Former McKesson Chair Charles McCall Found Guilty of Securities Fraud

A San Francisco jury has found former McKesson chairman Charles McCall guilty of five of six counts of securities fraud. He was acquitted on a single charge of falsifying records.

Federal prosecutors said the former chairman, president, and CEO of HBO & Company covered up that company’s fraudulent activities, allowing it to be acquired by McKesson for $14.5 billion in January 1999. The fraud was discovered three months later, sending McKesson shares into a nosedive.

Former McKesson general counsel Jay Lapine was acquitted on all three charges he faced.

McCall was originally tried on the charges in 2006, but a mistrial was declared. He will be sentenced in March.

News 11/18/09

From Xper: “Re: Cedars Sinai. The ED is live, including the docs — yes, CPOE at Cedars! — seems like anything really is possible. Nurses are live on the system now and so is registration and billing. They appear to have more food and PR junk than support calls, probably a good thing. Many Epic folks are on site to make sure this goes well, but it’s kind of cool to see all the leaders here during the 40 hour go-live and sitting in the actual command center. One of the better projects I’ve seen as a consultant.”

From Kate Spayed: “Re: Windows 7. Anyone know which EHRs are compatible?”

From Dick Scrushy: “Re: Mark Leavitt of CCHIT. You should interview him.” I asked this week. He said no.

From Industry Watcher: “Re: Cerner. More bad news for Cerner in the US. Saint Peter’s University Hospital in NJ has decided to replace all Cerner Millenium clinicals for two primary reasons: (a) Cerner continually presented work orders for work outside scope and, (b) physicians were starting to admit elsewhere because of issues with Cerner CPOE. McKesson’s Horizon was selected as the vendor to replace Cerner. By my count, that means Cerner has been replace seven times in the last 18 months.” Unverified.

From The PACS Designer: “Re: FDA and iPhone apps. Back in February of this year, there was some discussion about the FDA’s role when it comes to using an iPhone for a clinical procedure. Now that the interest in iPhone apps for healthcare is gaining momentum, it would be a good time for comments to be sent to the FDA on if or how the iPhone apps issue should be handled. It’s hoped that the FDA won’t slow iPhone innovation and only regulate iPhone apps that are part of a system design submission seeking FDA approval.”

From Former Colleague: “Re: death of Frank Canestrari. He passed away suddenly on Sunday, November 15th at his home. He was the president of Newbold/Addressograph Corporation. Frank led the organization for the past two decades.” The online guest book is here and services will be at noon Thursday in Roanoke. 

David Brailer’s Health Evolution Partners takes an equity position in CambridgeSoft, which offers a long list of life sciences desktop software and scientific databases.

Keane announces that 13-facility Ernest Health has extended its agreement and will be installing Optimum Patcom at all sites current and planned. University Physician Healthcare (AZ) will also install several Optimum modules, including Patcom, HIM, scheduling, and document management.

The National Library of Medicine releases a draft of a crosswalk between SNOMED CT and ICD-9-CM, inviting users to give it a try and let them know how it goes. The intention is to automate much of the work required to turn clinical terminology into billing information. It was developed by SNOMED Terminology Solutions.

Intellect Resources is running a series of interviews it’s doing called IR Beat, kind of a radio show for HIT. The latest one’s on cloud computing and the one before is about Epic certification.

Dee Cantrell, CIO of Emory Healthcare (GA), is named CIO of the Year by the Georgia CIO Leadership Association.

A hematologist and his programmer son, both from New Zealand, are named finalists in a healthcare software contest for their warfarin monitoring system for patients at home. Their blood thinner system works like a glucometer, with patients testing a drop of blood in an INR electronic reader and then receiving electronic advice (along with their doctor) of dosing changes needed. I think there are already warfarin point-of-care test kits for home use, but the software is darned cool.

The London newspaper says Summary Care Records will be uploaded to the NHS spine by the end of next year, also warning that everybody’s records will be available except those who specifically opt out. The timing of that announcement wasn’t so great since NHS Hull announced a data breach by a former employee the same day.

UPMC will manage 30,000 PCs with Verdiem Surveyor, a centralized system that enforces and monitors PC power policies without disrupting users. UPMC says it will reduce PC power consumption by half and save $1 million per year.

Medversant may be crass in using the Fort Hood shootings in its PR pitch, but it still has an interesting idea — continuous credentialing, where provider licenses are constantly checked against OIG and DEA records, but also against general Web information such as social networking sites, articles, and blogs. Also interesting: its recent study found that 1.9% of practicing medical professionals did not have a license and 18.7% had expired or falsified credentials or malpractice judgments.

E-mail me.

HERtalk by Inga

A new study by the Harvard School of Public Health finds that the use of EMRs has not had any effect on healthcare cost or quality. I’m sure some HIT critics will point to the study as proof that we should stop spending billions on EMRs. I personally side with Masspro’s Dr. Karen Bell, who believes the findings highlight the need to focus on helping physicians, hospitals, and the public health system use technology more effectively.

NYU Langone Medical Center launches the first phase of its EHR implementation, taking live its Trinity Center faculty group in Manhattan. Patients can also now access the practice’s SmartChart portal.

The National Institutes of Health’s Fogarty International Center grants Indiana University and the Regenstrief Institute a $1.3 million award to establish the East African Center of Excellence in Health Informatics. The center will focus on increasing the capacity of EHRs in the region and teaching East Africans to use electronic tools to solve healthcare problems. The center’s director claims that Kenyan clinics using EMRs are able to serve two to four times more patients than those using paper records.

GetWellNetwork appoints Michele Perry COO, tasked with helping to “lead the company to a new level of growth.” She was previously involved in three IPOs, so perhaps that’s the “next level” the company has in mind.

A new KLAS report takes a look at Allscripts a year after its merger with Misys. KLAS surveyed 200 Allscripts clients and found declining customer satisfaction in several key areas. However, Allscripts remains the “most-considered” vendor in outpatient EMR purchases (which sounds about one step better than always being the bridesmaid, never the bride). The release of v.11 created challenges, though clients on versions 11.1.5 or higher are seeing positive results. About 85% of Misys EMR users who plan to replace their EMR say they’’ll go with Allscripts Professional EHR, which is being offered at a relatively low migration price.

Meanwhile, Forbes has a nice write-up on Allscripts iPhone app, Allscripts Remote, which gives physicians real-time access to patient data, fast communication with ERs and the ability to e-prescribe (the article says “e-mail prescriptions,” but I am assuming the author meant e-rx.) Allscripts Remote also made New York Times columnist David Pogue’s listof the top health-related iPhone apps. Right up there with PeriodTracker. Really.

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Singapore General Hospital actives Eclipsys’ Sunrise Patient Flow solution at its 1,500 bed facility.

Using reporting tools from EDIMS, 22 New York and New Jersey area hospitals are providing their state health departments daily H1N1 influenza data. Details include the number of patients by county with flu-like symptoms and a breakdown of those with respiratory and/or GI symptoms.

Over half a million users are now live on Sentillion’s single sign-on and context management solutions.

Community health organization Neighborhood Healthcare (CA) selects eClinicalWorks’ PM/EMR and Enterprise Business for its 115 providers across 11 locations.

Computerworld releases its annual salary survey of IT professionals. Not surprisingly, the economy has had an impact. Salaries were flat and bonuses and benefits were reduced or eliminated. Nonetheless, IT folks remain satisfied with their career choice, though they may be feeling stress over job security. If you are a CIO, you’ll likely find the best-paying jobs in the mid-Atlantic, with compensation averaging $172,000 a year.

CliniComp contracts with Multi-Services Group to provide training services at military treatment facilities using CliniComp’s inpatient documentation solution.

Cost management company Broadlane acquires Healthcare Performance Partners, which provides Lean Healthcare and Six Sigma consulting services.

Harris Corporation also makes an acquisition, buying Patriot Technologies, a provider of integrated and interoperable HIT solutions for the federal government.

Business associates are largely unprepared to meet HITECH’s data breach-related obligations. One-third of surveyed business associates (billing, accounting and legal services, claim processors, pharmacy chains, and offshore transcription companies) were not aware that HIPAA’s privacy and security regulations applied to them. Comforting.

DigitalPersona says its biometric fingerprint reader, which is incorporated into the Picis ED PulseCheck product, is being used by 150 hospitals.

E-mail Inga.

Healthcare IT from the Investor’s Chair 11/17/09

Update – The IPO Market Return

Or in the words of Santayana, "Those who cannot remember the past are condemned to repeat it."

As I write this post, the IPO market continues to rock and roll. As some confidence returns, investors look for new places to put money, and perhaps dress their year-end performance results with some nice IPO bounces. Wall Street is, of course, happy to oblige, especially in our own little corner of the economy, healthcare information technology.

Accretive Health’s IPO prospectus continues to wend its way through the bowels of the SEC. Management has no doubt endured the begging of numerous middle market firms trying to catch a few crumbs left after the four big banks received 95% of the available dollars. Given the size of the offering ($200 million), 5% economics is still over $800 thousand in fees left up for grabs, so you can’t blame folks for wanting a piece of it.

First of all, it’s an impressive transaction to be on, and nobody wants to blink. Second, there are a few small bragging rights: “They could have picked anyone, but they chose us”, I’m sure managing directors or partners will tell other prospects. But finally, as I said, even if they put two more banks on for $400K each, it’s high margin and extraordinarily easy business.

Recall our earlier discussion on IPOs with organizational meetings, drafting, etc.? That’s all been done before the new bank shows up. All that remains for the lucky new co-manager(s) to do is hold a few basic diligence calls, draft a memo to their firm’s commitment committee (the inter-departmental group that approves participation in equity transactions), and then take some slapping around by said committee as they ask the bankers the ritual hard question in this situation: “Doesn’t this set a bad precedent, to put our name on the cover for only (or perhaps less than) 5% economics?”

In the end, however, I’m confident Accretive will have its pick of underwriters. A fee’s a fee, especially in this market, and in my experience, the average managing director level banker will spend less than half an hour working once hired, farming it out to VPs, associates, and analysts. (readers who would like a Who’s Who of roles in a bank, please feel free to submit a question).

Meanwhile, HealthPort is concluding its road show this coming week as it works to convince portfolio managers and buy-side analysts that even though over 85% of revenues are related to release-of-information services, it really is a revenue cycle management company and should be valued as such.

Ask the Chair

I really appreciate the comments and questions I’ve received, both posted and e-mailed, so please keep them coming as I aim to inform and educate, not just ruminate. Let’s take a few:

Who coaches the management of publicly traded companies on what they can and can’t say?

It’s actually a combination of people, but last word is given to the lawyers. Part of the role of the board, I believe, is to help mentor first time public company CEOs, helping them strike the right line between promoting their stock (which is, after all, part of their job) and telling only truth. There are also investor relations professionals who do this for a living, though I’ve found their quality varies dramatically. Further, it will come as no surprise that, in both my prior lives as research analyst and investment banker, I’ve always tried to share my views on good Street communication, and I’m sure other bankers and analysts do as well.

At the end of the day, however, given the myriad SEC rules and regulations on stock promotion and our litigious society (and class action lawyers who don’t wait for the phosphors to fade on a negative press release to file a claim), it’s corporate counsel who often has the last word. This has been even truer since the adoption of SEC Regulation FD in 2000. Reg FD (for Fair Disclosure) was adopted to eliminate (really minimize) the phenomenon of selective disclosure that was rife on Wall Street. Companies would often tell their favorite analyst (who usually seemed to have a buy rating on the stock) a material fact before others, allowing him or her to share it with their best clients. Clearly that puts the investing public at a disadvantage, so the SEC adopted FD and lawyers suddenly had a lot more press releases to vet.

Let’s say I’ve been burned by the stock market and would like to invest some money, say $50,000, in a healthcare IT startup. Is that a good idea and how would I go about doing it?

Individuals investing in private, early stage companies are known as “angel investors”. There are pros and cons to making investments like this.

In theory, the readers of this blog, as well as being charming and perceptive, should know more than most anyone about the prospects of a healthcare IT startup. Recall that legendary investor Peter Lynch advised us to invest in what we know. A few things to think about beyond the obvious questions of “is this a good business?” are: “Do I trust and respect the judgment and integrity of the entrepreneur?” “Does this seem like a fair price for the company?” and dozens of other questions.

I think the first question to ask before an individual invests in a private company is, “How much do I care about that $50,000?” If you need it for Junior’s college tuition or your retirement in the next five or ten years, don’t even think it. Venture investing (which is what this is) is extremely high risk, that’s part of why venture investors demand high returns. Further, most startups fail (and HCIT is a tough area for success). VCs protect themselves there by investing in a portfolio of companies to diversify away some of their risk (typically, they expect multiple failures or break-evens for each success).

Also, ask yourself how you’ll get your money back: will the company be sold or go public? How much more money will they need? Angel rounds are usually early in a company’s life cycle, and subsequent money raised could well dilute your investment (lower the percent of the company you own). If you think you have the opportunity to invest in the next Epic Systems or athenahealth and are willing to take a flyer, more power to you, but caveat emptor (and good luck).

And finally, Matthew Holt wrote:

Ben I think you should take Ms. Faulkner on a fake road show, and then write that up.

Judy, if you (or one of your staff) are reading this and you would like the opportunity to hit the road and meet with the high and mighty of Wall Street to share your views of the sector and the publicly traded companies that make it up, I’d be thrilled to accompany you. I am pretty darned confident we could have the trip sponsored by a brokerage firm who’d also make a hefty donation to your favorite charity.

And if you agree, I’ll also go buy five lottery tickets and take a trip to Vegas, because it’s clearly my lucky day 😉

Thanks for reading, have a great Thanksgiving, and keep those posts and e-mails coming.

Ben Rooks
The Chair

Ben Rooks is the founder of ST Advisors, a strategic consultancy offering long-term and project-relationships to companies and financial sponsors. He earned an MBA in healthcare management from The Wharton School of the University of Pennsylvania, has done healthcare IT equity research, and has worked as an investment banker in over 25 successfully closed healthcare and medical technology transactions valued from $40 to $365 million.

Monday Morning Update 11/16/09

From HITMarqueen: “Re: OR cameras. I’m curious if you have any thoughts on the recent ruling by Rhode Island’s Dept. of Health that requires video cameras be installed in all Rhode Island Hospital operating rooms to monitor patient safety during surgical procedures? This is in addition to a $150K fine for the most recent wrong-site surgery at the hospital.” The state had to do something. Rhode Island Hospital has done five wrong-site surgeries since 2007, most of them really stupid (three wrong-side brain surgeries and the most recent gaffe, operating on the same finger twice instead instead of the two intended fingers — how can you make excuses for that?) Surgeons weren’t marking their sites and time-outs weren’t being done, which sounds like a great reason to revoke their privileges. The state ordered the hospital to assign someone to watch the camera for at least a year, observing every surgery to make sure the marking and time-outing are done (sort of like a football replay official, I guess). They’re darned lucky to be allowed to keep their OR open. Want to bet it’s not just the OR that has problems?

From H. Boc: “Re: Pano Logic devices. HBOC had one of these years ago. Whenever money was nearby, a little hand would come out of the box and snatch it. Then a voice in the box would tell you that the software was going through an upgrade and would be delayed for install.” That must have been a Pathways box. Maybe it handed back a side letter.

From Connie Ripley: “Re: content management. I’m curious to get an idea of how many healthcare or HIT companies are taking Content Management seriously? I see this as an area in dire need of improvement and I can tell you straight from the trenches that it’s not for the faint of heart.”

From Mercy, Mercy Me: “Re: parking garage advertisement. This is what attracts doctors to use CPOE.” UPMC Mercy has the right idea since you only have a few areas in which you can get the attention of doctors: the parking lot, the doctor dining room or lounge, and the chart completion area. Once they get them on CPOE, they can add nag screens for subtle messages of propaganda. Or, send them off to re-education camp

From Peter Gunn: “Re: HIMSS. Dang! I was dying to go to HIMSS last year in Chicago, but I live in Atlanta, and now that HIMSS is here in Atlanta, it sounds like it’s not worth going!” I’ll go out on a limb and say that it’s been years since it was worth going if you consider just the official offerings — the self-congratulatory opening session, lame keynotes, mediocre educational programs carefully limited to ensure vendor access to providers in between, having HIMSS-sponsored and ad-filled publications thrust into your face at every turn, and being herded to the exhibit hall like cattle in a slaughterhouse. The best thing about HIMSS is all the non-HIMSS people and events. They haven’t figured out a way to screw that up yet (although the uber-commercial tone threatens to keep providers home, which would then make the conference pointless). You could get most of the value of the conference by not registering at all, just hanging around the public areas of the convention center and attending non-HIMSS events. That would save you only $640 of the total cost, though. There are many things I don’t like about the conference, but I still go.

From Michelle Flaherty: “Re: EHR vendors. QHR will acquire Clinicare, a KLAS winner (Chartcare). Both companies are in Canada. Also, Noteworthy Medical Systems, acquired early this year by CompuGROUP Holding AG of Germany, is sunsetting its non-ASP product.”

From Just Checkin’: “Re: HIMSS shindig. So admittedly we’re not even to Thanksgiving, but given the need to schedule time off way in advance, I gotta get organized. Will the annual shindig take place at HIMSS? If so, is there a date?” I theorize that the beginning of winter gets people thinking about HIMSS, even though it’s a while away (I’ve booked an ultra-cheap hotel already myself and need to pay my $640 registration fee before it jumps to $740 on December 15). I’m still working on details of the reception with the sponsoring company. It is horrifically expensive to put these on — you could have a swanky evening in the best restaurant in Atlanta and still spend a lot less than it costs per person to offer just  a couple of drink and snacks in a private reception. When we first did it in Orlando, I was naive enough to think that we could just buy out some big restaurant and spend $75 per head for an open bar and dinner, but that brings other challenges: which places are available during HIMSS, how many can they hold, how do people get to and from, is it suitable for mingling and having a speaker or two, and how many slots does the sponsoring company want for their own use. It’s also a tough sell to vendors since many of the attendees will be HIStalk readers who work for other vendors. I’m hoping for the usual Monday night, but it’s still up in the air.

Speaking of which, it will be HISsies voting time soon. To prevent the usual ballot box stuffing, only those on the e-mail blast list will be able to vote this year. If you want in, put your e-mail address in the Subscribe to Updates box.

HIE service provider MobileMD gets $4.75 million in a VC funding round led by Health Enterprise Partners.

Athenahealth is awarded a patent for its athenaNet billing rules engine. Shares rose almost 5% Friday after the announcement, closing near their 52-week high.

An MIT research assistant creates SixthSense, a combined camera and projector worn around the neck that turns any surface into a screen and input device for smartphones, which he says will allow low literacy citizens of India to use software applications as their gestures are translated into commands. The TEDIndia demo video is amazing. If you’ve seen Minority Report, it will look familiar. Manufacturing costs are estimated at $350. The audience went bonkers, especially when he used his hand as a screen in the picture above.

Here’s my response to the announcement that HIMSS won’t be going back to Chicago because it’s too expensive: duh. Everybody who has every been involved in conference planning is well aware that strong unions, expensive hotels, and rife corruption have made Chicago a terrible place to hold a conference (not to mention that it snows in April, as we now know, although that was a plus to HIMSS because it kept people in the exhibit hall instead of doing something fun). If HIMSS was shocked (no pun intended) by the electrical costs of the most recent conference, then it didn’t do its due diligence and the vendors who had to pay those ridiculous costs ought to be mad. I’ll predict now that exhibitors will be griping after the Lost Wages conference that everybody bailed on the exhibits to go to the casinos and shows.

September’s Harvard Meeting on an HIT Platform (the “HIT should work like an iPhone” meeting) was invitation-only, but they’ve posted videos and an executive summary (warning: PDF). It includes Aneesh Chopra and Todd Park talking about turning NHIN into the “Health Internet”, hoping to make a lot of patient data available around which new applications could be built.

A non-profit hospital paying its CIO over $500K is not clearly excessive, say 64% of survey respondents. New poll to your right: is it OK that HIMSS offers cash payment to conference attendees who attend vendor demos?

The Madison paper covers the construction of Epic’s second campus, with the four buildings now halfway finished and one occupied. It says the company will add another 200 employees this year for a total of 3,400, including a Netherlands office with 35.

Speaking of Epic, this comment from a David Blumenthal e-mail (that I get, for some reason) seems to be a shot at MyChart and Epic’s other data sharing programs that work only for Epic-using hospitals: “… we cannot support arrangements that restrict the secure, private exchange of information required for patient care across provider or network boundaries.” Glen Tullman was also talking apparently talking about Epic (since he’s made similar comments elsewhere that named them specifically) in my interview with him this week:

“We need an interoperable system no different than the ATM networks that we use, no different than cellular networks. We have many different competitors, but they’re all using — they’re all connected to a network exchanging information; and of course, no different than the Internet. That’s the model that everyone ought to be forced to play in. We have some holdouts who are really not supporting this idea of full interoperability. So if I could change one thing, I would say we’ve got to much more aggressively push on interoperability.”

I had a question I would have asked had we not been running short on time: “Wouldn’t Allscripts do the same thing if it had the same chance as Epic?” Not for unsavory reasons, but because having big market share in an area provides some fast, cheap interoperability opportunities that are great for patients in those areas, even if they don’t tie into whatever regional or national networks that are being considered.

Exempla Lutheran Medical Center (CO) goes live with its Epic EMR. The three-hospital cost: $85 million, plus another $4 million for its physician practice.

Tampa-based Tech Data forms a healthcare business. Stimulus dollars may not be doing much good for unemployment, but they’re bringing a lot of companies into healthcare that weren’t interested until the taxpayer money chummed the waters. All I’ll say to the prospects they’ll try to convince of their newfound interest: lots of companies got out of healthcare just as fast as they got into it when the expected profits didn’t materialize. It’s not like we’re a new industry.

The ACG Boston 2009 Fall Conference & Private Company Showcase is this week in Boston. Speakers: John Halamka (of course), Todd Cozzens of Picis, and Carl Byers of athenahealth. Cost to attend the 3.5 hour conference – $330.

A doctor in China loses his job and his license after investigators checked computer records and verified that he was playing online computer games at work while a five-month-old baby he was supposed to be monitoring died.

Apple files a patent for its long-rumored tablet PC.

University of Maryland Medical System will float a $250 million bond sale, with a portion of the proceeds to be spent on clinical systems.

Merge Healthcare will sell $27 million worth of new shares to pay off debt. Shares are worth eight times what they were a year ago, but still barely more than 10% of what they sold for three years ago. It also has expanded its offerings in China.

E-mail me.

CCHIT Chair Mark Leavitt Announces Retirement

The Certification Commission for Health Information Technology announced today that its chair, Mark Leavitt, MD, PhD, will retire from the organization in March. A search firm has been engaged to recruit his replacement.

Steve Lieber, HIMSS president and CEO and chair of the CCHIT Board of Trustees, said the board “accepts Mark’s decision with reluctance” and says the search for his successor will be “open and transparent.”

News 11/13/09

From Vendor Bribes: “Re: Amazing bribery to EMR buyers via HIMSS.” The HIMSS Takin’ HIT To the Streets campaign (gag, even for Doobie Brothers fans) leaps that last boundary of member organization common sense —  they’re paying people to attend the sales presentations of their vendor members. I’ve been watching the remake of the old miniseries V and I think maybe vendor visitors have taken over Steve Lieber’s body since the previously furtive and tentative vendor-HIMSS gropefest has advanced to a full-on public consummation.

From Dr. Know: “Re: HIMSS. I think that HIMSS needs a shock to the system. We all recognize their priority is to serve the interests of the vendors and not hospital end users. Therefore, I wonder whether an organized boycott of this year’s conference is in order?” I’m not a fan of boycotts. If members and attendees don’t like how they are being represented, they know their options. Without providers as attendees and members, the vendors would bail quickly.

From Ryan: “Re: HIMSS. Not sure why Siemens would pull out of HIMSS 2010 in Atlanta, as they have an office in Alpharetta.” They still would have to buy horrendously expensive exhibit space, pay people to work the show, pay union carpet sweepers and power strip deliverers, and bring in people from places a lot further away than Alpharetta. All to reach the mostly non-decision makers (competitors, consultants, and people who don’t influence hospital IT purchases) who pad out the otherwise impressive attendance numbers. Siemens did it before (as SMS) and this time around, Cerner can’t shame them to prospects since they’re not coming either.

From Hockey Dad: “Re: EMR ratings. 2,556 primary care physicians (family doctors) rate their EMRs. Results published in Family Practice Management from AAFP.” You have to subscribe to read, but Hockey Dad sent a PDF. The article admitted some unavoidable bias (self-selected respondents, too many vendors to ensure adequate sample sizes for all, and different levels of expectation based on practice size) and accordingly warned about taking the results as anything significant. They didn’t really name overall winners, but the closest thing to it placed the top 10 as (1) e-MDs, (2) MEDENT, (3) Praxis, (4) Amazing Charts, (5) eClinical Works, (6) Epic, (7) Practice Partner, (8) Allscripts Professional, (9) Centricity, and (10) Aprima.

From Demetri Noh: “Re: survey. Got this survey, which appears to be from a rival group of HIMSS.” Or “HIMMS”, if you like their version. It’s not clear who funded the research firm’s survey. It’s a great time to be starting up a HIMSS alternative, if you ask me, although I don’t know if that’s the point of the survey.

From Billy Bong: “Re: radiologist. This can’t be good for the industry.” An Atlanta doctor who runs a radiologist coverage service faces 20 years in jail, charged with letting unlicensed employees write up his interpretation reports for images he didn’t bother to look at.

From Craig Powerplay: “Re: AHA Solutions. They understand their endorsed products only to the extent that they need to believe people will buy it. They only make money if the endorsed product/ service sells. When we negotiated with them, we didn’t see much understanding in what our product was, but they did understand this:  press hard for a high yearly endorsement fee and a high percentage of each sale. We passed — our margin would have been near zero.”

From The PACS Designer: “Re: RSNA iPhone review. With the popularity of the iPhone in healthcare increasing, you may want to check in at the RSNA for a presentation by Presenter Dr. Krishna Juluru, an assistant professor of radiology at Weill Cornell Medical College. Along with others, he will be discussing the use of the various healthcare apps in radiology, and how they can improve the care process.”

Listening: Amorphis, another of those Finnish progressive metal bands that I like.

I interviewed Allscripts CEO Glen Tullman on HIStalk Practice. If you decide to check it out, drop your e-mail address in the Get Instant Updates box on that page and you’ll be the first to know when we run something new there (it’s a separate e-mail list since not everybody who reads HIStalk follows physician practice software).

Cris Assif is named managing partner of consulting firm Entrust Healthcare.

A reader forwarded an e-mail from Duncan James, president and CEO of QuadraMed, welcoming Michael Jarrett as the new VP of client services, coming over from McKesson but also sporting QCPR experience from its previous owners Per-Se and Misys. Linda Baum and Linda Benson were wished well in future endeavors required to take place elsewhere.

I can’t find any updates on Charlie McCall’s trial. If you’re in San Francisco, you could wait outside the court house and snap a picture for me, and maybe thrust a recorder in his direction while asking accusatory questions that might startle him enough to answer.

EDIMS, the Livingston, NJ based vendor of emergency department systems, is supporting HIStalk as a Platinum Sponsor, so thanks to the folks there. Its EDIMS flagship product is live at 39 sites, has documented over 12 million encounters, and is used by EDs that document 100% of their patients compared to a national average of 40%. It offers a quick registration kiosk, nursing documentation, graphical patient tracking, an alert-driven nursing dashboard, CPOE, order sets, charge capture, prescription writer, medication reconciliation, and lots of other features. I appreciate their support.

McKesson announces Horizon Connect, an interoperability product. For home buzzword-counters, the press release included these: solution suite, seamlessly, discrete, actionable, workflow, collaboration, continuity, aligned, continuum, and ubiquity.

Epic Systems is among the financial backers of Porchlight, a Madison prevention and treatment agency for homeless veterans.

Iowa State University researchers develop software that converts CT and MRI scans into 3-D representations that can be navigated by joystick, making them useful for doctors for planning surgeries and for teaching. As one said, “2-D is guessing and 3-D is knowing.” The product has been commercialized as a $4,995 PC package that uses Xbox controllers. The above image is a converted cardiac CT.

St. Vincent’s Catholic Medical Center (NY) replaces its PC desktops with a virtual desktop infrastructure, speeding up their network since the zero client cubes do screen scrapes of VMware server-hosted applications. The 3x3x2 inch Pano Logic devices have USB plugs that connect to a virtualized Windows desktop server in the data center — no moving parts, minimal energy consumption, and minimal footprint.

Medical Mutual of Ohio will roll out Intuit’s Quicken Health Care Expense tracker to its 1.6 million members. A consumer advocate says easy-to-read bills are good, but reminds, “Even if you are armed with this information, it’s not as if you shop for health care directly. You go with your insurance company. It’s unclear that the information really translates into any new buying power.”

Sam Heard, the doctor who runs Ocean Informatics in Australia, is profiled in a newspaper article. His company developed openEHR, a “shareable EHR” chosen by Sweden as the basis of its national eHealth infrastructure. Its template designer is pictured above.

The nursing school at Case Western Reserve University gets a $1.3 million grant to develop avatar-based software that teaches patients to communicate with their doctors. They envision it running on a kiosk outside the doctor’s office to coach patients on what to ask.

A critical results related lawsuit verdict: the doctor of a hospitalized 18-year-old woman who had just given birth orders blood tests, which showed a serious infection. The hospital lab didn’t get the results to the doctor in time to avoid a complete abdominal hysterectomy. The jury returns a $2.3 million verdict against the hospital.

E-mail me.

HERtalk by Inga

Design Clinicals reports that it’s on track to double its revenue and product sites for FY09. Its MedsTracker medication reconciliation product is now live or in implementation mode at 18 sites. Mr. H interviewed founder Dewey Howell a couple years back when the company was in the midst of its first installation.

Hewlett-Packard agrees to pay $2.7 billion to acquire 3Com. The acquisition strengthens HP’s position as a one-stop shop for corporate customers.

Trinity Health plans to install seven of Elsevier’s online clinical decision support solutions across several of its facilities.

Picis recognizes winners of the Picis 2009 Customer Recognition Awards, selected based on their use of Picis solutions to improve their financial and clinical operations in the ED, OR, or ICU.

Allscripts contracts with DecisionOne to provide hardware infrastructure support to its clients. Allscripts internal hardware service personnel will integrate with DecisionOne’s field service organization. Sounds like a good move as it allows Allscripts to focus on the software side of the business. Having an internal field service team is less critical in today’s server/PC world than it was in the good old days of proprietary hardware.

HIMSS announces it will head to Sin City for the 2012 Conference and Exhibition. According to the Chicago paper, HIMSS chose Las Vegas over the Windy City because of the high cost of labor at McCormick Center, with electrical service at this year’s conference costing 4-10 times as much as it did in Orlando the year before. I love Chicago, but like the Vegas choice simply because the average February temperature is about sixteen degrees higher.

Iowa Health System deploys McKesson’s Horizon Medical PACS solution at 34 locations throughout Iowa.

Healthvision calls its third quarter “healthy” based on its closing of 97 transactions, including 13 new customer engagements.

Intel’s Digital Health Group introduces a mobile handheld device designed to assist people with dyslexia or vision problems. The Intel Reader uses a camera to capture text and converts it to digital text. The device then reads the text aloud. List price: $1,499.

API Healthcare signs an agreement with Logicalis to offer remote hosting services to API clients.

Premier Purchasing Partners awards Meta Health Technology a 36-month contract to provide Premier members special pricing and terms for Meta’s patient chart abstracting and Electronic Physician query software products.

Scott A. Storrer takes over as president and CEO at MEDecision. The transition has been in the works since Storrer joined the company in 2008. Founder and current CEO David St. Clair will retire December 31, but stay on the board for one more year.

First Citizens Bank agrees to market mPay Gateway’s patient payment system to its physician practice clients.

Indian police arrest the head of an outsourcing company for allegedly selling the medical records data of patients treated in a British hospital. An undercover investigation revealed Vikas Dhairyashil Bansode had thousands of records that included confidential clinical and financial information. Bansode and his accomplices obtained the records from IT companies contracted to convert the paper records to digital. The group then sold individual records to middlemen for as little as $6 each via Internet chat rooms.

Senator John Kerry introduces legislation to help small medical practices become eligible for SBA loans to cover EMRs and e-prescribing costs. Funds could be used for both hardware and software.

A whopping 94% of healthcare organizations don’t think they are ready to comply with the privacy and security provisions included in the HITECH Act. The new regulations, which go into effect in February, extend existing HIPAA rules including increased enforcement, penalties, and audits. Funding is the biggest barrier.

The University of Colorado Hospital signs a contract for multiple Lawson enterprise applications to enhance HR and overall business operations.

Healthwise, a non-profit provider of consumer health information content, lays off over 10% of it 222 employees. It has traditionally provided printed materials, but the market is shifting to electronic sources. Healthwise is now focused on providing content via EMRs.

E-mail Inga.

News 11/11/09

From Downwit-IT: “Re: HIMSS. Following Cerner and Meditech, Siemens has made the decision to pull out of the upcoming HIMSS conference. No booth, no representatives traveling to Atlanta. Siemens will reach out to its customers and prospects via virtual, Internet-based means.” Unverified, although I don’t see their name on the exhibitor list. Anybody else not going?

From Keenen I. Wayans: “Re: AHA Solutions. Would you look favorably on a product that earned their endorsement?” It wouldn’t influence my opinion, but I’d like to hear what everyone else thinks. It’s a pay-to-play award, but that alone doesn’t make it worthless, I guess.

From Larry Fink: “Re: stock. If you compare the ten year-stock performance of Cerner and Eclipsys, the difference is mind-blowing. Cerner is up 948% over ten years (including 106% this year); Eclipsys is up just 18% over ten years.”

From Nasty Parts: “Re: Sage. Jason Dvorak, most recent VP of sales, resigned last week. Multiple sales execs have also resigned recently. Rumor is that Sage Healthcare is interviewing to hire a new company president.” I invited Sage to respond directly. “2009 was a very positive year for Sage Healthcare. With the opportunities that exist in this marketplace today, Sage plans to expand the leadership team with the hiring of a Division President in the near future.”

From Anon: “Re: Being John Glaser. The title sends a message that the subject is a narcissist.” I made that title up because Being John Malkovich popped into my head, knowing that John is anything but a narcissist. I didn’t see the movie, by the way, but Ebert’s review made me think it was appropriate: “Malkovich himself is part of the magic. He is not playing himself here, but a version of his public image — distant, quiet, droll, as if musing about things that happened long ago and were only mildly interesting at the time.”

From Wounded in Plano: “Re: Dell. The Dell-Perot merger has already started to see the loss of healthcare talent that Dell sees as dead weight. Dell is sending projects overseas (including clinical EMR support), laying off ‘expensive’ talent and focusing on a manufacturing mentality in a consulting world.” Unverified.

From The PACS Designer: “Re: Sectra’s loss. TPD is deeply saddened upon hearing of the accidental death of Sectra’s president, Dr. John Goble, in a helicopter crash. The selection of Thomas Giordano as acting president is a move in the right direction to continue Sectra’s strong presence in this country.  My deepest condolences go to his family, co-workers, and friends.” Goble, 58, had led US operations for the company since 1997.

From Funny: “Re: SEEDIE. Very. And it could be funnier if it wasn’t so true.” I’ve mentioned SEEDIE and the Extormity EHR before, pretty funny parodies (although also ironic in its criticism of technology — the site is down at the moment with a MySQL error). I didn’t notice until now that they’ve been putting out phony news items, also funny:

After a raucous 3 minute debate, the SEEDIE board of directors voted against PHR standards that would force certified EHR vendors to interoperate with personal health record systems using a common set of data standards.

“Our members advocate a walled garden approach, with a distinct preference for proprietary PHR applications that treat interoperable vendors as untouchable members of a caste system,” said SEEDIE executive director Sal Obfuscato. “Like Farmer Brown in the tale of Peter Rabbit, we want to keep all those rapidly multiplying PHR companies from nibbling our electronic health record cabbage.”

Today is Veterans’s Day. If you served, thank you. If you didn’t, thank them.

Firefox has been inexplicably bogging down constantly for me, requiring me to three-finger salute it, so I switched back to Chrome. Darned annoying, though: you can’t get Google Toolbar for Google Chrome. Sounds like they have some healthcare IT DNA in there somewhere.

Ingenix will acquire CareMedic, a Florida-based vendor of revenue cycle solutions for hospitals, in an all-cash deal whose terms were not announced.

Welcome and thanks to Quality IT Partners, new to HIStalk as a Gold Sponsor. The Mt. Airy, MD company, which will be nine years old next month, offers its consulting clients (hospitals, health systems, long term care, payers, pharma, etc.) first rate services at a value-based cost structure. The company almost never advertises, so I was pleased to hear this from Director of Business Development Bruce Werner: “The President of our company (Mark Debnam) and I have been following HIStalk for quite some time and we recently got our leadership team hooked on it as well.  The leadership team unanimously voted to invest in HIStalk. You and your team have done a great job with the site and we are proud to be a sponsor!” Inga and I appreciate that.

John Piano, the founder and CEO of tissue and organ EMR vendor Transplant Connect, is named Better Man for 2009 by GQ Magazine, which recognizes “charitable work, volunteerism, and/or community involvement.” He received the award at the Gentlemen’s Ball (really). I don’t know if physical appearance was judged (it’s GQ, after all, not that I have any idea whether he’s attractive or not) but his company helpfully included lots of flattering photos.

The Carolina eHealth Alliance will use Oacis HIE from TELUS to power its health information exchange, starting with 12 EDs in South Carolina’s Lowcountry. The product includes an EMPI and the Oacis Clinical Viewer.

Weird News Andy hacks this story up: researchers funded by a Gates Foundation grant say their cough-analyzing software, which will run on cell phones or MP3 players, can diagnose disease by measuring coughs.

Kronos announces several new Q4 sales, along with financial results that include $672 million in FY revenue and $143 million EBITA.

Being a non-profit wage slave, I don’t pretend to understand the “variable prepaid forward contracts” that Cerner founders Neal Patterson and Cliff Illig just exercised ($64 million worth). Somehow they get money now for shares to be sold in the future (three more years in their case). All I know is it’s one of those fancy hedging strategies that sometimes gets people in big trouble with the IRS.

Mayo Clinic and Steelcase study the influence on the latter company’s computer furniture, which was designed for Mayo to help doctor and patient view a computer monitor together for teaching.

Idiotic lawsuit: a man goes into a deli and claims he was bitten by the owner’s cat. He’s suing for $5 million.

HERtalk by Inga

The VA Heart of Texas Health Care Network expands its collaboration with CliniComp, adding the company’s Esentris Critical Care solution.

Jordan Hospital (MA) selects ClaimTrust InSight Denials for claims denial management.

eClinicalWorks adds another IPA to its client list with the signing of Catholic Independent Practice Association (NY). The IPA purchased 150 PM/EMR licenses to connect community physicians and will work with eCW to tie into the HEALTHeLINK RHIO.

Former Allscripts-Misys and Emdeon exec Ray DeArmitt takes over as the executive VP of sales for NotifyMD.

Hoag Memorial Hospital Presbyterian (CA) expands its partnership with Surgical Information Systems with its purchase of the SIS’s anesthesia, BI, and tissue management products.

NextGen Healthcare just completed its user group meeting in Washington DC, reporting attendance of over 2,700 and featuring keynote speakers Newt Gingrich and Howard Dean. The hot topics: ARRA, healthcare reform, interoperability, and patient-centered medical homes.

iSirona appoints John Cooper chairman of the board, replacing iSirona founder Dave Dyell, who will continue to serve as CEO. Cooper’s previous gigs executive roles at Sungard, Eclipsys, and SMS. Totally off subject, but am I the only person who thinks of that song by the Knack every time I see the iSirona name?

The healthcare sector added 28,500 new jobs in October, 10,000 of them in hospitals.

OhioHealth selects ProVation Order Sets to automate its creation and management of evidence-based order sets.

If you are a regular HIStalk reader, the details in this report will not surprise you. Scientia Advisors expects the global HIT market to grow 11% over the next four years, with the US setting the pace. Most new investment will go towards EHRs. Lower-cost remote hosting will increase in popularity for smaller hospitals and clinical decision support systems will continue to impact the clinical diagnostics area. SaaS and open-source models will drive down pricing, they say.

HealthBridge selects Mirth Meaningful Use Exchange for its interoperability infrastructure. Once implemented, HealthBridge will become one of the first HIE’s to enable physician access to the NHIN.

CSI Tech wins the implementation contract for Grady Health System’s (GA) $40 million Epic installation. The inpatient and ambulatory installations will take 18-24 months. CSI Tech already handles Grady’s ongoing internal IT needs.

Here’s an iPhone application I don’t need but wouldn’t mind seeing one day. Lit: A Game Intervention for Nicotine Smokers is in development at Columbia University’s Teacher College and will be released within two years. The application is designed to emulate the physiological responses smokers get from smoking and would involve blowing into the device’s microphone. The RWJF is funding $150,000 for the project. With cigarettes costing an average of $5 or more a pack, it will be interesting to see how the application is priced.

Hayes Management Consulting announces it will be offering services for ARRA-funded Regional Extension Centers, including EHR readiness assessments and planning, clinical workflow redesign, EHR selection, and HIE development.

MEDSEEK honors seven clients who earned a total of 15 eHealthcare Leadership Awards at the company’s 13th Annual Healthcare Internet Conference. They were selected from over 1,100 applicants.

Kaiser Q3 numbers: operating income $336 million; net income $569 million. These numbers are significantly higher than last year’s when the company suffered major investment losses. Meanwhile, enrollment dipped about 63,000 to about 8.58 million.

E-mail Inga.

Being John Glaser 11/10/09

While waiting for my annual physical, I enrolled in a research study. (About every other year, I participate in a research study. Two years ago, a sleep apnea study involved me spending the night in an iron lung with electrodes in my mouth and all over my head and chest. Not conducive to a good night’s sleep).

My current study centers on healthy behaviors. The study is intended to improve the health behaviors of people who are fundamentally healthy (my blood pressure, cholesterol, weight, etc. are fine) through a set of pretty modest interventions. Armed with a pedometer, a Web site for recording progress, and an every-other-week call from Maria (my “health coach”), I am supposed to:

Have one multi-vitamin each day. Duck soup.

Eat three or fewer servings of red meat each week. This takes some thought and planning, but is not that hard.

Eat five to seven servings of fruit or vegetables each day. Since I usually eat one meal a day, this has proven to be a real challenge. I tried to persuade Maria that onion rings were a vegetable. As was a cup of coffee (coffee beans come from plants) and vanilla ice cream (vanilla beans also come from plants). She wasn’t buying it. But I have been able to drink some fruit juice during the day and toss down a banana and apple, allowing me to meet this goal.

Walk 10,000 steps a day. During a normal day “at the office”, I will walk 3,000 steps. This means I have had to find an hour each day to walk to get the other 7,000 steps. Finding that hour takes some planning — for example, getting up early to walk before work. (This has turned out to be an enjoyable experience — it’s quite cool to watch the sun come up over the Capitol Building and the Washington Monument).

So far, three months into this six-month study, I have been pretty good at meeting my goals. Maria has not scolded me.

This experience has reminded me that maintaining health, restoring health, or ensuring that a disease does not progress requires that patients engage in “health behaviors.” And it has reminded me that instilling such behaviors is a multi-faceted undertaking. I am not as well versed as those that have deep experience in this area, but this study experience seems to indicate that four factors must be present.

Focus. You have to know which behaviors are the ones that must change or be performed. This can be different — lose weight, take medications, take it easy after surgery, or stop smoking — across patients and situations.

Information. The patient needs information. This information is diverse — the linkage between the behavior and health, specific data about the behavior (e.g., coffee is not a vegetable), and behavior alternatives (how many steps is a game of racquetball?)

Tools. For example, my pedometer and the Web site to daily record whether I met my goals. Depending on the behavior, there can be other tools. Some do not involve IT, like nicotine patches. Some do involve IT, such as measurement and transmission of blood pressure.

Motivation. The desire to alter one’s daily routine to adopt a more healthy routine is probably the most important factor. It is also the most complex and difficult factor. Why would I get up an hour earlier to walk when I can use that valuable time to sleep? Motivation requires motivators (desire to please, guilt, basic type A behavior to achieve a goal, interest in living long enough to play with grandkids). It requires the removal of barriers that could discourage a motivated person, such as limited access to providers. It requires feedback on progress. It requires a social structure of family or friends that are supportive. And it requires the other three factors.

We will never have a reformed or transformed health care system unless we are broadly able to engage patients in managing their health. Cost reductions and outcomes improvements in treating chronic diseases require a motivated patient. Reducing unnecessary treatments is greatly facilitated by an informed patient. Improvements in the quality of care are helped by patients who make good decisions about which providers and health plans to choose.

We can help engage patients. Clearly we can provide tools and support access to information. While recognizing its complexity, we can also help with motivation.

Motivation opportunities range from making whatever IT is involved easy to use (reducing a barriers for a motivated person) to offering graphs of progress and corny but effective “attaboy” generated phrases to avatars that exhibit motivating emotions such as disapproval to online communities of others who can offer support.

While the opportunities can be listed, we have limited understanding of how to apply IT to motivate.

I need to go eat an apple. Otherwise Maria will yell at me.

 

John Glaser, PhD, FCHIME is vice president and CIO at Partners HealthCare System and is also on temporary assignment as Advisor to the Office of the National Coordinator. He describes himself as an "irregular regular contributor" to HIStalk.

Monday Morning Update 11/9/09

I decided it was time to update the About page, which answers questions I’m sometimes asked (why did I start HIStalk, why am I anonymous, how I decide what to write about, etc.)

Respondents to my most recent poll have a slight preference for not having the FDA regulate clinical software. That’s pretty close considering that vendors usually have the strongest feeling about that and are likely to click No. New poll to your right: what do you think about a hospital with over $1 billion in revenue paying its CIO over $500K? That’s not a loaded question – I’m just curious. Note: if you’re still seeing the old poll, clear your browser cache. 

HIStalk interviews are highly educational, depending on who I’m interviewing, anyway. If you have someone in mind (and, better yet, if you can hook me up), let me know. The ideal subject: someone who works for a non-profit organization on the front lines of something HIT-related, is doing creative work that the industry could learn from, and comes across as interesting on the telephone since that’s how I do them.

Meditech held its Physician/CIO workshop recently (I assume it was recently, anyway, since the write-up doesn’t say when or where it was held). Paul Egerman was one of the speakers, meaning I would have enjoyed it.

Meditech also just filed its 10-Q. For the quarter, revenue was down 4%, but net income swung from a $27 million loss to a $20 million gain (EPS $0.57 vs. -$0.76), mostly due to investment write-offs last year. Product revenue was down a slightly alarming 16%.

The Chicago Department of Public Health (CDPH) still can’t bill for mental health services because of Cerner problems (the article is in some kind of union publication, but it seems solid). They are using a different system for billing since fixing Cerner remains “an active process.” This conversion says it all. [Alderman]: "You’re saying that after 18 months you’re unable to work out technical glitches that prevent us from billing the state?” [CDPH commissioner]: “That is correct.”

Some nuggets from the just-published 2009 HIMSS Security Survey (thinking ahead to ARRA, since stimulus dollars are tied to privacy and security, not just Meaningful Use): 

• 61% said information security gets less than 3% of the IT budget, nearly unchanged from 2008.
• Fewer than half of the organizations have a C-level security officer.
• 74% have conducted a formal risk analysis, of which 52% found patient data to be at risk. Those problems took longer than six months to correct, said 40%.
• Most of them collect audit logs (firewall, application, server, intrusion detection, etc.) and review them manually.
• Electronic data sharing is already big (91%) and about to get bigger (HIEs, other hospitals, PHR vendors, and NHIN led the list), with 41% adding new security controls for that reason.
• Most used wireless security and electronic signature, with 67% encrypting transmitted data, 60% encrypting e-mail, 44% encrypting stored data, and 39% encrypting mobile device data. Only 29% had single sign-on.
• A third said their organization had experienced medical identify theft, although most reported no consequences.

From the Eclipsys earnings call: Sunrise 5.5, due out in the first quarter, will have a “more intuitive user interface”; the company is banking on heavy CPOE use by its customers to influence new ARRA-related sales; margin improvement efforts, much of them related to internal procurement costs, will consume $1 million in outside consulting fees each quarter but will pay for itself starting in the second quarter; they will target 600 hospitals of greater than 150 beds that do not have a recent-vintage clinical system; MediNotes / PeakPractice underperformed because it was run as separate businesses; demand for Premise / Patient Flow has slowed; 60% of their sales were to existing customers.

Cardinal spinoff CareFusion sells MediQual Systems (the Atlas clinical database vendor) to quality database vendor Quantros.

Speaking of Cardinal, neither it or CareFusion is doing all that great after the spinoff. Cardinal lost money (EPS -$0.11 vs. $0.69) and CareFusion’s Q1 profit was down 28%. Optimism was expressed.

Wound Management Technologies will buy the healthcare assets of VirtualHealth Technologies for $1 million in cash, 4 million shares, and royalty payments. I’ve written about the latter company before, surely one of the most bizarre business combos around: medical office software and gold mines (insert your own joke here). 

Interesting: Microsoft Research develops the $800 SenseCam, a low-res, wearable camera that takes two pictures per minute. It’s designed to help Alzheimer’s patients by letting them review pictures of their day, which seems to help them remember events long term since Alzheimer’s patients may store memories normally but can’t access them.

Henry Schein CEO Stanley Bergman on EHRs: “Electronic medical records will reduce the cost of health care, errors will be reduced, the quality of health care will go up. We don’t know exactly how long it will take, but it’s going to happen in the next few years. And we are the exclusive distributor for the number one player in this field, Allscripts.”

A Commonwealth Fund survey of primary care doctors finds that the US is way behind in several healthcare categories: access to care, providing financial incentives for healthcare quality, and using IT. Only 29% of practices provide after-hours care (other than the hospital ED). Less than half use electronic medical records, well behind the 90+ percent of several other countries. That’s despite spending twice as much per person as other countries.

Cleveland Clinic launches a site to teach student nurses how to use EMRs.

Some AMA members are upset that the organization’s trustees endorsed the House’s health reform bill without asking its members first (doesn’t HIMSS do that all the time?) Delegates will vote Monday on whether the endorsement should be withdrawn.

TELUS announces availability of its new mobile solution, TELUS MobileCare, for homecare providers.

HCA International wins the 2009 Innovation Award for its use of PatientKeeper Physician Portal.

HHS will award contracts to build out the Nationwide Health Information Network by the end of the year.

E-mail me.

News 11/6/09

From Ryan Nichols: “Re: CIO salaries. In 2004, you posted salary data for a number of CIOs, including some fairly high ones like Shands. How accurate was that data? Was there some other reason for some salaries to be off the scale, >$500K?” The salaries came directly from IRS reports, so they show exactly what a CIO was paid in one year, skewed only if that person quit and got lump sum benefits. Not true in most cases, including Shands — 2008 tax records show they paid Joan Hovhanesian $708K, more than everybody except the CFO (who made barely more) and the CEO, who got $1.26 million. Sweet, although not up there with what they pay Urban Meyer to coach football ($24 million over six years).

From Jerry Seinfeld: “Re: Tampa General. Heard a rumor that they will move to Epic from Siemens. Going to the board for final approval.” Unverified.

Listening: Travis, alternative rock from Scotland that sounds like an upbeat, pop-tinged Radiohead.

Eclipsys announces Q3 results: revenue down 5%, EPS $0.07 vs. $1.58, although most of the Q3 2008 earnings came from a one-time tax treatment. Without that, earnings were down 47%. The company also announced that North Mississippi Medical Center has chosen Sunrise.

QuadraMed announces its Q3 numbers: revenue down 7%, EPS $0.02 vs. $0.12.

Cleveland’s MetroHealth has had Epic for ten years, so Judy was there Thursday for the celebration.

An undercover journalist in England buys detailed medical records of British patients from two chat room “salesmen”, apparently provided by India-based transcription center employees. One said, “We can do really good business with these leads. These leads will give you diagnose, entire diagnose of all the customers, what the customer is facing … The floor managers, they are working as freelancers for me.” The records came from London Clinic, which doesn’t outsource transcription, but some of its doctors hired a local firm and may not have been aware that their information was being sent to India. In a quick marketing reaction, Atlanta-based Webmedx assures customers that all of its employees are US-based and therefore aren’t out of the reach of US laws.

HuffPo covers EMR stimulus money and the vendor marketing techniques being employed to go after it: “cash for clunker” rebates, interest-free loans, Walmart sales, and the Stimulus Tour. John Glaser is quoted as saying that ONCHIT will start tracking EMR prices and marketing claims, looking for any stimulus-related misstatements like the ones Siemens claimed Cerner user to steal its customers (and sued them over it, although it has settled, which I’m not sure I know until I read it in this story). HIMSS was invited to comment but, not surprisingly declined, knowing it might step on some diamond toes. I was amused that John Halamka was identifed as “John D. Halambra” in the article.

USA Mobility announces GA of I-LAND, a two-way emergency messaging system for hospital and government campuses that gets through in emergencies because it doesn’t use public networks.

Over 97% of healthcare organizations say they have behavior problems with doctors and nurses, according to an ACPE survey. Examples: yelling, cursing, insulting, refusing to work with each other, throwing objects, trying to get someone fired or disciplined unjustly, and harassing sexually. Many of the problems happen in public or in front of patients. Here’s an interesting one from the respondent comments: male surgeon says to female nurse, “You must be deliberately screwing up. No one could be so stupid as to be this incompetent.” Nurse replies, “If you don’t stop insulting me, I am going to drag you out into the parking lot and kick your ass.” Surgeon reports nurse to administration, nurse gets fired. Only 22% of respondents said doctors had been terminated over incidents, while 61% said nurses had.

Maybe this is related: a couple of readers Googling for the doctor road rage story may have uncovered an important trend — there are a lot of those stories in the news. Doctors have beaten motorists with Thermos bottles, punched women drivers in the face, and pinned a pregnant woman against a wall with an SUV. Do they teach anger management in medical school?

Dann from RelWare says the Fall Technology Conference of Midwest HIMSS in Grand Rapids this week drew over 400 registrants. He took a picture of someone reading HIStalk during the sessions, which creeps me out the couple of times I’ve seen that at HIMSS (I write it entirely alone with only e-mail contact, so seeing someone read it in person makes me feel exposed).

I missed a couple of graphics from Mark Moffitt’s Web services article (you code geeks will love it because it shows a little bit of programming and some XML). I also ran across this video in which doctors talk about it and give a quick glimpse or two.

NHS is threatening its suppliers CSC and BT with termination if they don’t hit the November dates that were set earlier this year for bringing patient systems live. Sounds great, other than the previous suppliers it tried to hardball walked away. I tried to suppress the sophomoric cackling as I read the name of the hospital that went live this morning on Lorenzo, but I couldn’t — NHS Bury. 

My UCSF sources told me in August that it was stopping its Centricity project (finally verified by UCSF in mid-October). They also said that Epic would be brought in as soon as the lawyers killed the GE contract. Right again, apparently, as negotiations with Epic are underway and, if all goes well, implementation will start in the first quarter. I snooped around and found a copy of the e-mail online (warning: PDF). The GE experience must have been ugly: “I understand the frustration in our prior efforts over the past several years, and the concern that we are facing another two years of this work. However, because we are going with an established, proven system, we can have much greater confidence that in two years we will have the tools that our clinicians need to improve the quality and safety of the care they provide.” Wonder what that Strike 1 cost them?

Speaking of Epic, I got a nice note from Dr. Lucy, aka #1 Dinosaur, who was surprised to find that people assumed her EPIC FAIL line in her anti-EMR blog post that I mentioned referred to that Epic (she’s a fan of FailBlog and was riffing on that about EMRs in general). She does, however, stick to her guns in not buying an EMR for her practice, with her reasons listed in this post:

A man in the back spoke of the new EMR he had just purchased for $30,000. Once all the numbers were crunched, though, it turned out he was only going to see about $3,000 in P4P bonuses. The response, delivered somewhat more softly than the stentorian tones of the main presentation, was that his return was more likely to be in the areas of quality and lifestyle. I imagined presenting a proposal to an insurance company — actually to any kind of business — and saying, "Now, you’ll only make back about 10% of your initial investment, but you’re likely to see improvement the areas of quality and lifestyle."

And speaking of EMRs, cost is a big concern for doctors, but 58% of them know nothing about ARRA. 

Philips and the biggest insurance company in the Netherlands start a pilot project to develop home monitoring programs there.

This strikes me as bizarre: the MyMedicalRecords people engage a clinical trials company to help bring its monoclonal antibodies assets to market. An earlier announcement says it acquired the technology when it did a reverse merger with Favrille, Inc. in January 2009, although all the Phase III trials results I could find indicated that all of Favrille’s products were flops. The news didn’t seem to help the parent company’s share price, now down to less than eight cents, about a quarter of what it was worth in May.

Pharmacy OneSource acquires the MedBoard in-hospital drug delivery tracking system from MedKeeper.

Strange: a Phoenix doctor’s office gets 1,000 hang-up calls a day from a man angry at a former practice employee with whom he had a relationship. He’s done it for months and says he will keep it up for 25 years. They can’t block the calls because he’s in Jordan.

eHealth Ontario’s $236 million contract, signed quietly a few weeks after its CEO and board chair quit after a bidding scandal, will give 5,700 doctors a connected EMR – less than a fourth of those practicing in the province. The backlash over Ontario’s problems has stalled approval of a request from Canada Health Infoway for $500 million of what is basically stimulus money, although its audit was clean. That non-profit has spent $1.5 billion so far.

State government in India, annoyed that private hospitals obligated to treat poor patients are turning them away, directs them to post a count of empty beds daily on the Web page of the Director of Health Services. The newspaper article concludes that “If this works as planned, it will mean that patients will no longer have to share beds, limiting cases of infections.”

David Grant USAF Medical Center (CA) goes live in six weeks on ClinicComp Essentris CPOE, repository, and alerts.

Seton Family of Hospitals (TX) says its Sychron desktop virtualization saves caregivers 30 minutes each per day since the “roam button” allows them to save a session, leave, and then pick up where they left off on another PC without logging in again.

IMS, the big seller of patient and prescription data, sells itself for $5.2 billion, the largest buyout of the year. Thank them if you believe drugs are too expensive since they specialize in telling drug companies how to wring the most profit out of their products.

The SEC settles with imaging vendor Merge Healthcare and its former CEO and CFO for improper revenue recognition that overstated net income by 230% for three years, resulting in a $500 million hit in market cap when it was discovered. The former suits will pay a combined $870K. I read the original complaint and it said Merge did what an insider told me that HBOC did in the 90s — shipped empty boxes to customers when products weren’t ready so the revenue could be recognized anyway.

The whistleblower who turned in a Texas hospital group for paying doctors kickbacks for referrals gets a 20% share of the settlement amount — $5.5 million. Anybody know a really crooked hospital that’s hiring?

Q3 results for AMICAS: revenue up 121%, EPS $0.05 vs. -$0.02, handily beating estimates of $0.01 and guiding up. The one-year share price graph is above (they’ve nearly tripled).

Odd lawsuit you’ve already seen: the woman mauled by another woman’s pet chimpanzee has already sued its owner for $50 million, but now her family wants to sue the state of Connecticut for another $150 million because it didn’t prevent the attack.

E-mail me.

News 11/4/09

From The PACS Designer: “Re: Windows 7. Microsoft has released a 90-day trial copy of Windows 7 for IT professionals to use in testing Windows 7.”

From Charles Chips: “Re: road rage story. The doctor was found guilty on all counts.” Thanks for the link. After some soul-searching, I’m going to pass on running specifics even though I said I would once the jury had reached a verdict. The person’s in enough trouble already (looking at up to 10 years in jail) without having the details trumpeted to the industry just because their employer is an HIT vendor and just because I happen to know that. I’m a Golden Rule kind of guy, so I’ll sleep better knowing that, right or wrong, I didn’t go against my conscience. You can probably Google it.

This moment brought to you by Weird News Andy: “Snoring less improves your golf game. Yes, a bit late except for those in Florida, but remember it for the spring.” Another reason to seek treatment for sleep apnea — the handicap of golfers studied improved by three strokes. I like that the UK newspaper, obviously scratching their heads at not having a photo of a CPAP-wearing golfer on the links, stuck in an unrelated picture of Barack Obama holding a golf club.

Ingenix Consulting names John Nackel as CEO, replacing Ted Chien.

Thanks to the reader who sent over the six best practices for medication administration from CALNOC, which dramatically reduced errors in several large hospitals. They are simple: (a) check the medical record against the med; (b) don’t get distracted; (c) leave the label on the med until it’s given; (d) use to methods of patient identification and explain the med to the patient; (e) chart the med immediately after giving it; and (f) check the Five Rights. Bedside bar code verification isn’t on the list. I supposed you have to assume that if these steps reduced errors, they weren’t doing them before, but it’s not much of a magic bullet for those looking for one.

eHealthOntario issued another $236 million in contacts after CEO Sarah Kramer resigned in July over excessive consulting expenses. A political opponent is outraged that the government made no announcement about the new agreements, saying “It’s very ominous that at the height of the controversy around the billion-dollar boondoggle at eHealth, the government slipped another $236 million out the door.”

MD Buyline jumps on the ARRA EHR bandwagon, offering an odd lot of services (a glossary, a list of Web links, customer survey results, etc.) Maybe their services have improved since I was pressured to subscribe to them years ago.

The Advisory Board Company reports Q2 results: revenue up 1.2%, EPS -$0.14 vs. $0.32, but a lot of that loss was one-time write-offs. Shares that were in the high 60s three years ago are at $25.45 now, dropping the market cap to around $400 million. None of the executives are big holders, with even the president holding only around $350K worth.

A guest editorial in a Toronto newspaper says the Canadian government’s H1N1 vaccination rollout “looks like rush hour at a Mexican bus terminal” (I’m a bit uncomfortable with that choice of words). It lauds, however, a clinic that used its scheduling system to book vaccinations and its EMR to verify that recipients were high risk, resulting in no patient waiting. It summarizes, “If there were a Group Health Centre in every Canadian community, the H1N1 vaccination campaign wouldn’t make us look like a Third World country. We need more effective primary health care in Canada and we need to seamlessly link primary health care to public health.” Don’t we all.

London hospitals are testing a “digital patch” that allows wireless patient monitoring, with information being downloadable into a smart phone or integrated directly into EMRs. Toumaz Technology, which makes the Toumaz Sensium, says its on-board chip extracts critical information and not just raw data, working over low-power radio.

Here’s a fun blog post complaining about EMRs from the perspective of a family practice doc who can’t get information about his or her ED patients. What’s notable: the gripes (“The Emergency Department EMR from Hell”) apparently involve Epic (it’s too detailed to summarize). I really liked this comment from an anonymous reader of that site, though:

“Medicine is often compared unfavorably to the airline industry in its failure to use checklists to avoid mistakes. Well, I’m pretty sure there’s no checklist that requires a pilot during take-off to go into the cabin and ask who ordered the fruit plate. But the forces that run modern medicine (including our professional societies) feel that there is no administrative task too trivial that it should not be allowed to interfere with the doctor’s interaction with his patients. This trend is only exacerbated by making an EMR the focus of the physician’s concentration. Basic point: anything that reduces the time and mental energy a physician has to bring to direct, one-on-one patient contact is BAD.”

From accidental Googling, I see that Sharon Howard, formerly of Sage, is now VP of marketing at RelayHealth.

I editorialize on PR-fueled H1N1 data reporting in my guest editorial at Inside Healthcare Computing this week. I must have had too much soda since I sound manic: “Just be aware that people exaggerate their own illness for maximal sympathy or as justification for skipping work, so any kind of sniffles or tiredness will convince people to say they have H1N1 because they heard about it on Oprah (‘headaches’ become ‘migraines’, ‘a cold’ becomes ‘the flu’, and ‘getting sick from too much Super Bowl beer, wings, and guacamole’ becomes ‘food poisoning’).”

I see HHS got a few EMR comments on its site, some of which are good. Here’s a snip of one I agreed with as a contrarian: “The fictional scenario of showing up unconscious at some distant medical center, alone and without ID and contact information, and needing instant treatment that solely depends on an EHR (not on physician judgment) is so rare as to be nil.” Most medical care is delivered near the homes of patients, so it would be a stretch to justify spending a lot of interoperability money to avoid the oft-told “unconscious in a Florida ED on vacation alone and avoided a penicillin allergic reaction” fable that happens, but rarely.

In England, three thumb drives are lost that contained information on 76 cancer patients, stored in unsecured Word documents.

Odd lawsuit: a woman sues her former lover, the married head of the OB-GYN department of Greenwich Hospital, claiming the doctor used the OR for their trysts, told her to get Hepatitis C vaccine afterward, and illegally injected her with Botox. He says she’s out to get him after he dumped her at his wife’s insistence, saying the former mistress posted Internet comments under his wife’s name that called him “a pervert”.

John Fontanetta MD, CMO of ED systems vendor EDIMS and a practicing ED physician, is named a Top Emergency Doc in a survey by New Jersey Monthly Magazine.

A psychiatry magazine says stimulus dollars won’t encourage psychiatrists to buy EMRs because the Meaningful Use criteria will be aimed at generalists controlling chronic physical disease. A New York state mental health official says quality indicators exist for psychiatry if HHS really wanted to use them to define Meaningful Use for that specialty. He also pointed out that hospitals look harder for physical conditions whose treatment generates revenue, which has encouraged vendors to focus on the broader market.

Fletcher-Flora announces GA of its lab outreach portal. 

Jeff Arnold, a founder of WebMD, launches Sharecare.com, which features expert advice from “celebrity physicians”, big-name hospitals, and “Knowledge Partners”, advertisers who provide answers marked as sponsored comments. Oprah is a backer.

E-mail me.

HERtalk by Inga

From DragonGuy: “Re: conversations meeting. Had a great Dragon conference in Vegas last week. Dragon 10.5 will (we all hope) partially solve the ‘Citrix issue’. The room was mostly filled with Epic-based hospital IT people wanting to improve the experience for their docs:  Kaiser, Cleveland Clinic, and similar.”

Drummond Group, which provides interoperability/performance testing and certification, announces that it will apply to become an EHR certifying body once ONC releases its requirements. I think mixing things up a bit and giving CCHIT some competition isn’t a bad thing. Of course the introduction of choice is bound to lead to strife, with certifying bodies and their constituents each claiming superiority. Perhaps competition will reduce certification fees, which would be especially appealing to smaller vendors. Now that Drummond has announced its intentions, will other entities step forward as well? Could be fun to see what unfolds.

Perot Systems is now Dell Services Global Business Unit, following Dell’s purchase of 90% of Perot’s outstanding shares. Perot CEO Peter Altabef was named president of the division.

Hospital have had a total of 126 mass layoffs (50 or more employees) through the end of September, which exceeds the 112 layoffs for all of 2008.

dbMotion opens a regional office in Singapore to address the growing demand for EHR solutions in Asia-Pacific.

Mediware reports a 184% increase in earnings over last year, and a 9% jump in revenue. Shares climbed 15%  based on its better-than-expected numbers.

West Penn Allegheny Health (PA) makes plans for a new medical school, as well as an overhaul of its 700 member physician practice group. Despite a $34.6 million loss for the nine-month period ending March 31, West Penn is investing big money in EMRs for its physician offices.

McAllen, Texas once again makes healthcare headlines. The area’s largest hospital system agrees to pay the federal government $27.5 million to settle allegations that it paid doctors illegal kickbacks to refer patients to its facilities. The government claims that South Texas Health Systems disguised payments to doctors in a series of sham contracts that included medical directorships and lease agreements.

St. Rose Hospital (CA) deploys Horizon Cardiology CVIS from McKesson. Meanwhile, Crittenton Hospital (MI) selects McKesson’s Horizon Enterprise Revenue Management solution.

The seven-physician Toledo Orthopaedic Surgeons group selects SRS EMR.

HHS says it’s taking HIPAA violations seriously, imposing significantly stiffer penalties for HIPAA breaches. The maximum penalty for a civil violation jumps from a mere $100 to a hefty $25,000 fine. The penalty cap was also raised from $25,000 to a whopping $1.5 million.

Following what seems to be low-tech techniques, VHA helps 28 hospitals in Oklahoma and Arkansas improve ER traffic. Most of the EDs made significant reductions in wait times and LWBS rates, despite increases in patient volumes. I was surprised that VHA did not attribute the improvements to some new HIT tool. Instead, old-fashioned internal competition and communication were the main forces at work. One VHA official says, “The real driver for improvement for these hospitals is not comparing themselves to national standards, but with each other. Once a hospital administrator sees that another hospital has achieved success, he or she picks up the phone and asks how.” Now that’s innovative.

Bermuda’s primary hospital and urgent care center are getting rid of paper processes and installing MEDHOST’s EDIS.

CareTech Solutions reaches an agreement to acquire IGCN, which helps hospitals build and manage Web sites.

Moses Taylor Hospital selects ClaimTrust’s InSight Denials to track and analyze claims.

Cortland Regional Medical Center (NY) contracts for ProVation Order Sets to automate evidence-based order sets.

E-mail Inga.

Monday Morning Update 11/2/09

From HISJunkie: “Re: InfoLogix. Looks like they are on their last breath. Never did think this outfit would make it. They always seemed kind of shifty to me — did the Wall Street dance, pumped it up, took it public, made a killing on stock sales … then puff!” The company, which sells an odd lot of healthcare systems ranging from RFID to ERP, defaults on loan covenants requiring it to keep $1.5 million of cash. They were supposed to either raise $12 million or sell themselves by July 31, but missed the deadline. Share price has dropped steadily over the last couple of years, from over $5 to the current $0.18 and a market cap of less than $5 million.

From CK: “Re: Lindsey Jarrell, CIO of BayCare. He was awarded the CHIME-AHA Transformational Leadership Award on Thursday at CHIME’s Fall Conference.”

Jonathan Bush in the athenahealth earnings call, acknowledging that the company is at capacity in its EMR implementations: “.. our Clinicals implementation process still has some vestiges of the early EMR thought that went into building it. EMR is a shitty way to get a practice online. It’s just garbage, and we still have that stock inside of some of our thinking. It’s almost gone … we are getting much more of our thinking oriented towards, ‘This is a clinical information network.’” He answered a question about enterprise deals with a little jab at the big HIT vendors: “We don’t have massive professional golfers on the ground ready to be buddies with these people the way some of our giant competitors do. The athena jet doesn’t fly people into the experience center to have a day of visualizing the software of the future.”

Interpreters at UNC Hospitals (NC) replace their pagers and cell phones with the iPod Touch at half the cost, also rolling out a customized version of their ServiceHub dispatching software to work over WiFi.

British parliament member Richard Bacon gets his answer on how many people actually use NHS’s Lorenzo system in the five early adopter trusts: 174 total, with a peak concurrent user count of 19, according to NPfIT. Bacon’s cost estimate of up to a million pounds per user may not be far off.

Data analysis vendor Initiate Systems (I challenge you to concisely describe what they sell after a quick glance at their Web site, but they’ll always be an EMPI vendor to me) acquires interoperability vendor Accenx. You may recall that Initiate was initially an investment and also a vendor of the CIA (identity intelligence stuff, which was big during the previous administration) and also pulled its $75 million IPO last year.

Weird News Andy, straying from his core competency of weird news, recommends this healthcare series by noted thinker Dr. Thomas Sowell. I like it that Sowell is not only brilliant, but actually writes so you can understand it (unlike the 99% of academics who lapse into obfuscatory journo-babble). “In reality, an injured, deformed, or brain-damaged baby and an eloquent lawyer can lead to jury awards in the millions of dollars, even when it is by no means clear that the doctor who delivered that baby was in any way at fault … It costs a jury nothing to ‘send a message’ warning doctors to be more careful, and the particular doctor in the case at hand probably has insurance from a company that can pay a few million dollars easily out of its billions of dollars in assets.”

The HIT Standards Committee wants to hear about your EHR experiences, good or bad. You can also vote on the submissions of others. “Today, the Health IT Standards Committee within the Department of Health and Human Services will begin an unprecedented effort to get the public’s view on how our work might ‘pull forward’ the benefits of healthcare information technology (IT). Specifically, we’re interested in uncovering new strategies to accelerate the adoption of health IT standards.” Your comments are welcome by November 19, the date on which they will be presented to the committee. 

Results of my CPHIMS poll are above. Apparently, the credential doesn’t hurt but also doesn’t usually help, which is what I would have said. New poll to your right: should clinical software be treated as a medical device under FDA guidelines?

Border unrest escalates between Missouri and Kansas, bitter combatants fighting for the right to pay Cerner hundreds of millions of dollars in incentives to lure its office complex and the pro soccer team that Neal and Cliff own chunks of to their apparently economically desperate states. Right as Cerner was choosing its new BFF state, Missouri hires the commerce secretary of Kansas who was instrumental in putting the Kansas package together. Kansas officials, sustaining mortal wounds in the civic pride area, said that’s was like a baseball player switching teams during the World Series, with one adding, “We thought (Kerr’s) Number 1 goal was to bring jobs to Kansas, but find out now he was working to take his own job to Missouri.”

Doctor complaints about patient safety and an increasing backlog of delinquent charts lead Jefferson Regional Medical Center (PA) to go back to paper for some reports. They’re using Siemens, as evidenced by this cheery article about how swell it was going in 2007. You wouldn’t think chart completion would be such a big deal.

TPD has updated his list of iPhone applications.

A quiz question for you non-newbies, spawned from some random Googling: in what year did these companies first make the Healthcare Informatics Top 100: Per-Se, Applied Healthcare Informatics, Object Products, and Triple G? (hint: it was the same year that these companies were acquired and therefore fell off the list: Phamis, Amisys, Medicode, Medicus, HPR, Bukstel & Halfpenny, SDK, Rothenberg, and HCI).

The Teamsters put out an angry press release against McKesson, which sided with the minority of shareholders in continuing to allow “golden coffin” provisions to be offered without shareholder approval. Those provisions pay a lump sump to heirs when a senior executive dies, $25 to $39 million when John Hammergren meets his maker (in addition to the $80 million his family would get from his retirement plan). “Mr. Hammergren took home $29 million in total realized pay last year alone and has ample opportunities to provide for his estate. We believe shareholders should have a say in whether they’re saddled with payments made without receiving any services in return, and clearly our fellow McKesson shareholders agree.” For the first time ever, I agree with the Teamsters. Hammergren is always in the top ten lists of executives salaries, benefits, and security costs. You would think he founded the company instead of just coming on board eight years ago. Maybe Senator Grassley should look there if he wonders why healthcare is so expensive. But, if MCK shareholders would rather he get the money than them, so be it.

A hospital in Ireland reduces appointment no-shows by 44% by sending patients text message reminders.

Speaking of text messaging, StaffKnex, a nurse scheduling vendor whose product sends text messages about open shifts and schedule changes, raises $1.3 million in funding. The product originally sent only text messages, but it now converts them into voice messages for recipients who don’t like texting. Interesting: recipients can respond to the message (“I’ll work that shift”), the scheduler is alerted to the overtime cost involved, and the request is routed to the supervisor for approval.

A group of California hospitals that includes Stanford, San Francisco General, and two Kaiser facilities says it reduced medication administration errors by 88% by following best practices from the California Nursing Outcomes Coalition. I was hoping to find a list of those practices but struck out.

Patrick Soon-Shiong, the billionaire drug company founder with a keen interest in healthcare technology, offers to back $100 million in loans to reopen MLK-Harbor in LA. He’s on the board of Dossia. I tried to line up an interview awhile back, but he passed.

Charlie McCall’s attorney says he’ll call former HBOC president and CFO Al Bergonzi to the stand. He says Bergonzi, convicted years ago, will back Charlie’s story that all the phony accounting happened without Charlie’s knowledge.

Merge Healthcare’s Q3 numbers: revenue up 16%, EPS -$0.02 vs. $0.01. 

Confidential records of House ethics investigators are made public when a junior staff member working on documents from home accidentally makes them available to his peer-to-peer file sharing application.

Quality Systems’ Q2 numbers: revenue up 22%, EPS $0.41 vs. $0.37, meeting expectations on earnings and exceeding on revenue. ARRA is accelerating PM/EMR sales, the company says. Market cap for the company, including its QSI and NextGen divisions, is at $1.74 billion, of which founder and chairman Sheldon Razin holds over $300 million worth.

Odd lawsuit: drug company Amgen is sued by 14 states for offering doctors kickbacks for using the anemia drug Aranesp. The suit claims that Amgen intentionally added extra overfill to the drug vial as a “free sample” that could be billed to insurers.

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News 10/30/09

From HITGhost: “Re: Aspyra. It voluntarily delists itself from NYSE Amex.” The market cap of the LIS/PACS vendor is down to $1.4 million, so obviously it’s not worth the administrative cost to stay publicly traded.

From UKnowMe: “Re: Accenture. I hear that Accenture is eliminating its healthcare practice over the next 2-3 months and will be releasing 300-400 people. Can anyone confirm?” I haven’t heard that, but Accenture just launched the Center for Health. I never know what a company or university means when it announces a “center” that doesn’t seem to involve new people, new facilities, or anything more than a new marketing campaign and maybe a new suit or two, but it happens all the time. Here’s another one: IBM is opening a Health Analytics Solution Center in Dallas, which one of its people says is related to Dell’s Perot acquisition.

From Weird News Andy: “Re: brain surgery. Being in Britain, the patients did not have to pay through the nose for this procedure.” Surgeons are removing skull base tumors through the nose, with one patient leaving the hospital just to days later. Just in case this doesn’t impress, the newspaper article gives a graphic description of the alternative: “Previously, neurosurgeons would have had to split the facial skeleton or peel back the scalp and remove the skull on the forehead to complete the same operation.”

Athenahealth reports Q3 numbers: revenue up 37% to $49 million, EPS $0.14 vs. $0.14, missing expectations of $0.16.

In Britain, a member of Parliament wants to know the cost of iSoft Lorenzo at early adopter sites, saying the number could run anywhere from hundreds of thousands to even millions of pounds per concurrent user. Richard Bacon says Lorenzo isn’t providing value and Cerner Millennium “has caused absolute havoc.” On the other hand, the arguments seems largely political.

HIMSS continues its acquisition of other member groups, this time taking over the Medical Banking Project (HIMSS always calls it “unification with” the group it takes over). Its membership is a bit company-heavy with 163 individuals and 42 corporate members. The only employee mentioned is its founder, from whose home in Franklin, TN it is apparently run. I could find only one reference that called it a non-profit, with its own materials describing it as “a self-funded policy research firm.”

CHIME awards Ivo Nelson, chairman of Encore Health Resources, its Lifetime Achievement Award. I couldn’t find a link for the press release that someone sent me.

A radiation oncologist says Varian’s linear accelerator sales should increase in an economic recovery, but its clunky ARIA oncology EMR is a dog that might hold it back. In his words, “ARIA is far too complex and does none of the simple everyday tasks well. Obviously written by an engineer with little clinical input from the end users, ARIA is a major physician dissatisfier, as they find daily tasks much more time consuming.” Just what you want your doctor to be struggling with as they’re treating you for cancer. If you agree with his opinion, that is.

In all the Charlie McCall talk, I shamefully neglected to observe the October 18 11-year anniversary of the announcement that McKesson was buying HBOC. I editorialized about his first trial back in 2006, with this shout-out to the neglected McKesson shareholders who got burned the worst: “Among those involved were certainly some crooks and some fools, but let’s not forget those who suffered most, those McKesson lifers who had stashed away years’ worth of shares of their unexciting company’s stock instead of risking it on flaky enterprises like Microsoft and Dell. When lonely old conservative widower Dad McKesson brought home a sexy young step-mom named HBOC, she stole the kids’ piggybank.”

Cerner announces Q3 numbers: revenue down 3%, EPS $0.57 vs. $0.54, falling short of revenue estimates. System sales were down 14% and global revenue was down 23%. CERN also guided down on Q4 revenue. Neal actually chimed in at the end of the conference call.

A little recognition for HIStalk’s Founding Sponsors: Medicity and Nuance. Medicity has started a rather cool HIE Blog, I notice, that unlike the usually crappy corporate “blogs” that have “posts” written by chipper marketing types that don’t even claim to be written by executives, Medicity’s is the real deal. Included are posts from one of the smartest people I know in the biz, Robert Connely. Both companies (eScription, in the case of Nuance) were among the sponsors of HIStalk back when I was writing it with a chisel on stone, so I ought to thank them a little more often.

Allscripts used to own the domain escripts.com but let it lapse, so it went up for auction this week. There were no takers at the expected range of $10-25K. On the other hand, medicalpractice.com went for $9,000, conciergedoctor.com fetched $1,250, and h1n1fluvaccines.com was bought for $1,000.

I e-mailed the Canadian medical device licensing people about classifying EMRs as regulated devices. I appreciate this response:

In general, but not necessarily inclusive, patient management software is any software that is intended to be used to diagnose, treat, mitigate or prevent a disease, disorder or abnormal physical state, or its symptoms, in a human being. Please be advised that the classification of patient management software as a medical device and the requirement for licensing is not a new approach taken by Health Canada. Manufacturers have always been responsible to undertake their own due diligence to determine regulatory requirements. Health Canada has considered software of this nature a medical device for several years. Health Canada did not create the notice regarding patient management software with specific ‘information systems’ in mind. It has always been Health Canada’s role to review medical devices to assess their safety, effectiveness and quality before being authorized for sale in Canada.

According to the US FDA’s interpretation, a medical device is “intended for use in the diagnosis of disease or other conditions, or in the cure, mitigation, treatment, or prevention of disease, in man or other animals.” It almost sounds like software vendors in Canada recognized their own products as medical devices and had them evaluated as such, but US vendors have staunchly argued that their products aren’t covered. Software that displays or manipulates lab results, provides diagnostic suggestions, or manages drug therapy seems to fall into the broad category as laid out by FDA.

Ten software developers in Rwanda who work on the OpenMRS EMR graduate from an 11-month course called e-Health Software Development and Implementation, part of the country’s effort to transform itself into an IT hub.

The Center for Connected Health and Mass General buy a Tandberg telepresence videoconferencing system for telemedicine. I thought they dealt more with home medical sensors and monitoring, but maybe the mission has changed.

A med student and his programming partner (isn’t that who always creates medical apps?) develop iMurmur, an iPhone-based learning tool for heart murmur. It has sold 15,000 copies to users in 35 countries, pushing its price from 99 cents to $2.99 and leading to its acquisition by a digital stethoscope company.

The King of Jordan hosts hosts a public demo of its VistA system, implemented by Perot and the non-profit Electronic Health Solutions. Jordan is creating a VistA educational program to make itself self-sustainable.

Jobs: Director of Business Development, Clinical Application Educators, Cerner Remote PathNet Support.

Half of the doctors responding to a British survey say they are too busy typing into the computer to look patients in the eye. One doctor said, “The demands of the patient’s agenda, the Government’s agenda and the requirement that everything I hear, say and do must be meticulously recorded make for an extremely crowded consultation.”

John at Chilmark Research finds interesting facts about the Dossia PHR. After they parted ways with Omnimedix and hooked up with the Indivo platform from Children’s Boston, they found that Indivo wouldn’t scale, so they had to rewrite it. John outlines other problems they’re having. One I’ll add is that PHRs aren’t exactly lighting up the skies and Google and Microsoft are formidable competitors for what little interest there is.

Odd lawsuit: welfare recipients in Michigan file a class action lawsuit against the state for not paying for adult dental benefits. The state is broke, of course.

Also going broke: California, which paid $2.1 billion in overtime to state employees last year. One state hospital nurse made $733K in overtime in a five-year period, while two other nurses at the same hospital made $132K each per year, twice their annual salary.

E-mail me.

HERtalk by Inga

The US Postal Service finds CalOptima’s missing CDs that contained unencrypted personal data on 68,000 members. The package landed in a secure postal facility in Atlanta and the disks appear to be intact.

GE Healthcare’s Medical Quality Improvement Consortium (MQIC) is submitting anonymous clinical data to the CDC to provide H1N1 tracking information. MQIC is a repository of de-identified clinical data captured from GE’s Centricity EMR users. Every 24 hours, MQIC is forwarding updated data that’s been collected from 14 million record patient records. Great use of EMR data, though I wonder if the patients (and/or providers) are aware their de-identified clinical data is being used for this purpose. Or if they need to know.

Would you be more willing to travel to Thailand for surgery if you knew the hospital was using Microsoft HealthVault to document your treatment? Me neither. Hospital officials at the Bumrungrad International Hospital in Bangkok seem to think it will add to their appeal. I believe the $5,000 knee replacement that would cost $50,000 at home is still the bigger draw.

St. Paul Eye Clinic (MN) selects SRS EMR for its 15-provider group.

API Healthcare announces that seven new hospitals have signed on for its human capital management solutions.

El Camino Hospital (CA) deploys Web performance monitoring solutions from Gomez, Inc. The performance and availability monitoring applications will concentrate on El Camino’s recently launched public Web site and its physician application site.

Ingenious Med reports that nine new organizations have added its inpatient practice management system over the last three months.

I love my iPhone, so I was not surprised to learn that 99% of all iPhone users are happy with their smart phones. In fact, we are two times more likely than BlackBerry users to say we are very satisfied. I’m not sure I can think of any other consumer product with a 99% satisfaction rating.

Speaking of iPhones, Harvard Medical School launches an application to update consumers with the latest H1N1 flu virus news, including tips for shaking hands or other body parts to avoid the spread of virus. (Do people seriously do this?)

One last iPhone comment: here’s a nice list of healthcare applications, complete with product summaries and pricing.

GE expands its healthymagination campaign, launching a new e-health business unit that is focused on connectivity among providers, hospitals, and patients. While the announcement suggests that GE is jumping into a brand new world, the core products sound familiar: LifeSensor PHR, Centricity HIE, a clinical portal, and master patient index technology. I guess GE wasn’t too concerned over the use of “eHealth”, even though the folks in Ontario sort of sleazed up the name.

Allina Hospitals collaborates with CVS’s MinuteClinics to align clinical care operations and medical oversight. Allina and MinuteClinic will also develop interfaces between their two EMR systems.

Regional Medical Center Anniston (AL) selects ProVation MD software for cardiology procedure documentation and coding.

A Florida man opens his mailbox and finds an envelope containing medical records of over 70 people. The full chain of events is unclear, though a postal employee or two seem partly at fault. Just a reminder that while we might one day have fully secure EMRs, we’ll never rid the world of stupid (lazy?) people.

Send Inga a scary note

News 10/28/09

From Midnight Oil: “Re: Australia. The South Australian Department of Health has posted a notice on its Web site for a Vendor Conference on November 13. The RFP, to be issued in mid-December, is for a full EPAS (enterprise Patient Administration System aka HIS) and an EHR, plus Billing, Mental Health, Oncology and ED as optional components.”

From The PACS Designer: “Re: Windows 7. TPD was thinking of buying Windows 7 to load on a laptop, but now will wait based on what PC World had to say about it. It appears that the install procedure has several flaws in it, thus frustrating buyers of this new operating system. A major flaw is not recognizing the product number after entering it as instructed by the program!” I think many of the problems came from that student discount version that I have a coupon for, which had some kind of snafu with Digital River’s download package. In the mean time, I installed a Snow Leopard upgrade the other day without doing anything more than starting it and checking back a few minutes later to make sure it finished. And unlike the XP-to-Win7 “upgrade,” it did not require a fresh install. Advantage: Apple.

From HISFan32: “Re: Waterbury Hospital. Despite having spent mucho dinero on a consultant over the last five months to evaluate Meditech, WH has decided to retain Cerner on a RHO basis. Why they wasted money on this foolish endeavor is beyond reason. They had only had a successful install of Cerner only a few years ago.”  

 

SRSsoft of Montvale, NJ has become a Platinum Sponsor of HIStalk, which Inga and I appreciate very much. The company offers a hybrid EMR (“specifically designed for high-performance, high-volume, high-revenue practices”) that focuses on workflow, not physician data entry, and thus enjoys a 100% adoption rate. Their site contains 106 testimonials that include the practitioner’s name and location (don’t you hate anonymous product testimonials that you can’t check?) CEO Evan Steele’s blog, EMR Straight Talk, is here. I’m impressed with the executive team’s credentials (lots of Ivy Leaguers, a former naval aviator who served in Vietnam, and even a sales EVP who has a Harvard MBA). Thanks to those folks for supporting HIStalk. I was going to take their six-question Stimulus IQ Test, but I was afraid I’d do poorly and would have to disclose that fact.

The Coalition for Patient Privacy urges HHS (warning: PDF) to repeal its HITECH interim rule covering breach notification, complaining that organizations involved in a breach don’t have to notify anyone if, in their judgment, those people whose information was compromised won’t be harmed by the exposure.

Professor Jon Patrick of the University of Sydney says the government should cultivate development of local open source expertise instead of importing proprietary software that wasn’t designed for Australia’s health system. I asked if he’d heard more about why the University pulled his article critical of an ED system implementation offline last week, but he still doesn’t know.

McKesson announces Q2 numbers after the bell: revenue up 2%, EPS $1.13 vs. $1.19, which beat expectations. Shares are up a little in after hours trading.

Speaking of McKesson, former HBOC chairman Charlie McCall is on trial again in San Francisco. The US attorney claims Charlie and general counsel Jay Lapine cooked the books to inflate revenue right before McKesson insanely bought HBO & Company for $14.5 billion in 1998 (nearly 40 times even the phony earnings), only to see its own shareholder value drop 48% just months later when the house of cards collapsed. McKesson shares still haven’t recovered from the mini-Enron, priced today lower than in their pre-HBOC heyday in 1998 (not to mention the nearly $1 billion McKesson paid in 2005 to settle shareholder lawsuits). Charlie’s mouthpiece told the jury today that his man was wronged by his trusted lieutenants, who conspired without his knowledge to write side letters and recognize phony revenue. That mouthpiece, of course, has an impeccable track record of defending those accused of white collar crime, including former labor secretary Ray Donovan, former agriculture Mike Espy, former Cheney chief of staff Scooter Libby, junk bond king Michael Milken, and the corporations behind the Exxon Valdez environmental disaster. He got Charlie and Jay an acquittal on one charge and a mistrial on the others in 2006, so here they are again in a retrial. Not to be pessimistic, but I feel sorry for a barely-six-figures assistant attorney who has to butt heads with Charlie’s uber-expensive dream team.

Cerner and Eclipsys are the final two vendors being considered to implement clinical systems for Sidra Medical and Research Center in Qatar. It must feel odd not to see Epic sitting across the table.

Speaking of Cerner, Hospital de Denia is the first in Spain to move to a single-vendor EMR, using Millennium.

Vocera ships its first smart phone, developed by Motorola and running Windows Mobile. It supports dual-band wireless networking and supports a fixed number and role-based permissions. It does not look like a Star Trek communicator, however, unlike the original Vocera badge device.

The Wall Street Journal lists the HIT vendors that were sent Senator Chuck Grassley’s letter asking for contract and product defect information: 3M, Allscripts, Cerner, Cognizant, CSC, Eclipsys, Epic, McKesson, Perot, and Philips. I’m not sure why some of those companies were included since they don’t sell inpatient EMRs (and what about Meditech, QuadraMed, Siemens, IntraNexus, Healthland, etc.?) Maybe he actually got complaints about these specific 10, which seems unlikely. This will be fascinating to watch in any case – what will the fiercely independent and reclusive Judy Faulkner do? And will the CEOs make nice long enough to ask each other whether they plan to comply and to what extent?

Thanks to Health Data Management writer Joe Goedert, who credited HIStalk in his story about the CalOptima data breach. Lots and lots of press get their ideas and sometimes their actual stories from here, but it’s uncommon for them to give credit. He and I have swapped e-mails a couple of times and I consider him first rate.

A reader forwarded a technical alert from McKesson that warns Horizon Clinical Infrastructure clients that hard-coded passwords were posted on the Internet. I found the document refreshingly free of mumbo jumbo as it listed some user actions that hopefully aren’t new to anyone technical since they are basic auditing stuff: check your firewall, disable TELNET, enable SSH, and change system-level and Oracle passwords. I’m no security expert, but the exposure seems minimal — any bad guy would need to penetrate the firewall and get into the application or database server to do any harm (the passwords don’t work from the application, I assume). Most interesting to me was the reminder that McKesson’s documentation is “Produced in Ireland,” as it says at the bottom of the notice. That always strikes me as both odd and fascinating. I may need to inspect the facility first-hand at someone else’s expense to augment Senator Grassley’s inquiry.

A cardiac hospital in Malaysia goes live with the myCare2x open source hospital information system. You can run the demo system live here, although it didn’t work for me in Firefox but did in Chrome.

Some nice news on QuadraMed CPR, which got four new sales. Everybody always forgets about them as a clinical systems player, but in the last system selection I was involved with (admittedly years ago), our nurses and I liked their product better than those of the competition (although it was Per-Se Patient1 at the time and we weren’t sold on the company). Shares are close to a 52-week high.

Kaiser Permanente will start a pilot in January in which it will exchange patient information electronically with systems from the VA and DoD (that comment is way down the page in the next-to-last paragraph of the story, but I don’t think I’ve heard it until now).

iPhone clinical alert vendor Voalte is profiled in its hometown paper in Sarasota, FL, along with its customer Sarasota Memorial Hospital. The reporter noticed the pink pants the Voalte people wore at HIMSS. 

Dossia announces that its PHR can now manage information for both employees and their dependents.

The Wii Fit is the first computer game to be endorsed by British government, specifically the NHS. Nintendo will use the NHS’s Change4Life logo in its advertising. I can say first hand that it’s amazing, especially now that other really good fitness software has come out that uses the Wii console and the balance board (Wii Fit Plus, Gold’s Gym Cardio Workout, Active Life Outdoor Challenge, My Fitness Coach, etc.)

Odd lawsuit: Nevada’s controlled substance prescription database flags a woman buying large quantities of hydrocodone and Soma, so the Board of Pharmacy sends letters to 14 Las Vegas pharmacies warning them that she could be a drug abuser. A year later, the impaired woman runs over a motorist changing a tire on a highway shoulder, killing him and seriously injuring another man who was helping him. The survivor and family of the deceased man are suing Walmart, Walgreens, CVS, Rite Aid, and other pharmacies, claiming they shouldn’t have filled her prescriptions after receiving the state’s warning. Drugstores say they’ll get sued by both sides: for refusing to fill questionable prescriptions or for filling them for someone who later causes harm.

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HERtalk by Inga

Peeking doesn’t pay, as evidenced by the federal sentences handed down to three Arkansas healthcare workers. A physician and two hospital workers are ordered to pay fines and are sentenced to probation after improperly accessing the medical records of a slain TV reporter. The doctor received the harshest judgment, which included one year of probation, a $5,000 fine, and 50 hours of community service educating professionals on HIPAA.

Carroll Hospital Center (MD) implements multiple applications from Lawson Software, including enterprise financial management and asset management suites, Lawson Business Intelligence, and HR management suite.

Picis says that over the last two quarters, six large IDNs have contracted for the Picis LYNX E/Point revenue management solution. Picis also announces it has extended its relationship with The Sullivan Group, a provider of risk management and performance solutions for EDs. Under the multi-year agreement, the companies will integrate the Sullivan Group’s risk management content with Picis ED PulseCheck.

I normally wouldn’t mention a news piece like the article above, posted on Foxnews.com. However, the headline caught my attention and I think some of Mr. H’s grammar and spelling snarkiness must be rubbing off on me.

Blood Bank of Alaska selects Mediware’s LifeTrak Technology for blood donor management.

Virtua, a multi-hospital healthcare system in New Jersey, selects NextGen EHR for its Medical Group network. In addition to implementing NextGen across its 23 locations, Virtua will offer NextGen EHR to its community-based physicians.

Congratulations to all the employers named to Modern Healthcare’s 100 Best Places to Work in Healthcare. Sadly, HIStalk came in at #101 and thus failed to be mentioned. But, Mr. H says it was an honor to be nominated.

When it opens its doors next year, The Roy and Patricia Disney Family Cancer Center (CA) will use the latest oncology products from Elekta. This includes EMR, workflow management systems, and treatment planning.

The Brooklyn Hospital Center (NY) contracts for several Eclipsys Sunrise applications.

Privately held Sunquest Information Systems reports that its fiscal year 2009 (ending May 31) was the most successful one in its 30-year history. Its FY2010 first quarter was also strong, with sales up 30% from the previous year.

Rhode Island becomes the first state to use e-prescribing records to track the spread of swine flu statewide. A brilliant example of using HIT to improve patient care (although the tracking is based on prescriptions of Tamiflu and other antivirals). Maybe things are different in Rhode Island, but in many parts of the country, physicians are reluctant to prescribe antivirals, so maybe the data isn’t all that helpful (although the directional trend may be valid). Still, I like that someone is at least trying to use that data for more than tracking prescribing trends.

New Mexico Governor Bill Richardson names the NM Health Information Collaborative the state’s official HIE. The organization will partner with MedPlus to create the HIE infrastructure to connect with physicians.

Rex Healthcare (NC) introduces Rex Express Care urgent care clinic wait meter for smart phones. This handy application (with a long name) provides instant wait time information for each of Rex’s three urgent care clinics. Great idea , but more importantly, it has helped me come up with an even better application. You know how the airlines will send you a text or e-mail telling you the status of your flight? How about an application that sends a similar note saying whether or not your doctor is running on time? Just think how handy it would be to know your doctor is 30 minutes behind so you have extra time to keep working or to stop off for a Starbucks. I’m sure it could be automated to some sort of appointment scheduling system. Feel free to steal my idea as long as you call it the Inga Meter.

The New York eHealth Collaborative appoints David L. Whitlinger its new executive director. The organization also announces it has received a $35 million grant from the State of New York to support the NYeC’s efforts to advance HIT implementations.

Regular HIStalk reader Jon Wikstrom sent over a note saying he has posted an album to Pandora. “You were the first person who ever made me aware of Pandora, though there seems to be wide recognition of it now whenever I mention it to someone.” I guess I mentioned Pandora a year or more ago, when I first set up IngaRadio (which is still out there, by the way.) Jon’s got some sweet vocals (in a James Taylor-ish way) with some jazzy influence. It may not be edgy enough for those favoring Mr. H’s picks, but I’d give it a thumbs up.

E-mail Inga.

Monday Morning Update 10/26/09

From Croc Dundee: “Re: academic censorship! The Australian Ministry of Health has forced the withdrawal of Dr. Patrick’s essay on EHR problems in the ED in NSW. See his page now – the download is disabled. Was Cerner involved?” Beats me, but Scot Silverstein archived a copy. It’s anecdotal, opinionated, and more of an editorial than a research study, but interesting. The fact that someone doesn’t want me reading it sent me looking for a copy. Jon Patrick tells me the university took it offline late Friday afternoon and he’s meeting with them Monday to find out why. Rumor has it that complaints were made.

From Fil_Peed: “Re: Eclipsys User Conference. Mr. Pead’s ‘joke’ went over like a lead balloon. Here was the opportunity for him to make a mark on the client base, many of whom he was meeting for the first time, and instead he makes an off-color analogy to what one should do in bad economic times and customers started walking out.” I’ll withhold judgment until someone tells me what he said.

From HITGhost: “Re: lost data. CalOptima reports that its claims imaging vendor, ImageNet, accidentally sent out unencrypted DVDs that contained claims from 68,000 of its members. The DVDs were sent to CalOptima via certified mail, but never reached CalOptima. CalOptima actually posted this information and identified ImageNet on its home page.”

From Avon Calling: “Re: a paperless and telephone-less, state-of-the-art hospital. Babies turn blue, but are always OK. Did Han write the classic CPOE-caused mortality paper from this hospital? And with all of those computers, there are gaps in the record?” UPMC’s Children’s Hospital of Pittsburgh is criticized by the state health department for not responding to a report in which a baby’s mother claimed her baby turned blue but nurses didn’t respond to the emergency alarms. The mother says the nurse’s emergency alert phone wasn’t working, but the hospital disputes that. According to the investigation report, the alarm phones that were claimed not to work were from Emergin (Philips). Children’s was indeed the subject of a 2005 journal article that showed that the use of Cerner Millennium for CPOE was the second-best predictor of patient death, behind shock but ahead of coma (I criticized that conclusion right after and I’ll stand by that – the hospital made some spectacularly bad implementation decisions).

From Ex-Cerner Guy: “Re: Methodist-Gary. They have lost $220 million over the past five years. The consultant was suggesting Meditech, a system they might be able to afford and still be able to pay the consultant.” It’s hard to believe that one hospital would, over just a few years, sign with Epic, drop it for Meditech, and then contemplate going back to Epic.

Speaking of Cerner, St. Bartholomew’s Hospital in London faces fines of $650,000 per month for lengthy patient backlogs that it blames on the “dreadful” Cerner Millennium. I doubt it’s that simple, but blaming the computer is always convenient.

Listening: Muse. I mentioned them before, but I cannot get enough of this band, maybe the best music I’ve heard in a few years. The live album, Haarp, shows they aren’t just studio overdubbers. My highest recommendation.

Welcome and thanks to Dentrix Enterprise, now a Platinum Sponsor of HIStalk. The company is featuring its Dentrix Enterprise Electronic Dental Record, the industry-leading paperless, centralized record system for community health centers. You can read a product review by the National Network for Oral Health Access here (warning: PDF – it’s on page 29). Dentrix Enterprise is a wholly owned subsidiary of Henry Schein, Inc. a Fortune 500 company with annual sales of over $6 billion. Thanks much to Dentrix Enterprise for supporting HIStalk.

GE says the rumor about its Centricity Cardiology layoff is not true and that the system continues to be sold, installed, and developed. Instead, my contact says, “We’re just migrating the business from local to global over the next few years and have shifted some resources for future project development to avoid redundancies.” Sounds like the product is fine but the people working on it aren’t.

A fun practice EMR comment from Gartner’s Wesh Rishel: there are hundreds of systems, not including those developed by “nephews of doctors.” On ARRA: “If they put up $44,000, they don’t want the doctor to buy (Microsoft) Office and open a spreadsheet.” He also predicts that those hundreds of EMRs will shake out to 10. The same article (which is excellent and objective, by the way, since it was written by a local paper’s reporter) quotes Cleveland Clinic CEO Toby Cosgrove on EMRs: “Whether it will drive down quality, I don’t know. It doesn’t increase efficiency or lower costs.” Cosgrove says he told the President that the biggest savings will come from e-prescribing.

A Mass High Tech article covers Lawrence General Hospital’s IT systems, including its Picis ED PulseCheck system that an ED doctor says reduced wait times by more than 30 minutes and reduced ED walkouts from 6% to 1%. It also notes that transcription costs were reduced by $600K per year and revenue was increased by $5 million for IV charges alone through accurate documentation. The hospital will replace most apps (not the EDIS, though) with McKesson Paragon.

The e-mail update subscriber list just passed 4,800 people, some of whom are your archest of enemies and competitors who will read (and possibly act on) time-sensitive news before you if you haven’t entered your e-mail address in the Subscribe to Updates box to your upper right.

CPSI announces Q3 numbers: revenue up 8.7%, EPS $0.37 vs. $0.38.

Two universities get ARRA grants for EMR projects related to genomics. University of Virginia will collect $1.9 million to create a genome-enabled EMR that will be part of Epicare. Vanderbilt is given $415K for its Vanderbilt Genome-Electronic Records project, which will look for a link between blood values and arrhythmia and also develop natural language processing tools to mine EMR data.

Bloomberg profiles rookie private equity manager David Brailer, whose Health Evolution Partners has invested $120 million of California pension money from Calpers so far. He says he will invest $150 to $200 million each year starting next year. A pension consultant comments, “No matter how you look at it, $1 billion is a lot to allocate to someone with no track record.” Some of the biggest investments so far involve radiology. One investment that sounds interesting is in Triveris Inc., which offers an add-on insurance plan just for diabetics that emphasizes preventive care using software to identify diabetes risk. It’s part of Health Network America.

TriZetto issues a press release to notify an impatient world anxious for yet another PHR that “additional features and functions” of its own version will be ready by year end. The opening sentence of the breathy press release is possibly the most awkwardly structured and confusing sentence I’ve read lately.

Not Yet sent a copy of an October 16 letter sent by Senator Chuck Grassley to Cerner and nine other big HIT vendors (I posted the full letter here). The Senator said, as the ranking member of the Senate Committee on Finance, that he is collecting information about healthcare software defects. He cites “learned intermediaries”, “hold harmless”, and “gag orders” clauses that let software vendors shift responsibility to users and prohibit them from disclosing defects. The Senator asks whether the vendor’s contracts include those provisions, asks for copies of all user correspondence involving software complaints or concerns, requests documentation of any lawsuit settlements, asks whether the vendor has offered financial incentives to facilities or providers to get them to choose its products, and wants to know how the vendor tracks reported defects.

My most recent poll asked about your plans for Windows 7. The voting was pretty evenly divided, but reading between the lines is interesting. Around 37% of reader employers plan to use Windows 7 compared to 61% of those readers themselves. New poll to your right, suggested by a reader: what would your reaction be to seeing the CPHIMS credential on the resume of a job candidate?

Perot (soon to be Dell) announces that it has been contracted to develop a plan for a city-wide RHIO in Changsha, China.

NIH awards the University of Florida a $12.2 million stimulus grant to develop a Facebook-like social network that will allow scientists to find research opportunities.

The creator of the MySQL database says Oracle should sell it to a third party to soothe antitrust concerns about its Sun Microsystems acquisition. Suggested buyers were Red Hat or Novell.

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News 10/23/09

From Bill Costanza: “Re: HIMSS keynote speakers. I’ve ranted to HIMSS about the lame speakers who have no bearing on either IT or healthcare. They would rather have vapid celebrities to entertain the troops. I can just see Bob Hope and his golf club on stage.” I quickly came up with 10 I’d like to see: (a) Bill or Melinda Gates (to talk about global health and atone for Ballmer); (b) Larry Ellison (an entertaining wacko); (c) Richard Grainger (to describe the folly of massive civil works healthcare IT projects); (d) Barack Obama (he hasn’t done much, but he’s maybe the funnest and nicest President so far); (e) Suzanne Somers (cute and fun for a 63-year-old and full of all kinds of bizarre medical theories); (f) Senator Chuck Grassley (hates government and healthcare waste and suggested that AIG executives who got huge bonuses from taxpayer bailouts should quit); (g) Judy Faulkner or Neil Pappalardo (pioneering industry recluses); (h) any health bigwig from Chinese government; (i) Ben Carson (Hopkins neurosurgeon); and (j) Hans Rosling (Swedish global health expert and inventor of free healthcare statistical display software). I could also be convinced to back Artie Lange, Bill Murray, or Kate Winslet as the token celebrity.

From Doug N. Nuts: “Re: patient safety. Thought you might be interested in Bob Wachter’s commentary on the media and safety. This is an excellent site for safety in general and has great monthly CME.” The editorial postulates that hospitals in the Northeast and those known to house celebrity patients get disproportionate coverage for making medical errors, and even though hospitals shy away from the publicity, they generally emerge better after the public scrutiny (Hopkins, Dana-Farber, and Duke are given as examples). I agree completely. It’s a shame that greedy conglomerates bought local newspapers, loaded them with debt, and mismanaged them into near irrelevance — we need real reporters as public watchdogs. Since the trade rags do little original reporting of real news, especially if it makes any healthcare stakeholder look bad, almost all the big patient safety stories come from the local newspapers or peer-reviewed journals.

From Lady Pharmacist: “Re: hi. Could you put in a kind word? This week is National Pharmacy Week. There are a number of pharmacists and pharmacy technicians (both in hospitals and the vendor side of the world) involved with informatics and are trying to make software / products / systems safer as it relates to the use of medications and ultimately patient safety.” We love pharmacists and techs at HIStalk, so here’s that shout-out, especially for those who serve patients in an IT or patient safety capacity. I always give lab people credit for being excellent developers, adopters, and users of IT, but the unquestionably most complex set of functions and workflows to automate in healthcare involve the ordering, dispensing, and administering of hospital medications. As the photo above proves, lady pharmacists like yourself have been providing pharmaceutical care for at least 50 years.

From Lee Samosa: “Re: GE. GE has pulled the plug on development of the Centricity Cardiology DMS program. All of the developers and most of the support staff in the Sioux Falls office were laid off this week, leaving behind a small team of sustaining engineering and a single Level 4 support person to support the installed base.” My GE Healthcare contact is checking on this. That’s the cardiology data management systems group.

From Certifiable: “Re: Epic. Gary (IN) Methodist de-installed Epic, at the recommendation of consultants who deemed Meditech more appropriate. I have heard they are considering an Epic return.” Any hospital considering those systems as interchangeable alternatives, much less swapping them back and forth, is clearly in need of some soul-searching.

From EndoIndiana: “Re: Mr. Richard Johnson, CIO of Clarian Health. He died in the last few days of metastatic renal cancer.” Richard Frederick Johnson, 50, died Tuesday. Online condolences can be left here.

I messed up the Moment With featuring Jon Phillips last night (I was tired). I posted it to HIStalk Practice by mistake and sent out the e-mail blast without noticing. Inga caught it right away, so I then posted to HIStalk like I originally intended and sent out the corrected link (no spam intended). So, Jon is up on both sites, which I told Inga is like when the president’s speech is on every TV channel.

Dr. Gregg Alexander thanks the folks who stopped by the Pediatric Office of the Future exhibit (under the white roof during setup above) or his get-together after. He was sick as a dog, so I think he was in a daze, but he was a trouper throughout.

Omnicell’s Q3 numbers: revenue down 16.1%, EPS $0.03 vs. $0.09. The CEO says he’s happy with that and shares are up a little, so expectations must have been low.

I was talking to a colleague about today’s Windows 7 launch. Both of us longed for the good old days when desktop software was so important that people slept outside computer stores (remember those?) to be early in line when the store opened at midnight. Actually, I should correct that: there are still massive lines when products launch, but only at the Apple Store.

The nice folks at MedVentive e-mailed to let me know that they’re hosting a Webinar next Thursday, October 29 at 1:00 Eastern entitled “Measuring the Business Value of Business and Clinical Intelligence (BCI)”. The company offers intervention, registry, dashboard, and P4P solutions for providers, along with quality, scorecard, registry, HEDIS, and Medicare Advantage programs for health plans.

AHIMA will publish a new book next month called H.I.T. or Miss: Lessons Learned from Health Information Technology Implementations.

Allen Tien, MD, MHS of mdlogix checked in to say that Johns Hopkins is using the Subject and Protocol Registry of the company’s Clinical Research Management System for all of its new studies. It’s being used for 790 studies, 15,000 subjects, and more than 1,000 users in all departments.

Florence Community Hospital (AZ) brings in a new management team, among them CIO Stephen Franken, formerly CIO of San Juan Regional Medical Center (NM).

Jobs: Clinical Application Educators, IT Manager, Laboratory Systems Application Analyst.

Document management and revenue cycle management vendor HealthPort announces the terms of its upcoming IPO, with a market value of $338 million at the midpoint of the proposed range. The Alpharetta, GA company has annual revenue of $285 million.

International Medical Solutions announces availability of smart forms and Web-based mobile applications to manage informed consent processes digitally.

Fletcher Allen Health Care chooses Netezza and Business Objects for its Cerner-fed data warehouse.

Ranjan Das, the 42-year-old CEO of SAP India, dies of a heart attack. He worked for InterSystems and Oracle previously.

In London, Kingston Hospital NHS Trust goes live with Soliton’s radiologist and pathologist workflow system, powered by Nuance Healthcare and integrated with iSoft RIS, Sectra PACS, and Clinisys LIS.

Cal Berkeley researchers dream up CellScope for the developing world, a microscope attached to a cell phone that allows sending highly magnified sample images to medical experts anywhere.

A writer decries companies that jumped all over Second Life, only to leave it littered with virtual ghost towns after they abandoned them to chase equally trendy but newer technologies like Twitter. Called out: Cisco’s Virtual Palomar West, intended to promote “The Hospital of the Future” and Cisco’s medical-grade network, but now “totally deserted and mostly broken.” I’m not sure I believe that even though I always thought Second Life was an over-hyped bust.

The Quantum Group gets a delisting notice from Amex and voluntarily decides to trade its shares on the OTC BB. Amex didn’t like the fact that it “sustained losses that were so substantial …that it appeared questionable, in the opinion of Amex, whether the Company would be able to continue operations …” The company offers “a 21st Century EMR Solution” (not surprising since that’s the century we’ve been in for quite a few years now), an MSO, and provider services. Shares are trading at 55 cents, for a market cap of just over $6 million.

A hospital rabbi is fired for violating HIPAA privacy laws after writing an essay about comforting the family of a security guard killed at the U.S. Holocaust Memorial Museum. She says she didn’t say anything that wasn’t public knowledge. She thinks the hospital fired her for complaining that it pays male rabbis more, so she’s thinking about suing.

Researchers in Japan develop software that predicts with 80% accuracy the chance that a 911 caller will die. It may have application in routing ambulances to the most critically ill callers. I say license it to Hollywood to make another sequel to The Ring.

United Health posts Q3 earnings that beat Wall Street expectations, with one of its fastest growing segments being its Ingenix healthcare IT business.

CareTech Solutions is named one of the best places to work in the Detroit area.

Odd lawsuit: a psychiatric hospital patient sues the facility for $7,500, claiming it should have prevented a female employee from having sex with his roommate. She already admitted it and quit.

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HERtalk by Inga

GE launches a $250 million equity fund to invest in small healthcare technology. The GE Healthymagination Fund will focus on HIT, life sciences, and diagnostic companies developing unique and innovation business models and services. The fund is part of GE’s $6 billion Healthymagination initiative. GE’s total revenues in 2008 were $187 billion, by the way, making the $250 million equity fund look smaller than a rounding error.

System integrator Emtec expands its healthcare offering with the signing of partnership agreements with FairWarning and BridgeHead Software.

Federal authorities admit that the lack of electronic interfaces between labs and provider EHRs continues to be a challenge to the industry. Technological and financial challenges force many labs and providers to rely heavily on paper and fax options. The HIT Policy Committee heard testimony on the topic this week as it prepares its meaningful use recommendations for HHS and the ONC.

Former PracticeOne and Picis CFO Scott Lentz takes over CFO responsibilities at Aprima Medical Software. Interestingly, Lentz started at PracticeOne just this last January.

The American Academy of Professional Coders introduces an online ICD-10-CM code conversion tool that converts ICD-9-CM codes to ICD-10-CM codes (and vice versa). The tool is free and looks pretty easy to use, even for someone who knows nothing about coding (like me). Note that the site doesn’t provide any sort of data conversion of your existing files, but advises you which ICD-10 codes will take the place of the current ICD-9 scheme.

You got to know this was a painful discovery. A Canadian medical office realizes it permanently lost two years worth of electronic patient records, presumably during an EMR conversion.

Across the pond, Basildonand Thurrock University Hospitals NHS Foundation Trust awards a contract to Sentillion to deploy expreSSO single sign-on.

Integrated Medical Services (AZ) selects Allscripts’ EHR, PM, and RCM solutions for the members of its physician services organization.

The White Stone Group installs the latest version of its TRACE software at San Antonio Community Hospital (CA.) The implementation is the first for this newest release, which tracks communication across the healthcare revenue cycle. I interviewed the company founder Guile Cruz a couple of years ago and was impressed with the number of prominent clients and its highly functional product.

Presbyterian Intercommunity Hospital plays host to physicians and technicians from Singapore who were checking out the hospital’s EMR (Eclipsys, I believe). The Singapore group wanted to see an EMR in action before implementing their own at their 1,600-bed Singapore General Hospital.

Hoag Memorial Hospital Presbyterian (CA) implements Amelior EDTracker solution by Patient Care Technology Systems. The hospital will use the system to track patients in its 66,000-census ED.

Here’s a prediction that’s sure to appeal to many readers: up to 50,000 new HIT positions will be created over the next several years as a result of the federal stimulus package. A recent Robert Half survey of healthcare CIOs found that 76% were looking to hire network administrators in Q4 and 72% were positioned to add desktop support. If you need a lower-tech job, be assured that demand for medical records clerks is also on the rise, making Robert Half’s list of 10 Promising Jobs for 2010.

VeriChip continues to try to re-establish itself in the market, announcing a strategic partnership with the Diabetes Research Institute(DRI). VeriChip and DRI are developing a glucose-sensing RFID microchip. VeriChip also hopes to incorporate findings into its Health Link PRH.

I think this may be the best name ever for a business: Snoring Isn’t Sexy, LLC, which offers an online directory service to facilitate communication between patients and providers. The company just announced that it can handle the secure transmission and storage of all electronic communication. Curious logo, don’t you think? Is the suggestion that you get to sleep with beautiful women if you don’t snore, or that perhaps some beautiful women actually snore? (unlikely)

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News 10/21/09

From Winston Zeddemore: “Re: SNOWMED. Almost as bad as ‘HIPPA’ eruptions are ‘SNOWMED’ eruptions, where the terminologically naive misspell the name of SNOMED-CT. Here is a link to the latest, courtesy of Government Health IT.” Revisionist history does not work well with Google caches (see previous and current images above). While they were doctoring it up, they should have corrected physician’s to physicians’ unless they are being extra-pessimistic in assuming that only one doctor will be using an EMR by 2015 (not likely since they’re owned by HIMSS now). The same reporter misspelled it the same way in Government Computer News, so it’s time to fire up that spell check dictionary. Googling turns up several other examples by people who should know (or is that KNO?) better.

From Will Weider: “Re: de-identification. Wired finally picked up a story you highlighted months ago.” They sure chose odd sources in trying to flesh out a New York Times article about patient privacy: CCHIT’s marketing director, investment guy George Hill, and a 2007 quote from PAMF’s Paul Tang from Modern Healthcare (which they spelled wrong). They did, however, spell HIPAA correctly and put up a nice graphic from Patient Privacy Rights (although it was too small to read).

From ITRN: “Re: Epic. Did KLAS report they had a de-install in 2008?” I don’t have access to KLAS (I have no KLAS, in other words) so I’ll ask readers to chime in.

From DDD: “Re: Windows 7. I upgraded a month ago and have found it to be more and more intuitive every day. There’s no ‘killer app’ per se, but management of multiple apps, windows, files, etc. are amazingly different. Learn how to use it, and I’ll bet you become a fan.” They said that about Office 2007. At work, I de-installed Access 2007 and went back to 2003, every minute in front of Word is torture, and the only reason I don’t dislike Excel and PowerPoint is that I don’t use them much. Like they say, change is welcome only when the status quo is untenable, which it wasn’t. Maybe I should install Win7 on a spare PC (I love that PCs are so cheap that everyone has spares) and report.

From Secret Squirrel: “Re: McKesson. Horizon Clinical Infrastructure (HCI) appears to use hard-coded database passwords. A security organization has run the entire password list online.” I thought everyone knew that, but maybe not (I reconsidered adding fuel to the technical fire, so I’m not including the link). The poster was amused that e-mailing security@mckesson.com bounced back as undeliverable. I would imagine that many vendors have services that log on as “users” that may or may not use encrypted passwords, some of which give full read/write/update database privileges. I would also imagine that vendors ship default passwords (some intended as their own “back door” in case clients screw up) that unlock every system they’ve ever sold. The clients I’ve known never seem to worry much about that.

From Just Curious: “Re: EMR. I’m sure you got this question by the thousands already, but I’m curious as to what vendor your PCP uses for his/her EMR? Thanks and keep up the great work!” It’s McKesson, he told me last time, although he didn’t seem too certain.

From Enrico Brizzi: “Re: CPHIMS. I was wondering what the industry’s current view of the CPHIMS designation is, specifically in Canada since CPHIMS-CA is fairly recent.” I have my own opinions, but I will leave others to express theirs for a change.

From Sore Arm: “Re: flu vaccine. The Atlantic is running a major article questioning the received wisdom about flu vaccines and antivirals, for both seasonal flu and H1-N1.” The article speculates that the benefit of flu vaccine has been wildly overestimated due to the inherent variability in a self-selecting patient cohort (i.e., it’s healthier people who get the shot even though unhealthy ones are the target audience, so naturally they live longer). Also, that a lot of “who the hell knows” deaths get incorrectly coded as influenza. The conclusion from a noted investigator: getting the flu shot doesn’t reduce mortality rates at all. The high-powered naysayers say, studies aside, they still believe in it and don’t like all the frowny talk. The article also questions why the US government has stockpiled millions of doses of Tamiflu and Relenza despite lack of evidence that they are effective.

From Bernie Tupperman: “Re: Archimedes. Kaiser licenses it to corporations to screen employees, but you can use it free since it was licensed to the American Diabetes Association. You put in your numbers and it takes about 10 minutes to crunch your data to show your 30-year risk of diabetes, stroke, heart attack, and complications. You can then play with the numbers – what if you lose 20 pounds or start taking aspirin? This is a great patient motivational tool and I am busy telling EVERYONE.” That is just cool (access it here). I didn’t realize that it was Kaiser’s but it is definitely an eye-opener. Brilliant.

The VA engages the Industry Advisory Council to identify the issues involved with keeping and modernizing VistA. This sounds ominous: “… opportunities and impact of modernizing and deploying VistA upon private industry …” Surely they aren’t considering dumping VistA just to protect for-profit vendors.

Weird News Andy sniffs out this story about a high-tech scalpel that detects the presence of malignant cells from cauterization smoke, helping surgeons remove all parts of a tumor.

Gila Regional Medical Center (NM) chooses the Cboss patient payment portal.

Cleveland vendor Lakeshore Health System announces Urgicode, which notifies the pharmacy via a cellular network when a code cart is used, then allows restocking by bar code. They probably should have held off on the press release until they improved their Web site a bit, like maybe adding the company’s address, phone number, or that same press release.

Healthcare Growth Partners releases its Q3 2009 Healthcare IT Transaction Summary (warning: PDF). Not to give away the conclusion, but merger and acquisition activity is on the upswing.

TPD forwarded a link to the Kaiser Family Foundation’s tool for comparing health care reform proposals.

I enjoy reading comments left for articles, but I need to disclose that I have the obligation to edit or remove those with advertising, personal attacks, or questionable claims. That almost never happens, but just so you know.

GE Healthcare announces that something has finally come to market from their Intermountain relationship: a new real-time decision support product. Details were skimpy and buzzwords were ample, but it might be interesting given Intermountain’s original HELP system and the work of Brent James. It will be “unveiled” at HIMSS.

Speaking of HIMSS, I keep forgetting to mention the keynote lineup for the March conference: Sprint Nextel CEO Dan Hesse (I’ve never heard of him and Sprint’s shares have dropped from $25 to $3 in four years, so I’ll pass); celebrity doctor Sanjay Gupta (you can see him free everywhere); Harry Markopolos (him I’d see – he’s the former Army officer and securities executive who tipped off the SEC boneheads about Bernie Madoff); and pilot Sully Sullenberger (who has started a safety consulting firm and might be interesting). Given the propensity of HIMSS to grab whomever is popular at the moment, I expected Balloon Boy (like Dana Carvey and that guy who sawed his own arm off in previous conferences). I should run a poll on who they should get since I haven’t been happy with the choices for several years.

Vangent, Inc. says ONCHIT has chosen its HIEOS HIE system as a component of NHIN CONNECT Gateway Version 2.2, which includes XDS.b and XCA profiles (its open source Wiki is here).

Sequel Systems announces GA of its SequelMed Patient Portal for practices, priced at $75 per provider per month according to its site.

San Francisco IPA Brown & Toland Physicians says one reason for its spat with UCSF is that the hospital didn’t want to participate in its EMR program. From Googling, it appears that the practice uses GE for practice management and Allscripts for the EMR. UCSF, you may recall, just halted its own GE Centricity Enterprise project. According to a rumor posted here last year, the IPA was threatening to cut off referrals to doctors who wanted to stop using its EMR and billing services.

More e-health fraud accusations in Canada, this time in British Columbia. Allegations have been made that health ministry officials paid falsified invoices and improperly chose vendors for an $108 million project.

And more: Canada Health Infoway is under government scrutiny for heavy use of consultants, missed deadlines, and having spent $1.6 billion so far with another $500 million on the way. The newspaper article points out that Infoway fell far short of its goal of covering 50% of Canadians with an EMR by March 2010, currently stuck at 17%. The federal auditor’s report will be out next month.

Geisinger Health System (PA) partners with Navigant Consulting to offer consulting services, including those related to EMRs and process improvement. I’m not sure how I feel about that or any other hospital business that has nothing to do with caring for their own patients, but it’s all the rage.

The managing partner of consulting firm Courtyard Group, stung hard by the reports of auditors investigating eHealth Ontario, says his firm was deeply entrenched in the project, but only because the agency’s people were clueless and without goals. He claims the company billed only $7 million of an authorized $10.6 million. His quote about the predecessor agency Smart Systems, which spent $800 million to build a non-Internet based network that went mostly unused: “I remember a conversation with the previous CEO of Smart Systems and he was very proud of the fact Ontario was the only jurisdiction in the world building a private health network. My reaction was, maybe the fact we are the only ones doing it might be an indication this is a bad idea.”

Epocrates announces that its drug reference will run on BlackBerrys.

Virtual Radiologic upgrades its vRad Enterprise Connect product work with new mobile device and speech recognition support.

Cedars-Sinai and GE Healthcare get their first lawsuit (of many, no doubt, and this one seeks class action status) over the CT radiation overdoses caused by unnoticed equipment settings.

Odd: the IT guy at an animal hospital changes the computer system to record a Valium tablet dispense when artificial tears were ordered, allowing him to pocket 18 of the tablets worth $3. The animal hospital let him slide after he quit over it, but then filed a report after the admitted addict tried to claim unemployment.

MIT’s Technology Review interviews ONCHIT head David Blumenthal. I like his terse answers: the writer asked why insurance companies don’t push EMRs, and he said, “The insurance companies have been able to pass along the costs of waste in our health-care system to their clients.” When asked about why progressive hospitals like Blumenthal’s own Mass General don’t share data, he said, “There has never been a business case for health-information exchange. As a matter of fact, there has been a negative case: if you give away your information, you may lose it. You may lose the patient.”

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HERtalk by Inga

California-based St. Joseph Health System cancels its Perot IT outsourcing contract and establishes a new system-wide service center in Lubbock, TX, expecting to add 60 jobs and $3.1 million in salaries the first year.

Healthcare deals represented nearly 30% of all US mergers so far this year, based on dollar value. Typically, healthcare represents only 10%.

Swedish company Anoto Group announces that the EDs at Western Maryland Health System have transitioned to MEDITECH’s EMR and are using Anoto’s digital pen and paper technology. In case you missed it, I mentioned a similar product called Shareable Ink that I saw at last week’s MGMA meeting. As long as the data capture will fully integrates with the EHR and the price point is reasonable, I think the digital pen technology has a lot of potential.

I’m thinking about trading out my Snuggie for one of these. Arizant Healthcare introduces a fully covered hospital gown that features a built-in warming system that blows warm air through tiny holes in the garment. The “Bair Paws Flex” gown sounds like the perfect Christmas gift for that hard-to-buy-for relative.

Cerner teams up with CDW to promote Cerner’s PowerWorks, the first time Cerner has offered its ambulatory suite through a national partner. Clearly Cerner wants to make sure it receives its share of the ambulatory EHR money that vendors expect to flood the market.

Picis announces that 25 hospitals have selected its Anesthesia Manager software this year. Among the new contracts are two with the VA for Picis Anesthesia Manager, PACU Manager, and Critical Care Manager.

University Children’s Eye Center (NJ) selects SRS’s hybrid EMR product. The Eye Center’s physicians are on faculty at RWJU and St. Peter’s University Hospital.

Axolotl Corp. realigns its management team, naming a new president, COO, and two VPs.

Wolters Kluwer Health announces new sales, including SwedishAmerican Health System’s (IL) and Signature Healthcare Brockton Hospital’s (MA) purchase of ProVation Order Sets to automate authoring and maintenance of evidence-based order sets. Sadler Clinic (TX) is also adding ProVation MD for procedure documentation and coding.

Oregon Health & Science University says it has received $51.5 million in ARRA funding, which has helped create 116 full- and part-time jobs. That’s about $444,000 a job, though the university does expect to add more. So far, the grants have funded over 100 research projects which require additional lab employees.

Eclipsys names six winners in its 2009 Circle of Excellence Awards. Winners had to demonstrate innovation and achievements in  process improvement, adoption, or collaboration, or actively participate in the Eclipsys ClientConnect program. Recipients were given $2,000 to be donated to a charity of their choice.

Rutland Regional Medical Center (VT) agrees to serve as a national host site for visiting community hospitals. Rutland will demonstrate to visiting clinicians and administrators how they utilize various GE solutions.

The MEDSEEK folks informed us of their ranking in Deloitte’s Technology Fast 500 program, based on the company’s 346% fiscal year revenue growth over the past five years. There was no healthcare-specific grouping. but I identified several in the “software” group. Congrats to GetWellNetwork, CAREfx, Red Hat, CodeRyte, athenahealth, and other HIT companies making the list.

BryanLGH Medical Center (NE) contracts for Salar’s electronic forms tool.

NorthBay Healthcare (CA) retains PHNS to assess its readiness for obtaining ARRA funding, an example of stimulating the economy without the government spending a dime.

Physicians are using Kryptiq’s escriptMessenger software to send 310% more electronic prescriptions than last year. Its 10,000 users send about 1 million electronic prescriptions per month. I think it is safe to say that e-prescribing is finally catching on, in the same way everyone has long been predicting EMR will.  Hard to believe it has been 5-1/2 years since George W. Bush made mention of computerized health records in his 2004 State of the Union address.

Social media update: I now have 25 friends on Facebook (and frankly pretty amused by the amount of time some of our readers spend doing goofy quizzes). Also, 216 connections in LinkedIn (which is about 100 less than Mr. H, but who is counting?) Also, 574 followers on Twitter (200 less than Mr. H, not that I noticed.) Forever the undercard.

E-mail Inga.