housing bowtie-wearing academic doctors) and yet (or more likely, because of) has the highest healthcare costs. According to the article, Sen. John Kerry strong-armed CMS and Don Berwick to use our money without consulting us first, which I guess we might as well get used to as healthcare “reform” starts tapping an already wildly indebted Uncle Sam, who gets a lot of his healthcare ideas from Mass, even the fantasy that reform will somehow lower costs while insuring dozens of millions of new people. Maybe Uncle should be looking at the sensible, practical middle of the country instead of the extremes on the ends. From its most recent federal tax records, BMC paid its previous CEO $1.3 million and she got another $3.5 million when she left last year right before the hospital’s big profit turned into a loss. Somehow, that doesn’t make me feel better about my involuntary donation.
From Allscripts: “Re: the note from Clinical Wisdom on KLAS. We agree that there is a conflict of interest in having vendors pay large fees to the same company that is producing the ratings. We reached the same conclusion a few years ago and discontinued the practice. After our recent merger with Eclipsys, we inherited an existing Eclipsys contract that was in place with KLAS, so the information reported by the writer was technically correct. However, we have now canceled that contract and we do not currently pay KLAS anything. We realize that is counter-intuitive as we currently are and have consistently been highly rated across many product categories by KLAS, but ultimately we didn’t feel it was right to pay a firm that was also rating our products. Over the last two years, we have re-invested those dollars in a ‘Net Promoter Score’ process, which is widely considered across many industries to be the ‘gold standard’ for measuring customer loyalty. Using this rigorous, statistically valid methodology (developed by Satmetrix and Bain & Company), we get client feedback directly in a very methodical way and then act immediately on what we learn. The bottom line is that we agree with the Consumer Reports analogy from the writer – KLAS should provide a full accounting and disclose what they receive from every vendor. In that same light, we would encourage other vendors to disclose how much they are paying KLAS – complete transparency is critical when you’re talking about the core technology that providers use to make decisions vital to every American’s health.”
From Ben Cannoli: “Re: IOM’s study of HIT best practices. The IOM report is incredible even after a decade. I’m glad they are leading. HIMSS has been weak, negligent, and pathetic on this issue, but I don’t believe they can strong arm the IOM.” Inga mentions it below. The IOM gets an ONCHIT grant to look at how HIT affects patient safety. It will cover some industry hot buttons: surveillance and reporting of HIT-related patient safety issues, discussion of the possible roles of federal agencies like FDA or AHRQ, and impact of certification bodies and trade associations (HIMSS, you’d expect). I’d bet that Don Berwick made this happen. I don’t know how much they’ll get done for $1 million, but I’m interested to find out.
From Digital Bean Counter: “Re: real-time claims adjudication. Is it taking off yet? Any big players?” Little help, if you know.
From VaHooGirl: “Re: Martha Jefferson Hospital. No longer a rumor – they are merging with Sentara to become its 10th hospital.” Verified.
From TuTu True: “Re: Mrs. HIStalk. A source tells me that Inga is Mrs. HIStalk. Be honest – true or false?” False. And to answer the other occasional rumors: (a) yes, there really is an Inga – it’s not just me pretending to be her; (b) yes, she really is a woman, and (c) yes, the Inga picture at the end of her posts really does look like her since I paid some offshore artist $15 to draw it from a photo.
From Luke O’Scyte: “Re: correction about the Canadian government spending $500 million on EMRs. Please replace ‘spending’ with ‘wasting.’ I’m highly skeptical of the value that will be generated from that half a billion dollars.”
From Portly Gentleman: “Re: Allscripts. A couple of executive suite offices are about to become vacant.” PG provided credible names and I’m sure his information is correct, but I feel funny about mentioning names of people leaving jobs. Watch for announcements early next week.
From MSFTGUY: “Re: McKesson Paragon. Just went live at 391-bed Lake Charles Memorial. Several big hospitals have gone live on Paragon this year. Maybe folks have a choice between a system that doesn’t work and is only 1/3 of an HIS (Cerner) and one that’s ridiculously irresponsible to purchase (Epic)?” I did some work at that hospital once. Nice folks. None of the systems you mentioned are for everybody, so it’s hard to criticize their choice, especially if it was a lot less expensive.
From Perineal Flowers: “Re: [name omitted] is one of two finalists to be CIO of Tenet.” I’m expunging the name since I’d sure hate to get someone fired if they don’t land the rumored new job after all, but I did manage to contact them. They humorously (or so I assume) told me the rumors also have them going to Allina, Duke, and Partners, all of which have open CIO jobs along with Tenet. I’m pretty good at reading between the lines, so I think there’s fire underneath that smoke. We’ll see from which direction soon, I’m betting.
Listening: The Tyde, obscure, Byrds-like LA jangle surf.
A scrappy Austin-based non-profit investigative publication runs a pretty good story on the ongoing sale of de-identified hospital patient data by the Texas Department of State Health Services. Among their customers: GE and a company that runs background checks for border security. Deborah Peel MD was quoted as saying that a HIPAA loophole allows selling patient data to any entity that claims to be doing “research”, which isn’t defined. Now this is funny: the only parties that stay anonymous aren’t the patients, but rather the people who download the free data files covering 1999-2003. The article wanders all over the place and is predicated on your believing that de-identified data can be re-identified (which it definitely can to some reasonably high percentage, but some people refuse to believe that fact). If newspapers weren’t going broke, they should fund a re-creation of that experiment where patient data was re-identified by linking to common fields from other government-sold databases, such as driver’s license records.
Here’s another fun tidbit from the Austin article, even though I don’t believe its accuracy. The guy who wrote The Long Tail estimates that free EMR vendor Practice Fusion takes in $250 million per year from selling the de-identified patient data stored in its systems, dwarfing any possible revenue it could make by selling software. It cites a Practice Fusion job ad on Craigslist for a Data Sales Director, someone with experience creating “an aggressive data monetization strategy” who can pitch to “pharmaceutical companies, medical device companies, insurance carriers, government entities …” and “establish a fair market price for EHR data and negotiate effectively with buyers.” That position is still being advertised on Practice Fusion’s site, but the language has been dialed back a lot.
Cerner caves in to patent trolls Acacia Research (“research” meaning “writing threatening lawsuit letters to companies to see who will pay up”) and will pay that organization for the privilege of selling PACS, which Acacia’s often-waved patent claims they invented. Acacia’s strategy is smart: they threaten to sue, but offer a license for less money than it would cost to mount a legal defense. Most companies pay up and the threatened suits rarely go to court, although Epic mounted a swift legal counterstrike for being threatened. I never heard how that turned out, but it doesn’t matter – I still admire their willingness to fight for what’s right.
This is brilliantly funny: You may know Ross Martin, MD as the guy behind the HITECH Operetta and Meaningful Yoose Rap in his role as President of The American College of Medical Informatimusicology, although he has a less interesting but probably much more lucrative HIT consulting job. He writes a hilarious letter to the editor of The New York Times for not publishing a previous letter of his, threatening a class action suit by rejected would-be authors and signing it, “Yours in the quest for wealth creation through victimization, President, Literary Mediocrity Association.” They whittled his piece down to a paragraph, but they did run it. I think the HIStalk audience is more appropriate for his type of humor than that little New York paper.
WorkflowOne, which claims to be “the nation’s leading name in healthcare document management,” puts that leading name on a Chapter 11 bankruptcy filing. Premier just renewed its contract with the company, claiming that “no one is better prepared to help Premier members reduce costs and gain efficiencies across their entire print lifecycle than Workflow One.” Doh! Still, the company has big revenue and EBITDA, so I’m sure they’re not going anywhere. It seems odd that they even filed, frankly.
Sharp Healthcare chooses Aternity Frontline Performance Intelligence to monitor application user experience.
Vanderbilt launches its first preventive genetic screening program, testing all cardiac cath patients for clopidogrel metabolism problems and storing the results in their EMR so that a different blood thinner can be used if needed, avoiding expensive and dangerous blood clots. Several other drug-affecting genetic traits will be tested as well. Now that’s just cool.
Several national pharmacy organizations launch the Pharmacy e-Health Information Technology Collaborative, which will work to get pharmacist-needed functionality into EMRs.
CMIOinterviews one of my favorite CIOs, Denni McColm, from 74-bed Citizens Memorial Healthcare in Bolivar, MO (the only one of very few HIMSS EMRAM Stage 7 hospitals, a standout on the list dominated by big, rich health systems). CMH has a bi-directional CCR interface with Google Health that Denni says will meet Meaningful Use requirements, saying interoperability doesn’t necessarily required an HIE. They’ll use Google Health to make sure patients who ask get a copy of their medical record within the MU-specified timeframe.
ChartLogic earns EHR certification from Drummond Group.
iSoft convinces its bankers to reorganize the company’s debt. Shares are still at 13 cents. You would think those two events might attract takeover interest, but the company’s chair says conditions remain “challenging.”
A Chicago cardiologist will pay $20 million and spend five years in prison for defrauding Medicare and private insurance of $13 million, turned in by another doc who gets $3.5 million as the whistleblower. The cardiologist submitted 14,800 false claims that added up to more than 24 hours a day of work from 2002-2007, so he enjoyed a lavish lifestyle until the case finally ended. When the Feds raided his house, they found $6.7 million in uncashed insurance company checks.
The Allscripts/Eclipsys crew sent over an invite to EUN 2010 Outcomes Through Innovation, which is the user meeting for Eclipsys clients. Wish I could go because it’s in one of my favorite cities, San Diego. The event is October 10-13 at the Manchester Grand Hyatt.
The board of governors of Good Samaritan Hospital (IN) approves the $400K purchase of McKesson’s PACMED and MedCarousel pharmacy packaging systems. At the same board meeting, the director of IS says the hospital is on target to earn nearly $7 million in ARRA incentives over the next six years.
St. Vincent’s Healthcare (FL) extends its seven-year partnership with TeleHealth Services. The health system will implement TeleHealth’s TV and interactive patient education solution at St. Vincent’s and St. Luke’s hospitals.
I noticed that Intellect Resources posted this article about the current shortage of IT professionals in the Nashville area. Middle Tennessee is home to a number of large HIT employers, including HCA, HealthSpring, Cogent Healthcare, and ICA. Several companies are working with on training initiatives at area colleges to help increase the pool of professionals with both healthcare and IT expertise.
Merge Healthcare adds two new perioperative solution clients: Exempla Saint Joseph Hospital (CO) and Kalispell Regional Medical Center / The Surgery Center of Northwest Healthcare (MT).
If you are headed to the American Academy of Pediatrics show this weekend in San Francisco, say howdy to HIStalk Practice’s Dr. Gregg Alexander. He’ll be directing the Pediatric Office of the Future exhibit, which will showcase technologies available for pediatricians. Dr. Alexander is pretty darned excited by the project, as evidenced by his latest Intelligent Healthcare Integration post.
ONC awards the Institute of Medicine a $1 million contract for a year-long study of HIT’s effect on patient safety.
The Tiger Institute for Health Innovation celebrates its one-year anniversary and provides an update of its work to date. The Tiger Institute is a partnership between Cerner and the University of Missouri Health System to create new technologies. So far UMC has implemented bar-coded medication administration and is rolling out CPOE in a couple of months (not sure why that would be considered innovative) and is working on several prototype projects, including a mobile app that allows physicians to review clinical data and give orders via smart phones.
CIGNA and St. John’s Mercy Medical Group (MO) launch a 12-month accountable care organization pilot program. The pilot will target patients covered by a CIGNA health plan and receive care from one of St. John’s 165 primary care physicians. Physicians have the potential to earn bonuses for meeting quality improvement targets and lowering medical costs.
Mayo Clinic and five other health systems form the Mayo Clinic Center for Social Media, dedicated to the use of social media to promote health, improve healthcare, and fight disease. The Center will offer educational conferences and webinars and develop social platforms to share training and resources. The website www.socialmediahealthnetwork.org will launch October 25.
Baptist Health (FL) partners with Vitalz to provide provider-to-provider portal services between 13 Solantic Baptist urgent care centers and 40 Baptist primary care offices.
Texoma Medical Center (TX) implements Skytron’s RTLS to track and manage 200 hospital assets. When reading the press release, I was amused that either the hospital or vendor thought it was noteworthy to mention that Texoma is also using the RTLS technology to monitor vendor sales rep visits.
This week on HIStalk Practice: BlackBerry thumb, cell phone elbow, and Facebook depression; medical students say having an EHR is a very important factor in their decision what to practice; Phreesia and a few first impressions.
Sponsor Updates
Fred Castillo, VP of healthcare mobility sales for AT&T and Eleanor Chye, executive director healthcare mobility product management at AT&T will participate in separate panel discussions at the CTIA Everywhere Healthcare event next week in San Francisco.
Methodist Hospital of Southern California goes live with API Healthcare’s Human Resources and Payroll solution.
Sharp Memorial Hospital (CA) selects GetWellNetwork’s bedside education/entertainment system. GetWellNetwork’s patient education and communications tools will be interfaced with Sharp’s Cerner EMR system.
Susquehanna Health (PA) plans will add the perioperative information management system of Surgical Information Systems to its three-hospital system. Susquehanna will integrate the SIS solution with its existing Siemens Soarian applications.
Albemarle Hospital (NC) selects the Access Intelligent Forms Suite to bar-code patient forms for auto-indexing via a document management system into its Meditech EHR.
Ingenix CareTracker earns CCHIT Certified 2011 Ambulatory EHR certification.
Zac Fritz joins My Health Direct as SVP of sales and marketing.
Here at HIStalk, we love well-intentioned works of charity. Thus, I applaud Cincinnati Bengals wide-receiver Chad Ochocinco for promoting contributions to Feed The Children. Ochocinco has his own personalized “OChocinos” cereal and includes a Feed the Children phone number on the box. At HIStalk, we’re also about getting the little details right, so bummer that Ochocinco didn’t get Mr. H to proof the cereal box. Perhaps he could have caught a certain typo before the box it hit the production line. Mr. H likes the occasional smut reference, so I’ll mention that the Feed the Children phone number listed was actually a phone sex hotline. Oops.
From Waterkeeper: “Re: CPOE reality. Another example.” A study finds that electronically preventing entry of CPOE orders for concomitant use of warfarin and sulfa drugs did great at preventing the potential drug interaction, but also delayed treatment in patients for which the simultaneous use was appropriate, causing Penn researchers to stop the study early as being unethical. Says the lead author: “[It] worked extremely well, but putting it in place actually hurt people … it’s naive to think that CPOE 1.0 is going to be perfect. This is a clarion call for continual evaluation of whatever we’re doing in terms of electronic interventions.” You’ve read it here in various interviews, but it’s worth reiterating: CPOE isn’t done just because it’s live and doctors are using it. That’s where the scientific work should begin, but unfortunately usually doesn’t as everybody declares mission accomplished and moves on to some other fire du jour that requires extinguishing.
From EMR Salvage Here, Can’t Bill There: “Re: downtime in Pittsburgh.” Included was an August e-mail to providers purportedly from Medical Service Associates, apologizing for problems in which a network failure led to the discovery that backups couldn’t be restored from either their own two backup systems or the two of their vendor. At the time of the late August e-mail, they still hadn’t restored anything from before the downtime. All unverified and most likely not the final word on the situation there, but my takeaway from experience is the same as always: backups don’t work at least half the time.
Inga e-mailed our sponsor contacts today about a little get-together we’re having for them in Orlando at HIMSS, separate from our Monday night HIStalk reception (nothing too fancy since it’s on a blogger’s budget, but sincere nonetheless since we really appreciate our sponsors). Response has been brisk, so if you’re the boss and haven’t heard about it, check with your internal person before we run out of space. If your company is on the fence about sponsoring HIStalk, we can probably make room if you sign up soon. Plans for the Monday night reception are progressing nicely as well. Expect a big evening that will go a bit beyond our usual food, drinks, and HISsies (running until late, so pace yourself). Stay tuned.
New readers sometimes get confused about who writes what on HIStalk, e-mailing the wrong one of us about something the other wrote. Here’s the deal: Inga writes the part starting with “HERtalk by Inga.” I write all the rest. I do most of the interviews, but I should mention that Inga did the most recent one with Doug Ardoin. And it’s all Inga on HIStalk Practice. Clear as mud, right? She and I are kindred spirits anyway, so we’ll figure it out.
Medical office patient check-in vendor Phreesia completes a $20 million Series D equity financing round. Jumping in is Ascension Health Ventures, the $325 million strategic healthcare venture fund of Ascension Health.
Strange: a hospital trauma nurse gets a 2 a.m. call on her cell phone from the California Donor Network, with which she’s familiar because of her job. They tell her that her brother has died and they need her permission to harvest his organs. Agitated, she goes to her other brother’s house and they call their sister-in-law to console her, only to hear the sleepy voice of her I’m-not-dead brother asking what they want. The hospital had given the donor group the wrong contact information, that of a patient with the same name but spelled differently. The hospital can’t explain the mistake except to say that the information was wrong when they switched computer systems in 2005. The coroner’s office claims they would have caught the mistake before taking the organs of decedent with the wrong family’s permission.
HHS’s open source CONNECT program wins the 2010 Wall Street Journal Technology Innovation Award for health IT. Runners up are diagnostic image sharing platform vendor lifeIMAGE (I interviewed CEO Hamid Tabatabaie a couple of weeks ago) and Disease Precursor Identification from Ingenix, which identifies people at risk for chronic diseases.
Munroe Regional Medical Center (FL) says it dropped ED-door-to-balloon time for heart attack patients to 48 minutes, below the national average of 62, by using incident command management software from LiveProcess to manage the Code Blue calls.
A Weird News Andy find: NewYork-Presbyterian/Columbia University Medical Center admits that someone accidentally opened up a server containing ICU patient information to the Internet. A patient’s family ran across the information via a search engine and told the hospital. I can’t decide which is more annoying about the hospital’s name: that it’s absurdly long with dashes and slashes or that they insist on conjoining New York into a single word for no apparent reason.
RIM previews its BlackBerry PlayBook tablet device. Like the Torch, I doubt it will generate much consumer interest, especially since it may work only on WiFi, not 3G/4G. That’s speculation since it’s not coming out until next year, making the video a bit premature in its lost cause of convincing iPad prospects to hold off. Businesses will probably like it, though.
The National Quality Forum endorses performance measures and preferred practices for care coordination. Among the latter is electronic medical records.
Ed Marx has updated his Tool Time post with responses to your comments.
Here’s another bad HIT press release, replete with enough odd phrasing, incorrect punctuation, and bizarrely missing information (like the names of the company’s president and the customer who are both quoted) to make it seem highly unlikely that the writer speaks English as a first language. Not that there’s anything wrong with that, but the company is in Minneapolis, where English is pretty common (albeit with a cute accent, like in this horrible, sappy movie that I just played from Netflix for Mrs. HIStalk while I pretended to watch while daydreaming).
The Canadian government will spend $500 million on EMRs in the next fiscal year, with $380 million of that going toward implementation.
ClearPractice announces GA of Nimble, which it says is the first comprehensive EHR for the iPad. It connects to the company’s cloud-based system by WiFi or 3G. Or maybe it’s not the first after all: an updated press release omits the “first” reference and fixes other unspecified errors in verbiage. The release came from a PR company, but it’s never encouraging (in a “Quality Is Job 1.1” kind of way) for a software company to let obvious mistakes get out the door. And in another tactical error, there’s a beautifully made demo video on their site (where I grabbed the screen shot above) that you’d be watching right now if they were smart enough to make it embeddable like everybody else does who wants widespread exposure for free (it’s called YouTube, people). Now I’ve lost interest.
Deborah Peel, MD of Patient Privacy Rights comments on an Information Week article about healthcare data breaches.
I don’t need a cell phone, but I’m thinking about getting the new model of the iPod Touch for running apps, checking e-mail where there’s a WiFi connection, and playing music and video. Good idea or not? I thought it was perfect until I read that Apple had to downsize the camera resolution from 5 megapixels to one to fit into the slim case. Still, it seems like a good deal for $299 for the 16 GB model.
Mohit Kaushal, MD joins West Wireless Health Institute of EVP of business development and chief strategy officer. He was a key player in developing the healthcare portion of the FCC’s national broadband plan, which includes mobile health, when he worked for that organization.
Bob Mitchell, former editor of the dearly departed ADVANCE for HIE, interviews John Glaser about his new job as Siemens Healthcare CEO.
Deaconess chooses Omnicell for medication management.
The Greater Dayton Area Hospital Association (OH) signs up with the HealthBridge HIE.
It’s funny today how many car problems are fixed with a software update. The same is true for implantable defibrillators, for which a new upgrade checks for electronic problems that indicate wire integrity problems that could cause patients to be shocked inappropriately.
Costs of Care, a Boston-based non-profit whose goal is to reduce healthcare costs by giving providers pricing information as they make medical decisions, announces a national essay contest. The best anecdotes from doctors, nurses, and patients illustrating healthcare cost awareness will earn $1,000 prizes. The judges are former HHS secretary Mike Leavitt, Atul Gawande, Tim Johnson of ABC News, the dean of the Harvard Medical School, and Mike Dukakis. Entries are due by November 1. The group, founded in 2009 by medical resident Neel Shah MD, plans to create smart phone and Web apps to provide pricing transparency.
A nurse at Seattle Children’s Hospital kills an ICU baby by mistakenly administering a tenfold overdose of calcium chloride. A 15-year-old died from a narcotic overdose at the same hospital last year.
InterSystems announces Cache’ 10, which adds database mirroring and a high performance solution for Java applications.
I’m totally behind, so be patient if you’ve e-mailed me. I’ll be vacating soon, which will dig the hole I’m in a week deeper, and then attending the mHealth conference to make the backlog worse, but my lack of timely response doesn’t mean I love you any less (that’s my go-to excuse when Mrs. HIStalk catches me paying insufficient attention to her or her movies).
From Jellico Jerry: “Re: reality check. Loved your point today about Cerner and Epic, and which deals Cerner won vs. Epic. Cerner won sites with no $$ (UHS, Tenet). Although they are still significant wins, they are very different client bases.” In case you aren’t up to speed, KLAS recently reported that nearly 70% of 2009 hospital EHR purchases were for Cerner and Epic. A reader then noted that if one were just reading HIStalk, you’d think Epic had “cleaned everyone’s clock.” We countered saying Epic got the bigger, more lucrative deals that really count. Anyone who’s dealt with either or both companies knows that Cerner will darn near give the software away to avoid losing a deal, while Epic won’t discount a penny.
The Ohio Health Information Partnership (OHIP) names its five preferred EHRs from the 40 that were considered: Allscripts Professional; eClinicalWorks Unified EMR/PM Solution version 8; e-MDs Solution Series 6.3.0; NextGen Healthcare EHR; and Sage Intergy suite 6.0. Interestingly, OHIP requires that the selected vendors conduct all technical support within the United States.
Quality Systems, NextGen’s parent company, strikes a deal with Pricedoc.com to incorporate PriceDoc’s online search marketing tool into the NextGen Practice Management system. Pricedoc.com is basically a medical version of the travel site Priceline.com, giving patients the chance to name the cash price they are willing to pay for particular procedures or services. Sounds like the deal gives Pricedoc.com access to NextGen’s PM client base and Quality Systems gets a spiff when physicians and patients connect.
T-System releases DigitalShare, a new solution made possible through a strategic partnership with Shareable Ink. DigitalShare allows clinicians to document patient encounters on T-Sheets using Shareable Ink’s digital pen to capture the data. I first saw the technology at MGMA a year ago and made the Mr. H-esque observation/prediction that it would be great technology for the ER.
Lehigh Valley Health Network selects QuadraMed’s Quantim computer-assisted coding solution to help prepare for its ICD-10 transition.
Confer Health Solutions acquires MediHealth Outsourcing, an HIM and clinical revenue cycle company.
Providence Health & Services hires Summit Healthcare to provide dictionary management and data migration services as it moves to Meditech 6.0. Providence also purchases Summit InSync and Summit Scripting Toolkit technology.
GE was the overall leader in the US ultrasound market last year, according to Millennium Research Group. GE increased its lead over Philips and Siemens and now holds about 27% of the $1.2 billion US market.
Former Cerner Eastern US general manager Greg White is promoted to VP and managing director of the company’s Middle East, Africa, and India region. He replaces Rich Berner, who returns to KC as VP of client development.
Axolotl introduces Elysium Discover, a suite of reporting and analytic tools for HIEs.
Northwestern Medical Center (VT) goes live this week on its first phase of Meditech.
ChartWise Medical Systems signs a strategic agreement with 3M Health Information Systems to integrate 3M’s Grouper Plus Software the clinical documentation tool ChartWise:CDI.
Frederick Jelinek, one of the pioneers in the field of voice recognition, died earlier this month. I had never heard of him before reading this article, but he’s credited with enabling computers to understand English. While that accomplishment is significant in and of itself, Jelinek’s challenging background makes his work even more laudable. He was born in what is now the Czech Republic and his dentist/physician father died in a Nazi concentration camp. After his death, Jelinek’s mother moved her family to the US. He graduated from high school and took a job working in a factory to help support his family Jelinek later enrolled in night classes, studied engineering, and eventually earned a doctorate from MIT. He spent his career with IBM and Johns Hopkins University, creating the bones for today’s voice recognition systems. Isn’t that a great story?
Friday marks the first day of the hospital payment year for implementing certified EHRs and using them meaningfully. Guess it would help to have some certified EHRs out there.
Sponsor Updates
eHealthAlign selects ICA as a strategic partner to technology and infrastructure for its multi-state HIE.
maxIT Healthcare earns a spot on Modern Healthcare magazine’s list of Best Places to Work in Healthcare.
Voalte VP Trey Lauderdale will participate in a panel discussion at next week’s CTIA Everywhere Healthcare event in San Francisco.
MEDecision announces that its Nextalign iEXCHANGE 8.0 solution is now generally available.
BridgeHead Software wins a contract with The Rotherham NHS Foundation Trust for healthcare data and storage management.
Picis and The Sullivan Group (TSG) will integrate TSG Clinical Rules risk management solution with Picis ED PulseCheck.
HealthEast Care System (MN) implements Ingenix Web.Strat medical coding technology, integrated with its McKesson HealthQuest billing system.
EDIMS announces that its ED EMR clients can access the admission review service of Proven Healthcare Solutions, which offers a 30-minute guarantee.
Today's post contains the phoenixes rising from the ashes of the post COVID telehealth era. There's two things that destroy…