News 11/21/08

From Wayne Twitchell: "Re: Boston Globe article. If you’re charged with something serious like manslaughter, do you get the local city/town lawyer to defend you, or do you go into one of the big city firms who have a lot of resources and do a lot of extra things (pro bono work, research, etc.) that a small local firm can’t do? I go with the big city firm. The defense and the outcome could be the same, but it’s my life we’re talking about. Granted, the national (or local) healthcare situation is different in that we’re all paying insurance and there’s the perception that our costs are going up because big city hospitals are getting more money for the same things that community hospitals do. But I think it’s unfair to compare a big hospital or hospital system to a community hospital just because they do some of the same stuff." 

From The PACS Designer: "Re: digitally connected patients and SOA. Intel has entered the digitally connected patient field with a new FDA 510(k) approved application called the Intel Healthguide which allows clinicians to monitor remotely the activities and conditions of their patients. Additionally, Intel will be using service-oriented architecture (SOA) to accomplish the monitoring tasks." Link.

From Unknown1: "Re: health benefits. I think it would be very interesting for you to do a poll on the current health benefits employers are providing their employees this year due to increasing costs of services, economy, etc. Here is a link describing the new plans UnitedHealth Group is providing all its employees. They are only offering plans with HSAs; annual deductibles of $4.6K per family and nearly $10K for annual out of pocket expenses. It is very disappointing to see a leading healthcare insurance company treat its employees the way it treats the providers — squeezing every last dime out of them." Link.

Listening: Camper Van Beethoven, 80s college radio eclectics whose music crosses all genres (and who knock out a respectable Pink Floyd cover).

CCHIT is only halfway covering its budget through certification fees so far, so they’re wondering if Obama will fund them after their federal contract ends on April 19. Seems like just about every Bush HIT goal didn’t amount to much except to get David Brailer a cushy post-government job (thriving RHIOs, EMR adoption, a strong ONCHIT, adoption of VistA, etc. were all kind of a bust) but at least CCHIT has had tangible results. Whether that’s good or bad depends on who you ask.

The Decatur paper writes a feature on St. Mary’s Hospital (IL) and includes a photo of its MEDITECH system.

Google’s SecondLife killer, Lively, dies early in its FirstLife.

Also kaput: the print version of PC Magazine, bowing out after a 27-year run to become an online-only publication. At the rate print publications are shrinking and dying, we’ll have plenty of trees.

To your right: put your name in the Subscribe to Updates box to join thousands of readers who get instant notification when I write something new. Or, right below that, click the Email This to a Friend icon to pop up a handy-dandy form to easily e-mail everyone you know to convince them to read HIStalk and help reduce the neurotic behaviors that Inga and I exhibit when we worry about being unpopular. The Search HIStalk box Googles through the 5.5 years of HIStalk, while clicking the ugly green box below it lets you send a confidential message (with attachments, even) to me like we were spies or something. And please, if you have the interest, please click some of those sponsor ads to your left to avoid me having to explain to some Internet hotshot company VP why they aren’t getting clicks and therefore will not be renewing their sponsorship, which will then raise those neurotic behaviors all over again.

AHRQ gives University of Texas School of Health Information Sciences at Houston a $1.3 million grant to train six students for five years on HIT. They’re working on interesting projects.

Jobs: Soarian Consultants (MA), Epic Resolute Consultant (PA), Multiple Epic Positions (CO).

Henry Ford Health System gets an eHealthcare award for its Web site.

Struggling Canadian EMR vendor MedcomSoft sells its Canadian Medworks 4.0 customer base to HTN for $85,000. Could be related to this announcement, in which a Canadian investment company places a $100,000 loan "to a third-party company in the healthcare/technology sector … to undertake a strategic acquisition." Seems like those numbers should have some additional zeroes to be worthy of press releases.

UCSD (CA) chooses FairWarning for privacy auditing.

Kindred Healthcare (KY) will use Allscripts Referral Management.

Document management vendor DB Technology names Charles Wilson as CEO.

At least it isn’t more Cerner problems: Royal Free Hospital in Hampstead has its ambulance booted. The private towing company said signs were clear, but the ambulance’s tracking equipment showed it was left for just one minute while the driver helped a patient into a dialysis facility.

Also in the UK, nurses are monitoring patients who transmit data to hospitals by cell phone. The t+ Medical software costs around $30 per patient per month.

And still again in the UK, IT systems three London hospitals are shut down and ambulances diverted after the Mytob mail worm is discovered on some PCs.

Unrelated: kudos to Rep. Gary Ackerman of New York, grilling the CEOs of the Big Three auto companies on why taxpayers should underwrite their continued incompetence: "There is a delicious irony in seeing private luxury jets flying into Washington, D.C., and people coming off of them with tin cups in their hand, saying that they’re going to be trimming down and streamlining their businesses. It’s almost like seeing a guy show up at the soup kitchen in high hat and tuxedo. It kind of makes you a little bit suspicious. Couldn’t you all have downgraded to first class or jet-pooled or something to get here? It would have at least sent a message that you do get it." 

A reader points out another way to help disabled war veterans (other than clicking the Project Valour-IT graphic to your right): donate money or raise puppies for Canine Companions for Independence.

Lofware announces Web services capability for its print server.

A New York Times article profiles American Well, which offers 10-minute virtual patient visits with physicians by Internet webcam through insurers. Interesting: AIG is providing malpractice insurance and it’s cheap enough that the health plans are paying for it instead of charging the docs. The company is a HealthVault partner. Almost everyone on the leadership team came from TriZetto.

Acquisition expert Derek Eckelman joins Sunquest as VP of business development.

Mammoth Hospital, which is anything but mammoth at 17 beds but is in Mammoth Lakes, CA, implements DeviceLock USB security. Some nice quotes are included from IT operations supervisor Paul Fottler. Sounds pretty cool: network admins can lock out USB ports, WiFi and Bluetooth adapters, peripheral devices, ports, printers, and other plug-and-play devices on PCs, even by day of the week and time. It also enforces encryption policies. It’s $42 each. PC Magazine gave it four stars and the company has some interesting free downloads: Plug and Play Auditor, Active Ports, Active Shutdown, and several other utilities.

The iCEphone, originally developed for the British military by The Medical Phone Ltd. of Edinburgh, Scotland, will be sold in a medical/emergency software configuration.

E-mail me.

HERtalk by Inga

From Tammi: “Re: holiday parties. My company doesn’t have holiday parties, but this weekend while chatting at the coffee shop, a couple mentioned their son runs a high-end restaurant in the Denver area. Included on his property is a venue which is booked a year in advance for corporate holiday parties. The companies are calling in great numbers to try to get out of their bookings.” In our unscientific poll to the right, it looks like 41% of companies are either cancelling or scaling back parties this year. I’m predicting a related decline in Alka-Seltzer sales as well.

With all this gloomy news about layoffs and poor financial results, I have decided I need news that lifts my spirits. Thus, the rest of today’s HERtalk will contain only good news. Up near the top is athenahealth’s plan to add 100 new jobs in 2009 in its new Belfast, ME facility, which already employs 140.

I also heard that Digital Healthcare, a provider of a retinal health assessment solution, just raised an additional $5 million in funding to expand operations. The NC company employs a number of former Misys folks, including former VPs Marc Winchester and Scott Sanner.

I am sure that Peter S. Amenta, MD, PhD is happy to be appointed the new dean for UMDNJ-Robert Wood Johnson Medical School. He has served as interim dean for the last two years.

Scott P. Serota, President and CEO of BCBSA releases a statement saying, “BCBSA and the 39 member Blue Cross and Blue Shield companies today announced support for every individual being required to have coverage and all insurers being required to accept everyone regardless of their health status.” For anyone who has ever been declined insurance, this is a comforting statement. AHIP had a similar endorsement today, announcing support for guaranteed coverage without pre-existing exclusions. (OK, I recognize that insurance for all has its issues, but remember, I’m having a happy post day).

Here is a technology I want to hear more about. M*Modal launches AnyModal CDS Mobile for the iPhone. Apparently the SaaS technology allows clinicians to dictate via the iPhone. The product uses “speech understanding” services that allow the dictation to be captured, understood, and transcribed real time, giving physicians the ability to immediately review and sign off on the document.

Speaking of iPhones, I’m betting this poor woman will be happier in divorce than she is in marriage. She discovers that her husband has e-mailed some “personal” photos of himself to another woman via his iPhone. He claims the Genius bar experts at the local Apple store said it’s a known iPhone “glitch” that photos sometimes mistakenly attach themselves to an e-mail address. The skeptical wife sends a question to an Apple discussion board, asking if other users agree with the Genius. The consensus: the marriage has the glitch.

Without a doubt, this story helped lift my spirits. Former Baylor Healthcare System (TX) VP of clinical transformation Mary Staley-Sirois leaves the corporate world to serve as VP of Global Program Development for MediSend, a non-profit humanitarian organization that provides medical aid, healthcare education and technology, and other services to hospitals in developing countries. Staley-Sirois will apparently take her extensive experience from Baylor and from Healthlink before that to grow the organization’s worldwide healthcare initiatives. Love it.

E-mail Inga.

Reports: Obama Chooses Daschle as HHS Secretary

The Washington Post reports that President-elect Obama has chosen former Senate Majority Leader and South Dakota Democrat Tom Daschle as Secretary of the Department of Health and Human Services. Sources also report that Daschle will be given broad healthcare policy responsibilities that include expanding healthcare coverage while reducing costs.

Daschle’s book, "Critical: What We Can Do about the Health-Care Crisis," called for a healthcare oversight entity similar to the Federal Reserve Board. He was supporter of the failed Clinton health plan in the early 90s.

The Republication National Committee is already criticizing the choice of Daschle, an early Obama backer, saying that both Daschle and his wife work for lobbying firms.

News 11/19/08

From Jamie Sommers: "Re: Payerpath. Word is that Art Glasgow, the Payerpath president, resigned from Allscripts-Misys today on a town hall conference call. He was a good guy and the reason why Misys bought Payerpath in the first place." Unverified.

From The PACS Designer: "Re: federated identify. You will be hearing soon about a new concept called federated identity. Microsoft and other software firms are working on bringing this concept to fruition in the next year or so. Cloud computing requires a better method of identifying users that won’t overload requests for additions to Active Directories. Microsoft has a software download called Services Connector that provides the ability to identify authorized e-mail addresses from federated databases through its Live ID software when logging on to a cloud service." Link.

From Fourth Hansen Brother: "Re: FDA. Have they been cheating in medical devices?" Link. FDA scientists claim that agency executives pressured them to change their findings so that medical devices could get marketing approval. 

NotADupe claimed last time that a marketing person planted the Clara Barton comment about an Allscripts product at AMIA since it sounded pretty rosy and "I was at AMIA and I didn’t see Allscripts/Misys there." I thought it sounded legit, although it was borderline because it was so positive. My Allscripts contact saw the mention and quizzed all the marketing people there to make sure someone didn’t go rogue and post a fake comment here, then cast the net wider to see what Clara Barton was talking about. There was indeed an Allscripts demo at AMIA, although a brief and informal one. Jacob Reider MD, the company’s medical director, did a five-minute demo of Allscripts Prenatal at the Primary Care Informatics Working Group on Saturday night in front of around 40 people. The product isn’t GA yet, but I’m sure you’ll hear more when it is. I also appreciate that Allscripts was ready to go after anyone on their side who tried to mislead readers here, which is fortunately unnecessary since everything was above-board.

From HITPundit: "Re: Partners. There is a good read in the Sunday Boston Globe about the Partners effect. I thought it was about patients? Non-profit status for most of these places is a joke." Link. Of course it is. The story is about how Taj Mahospitals get paid more money to deliver average care for certain services than their less-ritzy but better-outcome competition. It mentions Mass General’s $686 million expansion and Partners’ $1.7 billion in profit in the last four years, while Caritas Christi was borrowing money to pay for oxygen tanks. It also mentions Partners’ leveraging its patient perception to manhandle insurance companies, resulting in 30% higher payment than similar hospitals (although Children’s Boston has the highest rates in Massachusetts). The quote HITPundit liked came from the chairman of Partners’ board: "Some are able to spend more than others. It’s our fortune that we’re probably in the lead on those investments. And several hospitals aren’t able to keep that pace. And that’s what I, as a businessman, call market forces, if you will." I thought this snip was interesting: "And it is there, in the workaday world of hospital care, that the hospitals’ reputation for unmatched excellence fades – and with it much of the rationale for the higher payments they receive for such treatments. The growing, if still inadequate, body of data available about hospital quality paints a fairly consistent picture of the care at the Brigham and Mass. General: often good, but rarely extraordinary, and sometimes inferior to the care available at other hospitals."

From Pacstech: "Re: stolen records. How about an arrest warrant for the idiot that allowed the records to be stolen? With 25 beds, how many people in medical records are we taking about here?" Bags of paper medical records stolen from Down East Community Hospital (ME) wash up on a local riverbank.

From HCC Princess: "Re: CMS. CMS is auditing 30-40 Medicare Advantage Plans. Claims from 200 random members will be audited and apparently any unsubstantiated claims will be extrapolated across the entire plan’s membership base. CMS is looking to recover a lot of money."

From Vern Den Herder: "Re: Epic. A healthcare organization in Connecticut recently signed with Epic. Wondering who?"

From Vince Ciotti: "Re: the $25K IT project. Spending more in IT won’t get you squat for recognition. Spend less! Use the $25K as rewards for ideas in a cost-cutting campaign that solicits ideas from your IT staff. $10K to the winner, $5K to runner-up, etc. Have finance vet the ideas and only the ones finance says will produce real ROI (that is, reducing someone’s budget next year) get considered. In the 100+ IT assessments we’ve done with The Hunter Group and Navigant Consulting, some of the best ideas have been given to us by IT staffer we interviewed. Why pay us to find them – get them yourself from your own staff!!"

Computerworld writes up Midland Memorial Hospital’s OpenVistA implementation, although emphasizing "cheap" rather than "works just fine" (the "old code" remark was snarky, especially given that many commercial products are older than VistA, which was rolled out in 1996). The hospital’s project was named as a winner of a 2008 InfoWorld 100 award.

I admit that I’m old-school patriotic, not a fair-weather flag-waver, so I was happy to join in the Valour-IT Veterans Day fundraiser, which ends next Thursday (Thanksgiving Day — how appropriate). My 401k may be hitting a rough patch, but I can darn sure find a few dollars to help buy a severely injured soldier, sailor, or airman some technology to help them recover from devastating war wounds. Their sacrifice (and that of their families) isn’t diminished one whet by the fact that I don’t always agree with the orders they are given (I’m sure they’re not always thrilled about it, either, which is all the more reason to get them back on track). It costs around $700 to provide a laptop with assistive technology and I was happy to provide one to someone who deserves it. Being a 19-year-old kid surrounded by the constant threat of harm and miserable conditions far from home is bad enough, but being shipped back to your family missing limbs has to suck big time. All donations of any amount are welcome and are tax-deductible.

Barry Chaiken MD, formerly of McKesson and BearingPoint, is now CEO at Medting of Palma De Mallorca, Spain (field trip!) Never heard of them, but it looks like a physician collaboration platform for sharing cases that can include media.

TELUS, the Canadian telecommunications company that bought Emergis a year ago, which had previously bought Dinmar in 2006 (and therefore its Oacis clinical system), creates TELUS Health Solutions and says it will invest $100 million over three years in it.

SCI Solutions wins two marketing awards: one for its ad graphics and the top award overall for its Access Management magazine.

CodeRyte gets $13 million in Series D funding, for a total VC funding of $50 million.

It took Inga awhile to get confirmation from some earlier reader rumor reports, but she has verified officially that Ingenix has acquired Global Works Systems, Inc. and will make them part of Ingenix Consulting.

This stock analyst says GE is in big trouble, calling it "a bank disguised as an industrial conglomerate" and an over-leveraged one at that, saying that if GE fails, it "could trigger the mother of all bailouts." I’ve speculated all along that its GE Capital exposure was a lot more than Jeff Immelt was owning up to. Speaking of which, may we assume that Intermountain’s CareCast pig-lipsticking project is either dead or at least so far behind that no one could possibly still care?

Right after I wrote the above, along comes a GE Healthcare press release touting "Digital Day One" without ever really saying what it is, although data-sharing and new hospital construction are mentioned. I read the release three times and I still have no idea what they’re talking about, with no clarification available on their site because the press release isn’t there at all. Marc Probst is quoted, so Intermountain is involved, apparently with regard to "timely sharing of newly published medical breakthroughs and best practices."

But speaking of GE, this Motley Fool analyst tries to figure out which company is more screwed up: GE (GE Capital) or Siemens (bribery).

Half of primary care physicians say they’d get out of medicine if they had an alternative, all because of insurance and government red tape. Everything said there is pretty much what Susanne Madden said when I interviewed her.

University of Toledo’s McKesson EDIS implementation is written up on its site.

Former Cerner sales guy Mike Fiorito is named chief sales and marketing officer of cardiac monitoring services vendor  LifeWatch Services. Hopefully he’ll direct better press release writing since I had to read the first two paragraphs of this one at least five times to make sense of it (and I read a ton of press releases).

Texas Health Resources demonstrates a patient-doctor relationship tool built on the Microsoft’s Surface computers, that "wave your hand over the coffee table" gadget that Steve Ballmer kept yapping about in his HIMSS keynote. More important applications have already been built for it, however, as Harrah’s has Surface computers running in Rio Casino "allowing customers to flirt and order specialty drinks using the technology."

Children’s Health System (AL) picks what sounds like the entire Eclipsys Sunrise product line. A big peds hospital customer is a great opportunity, but I’ve never seen one yet that wasn’t a pain in the adult-sized ass. I guarantee that a six-hospital IDN with one peds hospital will spend 50% of the entire project effort just accommodating the sometimes bizarre but indefatigably argued practices in peds, always defended with the reminder that "kids aren’t just little adults." Sometimes I think they’re as unlike general community hospitals as a veterinary hospital, occasionally for good reasons.

Odd: a former New Zealand health district CIO goes on trial for stealing $11 million US by submitting false invoices. He had "grand properties," a luxury car collection, and a 150-foot, 17-bedroom yacht.

Misys CEO Mike Lawrie on the prospects for Allscripts-Misys: ""Everyone recognises spending in US healthcare is out of control and is projected to consume 17 per cent of [gross domestic product]. And they’ve just spent a trillion bailing out the financial system. There is a limit to how much money you can print. And my view is there’s no way, with a new administration, [rising costs] can be left unchecked. And technology will be part of the solution."

Spheris names former Pediatric Services of America CEO Dan Kohl as president and CEO.

Glenn Dennis is named president and COO of Perry Biomedical Corporation, which makes hyperbaric oxygen chambers. He was previously with DataLoom, Exigent, SoftMed, and GE.

Chinese Internet company Baidu.com reels when it’s found that a chunk of its paid search revenue comes from unlicensed medical and drug customers, whose paid links were mixed in with real results based on popularity. Its a lot like Google, making its founder a billionaire.

Kenya has an ambitious plan to connect all hospitals over the Internet for telemedicine, ordering supplies, and providing second opinions. It will also support TelePresence, Cisco’s high-quality videoconferencing tool.

East Tennessee Heart Consultants brags on its IT outsourcing to Claris Networks, claiming it costs less and is more reliable.

Hospital layoffs: Beaumont Hospital (MI), 500 employees; MetroHealth (OH), 25 employees.

The University of Texas System, reorganizing UTMB after Hurricane Ike damage and massive layoffs that started this week, brings in Kurt Salmon Associates to help develop a plan.

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HERtalk by Inga

A computer virus at Barts and The London NHS Trust causes a system shutdown that lasts more than 24 hours. E-mail and Internet access were affected, but not the Cerner application (finally there is an issue that couldn’t be blamed on a Cerner application).

Speaking of hospitals across the pond, several are facing closure because they are not attracting enough patients. Recent reforms allow patients to choose where they’d like to be treated, which has shifted traffic to the more successful medical centers.

The University of Missouri and Cerner are winners of CHIME’s Collaboration Award for using HIT to help UM family physicians and patients manage chronic diseases.

NightHawk Radiology Holdings announces the appointment of David M. Engert as CEO, following the resignation of Dr. Paul E. Berger. Engert is a former McKesson and Quality Care Systems exec. Berger, who co-founded NightHawk along with his son Jon, will remain as non-executive chairman of the board. Jon Berger, an SVP and board member, has also resigned from both the company and board.

Barcode POC provider IntelliDOT and latric Systems sign an agreement that formalizes pricing for interfaces, implementation, and maintenance for customers using Iatric System interfaces between IntelliDOT and MEDITECH solutions.

Beginning in January, the Seton Family of Hospitals (TX) is implementing a new dress code for nurses and other patient care employees. Tattoos must be covered and piercings limited to earrings and a small nose stud. I personally prefer fashion accessories to permanent body adornment, but tattoos don’t particularly bother me (assuming everyone has had the appropriate hepatitis screening), although I find I can never quite look someone in the eye if they have a nose ring or piercings in their eyebrows. Even though they have no effect on the quality of care, I suppose some patients would be more at ease if they didn’t see a naked lady tattoo while getting a blood draw.

Eclipsys claims they’ve exceeded sales targets for the EPSi budgeting and financial decision support systems for the first three quarters. Their announcement doesn’t mention if their sales goals were set too low or whether the sales have translated to higher profits, but, it’s still good to hear that someone is making headway in these economic times.

A friend mentioned that his employer (a law office) is downsizing its holiday bash this year. Rather than renting a steak restaurant for an evening of expensive food and drink, they’re having a holiday luncheon delivered to the office. Some of the party savings will be donated to charity. It got me wondering what other companies are planning; hence the new poll to your right. This year, Mr. H and I are planning a Virtual Holiday Party. We are thinking perhaps setting up an online chat and he’ll drink his beer while I sip on my wine. Mr. H is tight with his money, so he still hasn’t decided if we can bring dates to the affair. Meanwhile, according to the Raleigh paper, the Allscripts-Misys folks will have a chance to act like one big happy family at their convention center holiday bash.

Red Hat chairman Matthew Szulik is named E&Y’s 2008 Entrepreneur of the Year for turning his company into a billion-dollar business. Glen Tullman of Allscripts was a finalist in the Technology division.

MedcomSoft announces its Q1 results. The news remains bleak for this 2007 Best in KLAS winner, now desperate for a buyer. Revenues were down 10% year on year and the net loss was almost $800K.

Former VeriChip CEO Scott R. Silverman regains control of the company after a $5.4 million purchase of common stock. In addition, the company purchased all intellectual property rights related to its human implantable RFID technology. Silverman claims he is eager to “re-ignite” the company.

Virtual Radiologic appoints Kevin H. Roche to its board of directors. He’s a managing partner at Vita Advisors and formerly the CEO of Ingenix and general counsel for UnitedHealthGroup.

Thomson Reuters releases its annual study of the top cardiovascular care hospitals.

Peter Dolphin is named VP of business development for Beacon Partners. He was most recently the VP of sales at eScription, and before that worked at IDX Systems (GE Healthcare).

E-mail Inga.

Monday Morning Update 11/17/08

From GatorFan: "Re: Philips. Rumor has it that Philips is undergoing a significant restructuring that could result in a layoff of 5,000 people. The announcement will supposedly be made early next week." Apparent confirmation is here — the Plain Dealer says 5% of the healthcare headcount will be cut loose.

From Carlotta Ailes: "Re: retail clinics. RediClinic opens that largest retail clinic in the nation with Memorial Hermann. The clinics are using athenahealth’s EMR/PM system." Link. It’s in a Houston H-E-B grocery store, 926 square feet with three exam rooms and a blood draw room.

From Bill the Cat: "Re: OSF. Our company was told by the higher-ups at OSF that they were moving to Epic about four months ago. Plans are in place and it should be done in 2-3 years (migration is never easy)." And from Techsan: "Re: OSF. They are already live on Epic’s Ambulatory EMR and Scheduling, but they are now also replacing existing ‘core’ systems (i.e., remaining rev cycle and inpatient EMR) with Epic."

From NotADupe: "Re: Clara Barton. Sounds like you were duped by a marketing plant. I was at AMIA and I didn’t see Allscripts/Misys there." Could be, but it’s hard to tell. The comment (barely) passed the sniff test, I admit, but it was just believable enough that I ran it. Companies try planting PR sometimes, but I don’t run it if I’m suspicious (a consulting company that I should name tried it today, posing as a customer innocently inquiring about a competitor’s acquisition). A few companies have also stiffed me on their HIStalk sponsorship in one way or another (want me to name them?) and they won’t be getting mentioned here, either, at least not in a positive way.

From Nasty Parts: "Re: Sage Healthcare. Rumor is that [name omitted]’s days are numbered. Top consultants are looking at internal processes, comp plans, etc. All of Andy Corbin’s former hires are slowly being excised from the company. Everyone is happy." I didn’t feel right mentioning the name, but if it happens, I’ll give you credit for predicting it.

From Pro from Dover: "Re: layoffs. A week ago, McKesson began laying off salespeople, approximately 20% of ‘new’ salesforce. Also, Misys/Allscripts sales layoffs are beginning this week." It would be more newsworthy if a company wasn’t laying off, especially in sales, where "layoffs" is often a nice synonym for "parting ways with under-performers who aren’t making their numbers." It’s always been a cold business, but likely to be colder still for at least a short while. No one in sales would be surprised by that revelation. On the other hand, stocking up on cheaper noobs is hardly a recipe for success, so companies will have to balance expense vs. potential long-term benefit. 

From Chuck Lumley: "Re: Sensitron. Rajiv Jularia, CEO of Sensitron, died last month rather suddenly. The company and product status are unclear. While they struggled, they had an early stage, device-agnostic, Bluetooth-enabled vital sign data capture system."     

Listening: The Who, Live at the Isle of Wight Festival 1970. Video here. Keith Moon was the most exuberant and charismatic drummer in modern history, arguably the lead instrument instead of Townshend’s guitar, especially amazing since Moon was probably stoned out of his mind most of the time (a video from another concert shows him extracted unconscious from the drum kit by roadies and hauled offstage, with an audience volunteer chosen to finish up the set in his place). He died in 1978 at 32; bassist John Entwistle died in 2002. Daltrey is now 64, Townshend is 63. Also: The Dilettantes, 60s-sounding psych-pop.

Streamline Health isn’t so good at keeping secrets (or maybe they’re crafty about technically honoring a hospital’s wish not to be named, but identifying them nonetheless). This press release (warning: PDF) coyly refers to a "leading New York City-based medical institution" without naming it. Check out the link address, though. Super sleuth Inga noticed that. I told her this week that she’s like a terrier when she latches onto a rumor, instilling 60 Minutes-type fear in PR and executive offices as she starts bugging everyone she can find to tell her the truth. Readers benefit from that, of course.

Sentry Data Systems of Deerfield Beach, FL has shown its support for HIStalk by becoming a Platinum Sponsor, for which I am most grateful. If you’re in hospital IT, your pharmacy contact will be interested in Sentry because they offer Sentinel RCM (supply chain compliance, GPO, and 340b tracking), Datanex (secure technology backbone with APIs), and Sentrex (pharmacy claims, including 340b replenishment). Just announced: the HealthBIT business intelligence platform for hospitals, which constructs a queryable data set from clinical and administrative data sources and provides tools for reviewing clinical protocols, identifying patient safety concerns with pharmacy procurement, cost analysis, and a notification engine. Thanks to Sentry Data Systems for supporting HIStalk and its readers.

Nortel dumps ballast overboard (employees and executives) trying to stay afloat after a $3.4 billion quarterly loss. It appears to not be working as the stock sheds another 28% Friday to end up at $0.56 per share, dropping its market cap to just $278 million. 

Think your company is the only one struggling a little and laying off staff? Not so. I hear a lot of insider stuff and the headlines you see only begin to tell the story. Hospitals are getting stung hard by investment losses and lack of capital funds, so IT will take hits in many of them. I think that’s why companies are acquiring consulting firms — business should be good as hospitals try to implement and improve systems already on the books and new hires will be hard to get approved. Consulting firms are good at making a sound business case to strapped hospital CFOs (much better than the average IT department, unfortunately) so I think you’ll see more CIO replacements, more outsourcing, and more contract implementations tied to specific patient care and financial results. None of that’s bad unless you’re on the wrong end of it.

And speaking of providers, here’s a question for hospital CIOs, CTOs, and other IT management. Let’s say an average 400-bed hospital is cutting back on some big-ticket IT projects, leaving the IT department looking for high impact, short-term projects to knock out during the slack time. Let’s say the limits are $25,000 not counting internal labor, it can’t require capital funds, and it has to deliver high visibility/high ROI with immediate operational impact. What projects have you done that you would recommend?

Max Baucus (D-MT), chairman of the Senate finance committee, releases his Call to Action paper (warning: PDF) on health reform. From his remarks: "Let me be clear about one thing: There’s no way to really solve America’s economic troubles without fixing the health care system.If you fix Wall Street, you fix the housing crisis, you change taxes, you fix everything else, and you don’t fix health care, then government spending will keep going up. Health care costs suck up more than 16 percent of our economy, and they’re growing. Deficitswill continue to rise. And America will just have more economic troubles down the road."

Fundraising ends for Project Valour-IT on Thanksgiving, so click the graphic to your right to help provide assistive technology laptops to severely wounded soldiers. $37,000 has been donated so far and our Navy team is in the lead (although all money goes to all service branches – having teams is just a way to keep score). The project has no money for laptops at the moment and is hoping for $250,000 in donations to buy a bunch of laptops at around $700 each (DoD was so impressed with Valour-IT that they buy the Dragon NaturallySpeaking). Any amount is appreciated.

John at Chilmark Research likes the idea that big players are studying PHRs, but is skeptical about CITL’s optimistic, vendor-sponsored report. "For the cost/benefit analysis, CITL proposed a scenario of 80% user adoption within 10 years that will generate $19B in annual savings. 80% adoption? $19B is savings? What are they smoking over there?"

Odd: a Seattle dentist and oral surgeon (but also an MD) is sued for messing up a 15-year-old girl’s non-cosmetic breast reduction surgery. He’s been sued for malpractice at least 10 times, has paid out over $1 million in claims, and was mildly reprimanded (fined $4,000) for being implicated in the death of a liposuction patient, for whom CPR was initiated six minutes after the patient stopped breathing.

An industry rag wrote this, a reader reports, although it was fixed in the online version by the time I went for a screen shot: "In addition, Epic won the first certification for an enterprise EHR that provides comprehensive ambulatory, inpatient and emergency department EHRs that are inoperable."

Emageon’s acquirer HSS announces Q3 numbers: revenue up 106%, EPS -$0.42 vs. -$0.40. They’re good at hiding the loss, not mentioning it until the eleventh paragraph after leading off with a revenue headline and jamming in all the good-sounding numbers first. Readers with a short attention span might be impressed by their quarterly results.

Citrix will release its XenDesktop and XenApp software available for the iPhone in a few months, allowing all Windows applications to be virtualized and then run over an iPhone virtual desktop. That’s already available for Windows Mobile and Symbian devices, but the iPhone version will allow using the cool gesture stuff. I imagine this will be hot, although I don’t know how much work you could do on that little screen that doesn’t have a real keyboard.

An SVP of drugmaker Gilead Sciences advises Microsoft on healthcare IT: "If Microsoft really wants to own the world, create a standardized electronic medical records system and give it away for free the first five years. Then start charging." I bet he’s not nearly as keen on the idea of doing the same in his own industry, i.e. making generic Tamiflu and Flolan at a cheaper price instead of charging to much to treat diseases like HIV for a $2 billion annual profit. He’s got a point about standardizing by offering a free product that sets the standard by its own ubiquity, but then again, even a free EMR isn’t much of a deal for doctors unless it saves them time.

A British surgeon is suspended for downloading NHS medical information about his secretary, her family, and her boyfriend after becoming infatuated with her. He claims his current wife was a bad choice and he hoped to do better by turning the secretary’s information over to a private detective to check her out before he made his move. The secretary found out when the surgeon’s wife accused her of having an affair with her husband, after which the secretary then snooped around on his work computer and found her own medical records, the surgeon’s list of tactics on how he planned to win her over, and an impressively massive porn stash.

Cleveland Clinic doctors pick the Top 10 procedures and products that will influence medicine in the next year. On the list: NHIN (#10), which the good doctors must not know much about if they’re thinking it will have an effect in the next 13 months.

South Korea and its hospitals want a piece of the medical tourism action, trolling for budget-conscious Americans as well as rich Arabs who can’t get a US visa because of terrorism-induced red tape. One hospital is building a hotel, a concert hall, and an art museum to complement its 18-hole golf course. Immigration rules were changed to allow patients and families to stay up to four years without a visa. "For Hassan and Fatima Abdulla, the trip has been one seamless surgery/tourism package. When they arrived in Seoul in October, a car from Wooridul and an English-speaking nurse were waiting for them at the airport. Abdulla found his wife’s hospital room – furnished with a television, broadband Internet access, private bathroom, sofas and an extra bed – so comfortable that he decided to stay with her rather than go to a hotel." Reminds me of the old days of pre-outsourced, small-town hospital cafeterias, where local cooks made food that was good enough that townspeople would actually drop by for lunch. Now it’s just surly Aramark contractors heating up Sysco TV dinner quality fare, not much different than feeding prisoners.

University of Iowa Hospitals fires one employee and suspends seven more for snooping in electronic patient records.

Vendor Deals and Announcements

• Mac enthusiasts have a new kiosk option with the release of MacPractice Kiosk Interface with signature pad.
• Wandering WiFi is now providing wireless service at six Ardent Health Services hospitals in Oklahoma and New Mexico for patient and visitor Internet access.
• Perot Systems acquires Tullurian, a managed services hosting provider serving 13,000 physicians and 565 practices. Perot, by the way, has launched healthcare service operations in China. David Miller will serve as managing director for the region’s consulting and clinical transformation services.
• Lake Charles Memorial Hospital (LA) announces the start of a $6 million, three-year process of migrating to McKesson’s Paragon and Practice Partner digital health record solutions.
• Beaver Dam Community Hospital (WI) selects McKesson’s Paragon HIS and document management solution.
• Clarian Health (IN) activates a MobileAccess Universal Wireless network across three hospitals, covering more than 4 million square feet.
• HIE SharedHealth is using Orion Health’s Concerto Portal Solution to enable an EHR solution and provide access to its Clinical Xchange platform.
• Ochsner Health Systems (LA) is installing InterSystems Progeny Anatomic Pathology information system.
• Spectrum Health (MI) selects InterSystems Ensemble software for integration initiatives across the entire enterprise.
• Passport Health Communications and SelfPay Company announce a strategic partnership to provide electronic charity care assessments.
• Charlotte, NC-based Patient Care Technology Systems is more than doubling its office space to support its growing employee base.
• DocuSys names David Young, MD medical director for its Presurgical Care Management solution. Young founded Prompte, a company acquired by DocuSys earlier this year. He is also medical director of presurgical testing at Advocate Lutheran General Hospital (IL) and a faculty member at UCSD.
• The 45-radiologist practice Radiology Associates (AR) will utilize AMICAS Web-based PACS, AMICAS Reach, and AMICAS Teleradiology solutions.
• Former Misys Transaction Services and IBAX exec Denis Connaghan is named president and CEO of etrials Worldwide, a provider of adaptive eClinical software and services.
• Clinical Solutions will integrate HLI’s Language Engine clinical decision technology into its IntefleCS Telephone Triage and IntefleCS Face to Face applications.

E-mail me.

News 11/14/08

From Some Guy: "Re: OSF. Epic signed a deal with OSF Healthcare to replace all existing systems. Can you confirm?" I knew they were a EpicCare user on the ambulatory side. Confirmation welcome.

From John Oates: "Re: Centura. Heard that Dana Moore, the CIO at Centura Health, has had his role expanded to include lab, supply chain, business intelligence, clinical quality and safety, central verification office, community benefit, the regional float pool, real estate management, system recruiting, and Ask a Nurse." They might as well rename the place after him since he’s running it all. You know you’re a good executive and not just a good IT executive when they ask you to take on a bigger role, so that’s pretty cool.

From Donna Redd: "Re: pictures. Love the pictures you run. That was the last reason to read the printed publications, so I’m all yours." Thanks. I didn’t run them before because it was a pain (thanks to Microsoft for the software solution) and because of my adserver, which overloaded with page views to the point that pictures would have taken forever to load (thanks there to adserver genius Erik in the Netherlands, who redesigned the setup and made the page load nearly instantly). I still run the pictures small or thumbnailed to keep things snappy, part of our fervor to not waste your time (including in what we write about and how we write it, which sometimes fools new readers who figure "short" must mean "unimportant," leading them to completely miss something that we scooped everybody on. Writing less is hard work.)

From The PACS Designer: "Re: iPill from Philips. As the patient starts to become a receiver of better care through increased internal treatment focus, the iPill from Philips seems to be a potential winner in the war against disease. Also, being able to include the wireless function in such a small form factor really can bring added value an more comfort to the patient." Link. The pill (capsule, really) contains a microprocessor, battery, wireless radio, drug reservoir, and manually activated pump to allow medication release in a specific location.

From Clara Barton: "Re: Allscripts. Saw an impressive demo of a new tool for prenatal documentation from Allscripts this week at the AMIA conference. It’s interoperable (‘robust API, SaaS model, uses Mirth’) and very easy to use (mirrors ACOG form perfectly). Here’s the surprise: this came from the Misys side pre-merger! So someone WAS doing cool stuff in Raleigh. No details on release date (‘soon’) … mention of an OB/GYN group in Indianapolis who has been testing it since March and is raving about it." Sounds pretty interesting. The Mirth integration engine is cool. Maybe Allscripts should buy LMS Medical Solutions to round out their OB offerings (story to follow).

A hacker gets into a University of Florida College of Dentistry server containing the PHI of 344,000 patients. Technicians upgrading the server found an exploit.

Reminder: click the Project Valour-IT graphic to your right if you would like to donate toward giving a seriously injured soldier or sailor a laptop equipped with assistive technology. Imagine having your hands blown off by an improvised bomb in Iraq. You would appreciate being able to keep writing e-mails and use a computer, right? That’s where 100% of the donated money goes (laptops, Wiis for physical therapy, and GPSs for mobility). Thanks to those of you who mentioned you donated money or, in one reader’s case, a brand new Wii. The fundraiser runs through Thanksgiving and the Army team is beating our Navy team nearly two to one.

Jobs: multiple Epic positions (CO), NextGen Customer Support (PA), Clinical Expert/Consultant, MD or RN (NJ). Just ask and Gwen will send you her weekly job blast.

MedAptus promotes William Marshall to SVO of marketing and Rick Little to executive director of client services.

The SEC files insider trading charges against McKesson sales VP William Gallahair, claiming he overheard his supervisor’s telephone conversation about the impending acquisition of D&K Health Resources, then loaded up on shares, pocketing a $120K profit when the announcement was made.

An HHS pilot project in Arizona and Utah, announced Wednesday, gives Medicare recipients two years of their health records if they agree to keep a PHR on Google, HealthTrio, NoMoreClipboard.com, or PassportMD.

Patrick McCormick, aka PatrickMD, was a student finalist at AMIA as mentioned by Grant Ritter yesterday. He writes about the Facebook Medline application created by Steven Bedrick and Dean Sittig (or at least I’m assuming it’s Dean from the citation). Interesting, but I’m finding PatrickMD himself at least equally interesting: MIT computer science grad (BS and MEng), senior platform engineer with the Tellme voiceXML startup later bought by Microsoft, Columbia MD, and now PGY-1 medical intern at Mount Sinai. All these Boston people are always doing cool stuff. Must be the long winters.

OB software vendor LMS Medical Solutions gets de-listed from the Toronto Stock Exchange when shares drop to below $0.04. They dropped another 60% today, down to $0.02. The company just filed Q2 results: revenue was up 21% to $730K US, EPS -$0.04 vs. -$0.07. Seems like someone should be interested in them at that share price.

Medicity will hold its first customer summit in Salt Lake City February 19-21. Also mentioned in the company’s latest newsletter: a presentation by Daughters of Charity CIO Dick Hutsell on rapid access to clinical information; go-live of HSHS on MediTrust and ProAccess; and customer presentations coming at HIMSS in April. And as always, thanks to Medicity and Nuance/eScription for being HIStalk’s founding sponsors, going way back to 2004 when we could have had a meeting of all HIStalk’s readers in the private dining room of an IHOP (you know who you are – thank you).

Cielo MedSolutions announces that its evidence-based treatment guidelines are available as SaaS for third-party integration with portal and EMR products.

This is cool: the folks at Vitalize Consulting Solutions read my September 29 writeup about IT volunteer Robert Schilt, who is implementing basic technology on a shoestring at Goroko General Hospital in Papua New Guinea. Vitalize sent him 13 laptops, most of which will be used in the hospital, but one will go to the first PNG blind person to graduate from college and one will benefit a local school. Here’s a list of what he could use ("PNG people do not have two spare coins to scratch together") and donations received (nearly all of them sent by his faraway family to support the locals through him, you may notice). Here’s a response left by a young PNGer: "Wow!!!! What an awesome donation! THANK YOU Vitalize Consulting Solutions.I’m looking forward to following up on where these laptops end up and what lives they will change. Unbelievable."

The health of retail pharmacy workers is threatened by automated dispensing machines in drug stores, including those made by McKesson and Parata, according to an aerosol science lab.

If you don’t get e-mail updates when Inga and I write something new, that means 3,217 people are beating you to the scoop (some of them mortal enemies and competitors, no doubt). The cure: put your e-mail address and name in the Subscribe to Updates box to your upper right. Right below that is the E-mail This to a Friend graphic, which can be clicked to easily e-mail a few buds about good old HIStalk.

Insurer WellPoint is jumping into medical tourism, offering pilot participants free treatment in India for certain non-emergent issues. They’ll even cover a companion airfare, but that’s not overly generous considering that costs are a fraction of what US hospitals charge (example: knee replacements, $8,000 vs. $70,000).

Six Web site clients of CareTech Solutions win 2008 WebAwards, including Hendricks Regional Health (IN), which took home Outstanding Web Site. It looks cheery and easy to use.

Michael Donlon, former McKesson clinical systems sales VP, joins offshore medical call center operator MediCall as VP of business development.

Chronically ill Canadians wait the longest to see a specialist among eight developed countries, the headline says. Almost: same-day appointments were equally rare in the US at 26%, with citizens of both countries heading off to the ED as a substitute. Their patient-reported medical error rate was also the highest — except for the US, which also led in the percentage of respondents who said the health system was so screwed up that it ought to be blown up and rebuilt from scratch (if you believe survey conclusions without seeing the actual instrument and methodology, anyway). 

New telemedicine vendor SwiftMD gets a contract with an entire 300-home subdivision under construction to provide emergency medical services, including 24/7 physician access by telephone, Internet, or bi-directional video and also including PHRs. The company offers direct consultations, claiming you’ll be talking to a doctor within 30 minutes of signing up. Prices: $18 to enroll, $9 a month, and $59 per consultation for one person.

First Express Scripts got extortionate threats to release PHI. Now some of its clients are getting similarly threatening letters. The company has launched a site for updates and is offering a $1 million reward for the arrest and conviction of those responsible (so it should take about two days to have someone in custody, I’m guessing).

I get a little uncomfortable when I can’t tell non-tax paying hospitals from international conglomerate vendors. UPMC partners with GE to develop international cancer centers.

Hospital layoffs: Boca Raton Community Hospital (FL); several hospitals in Hamilton, Ontario; St. John’s Regional Medical Center (MO); Cheboygan Memorial Hospital (MI).

King’s Daughters Medical Center (MS) says its T-System EDIS cut wait times in half and sped up charge posting.

The whistle-blower in the Magee-Womens Hospital case apparently wins, despite a private settlement with no details. UPMC spat out a "no comment," while the woman said she was elated. She said she raised patient safety concerns; the hospital claimed she violated patient confidentiality.

Vanity Fair magazine’s lawsuit against the Navy over John McCain’s medical records is dismissed. A reporter claimed to have interviewed first-hand sources who said McCain was involved in a 1964 auto accident that was rumored to have injured or killed another person. The magazine wanted any of his records during that time from Portsmouth Naval Hospital. The judge said the Navy was right to refuse the Freedom of Information Act request since hospital records are exempted as an invasion of privacy.

Who’s the bad guy here? A drug dealer gets a 25-year-old woman hooked on heroin. She ends up paralyzed in ICU and her family tells the dealer she’s dead to keep him away from her. Someone tells the dealer where she is and he admits himself to the same hospital, then heads to the ICU claiming to be her relative. The family finds out he’s there. One of them, a 45-year-old male nurse, is charged with using the hospital computer to find the man’s room and then threatening to break his spine. The nurse is now defending himself in a nursing board hearing on whether he’s fit to practice.

E-mail me.

HERtalk by Inga

From: Dr. J: "Re: Advisory Board. Have you assessed the value of Advisory Board Company membership for provider organizations or vendors?” Neither Mr. H nor I haven’t ever looked into it and we don’t know what membership costs. Anyone care to comment?

The Big Brothers at Google are watching your keystrokes to detect regional flu outbreaks. Using the new Google Flu Track, Google tracks the input of such phrases as “flu symptoms.” Over the last few years, Google’s search data has been able to detect regional trends about 10 days before they are reported to the CDC.

Not surprisingly, privacy advocates aren’t too hip on Google’s new tool. Patient Privacy Rights founder Dr. Deborah Peel sent us this note. “We think Google needs to prove their claims–that’s transparency. The science is there to do effective de-identification—but we have no proof that is what Google did. This is very similar to our certification requirements for how vendors use aggregated de-identified info for business purposes such as improving how the site works, etc.” Peel also provided us a copy of the letter that she and EPIC.org president Marc Rotenberg sent to Google Inc.’s CEO Dr. Eric Schmidt.

Singapore’s largest healthcare group SingHealth has successfully activated Eclipsys’ clinical solutions. Within the first few hours, 1,500+ concurrent users were live across three hospitals and 12 clinics.

Medsphere signs a $9.7 million contract to provide support, maintenance and development for the Indian Health Service. The agreement extends Medsphere’s existing relationship supporting the agency’s Resource Patient Management EHR solution.

Speaking of Medsphere, ousted co-founder Scott Shreeve shares his recollections of the company’s early days and up until the time of the new regime. Scott and his brother Steve are winners of the 2008 Linux Medical News Freedom Award, based on their support of Free/Open source software ideals in medicine.

I inadvertently found this blog today and of course was drawn to the photos of the two adorable Hungarian medical students maintaining it. I know next to nothing about the fascinating world of radiology and nuclear medicine, but I could learn.

The VA contracts with HITT Contracting for a $32 million regional data center in West Virginia on the same grounds as the Martinsburg VA Medical Center.

The campus newspaper provides an update to KU’s transition to Epic’s EMR.

Twenty small hospitals across Kansas and Nebraska are sharing a single computer infrastructure to automate their patient medical records. Funding comes from the US Department of Agriculture and the nonprofit Great Plains Health Alliance.

InterSystems is opening a sales and support office in Dubai Healthcare City following an acquisition of key assets and staff from local distributor HBO Middle East.

UT Systems orders the layoff of 3,800 state employees at UTMB, claiming the medical branch is losing $40 million a month as a result of Hurricane Ike. Damage has forced the main Galveston hospital to be closed for renovations, though the medical school has re-opened. The layoffs represent nearly a third of UTMB’s 12,000 employees. UTMB is also the island’s largest employer.

Merge Healthcare is offering a new iPhone/iPod touch application that allows users to view digital medical images on their devices. A demo of Merge Mobile for the iPhone is free from the iPhone App Store, so I plan to load it up and check it out.

A Houston doctor sets up Telerays, a Web-based auction service that facilitates radiology interpretation services. Using an eBay-like model, hospitals or imaging centers can put up certain radiology/interpretation projects for bid. The (approved and properly credentialed) radiologist with the lowest bid wins. The hospital pays Telerays, who in turn pays the radiologist. Interesting financial model, though it does suggest all radiologists are equally skilled. When the company expands to plastic surgery, I think I’ll take a pass.

A Louisiana medical assistant is arrested on 342 counts of obtaining prescription drugs by fraud. Her suspecting doctor hired a computer expert to audit her computer and found numerous prescriptions generated without accessing a patient’s chart and that were later deleted (what EMR allows you to do that?) She’s accused of obtaining more than 20,000 tablets of various drugs and claims she took 20-30 pills herself each day. 

Aruba’s only hospital, Dr. Horacio E. Oduber, is implementing Cerner Millennium beginning in March. I bet there are a few Kansas City folks trying to get in on that gig.

CCHIT announces the certification of four new inpatient and ED and EHR products. In addition, Epic Enterprise Clinical system was certified as providing a comprehensive and interoperable ambulatory, inpatient, and ED solution.

E-mail Inga.

News 11/12/08

From The PACS Designer: "Re: digitally connected patient. TPD last year made HIStalkers aware of a new method being developed to capture patient information from remote locations. The first applications were seen in ambulances where patient info was sent to the hospital while transporting the patient. The Digitally Connected Patient or DCP provides caregivers with information about the patient’s condition and warns when conditions change that can cause harm to the patient. Now, the Cleveland Clinic Foundation has partnered with Microsoft on a pilot study to send patient data from the home to the hospital’s eCleveland Clinic MyChart and then to HealthVault to provide a more complete PHR of the patient experience." Link.

From A CSC Executive: "Re: NPfIT. You mentioned that CSC, Accenture, and Fujitsu slunk away from NPfIT. Could you update the note to remove the CSC? As the article mentions, CSC is still one of the major contractors and we took over additional responsibility when we picked up Accenture’s regions." My apologies. I’ve corrected that slip-up. Accenture and Fujitsu bailed out, but CSC is running a big piece of the project and not complaining about it as far as I know.

From Doogie Howitzer: "Re: Digital HealthCare & Productivity. It’s going down the tubes after two more issues." I can’t say I’ve ever read it either online or on paper, but maybe someone will miss it.

From Lou Loomis: "Re: Microsoft. In reference to your news on 11/7 about Microsoft, the attached was taken last weekend in Toronto. Several of us watched as the billboard operator added some patches to his Windows PC, rebooted, and then started the billboard software again. For reference, this billboard was about 3 stories high!!"

From Ouch: "Re: MEDITECH’s financials." Link. Q3 revenue was up, but net income went from a $27 million gain to a $21 million loss as the company wrote off $50 million worth of investment securities with permanently impaired value (maybe someone who was better in accounting class can help me interpret their numbers, which seem to look good other than the investment hit).

From FormerCT: "Re: layoff. Heard that HealthPort, formerely Companion Technologies, recently held another round of layoffs, its second since August, in an effort to improve the bottom line. The investors paid $40 million to buy Companion from Blue Cross and are having trouble turning a profit, let alone a return." Unverified.

From Stuck: "Re: Sage Healthcare. Mark Ryan, senior VP of customer services and support, has resigned." Unverified. He’s still on their Web page.

From Brother Windy: "Re: wherethemoneygoes.com. Any idea what happened to it?" The author of the site that railed against the financial excesses of non-profit hospitals, a caustic former Chicago reporter nicknamed Low Blow Joe, was outed as a paid shill for insurance big shot and health savings accounts advocate J. Patrick Rooney, who died in September. He also ran a vicious anti-Obama site for Rooney. Without Rooney’s paycheck, the site is apparently defunct.

From Wompa1: "Re: WHO report on world healthcare. This excellent analysis from The Cato Institute puts armchair musings to shame." Link (warning: PDF).

Proof that newspapers are not only getting skinnier, they’re also getting sloppier. This business journal story covers a local hospital’s EMR implementation, managing to (a) not give the hospital’s name except as ‘Harrison’ (it’s Harrison Medical Center); (b) not provide a location for either the hospital or the publication itself, except to say Kitsap (it’s in Bremerton, WA); and (c) not spell the vendor’s name correctly (Eclypsis instead of Eclipsys).

I mentioned that Sonitor was one of a handful of technologies that impressed me at HIMSS (disclaimer: they’re a sponsor now, but weren’t then). Anyway, I ran across the interesting slide above on RTLS opportunities from products like theirs.

I mentioned a few days back that I kind of liked Carol, "the Travelocity of healthcare," even though I’m totally unsold on all the brash consumer-driven healthcare startups trying to cash out before the bubble bursts again altruistically improve society’s health through consumer empowerment. Anyway, Carol cuts a fourth of its staff and changes its business model to focus on provider consulting and software, ditching the idea of letting consumers compare providers themselves. There’s $30 million in VC money shot to hell.

DR Systems claims it invented PACS and is going after other vendors, claiming patent infringement. Want to know what it costs to make them go away? Now you do: Emageon’s 10-Q says they paid DR Systems $1 million (it looks like a deal at $1,000 until you realize they’re omitting thousands).

Healthia Consulting, the force behind what some folks called the hottest event at HIMSS (the HIStalk party), will be rebranded under the Ingenix Consulting banner. Ingenix now has over 1,000 consultants from its several acquisitions and is serving providers, employers, insurers, pharma, and the public sector. Check out (and click) their new ad to your left to review their offerings.

The CEO and IT Director of 24-bed Eastern Plumas Health Care (CA) make a board pitch (unanimously approved) for a clinical system from Dairyland Healthcare Solutions (now called Healthland). Total cost with software, hardware, and implementation will be $322,500.

Scripps Health (CA) interim CIO Patric Thomas gets the job permanently.

Capsule announces 10 new DataCaptor medical device connectivity sales.

Patricia Lavely of Memorial University Medical Center is named CIO of the Year by the Georgia CIO Leadership Association.

Premise gets some big-name new customers for its patient flow solutions: Children’s Hospital Boston, Hospital for Special Surgery, and UCSF Medical Center.

IBA’s iSoft announces the launch of its Lorenzo system to the rest of the non-NPfIT world, taking shots at Cerner and other vendors in the press release. IBA says the potential market is in the billions and it expects to double revenue as a result.

The White Stone Group, which offers systems that document and track the business and clinical communications of hospitals, gets a nice profile in the Knoxville business paper.

The Longstreet Clinic, PC of Gainesville, GA wins a statewide e-Technology Award for its EMR implementation.

Catholic Health Initiatives will implement NCR’s MediKiosks to reduce patient wait time.

UPMC will use its patient database to create a voluntary registry for patients to be alerted about clinical trials.

The Wall Street Journal weighs in on ICD-10 in an article called Why We Need 1,170 Codes for Angioplasty. They seem to conclude that it’s cumbersome but probably necessary given the limits of ICD-9.

E-mail me.

HERtalk by Inga

From Lola Falana: “Re: HCIT funding. MDs could buck up and do CPOE. The now-tired ‘time is money’ excuse ignores that they have the equivalent of a gun in their hand with paper orders. They could come on board tomorrow at zero cost to them and get back the OE time with order sets, reduced calls, and other time-wasters. The culture is already changing with younger clinicians and increasingly onerous third-party, data-intensive reporting for compliance and reimbursement. I know MDs want subsidies, but let’s start with what we can do now with CPOE and Stark. We can adopt a patient safety culture without waiting for Barack. The whole country, including HCIT, needs change.” I agree that mandates may be the answer, though nominal penalties like 2% probably won’t be enough.

AARP, Business Roundtable, Service Employees Union, and National Federation of Independent Business send an open letter urging President-elect Obama and Congress to build on the SCHIP, to promote preventive care, and to advance HIT adoption. The four groups are part of an organization called Divided We Fail, aimed at promoting healthcare reform now.

A report concludes that excess installed capacity and initiatives to reduce health care costs will negatively affect sales of CT systems, MRI, and nuclear medicine scanners over the next five years.

A study finds that when patients receive treatment alerts along with their physicians, compliance increases by 12.5%, with the greatest improvement in diagnostic recommendations.

St. David’s HealthCare (TX) blames the economic downturn on its decision to lay off 50 employees in non-bedside, non-patient care areas.

The Ventura County, CA newspaper reports that the local county clinic system had 44,000 more patients in the last year while hospital procedures are down about 9% over last year.

Another sign of the times: Starbucks reports a 97% fall in profit (and a 50% drop in stock price over the last year). I’m not sure I could carry on if I didn’t know I could find a Starbucks within a five-minute drive just about anywhere I am, so I hope Howard Schultz figures it out.

Amid pressure from clinical staff critical of his management style, Northeast Health Systems (MA) CEO Stephen Laverty resigns. According to the Wicked Local Gloucester (great name for a newspaper), Laverty was focused on advancing HIT at this 100 Top Hospital. During his eight-year tenure, the hospital implemented a number of new technologies, including PACS, CPOE, and voice recognition.

Biopharmaceutical company Favrille and PHR developer MyMedicalRecords announce a merger.

ACS gets a $44 million deal to provide business outsourcing services for Florida Medicaid. ACS will be tasked with helping the agency save money on Medicaid bills by identifying possible private insurers.

Doctors in California, Nevada, and Hawaii claim that Medicare is late in paying them millions of dollars. The problems stem from May’s changeover to UPINs and September switch to a new claims processor.

E-mail Inga.

Veterans Day

Freedom is not free – thank a soldier or veteran and remember those who have given their lives. If you’re a veteran, on active duty, or serving in the reserves or National Guard, thank you.

In Flanders Fields
By John McCrae

In Flanders Fields the poppies blow
Between the crosses row on row
That mark our place; and in the sky
The larks, still bravely singing, fly
Scarce heard amid the guns below.

We are the Dead. Short days ago
We lived, felt dawn, saw sunset glow,
Loved and were loved, and now we lie
In Flanders fields.

Take up our quarrel with the foe:
To you from failing hands we throw
The torch; be yours to hold it high.
If ye break faith with us who die
We shall not sleep, though poppies grow
In Flanders fields.

Help a Wounded Veteran Recover

I like to think my problems are important, but only until I remember those soldiers who are coming back from terrible struggles in Iraq, Afghanistan, and other far-flung parts of the world. Kids are coming home horribly maimed and disfigured before they even had a chance to experience normal adult life. Despite their ruinous injuries, they might even consider themselves lucky because, unlike some of their fellow soldiers, they made it back.

I was struck today when I accidentally ran across Project Valour-IT, which is run by Soldiers’ Angels. The nonprofit group’s motto is, "May No Soldier Go Unloved." The project, originally named as Voice-Activated Laptops for OUR Injured Troops, supports severely wounded soldiers by providing them with voice-controlled laptops, whole-body video games for physical therapy rehabilitation, and personal GPS devices to help them relearn mobility with their impairments and physical challenges.

Donations go 100% toward the laptops – nobody in Soldiers’ Angels gets paid. They received this from a grateful soldier: "To Whom It May Concern, Hello, my name is LCpl. Andrew. I am a Marine that was wounded in Iraq and got medevaced to Brooke Army Medical Center in Ft. Sam Houston, Texas. I recently received a laptop. I was informed that it was you, the Soldier’s Angels that donated it. I can’t tell you how thankful I am to have support from organizations such as yourself. It really lets me know that there are people out there that still care about the troops and what they are sacrificing for this country. I appreciate what you have done for me and having this laptop is actually good therapy for my hand. Once again thank you and I am proud to serve this country knowing there are people like you that I am protecting. Sincerely, Andrew."

I was moved to do two things today. First, I donated $800 (anonymously), the amount needed to fully fund a soldier’s laptop. I spoke to the founder and she assures me it will be put to great use in one of the military hospitals. In fact, she invited me to visit either Bethesda or Brooke Army Medical Center to present it myself. If you want to donate that tax-deductible amount, you are also welcome to correspond or visit the recipient to encourage his or her recovery through moral support. They get a great deal from Best Buy on state-of-the-art laptops with all the assistive technology installed, ready for immediate use (she wanted me to thank Nuance for helping them out in the past with Dragon Naturally Speaking discounts, so here’s a shout out to them).

Second, Project Valour-IT is running a blog contest from now (Veterans Day) until Thanksgiving. You can donate any amount to help the cause. Donations aren’t tracked by blog, but rather by teams representing each military branch (it’s actually just for fun since all the money goes into the same pool, but it does spark friendly rivalries). I chose the Navy Team because: (a) I have been to Navy football games and the Midshipmen are the most disciplined and respectful students I’ve ever seen; (b) I will argue passionately that the Naval Academy is not only the most beautiful campus in the country, but is also in the top handful of colleges academically and competitively and maybe #1 when you count leadership; (c) Mrs. HIStalk’s father was a Marine; and (d) I can say I know a Navy Rear Admiral, Cindy Dullea of SCI Solutions. OK, it’s sketchy logic, but I had to pick one of the branches, so there you go.

If you would like to help Project Valour-IT, click the fundraising graphic I put up on your right, which will take you to a donation screen. Donate $250 or more and you’ll get a special gift. And, since I can’t see the donations and they aren’t tracked separately for HIStalk, please post a comment on this article (click the Comments link at the bottom) and just mention that you helped them out. Thank you for your support.

Monday Morning Update 11/10/08

From The PACS Designer: "Re: cloud slices. You’re going to be hearing segments of cloud usage described as a ‘Slices’. Since clouds are an SaaS offering, they contain numerous parts, some of which may not be needed by the service requester.  ince you may select a portion of that service, it gets defined as a thick or thin slice. If you design your application with several slices from different service providers, you are in effect creating what TPD would call a ‘Dagwood sandwich’.  Using these various slices is similar to using a utility for your service, and cloud usage is charged using the term ‘elastic compute unit’ or ECU, much like what you would pay for electricity through the use of kilowatts." Link.

From Aaron Rentz: "Re: Certify Data Systems. Has anyone heard of them? Their site (which needs some grammar revision) sounds like they have the ultimate interoperability machine. I don’t see how their technology could work as well as they claim out of the box, but it looks like they have clients." Link. They’re awfully secretive: no names of anyone involved are mentioned and the street address is used by a bunch of companies (right down the street from the Winchester Mystery House in San Jose). It’s a Ricoh Japan incubator spinoff.

From Lil’ Kimchi: "Re: athena CEO on CNBC. Great earnings, talks about Obama and HIT." Link.

Columbia University Medical Center and NLP International Corporation announce that the MedLEE natural language text processing application will be brought to market. It processes unstructured medical text, with a demo here.

Steve Lieber of HIMSS defends having the European Commission choose it (an American organization) as its eHealth conference partner. "We are not a US organisation. I mean we are a legal entity in Belgium as well as a US corporation … We established our legal presence in Europe because we want to avoid people thinking that there is a bunch of Americans trying to take over European eHealth policy or practice."

The Royal Free Hospital in London claims it lost $11 million in six months because of the "clunky workflows" of its Cerner Millennium build.

QuadraMed announces Q3 numbers: revenue up 17%, EPS $0.12 vs. $0.19.

Perot Systems retires the JJWild name. The MEDITECH consulting group is now just Perot Systems.

Accenture and Fujitsu slunk away from NPfIT after losing their shirts. Speculation is that BT is bleeding too, after the company announces poor Global Services division profits.

The first digital diagnostic system for Chinese traditional medicine is being tested.

It’s not electronic like Neal’s "tick, tock" rant, but a Georgia pediatrician sends an eerily similar (but paper-based) memo to employees of the medical practice she founded. It started with the title "War Declared," leading off with "since slackers have declared war on me by electing evil incarnate as president and guaranteeing that our business will never again expand, i will respond by declaring my own war on slackers." The doctor quit the next day, saying the memo was "simply stupid."

GE Healthcare is an investor in a $100 million private equity fund in Saudi Arabia.

University of Michigan Health System implements a hiring freeze. Imagine the Michigan economy if Ford or GM goes belly-up, which looks entirely possible.

A political group in South Africa wants the health minister to investigate the performance of hospital CEOs, which are hired by political appointment, observing that the experience of some of them is in politics, not management or healthcare.

Houston police are investigating the theft of backup tapes from Christus Health Care System, stolen from an employee’s car. Why they were there wasn’t mentioned.

The FBI is investigating an extortion threat against Express Scripts. The company received a letter in early October with personal information on several dozen patients, threatening to expose similar information on millions more patients if an unnamed sum of money isn’t paid.

Struggling Canadian OB system vendor LMS Medical System announces a "strategic restructuring," later more specifically defined as a 50% layoff.

Cook County’s hospitals bring in MedAssets to performing upfront financial counseling for patients.

Magee-Women’s Hospital (PA), defending itself in lawsuits from pathologists who claimed their names were signed to lab reports they hadn’t seen, blames its IT department for botching a system conversion. "The (Information Technology) department didn’t consult with pathology before they came up with the program. They created the fix themselves."

Laying off: imaging software vendor Vital Images. The company swung to an earnings loss in Q3, announced Thursday, and cut 11% of staff.

Vendor Deals and Announcements

• FQHC Horizon health Center (NJ) selects eClinicalworks EMR/PM solution for its 20+ physician group. http://www.eclinicalworks.com/2008-11-3bpr.php Tufts Medical Center and the New England Quality Care Alliance (Tuft’s physician network) have also selected eCW for the academic and community settings. eCW’s PM/EMR will be offered to the 900 affiliated physicians.
• SourceMedical announces the release of its Vision 2.6 version for ambulatory surgery centers.
• Dr. Jeffrey Wajda, VP of clinical services at LYNX Medical Systems, is appointed to the national reimbursement committee of the American College of Emergency Physicians.
• The Hospital for Special Surgery (NY) purchases Mediware’s BiologicCare product.
• 7 Medical, a provider of on-demand PACS and EMR solutions, is honored with an award for superior technology advancement and leadership in Minnesota.
• IntrinsiQ’s IntelliDose solution is selected by Cancer Center of South Florida to manage chemo treatments.
• Wolters Kluwer Health names Robert Becker its new president and CEO, replacing Jeff McCauley, who left this summer. Becker has been Kluwer’s Law and Business division global CEO for the last five years.
• Emtec introduces a mobile clinical workstation solution that integrates smart cards, thin-client computing, and mobile workstations. The solution also enables clinicians to access their personal computer desktop on other computers in a facility.
• Methodist Medical Centre (IL) deploys GE Carescape, GE Healthcare’s wireless platform.
• SAIC is awarded a $56 million contract to provide software and engineering services for VistA’s health data repositories program.
• Oconee Medical Center (SC) announces they’ve eliminated all serious five rights-related medication administration errors as the result of implementing IntelliDOT’s BMA.
• Compuware is providing the electronic connectivity infrastructure to permit clinical information sharing among Michigan’s Thumb Health Information System HIE.
• Streamline Health CFO Paul W. Bridge, Jr. resigns effective immediately, following notification that the contract for his current term ending January 31, 2009 would not be renewed. Bridge had been with Streamline for 12 years.
• Eight-provider Cardiovascular Associates of Mesa (AZ) selects Ingenious Med’s inpatient revenue cycle management solution.
• Huron Consulting Group is beefing up its healthcare practice group with the addition of 35-year consulting veteran Robert E. Wilson and the transfer of managing director Dirk VerMeulen to the company’s Health and Education Consulting practice.
• The VA is increasing its existing contract with InterSystems and partner Four Points Technology by an additional $2.8 million. The original contract amount was $34.9 million.
• Motion Computing touts the successful implementation of its devices with Allscripts Enterprise EHR at the 230 provider Springfield Clinic (IL.) Once fully deployed over the next few months, the clinic will have over 800 tablets and 1,000 docking stations.
• Patient Care Technology Systems announces Jaime Ojeda is its new VP of sales and business development. Ojeda has spent the last 15 years at 3M.

E-mail me.

News 11/7/08

From Booger: "Re: ACS. Heard through the grapevine – Charles Bracken, managing director of healthcare solutions at ACS, will be the new CIO of Catholic Health Initiatives." All I’ve heard is that Witt/Kieffer is doing the search.

From Mr. Rev Man: "Re: development cost. Does anyone know much money has been spent to date on R&D for Cerner’s ProFit and Siemens HIS Soarian products? We always hear about how much is being spent on clinical software solutions, but not much is known about the these products."

Mac at Sales Lead Insights has written up the results of my marketing survey. And speaking of that, the folks at Intellect Resources are putting together a forum addressing the impact economic conditions on the industry. They invite everyone (providers, payors, consultants, vendors, etc.) to report their company’s experience and outlook in their short survey, in which you may also volunteer to participate as a guest panelist or online forum attendee. I’ll have the results here, so it should be a good read on what’s going on.

A couple of folks e-mailed to tell me they nominated me for some survey that Healthcare IT News is doing on "who stirred up the industry" in 2008. There’s no way that they would let me win even if I got the majority of votes given their regularly expressed contempt for HIStalk, but thanks for the thought.

Jobs: Information Systems Director (WA), PharmNet Project Manager (no relo needed), HL7 Integration Architect (AZ).

The private equity company that owns 26% of IBA Health Group says it will remain a backer despite this week’s $1.1 billion collapse of its parent company. And speaking of IBA, the University Hospitals of Morecambe Bay NHS Trust is the first trust in England to go live on Lorenzo, developed by iSoft before that company’s acquisition by IBA last year. That’s a pretty big deal since the implementation is three years late, but it’s still a key part of NPfIT (which could use some good news right about now).

Health Robotics signs a big deal in the Middle East its IV automation technology (it competes with RIVA if you follow them, which I do). The deal includes 32 of its chemo-compounding "robots" and 175 of its non-chemo compounders. I see the company also has signed deals with University of Colorado Health System, University of Michigan, and Jackson Health System, so it’s looking pretty hot. I also know some of the US-based execs, as I found out when checking the company a bit further: former Eclipsys executives Peter Camp and Jack Risenhoover work there now.
 

Welcome and thanks to new HIStalk Platinum Sponsor Sunquest Information Systems of Tucson, AZ. Everybody knows them, of course, as a big player lab and rad, now expanding into Europe. It’s very cool that they decided to support HIStalk and I appreciate it. If you’d like to say thanks as well, click on their ad to your left and check out their offerings. As I’ve said before, it’s great to have the Sunquest name and company back.

Microsoft HUG will open membership up to those in Europe, the Middle East, and Africa. Which reminded me of a caustic-but-funny story I read in The Onion entitled Microsoft Ad Campaign Crashing Nation’s Televisions. "WASHINGTON—According to an FCC report released Monday, a new $300 million Microsoft ad campaign is responsible for causing televisions all across the country to unexpectedly crash … The new ad campaign, which features footage of everyday Americans using PCs, was launched as an upgrade to the poorly performing Jerry Seinfeld and Bill Gates commercials, which suffered unspecified failures in two-thirds of U.S. households. Microsoft pulled the defective ads in mid-September, but the move came too late, as countless televisions had already been infected with viruses and spyware … Recent frustrations with Microsoft have not been limited to its television ads, however. Earlier this week, a billboard promoting the company’s latest Windows platform angered hundreds in Detroit when it fell onto three cars, instantly killing all passengers."

Speaking of Microsoft, the company is offering Web start-ups Visual Studio, SQL Server, SharePoint, BizTalk, and Windows Server free … for three years (so it’s like open source, but only if your business goes down the tubes fast). Anyway, an early taker was doctor booking site ZocDoc, which I believe I’ve mentioned in the past. More info here.

And speaking of Microsoft yet again, the company raises some hackles by naming a programming language it’s working on M, apparently unaware that the name is a synonym for healthcare language MUMPS, which powers probably 80% of the HIT implementations out there, including those from MEDITECH, Epic, QuadraMed, and many others (courtesy of its inventor, MEDITECH’s genius Neil Pappalardo and the Mass General crew under Octo Barnett in the 60s). Microsoft’s Windows-only offering, part of its Oslo compiled .NET strategy, is supposed to be part of Visual Studio 2010. They say the name’s not final anyway.

Long Beach Memorial Medical Center CEO Terry Belmont quits. 

Infection control software developed by Tel Aviv University reduced hospital epidemics by 45%.

Axolotl’s Elysium e-prescribing solution earns SureScripts-RxHub Medication History certification.

I don’t know how I missed this: Dan Kinsella, healthcare practice VP with The Revere Group, has a blog called Healthcare IT Insights. The company was at the just-concluded Midwest HIMSS 2008 Fall Technology Conference, which I see has posted the presentations online.

A remote hospital in Canada, unable to find a pharmacist, signs up for a telepharmacy program in which a remote pharmacist will review and enter medication orders, also visiting once a month.

The Advisory Board Company’s Q2 numbers: revenue up 7%, EPS $0.32 vs. $0.45, with the CEO fretting about "member uncertainty about the budget outlook for 2009." Still, raking in $58 million from hospitals in one quarter is pretty darned good.

McKesson adds Swissray as its digital radiography partner.

George Washington University Hospital will implement clinical documentation from Baltimore-based Salar. I wrote about them in 2005, saying, "UPMC latches onto yet another early-stage healthcare technology: remote concurrent coding from a company I’ve never heard of: Salar. The CEO looks to be almost old enough to drive." Their client list now also includes Hopkins and UMass. It looks like a portable forms-style electronic system that overlays common clinical systems.

The Research Institute at Nationwide Children’s Hospital (OH) develops software for a Virtual Microscopy Microarray, a personalized medicine technology that will allow Internet-based virtual teams of pathologists to review microscopic tumor scans and their genetic underpinnings to develop patient-specific treatment plans.

Emageon drew two bids last month other than the $3 per share successful one from Health Systems Solutions to buy the company, one for $2.20 and the other for $2.45.

A computer glitch with the Florida Healthy Kids low-cost health insurance program causes thousands of children to be dropped from the program. The state blames ACS, which got an five-year, $87 million maintenance contract this year, for incorrectly migrating data to a new system.

CMS moves its January 1 ban on faxed prescriptions until 2012 "in the interest of patient care and safety and to encourage prescribers and dispensers to adopt e-prescribing." That helps e-prescribing, oddly enough, since some EMRs can only send prescriptions by fax and doctors would have simply gone back to paper.

Saudi Arabia gears up to provide for the health needs of 3 million participants in December’s Hajj, the annual Muslim pilgrimage to Mecca. The ministry of health will have 10,000 health care workers on the job, providing medical care, vaccinations, and emergency treatment, and also using computer links to hospitals and pharmacies to check resource availability.

The lawsuit involving a former Magee-Womens Hospital of UPMC medical records worker is underway. The hospital says they received two patient complaints that the secretary had leaked medical information. She says the hospital was upset because she provided records as requested to a pathologist who is suing the hospital, claiming that pathologists’ signatures were being attached to records they had not reviewed.

E-mail me.

HERtalk by Inga

The election is over and so far, the country’s problems haven’t been solved, nor has the sky fallen! The news channels will have to discuss something besides the latest polling results or which candidate went off script. I personally am looking forward to more coverage on Michelle Obama’s style selections. Analysts have now turned towards educating the rest of us on what the election results really mean, including how HIT will be impacted. Obama says he wants to spend $50 billion over the next five years to upgrade the healthcare technology infrastructure, which would provide particular benefit to vendors supplying EMRs and e-RXs. Supposedly most of the money would go to those physicians who have claimed current solutions are too costly. Personally I am left wondering 1) if such a proposal will actually be approved; 2) if $50 billion will be enough; and 3) if physicians will use the technology even if it is free.

AT&T is acquiring Wi-Fi service provider Wayport for $275 million in cash. Wayport provides hotspots for a number of healthcare systems (including HealthSouth, Inova, and Sun Healthcare) as well as hotels, airports, and McDonalds. With the purchase, AT&T’s Wi-Fi footprint will be expanding to almost 20,000 hotspots domestically. I’m pretty psyched that I can do some serious downloads on my iPhone for free while eating fries and a Big Mac!

Sentillion CTO David Fusari will be a featured speaker at Gartner’s Identity & Access Management Summit next week in Orlando.

Sonitor Technologies and JAOtech are partnering up to allow JAOtech’s multimedia terminals to be equipped with Sonitor’s ultrasound receivers. The solution allows the terminals to form the nodes for a hospital’s indoor position system.

I saw this announcement regarding nine-physician Durango Orthopedic Associates’ selection of SRS for its EMR solution and recall chatting with the SRS guys at MGMA. One rep told me very sincerely that SRS has “never” lost a client. I’ve pondered that a few times over the last couple of weeks and have wondered if it really is possible to please all your clients forever.

Vista Equity Partners, the VC firm that purchased Sunquest last year for $382 million, has announced the closure of its Vista Equity Partners Fund III with approximately $1.3 billion in capital commitments.

Lots of companies are announcing their third-quarter earnings. If the sampling below is any indication, organizations that rely of direct patient payment appear to be struggling more than the HIT vendors. Will the affects of a weaker economy trickle down to the vendors by the end of year? Or, perhaps vendors won’t see much change until 2009, when most organizations are following a (likely tighter) 2009 budget.

Rehab services provider HealthSouth announces a 98% drop in income for Q3 compared to last year. However, revenue increased about 7% to $456 million. Earnings were better than anticipated and the company expects the full-year earnings will exceed its forecast. HealthSouth attributes the low income number to the $17.1 million charge related to its litigation with UBS Securities.

Tenet Healthcare fell short of analyst projections with its $2.2 billion revenue posting for Q3. Earnings were $104 million, up from a net loss of $59 million last year. Tenet predicts 2008 total earnings will be between break even to $75 million. The stock price has fallen almost $2 this week to $2.48/share.

Perot Systems also saw a decline in its stock prices after predicting a slower Q4. Results for Q3 were on target and included a 9% rise in revenue and a 25% jump in income compared to last year. So far this week Perot’s stock has slid 20%, closing at $11.48 today.

athenahealth beats estimates with its third-quarter revenue growth of 35%. Non-GAAP adjusted net income grew from $2.1 million last year to $4.8 million and EPS was $.14.

Eclipsys also saw good growth with a 9% increase in revenues and a 36% jump in non-GAAP net income that was in line with analysts’ $.30/share projections.

The eClinicalworks folks forwarded me this link to Dr. Greg Hinton’s blog postings on this week’s user group meeting. Sounds like one of the lighter moments occurred on Election Day at the start of a presentation by Dr. Farzad Mostashari, who is chairman of the Primary Information Taskforce. Mostashari’s “Top Ten Reasons Why eCW and Girish are Similar to Barack Obama” was apparently a big hit.

E-mail Inga.

News 11/5/08

From The PACS Designer: "Re: Skyfire. If you want the PC look for HIStalk and also TV viewing on your cell phone, check out the demo from Skyfire, which is a free download. They claim to be better than most other cell phone Web and TV viewers and can easily outshine the iPhone and Opera-mini viewers." Link.

From Hari Seldon: "Re: product placement. There was a huge HIT product placement in the movie Serenity (above). I wonder how many other movies and shows have featured HIT products?"

From Fourth Hansen Brother: "Re: layoffs. 74 at Columbia St. Mary’s (WI)." Link. Add to the list from just the last couple of days: Shasta Regional Medical Center (CA), 150 employees; Charleston Memorial Hospital (SC), closing completely, 14 employees; RJ Reynolds Patrick County Memorial Hospital (VA), 40 employees; and Cooley Dickinson Hospital (MA), 47 employees.

The European Commission’s high-level, invitation-only conference will merge with the World of Health IT conference of HIMSS. I was going to make a joke about France surrendering to HIMSS next, but at least one person e-mails me a nastygram when I drag that joke out of mothballs, so I’ll claim new global enlightenment.

Wristband maker Precision Dynamics acquires healthcare label vendor TimeMed Labeling Systems.

AT&T is offering free Wi-Fi for buyers of some of its smartphones (including the new BlackBerry Bold, out today), with details of its Wi-Fi services here. Coincidentally, my AT&T contract just ran out last week, so I’m seeing what’s out there, although I’m too cheap for anything more than basic voice-and-text-message service.

 
Panasonic announces the $2,999 Toughbook H1 mobile clinical assistant, claiming six-hour battery life and featuring RFID and bar code readers, a 2-megapixel camera, a smart card reader, and fingerprint readers. Cool feature: it has a utility that sends wipe-down reminders to users and marks them as done in a database.

Cincinnati Children’s (OH) will use Click Commerce’s eResearch Portal to automate grant application and budgeting.

Uganda is considering implementation of an e-health system.

Sunquest names Richard Batch, formerly of Cardinal Health, as VP of product development.

Emageon will pay CEO Charles Jett $1.2 million in severance when the company’s sale to Health Systems Solution, Inc. is finalized.

Only in hospitals: a clergyman is taken to a British hospital ED to have a potato surgically removed from a rather private area. He claims he fell on it while hanging curtains naked.

E-mail me.

HERtalk by Inga

An AMA survey concludes that PQRI process needs to be made easier for physicians. Most could not download reports and less than half of those who did found them useful. Physicians also complained that reports took 12 months to receive, which didn’t leave them enough time to make adjustments to qualify for bonuses.

It sounds like MedcomSoft is running out of options for staying afloat long-term. The company will keep trying to find a buyer (at far less than the $15 million of new capital originally sought) or initiate a wind-down of the business. Each of MedcomSoft’s board members has also resigned.

Virtual Radiologic signs a deal to be VHA’s preferred provider of teleradiology services.

The six-county Mississippi Coast HIE will use Medicity’s MediTrust clinical operability platform and ProAccess clinical applications suite to exchange clinical data.

Versant Ventures invests $13 million in CodeRyte.

eClinicalWorks is hosting its four-day conference in Orlando, sold out with nearly 1,200 attendees. New products were announced for next year: eClinicalMessaging (physician-to-patient messages) and eClinicalMobile (smart phone access for physicians). Also announced: a new deal with Continuum Health Partners (NY) and its 3,300 docs. The nice folks at eCW invited Mr. H and me to attend this first national conference, but unfortunately neither of us could make it happen. I personally hate missing a good time, so if you are there, send us an update.

A construction journal discusses some details of Epic’s expansion, which will feature three 150,000 square foot buildings, a 177,000 square foot building, and a 752,000 square foot underground parking deck. Pedestrian tunnels will connect the buildings and geothermal fields will heat and cool the whole complex. It will be finished in 14 months.

Siemens Healthcare Diagnostics will lay off 151 Los Angeles-based employees on December 30th, according to reports.

The Minnesota Department of Health’s Office of Rural Health and Primary Care awards $3.5 million in grants to 21 EHR implementation projects.

The NY State Department of Health extends CSC’s contract to support the state’s Medicaid system with a $322 million, three-year contract.

Whitmore Lake Health Clinic (MI) faces closure over a $110,000 IRS bill. The clinic blames its large number of uninsured and underinsured patients.

A couple of Dallas area readers forwarded me this story. A Baylor Healthcare laptop taken from an employee’s car in September contained names and treatment codes for 100,000 patients and Social Security numbers for another 7,400. Leaving a laptop in the car is against Baylor’s policy and the employee was fired. Meanwhile, Baylor’s offering $1,000 for the laptop’s return and free credit monitoring to those affected.

Lakeland Regional Health System (MI), already a user of the agent-based healthcare exchange platform of Novo Innovations for its 70 affiliated physicians, signs a new deal to offer it to its remaining 200+ affiliated providers.

Oklahoma University Medicine is live on MEDSEEK’s consumer portal, just three months after starting implementation.

ABEO, the country’s second largest anesthesia-specific revenue cycle management services company, purchases Pasadena Billing Associates.

Hard to believe, but Mr. H and I are already starting on some HIMSS-related projects. One big one is our pre-HIMSS HIStech Reports, which highlight individual companies with an interview and Mr. H commentary. We include a magazine-style reprint that several companies handed out at HIMSS last year to great response (until they ran out because everybody was picking one up). If you’re interested, e-mail me.

E-mail Inga.

Monday Morning Update 11/3/08

From Barry S: "Re: Breakway Company comment. I have the same question. The focus group that they hosted seemed to be all about ‘how’ they can get into healthcare and trying to figure out what the next best thing would be, not about what they can do for us or the industry. Granted, the groups are designed to give them feedback. However, I was disappointed that it wasn’t very substantive. I am thinking that it just may be fluff."

From Sophie Sheridan: "Re: DR Systems patent lawsuits. I’ve heard from one industry source that the payoff (and settlement) for admitting you infringed on the DR patent is $500,000. However, a credible – and successful – defense to dismiss the suit would cost about $1.5M in legal fees. I wonder how the presumed income of $500,00 a couple of times a year fits into a business plan?"

From Frankie Saluto: "Re: ICD-9 vs. ICD-10. Looking at the list of ICD-10 codes for insect bites, it seems like a classic example of what may happen when one does not NORMALIZE a data model. The whole list could have been translated into three interrelated entities: anatomy (scalp, abdomen, etc), pathology (insect bite in this case) and visit/encounter  (first encounter, subsequent, etc.)"

Thanks to everybody who responded to my 2009 marketing survey. Some interesting facts from it:

• 29% of companies anticipate spending more on advertising in marketing and advertising in 2009, with 43% expecting to spend the same and 29% planning for less
• 93% will spend as much or more on blogs in 2009 as they did in 2008
• 67% of respondents said they will spend less on magazine advertising, which was also rated as the least effective program and the lowest return on investment
• HIStalk’s sponsors ranked their sponsorship as their most effective program (tied with trade shows)
• HIStalk was ranked #1 in return on investment by current sponsors
• The most important benefit reported by sponsors is mentioning company news and announcements

Also a surprise: readership shot up again in October, breaking the all-time record (September) by around 15%. Thank you for being part of that – I personally appreciate the support. It’s always slower in November and December, so if you want to help offset that, click the "Email this to a friend" graphic to your upper right to tell a few friends about HIStalk. Thank you.

Listening: Calexico, recommended by Tom. Kind of like Nick Cave meets a mariachi band on the way to a Pink Martini concert. Easy to listen to, unlike some of my weird picks. Like it lots, great suggestion.

Premise announces its patient flow solutions consulting services, led by Barbara Bryan. I keep predicting that credit problems will force hospitals to increase capacity virtually rather than physically, something that experts can make happen.

Lehigh Valley Physician Group (PA) chooses MDaudit compliance audit software from Hayes Management Consulting.

eHealth Ontario names Sarah Kramer, previously VP/CIO of Cancer Care Ontario, as president and CEO.

Jobs: Senior Software Engineer (WA), Senior Product Manager (UT), Client Services Director (NC), PMO Eclipsys, Cerner, or Epic (nationwide). Weekly job blast signup is here. In this economy, it’s best to be prepared.

Former FCG CEO Larry Ferguson joins the board of business intelligence systems vendor Accelrys.

Husband-and-wife professors from Case Western Reserve University want the federal government (CMS specifically) to oversee electronic health records with "rigorous regulation", citing security and privacy issues.

The SVP of Medtronics says the end of the line is near for medical devices. "You can’t keep stuffing gizmos into people to treat end-stage disease. When biotechnology gets right, we’re finished. Because it’s restorative, not palliative as devices are.” He also said easy investor money rather than American ingenuity led to this country’s leadership in such devices, noting that most of them were invented in other countries.

Hospital layoffs: Valley View Regional Hospital (OK): 127 employees. Newark Beth Israel Medical Center (NJ): 100 employees.

A UCF professor develops computer-generated patients that will be used to help medical students learn to make better decisions.

Odd lawsuit: a former hospital priest is fired after a woman claiming he seduced her files a $25 million lawsuit. She says he had Viagra mailed to her apartment and complained by e-mail about a groin rash he said he got from having sex with other women.

Another odd lawsuit: Washington Adventist Hospital (MD) is sued by the family of a heart patient who coded on the toilet of the locked bathroom of his hospital room and staff couldn’t find a key to get to him before he died.

Merge Healthcare announces Q3 numbers: revenue up slightly, EPS $0.01 vs. -$4.17.

WebMD’s Q3 numbers: revenue up 17%, EPS $0.18 vs. $0.19.

Shands-Jacksonville Medical Center (FL) fires 20 employees for accessing the medical records of pro football player Richard Collier. I noticed that the TV station’s story, which spelled out what HIPAA stands for, abbreviated it first as HIPPA, then changed it to PIPAA, shattering any illusion that that highly paid talking heads who read the news to you actually know what they’re talking about.

The CEO of Saddleback Memorial Medical Center (CA) gets a writeup in the business paper for its $60 million push for electronic medical records.

Intel has a November 11 announcement, apparently of its FDA-approved Health Guide PHS6000, which allows patients or caregivers to enter and transmit medical data.

A BlueCross BlueShield venture fund’s first investment is $5 million in Initiate Systems.

A hospital’s cancer care manager, testifying in an inquiry about the hospital’s lab mistakes and its failure to notify patients, has been on the stand for 129 days.

Vendor Deals and Announcements

• Midwest NeuroSurgery & Spine Specialists (NE) selects Intergy EHR by Sage for its eight-physician group.
• MedAssets releases a new Alliance Decision Support solution to help healthcare providers analyze and utilize operational information to improve financial performance.
• Patient Placement Systems partners with Iatric Systems to develop interfaces for to connect MEDITECH’s solutions to Patient Placement’s web-based admissions and referral management systems.
• The 30-physician CORE Institute (AZ) signs a three-year agreement with MedSynergies for revenue cycle services.
• A study by The Mary Imogene Bassett Hospital (NY) shows the implementation of its SIS perioperative system raised on-time first case starts by 35% and turnaround times by 33%. The hospital was able to reduce supply cost by $200 a case and increase surgery-related charge capture by 30%.
• Johns Hopkins is implementing iMDsoft’s MetaVision Anesthesia Information Management System.
• Methodist University Hospital (TN) has installed ForHealth Technologies’ IntelliFill I.V. for the automatic preparation and labeling of intravenous doses.
• NextGen announces Q2 earnings, with a 9% increase in net income over the previous year and a 31% rise in revenue. The company met analysts’ expectation for EPS and beat revenue estimates by $1.4 million with its $59 million performance.
• Henry Ford Health System is purchasing MRO’s RAC Tracker Online to manage its recovery audit processes.
• Innovative Consulting Group announces (warning: PDF) it is expanding its service offerings with the additional of an Epic practice. Serving as Epic Practice Director is Todd Shavor, an Epic Certified Ambulatory consultant who has worked on multiple projects including implementations at Baylor College of Medicine and the Harris County Hospital District.

E-mail me.

News 10/31/08

From JoJo: "Re: Frost & Sullivan’s HIT senior analysts/consultants. They appear to have lost them all. After years of being able to offer different content and provide strong insight (we used them for advisory for a new product introduction and emerging technology information), it seems like this ‘group in a corner’ of an otherwise lackluster place found new revenues elsewhere. We have been reluctant to seek others such as Advisory Board, Sg2, Gartner, or even the smaller joints since we had a such a strong machine running with them. Would appreciate any ideas from you or others for a few strong minds in the field."

From JonJon: "Re: The Breakaway Group. Can anyone verify them? They were at the CHIME fall meeting, but I really am not certain what they do. The focus seems to be EMRs, but the only account they could speak to was University of Tennessee and their new CMO came from there, so I am not clear if that is valid experience."

From Tony South Dakota: "Re: [magazine name deleted]. Ha, that’s rich. This was live on their business briefs web site." TSD had sent me a link an HIT magazine’s so-called online news brief that contains a story I ran nearly three months ago in HIStalk (not a rumor, an actual news story). Maybe that’s why 44% of respondents to my 2009 marketing survey so far say their companies will decrease print magazine advertising in 2009 (not to tip off the results early, but I figured that was relevant). Don’t worry, if you completed the survey using a company e-mail address, I’ll be sending out the compiled results this weekend. They are interesting.

From Rene L. Fallure: "Re: CCS. I attended the CCS HIT Spring Summit in Washington, DC. It was not well attended and those who did attend were the sponsor representatives and a few of their guests (expenses paid). Most of the speakers arrived just in time to speak and then hightailed it out the door. Content was weak and very little new. With other venues of more substance, I doubt I would attend another CCS event. The hotel was nice, but too expensive. Lunch was not included either day although the attendance fees were steep enough." Mr. HIStalk’s three critical meeting planner reminders: (1) a good breakfast and lunch will get you high evals even when everything else goes wrong; (2) allow a lot more socializing time for attendees than you think they need since that’s why they are really there; and (3) include an no-pressure, no-agenda evening social event that includes cocktails and even more good food. Running a meeting on the cheap doesn’t work when attendees are paying (and even when they’re not). I’ve been to a couple of events (not CCS ones) where the speakers got comped registration and travel and everybody else had to make themselves available for vendor pitches. The speakers were big name, but they looked at it as a free trip and did pretty much nothing more than show up and sleepwalk through the same old stuff.

From Pierre Doncarlo: "Re: UCI. I can confirm that Joy is out and Jim is back in an interim role."

Listening: Queen’s new studio album, just released. Paul Rodgers (Bad Company) takes Freddie Mercury’s place and the result is pretty good, less pretentious than the Bohemian Rhapsody-era Queen. Also: Margot & the Nuclear So and So’s, eminently listenable and fresh indie pop out of Indianapolis.

RWJUH signs with Lawson for HR, supply chain, financials, and performance management.

I mentioned UTMB’s under-recognized telemedicine program. Turns out that the AT&T Foundation has been funding UTMB’s AT&T Center for Telehealth Research and Policy, which publishes outcomes research, holds seminars, and trains fellows, since 2002. I also noticed that UTMB offers Web-based telehealth courses and the subject areas sound quite practical and useful (like what kind of staff and equipment you need and how to get reimbursement). I’ve talked to a couple of folks there and I’m a fan.

University Health System (TX) gets board approval to buy an RFID equipment tracking system from InfoLogix. CIO Bill Philips is quoted: "These little squares have holes in them so you can put them on a patient’s wristband. Think of psychiatric patients, Alzheimer’s patients. You want to know, I sent this patient to X-ray. Where are they now? They should have been back. My ultimate vision is, you start tagging surgical instruments in the OR like sponges. You wave a wand over them and hear ‘ping.’ You don’t leave them in.” That’s a pretty darned good description if you ask me.

ICD-10 sounds like a great idea, right? Who could be against a more descriptive coding scheme? Rich Elmore provides an example: an ICD-9 insect bite is 919.4. Under ICD-10, there are nearly 100 codes instead of one. 

Results of a new Picis survey say that maybe we Americans are too critical of our health system. About half of people who received healthcare services said they had a positive experience in both the European countries and the US. Most respondents said technology could improve care delivery, ranging from 80% in the US to 96% in Spain.

Geisinger Health will use ForeFront Transfer, Web-enabled patient transfer software from Central Logic Healthcare Systems of Ogden, UT. I see some other big names in recent press releases doing the same: New York Presbyterian, St. Joseph’s in Phoenix, CHW, and WF-Baptist. I don’t know who’s involved with the company because its site doesn’t say.

Continua and IHE sign an agreement to jointly promote device interoperability.

House Democrats, dissatisfied with technology adoption by doctors and apparently not troubling themselves with massive deficits and a wheezing economy, are drafting a new HIT bill.

The folks at Hayes Management Consulting just finished their latest newsletter, including an early recap of the company’s 2008 highlights.

Congressman Paul Ryan (R-WI) is a co-sponsor of a bill that would establish independent health record trusts where consumers could manage their own health records. Anonymized data sales would be allowed, but the proceeds would be split between the owner and the data bank, which would use the money to fund its operation. He would also require EMR vendors to link to those trusts. "The software packages that are out there – Epic, Cerner, McKesson, General Electric – they would have to have patches on their software systems for interoperability, for universal connectivity. To me, a lot of this is simply requiring interoperability among software providers so that these hospital and physician systems do talk to each other. You have to have that common architecture in order to have a system where we can compare apples to apples throughout the health IT system.” Sounds like he knows what he’s talking about, actually. He’s up for re-election next week.

DR Systems announces five new RIS/PACS sales.

University of Kansas researchers get a $2 million NIH grant to see if smoking cessation counseling by telemedicine works.

Cardinal Health’s Q1 numbers: revenue up 11%, EPS $0.69 vs. $0.82.

An interesting quote from a VP of telephone company Embarq (even if the company did just get sold for $12 billion): "My [chief financial officer] observed to me the other day that if I don’t stop the escalation in health care costs, we’ll be spending more on health care than we do on information technology. And in our industry, information technology is the core of what we do. If [Embarq] did information technology like the health care system has been doing it, we’d be giving you tin cans strung together with twine to do your communications.”

Hospital layoffs: Boone Hospital Center (MO), St. Joseph’s Hospital of Atlanta, Valley Presbyterian Hospital (CA).

Children’s Hospital Boston launches a philanthropy web site for 8-12 year olds.

A British nurse faces disciplinary action after hospital IT experts tracked her down for offering her panties for sale on eBay using her hospital e-mail address.

Intel funds a digital clinic in Russia.

St. Vincent Charity Hospital (OH) says its former director of marketing, who committed suicide with her husband in July, had stolen over $4 million from the hospital. The hospital had mailed payment for phony invoices to a PO box, where the woman’s husband picked up the checks and cashed them.

E-mail me.

HERtalk by Inga

From Sam Matalone: "Re: what the candidates propose. I have to start working for CNNmoney and they will talk to me." Sam has been trying for several weeks to get each presidential candidate to provide him some specifics on how they see HIT playing into their plans. Both camps are apparently too busy to respond. This story touches on each candidate’s health care reform proposal and this article summarizes each one’s plans. Both claim they want investment in information technology to drive efficiency, but the details are sparse. Too bad Joe the Plumber is getting all the attention rather than our own Sam the HIT guy.

At the risk of being called out bringing up too much political stuff,  here’s another nice little summary of the candidates’ plans. It comes from a publication called Medill Reports, which I thought was neat because it is written and produced totally by Northwestern University graduate journalism students.

I’ve been reading through the results (warning: PDF) of the 2008 HIMSS/HIMSS Analytics Ambulatory Healthcare IT Survey since it hit my e-mail yesterday. I feel like a bit of a nerd to say this, but I love this kind of stuff. Here are a few highlights from the survey of 500 individuals (primarily office managers) working at ambulatory clinics: (a) there are no dominate market leaders in this space; (b) only 13% of practices are planning an EMR purchase in the near future; (c) thirty percent of all practices had an EMR, 24% of the small ones, and 47% of larger groups; (d) cost was cited as the biggest barrier to EMR adoption (40%) followed by lack of interest in EMRs (25%).

Glen Tullman purchased 100,000 shares of Allscripts stock earlier this week. Now his boss Mike Lawrie has also upped his holdings, purchasing 70,000 shares for about $350K.

Healthvision announces that it added 15 new clients in the third quarter.

Wheeling (WV) Hospital’s board of directors approves the $20.9 million purchase of Eclipsys Sunrise, to be rolled out over three years. The hospital checked out 12 different companies before deciding.

Portico Systems has acquired Ethidium Health Systems. Portico’s offerings include solutions for managing provider operations while Ethidium develops clinical and collaboration tools (including EMR) for providers.

Huron Consulting Group is increasing its healthcare and HIT focus with the hiring of two industry veterans, Scott Kolesar from EDS and John Kavka from CGE&Y.

Women purchasing their own health insurance pay as much as 50% more than men for identical coverage. Insurers claim women use healthcare more than men and maternity costs are a factor for women in child-bearing years. However, women advocacy groups claim the gap is much wider than it actuarially should be.

HealthSouth receives $100 million in cash from UBS Securities as the two companies settle their lawsuit. The lawsuit stems from charges that UBS was part of a $2.7 billion fraudulent accounting scheme that included over a dozen HealthSouth executives between 1996 and 2002. HealthSouth is still awaiting judgments on suits filed against HealthSouth’s former CEO Richard Scrushy and E&Y.

Expenditures for diabetes medications have risen from $7 billion in 2001 to $13 billion in 2007. Patient visits have increased and newer drugs are more expensive.

Cisco cuts the ribbon on its new LifeConnections Center at its San Jose headquarters, which will include health care services, child care, and fitness offerings. Cerner is providing the health care clinic software.

AT&T sent me a text message on my iPhone today saying I now have free Wi-Fi access at 17,000 hot spots, including Starbucks. On their web site, they also mention some other cool spots to connect, including airports, hotels, restaurants and supermarkets. Kind of cool to think that I could be downloading Mr. H’s latest music recommendation while picking up a gallon of milk.

E-mail Inga.

News 10/29/08

From Houndoggie: “Re: UCI. The Eclipsys install got pushed again at UC-Irvine Med Center and the first casualty was Joy Grosser, long-time CIO. No word yet on what is going to happen. Jim Murry was brought back in the interim spot.” Unverified. I’m happy to run either confirmation or correction, whichever is appropriate.

From Slap Maxwell: “Re: AM/PFM. Yes, AM/PFM is the old SDK. It is quite functional and effective for Bridgeport and numerous other users. It does not get much press, but you can ask Eclipsys why. It seems to me they should be marketing the heck out of it.”

From The PACS Designer: “Re: RIS/PACS and EHR. TPD has mentioned in the past that some PACS suppliers include a mini-EHR in their systems. When a RIS is added to the PACS, the EHR becomes more robust in collecting  information, which can result in improved efficiency for the institution. Sectra, a RIS/PACS supplier, is taking the next step by partnering with an EHR supplier to bring more information into the RIS/PACS system. This move could start a new trend that others may emulate in the years ahead.” Link.

McKesson just announced Q2 numbers: revenue up 9%, EPS $1.17 vs. $0.83. Earnings beat expectations even when one-time items were excluded. John Hammergren bragged that the company was doing just fine despite the economy, but then mentioned that some of its IT prospects are delaying their decisions.

Parrish Medical Center (FL) deploys two solutions from the Thomson Reuters Clinical Xpert suite: CareFocus (clinical surveillance) and Care Navigator (mobile clinical information).

Only in America: the Kansas guy arrested for leaving his girlfriend stuck on the toilet in his mobile home for two months wins $20,000 in the lottery — for the second time this year.

Fred Trotter calls attention to the National Dialogue site, which is conducting a discussion on HIT and privacy through November 3.

If you’re a vendor marketing person, here’s a last chance to complete our seven-question survey on what 2009 looks like in terms of budget, priorities, etc. We’ll send you the aggregated results if you provide your e-mail there. I doubt anyone else can give you such a quick read on what to expect next year.

The insurance company that refused to pay for a woman’s $4,000-a-month, last-chance cancer drug helpfully volunteered to cover physician-assisted suicide drugs if she chose that option, a bargain for them at only $50. The cancer drug has proven to be nearly worthless in extending life, showing only a couple of months of extra life vs. placebo. If you’re the patient, naturally you want all the stops pulled out, even if it buys you only a little extra time. Should the rest of us have our rates raised for that? Beats me. Anyway, another hot issue is whether insurance should get involved with physician-assisted suicide.

Advanced Technology Consortium, a “virtual entity” of National Cancer Institute-funded organizations (Washington U. in St. Louis, UC Davis, MD Anderson, UMass, and others) will implement TeraMedica’s Evercore clinical enterprise suite to manage its patient case data sets including its DICOM archive, DICOM RT objects, and metadata.

Defaults on hardware and software loans are increasing. CHRISTUS CIO George Conklin says some software vendors are now asking for 50% down. Others are self-financing customers for competitive advantage.

Jobs: Eclipsys Clinical Consultants, Epic Consultant, SIS Project Manager.

Former Navy hospital CIO David Yovanno is named CEO of Web widget start-up Gigya.

The local paper runs a nice article on Children’s Hospital of Wisconsin’s teledermatology program, where dermatologists use videoconferencing to treat patients 100 miles away. It quotes an article suggesting that 28% of ED visits could be managed by telemedicine instead, which I don’t doubt at all. I’m surprised that telemedicine isn’t bigger than it is, particularly since I think I read somewhere that reimbursement isn’t the issue it once was.

Here’s a list of Mac-specific medical applications.

A research report from RTI International says that large databases, such as EMRs and anonymized claims data, can improve drug safety by alerting researchers of the adverse effects of specific drugs.

Lawyers may beat doctors in EMR adoption. A Florida company announces its Internet-based utility to send patient medical records from doctors to personal injury attorneys. Note that the “About Us” and “Our Team” sections of the Web page names and shows no one other than some stock photo people, although some sleuthing seems to indicate that it’s the same folks who run Rehab 1.

Wolters Kluwer announces its Brand Probability File, whose entire purpose is to analyze a given drug and decide whether it’s a brand vs. generic product for purposes of formulary coverage. As screwy as it might sound, that’s not an easy call sometimes.

The political race for board seats of Washington Hospital (CA) gets ugly. A cardiologist launches her campaign with a documentary claiming the hospital delivers poor care. The hospital responds by pointing out that her own medical privileges were revoked by other hospitals because of improper care. The CEO showed pictures of another candidate, an attorney, who she accused of promoting the movie, while the board chair started a political action group to criticize both candidates, saying the attorney candidate is “defending sex offenders, drug violators and white-collar criminals.”

The world’s most lucrative healthcare market? The Middle East, this conference says (and which software vendors are already aware). Beds will double by 2025 at a cost of $10 billion and the industry will be worth $60 billion. Maybe Inga and I need to expand our news coverage there.

Covenant Healthcare (TX) will lay off 91 employees. Medical Center of Central Georgia axed 208 people last week, including 17 managers earning an average of $120K. Texas Health Resources just cut 49 people.

IBM is working on browser-based mashup applications in its Opus Una project, which allows users to share audio and video in real time. The article says one version being tested involves doctors collaborating while viewing x-rays, sending their markings back and forth. A hospital will be one of the three industries participating in the proof of concept early next year. I found this site, which takes forever to load but apparently doesn’t do anything.

CPSI is named to the Forbes 200 Best Small Companies list.

UMDNJ is under investigation again as subpoenas are served for allegations of additional Medicare fraud.

HP is apparently doing a lot of infrastructure stuff with hospitals.

The Welsh Clinical Portal is rolled out to another hospital in Wales. I hadn’t heard of it, but it went live earlier this year.

Michael Frankenberger has joined Ascension Health Information Systems as CIO, moving from Alliance Information Management in Fargo, ND.

Four of the ten board members of LMS Medical Systems, the Montreal-based vendor of the CALM OB system that seemed to be getting some US traction, have resigned, one of whom was just appointed two months ago. The company announced three weeks ago that it had terminated its US distribution agreement with McKesson. Shares are down 25% to $0.06, off 94% from their 52-week high.

The Worcester Business Journal runs a profile of eClinicalWorks as one of the fastest growing Central Massachusetts companies.

E-mail me.

From Jay Volk: “Greetings from Cleveland. I am the president of Workflow.com. I read your column from 10-20-08 and I was surprised to hear that you visited our booth at MGMA and no one approached you to offer you a demo of our product. If you are interested in hearing more about our company, please feel free to call me at any time. I hope you enjoyed San Diego as much as all of us did. Cleveland seems a little colder than usual as a result.” Thanks for the note, Jay. Hanging out in a booth all day is not the most exciting thing and perhaps with all my free tote bags, stuffed animals, and pens they assumed I was just looking for trinkets (busted!) I’ll catch you at the next show. Meanwhile, I still think your booth looked great.

HERtalk by Inga

A University of Colorado Hospital study of 49,000 patients reveals that its use of Picis EDIS decreased ED length of stay by 15%.

Mr. Green Genes is the name of a genetically modified cat that glows in the dark. The fluorescent effect is part of a gene therapy experiment designed to combat diseases such as cystic fibrosis. The scientists claim the special glow does not harm his health. Mr. Green Genes would sure be a cool addition to my Halloween party.

VeriChip, the guys that make the RFID chips that go under your skin, is out of compliance with Nasdaq. The stock price has fallen below the required $1/share mark for more than 30 consecutive business days. Nasdaq will give it extra time because of market volatility, but the company has to comply by April 20th or risk de-listing. Shares are at $0.31 with a market cap of just $3.5 million, 93% off their 52-week high.

Alliance Imaging names industry veteran Richard Hall as president of Alliance Oncology. He comes from US Oncology and has served in leadership roles at PatientKeeper, McKesson, General Medical, and BrightStar Healthcare. Alliance also announced that Mark Carol, MD is the company’s new chief medical officer.

Lloyd Dean, Catholic West Healthcare CEO, says the 41-hospital health care system will spend $6.5 billion in capital over the next five years. A big chunk will be for connecting physicians to the system and for electronic medical records.

The integrated workflow automation solution from Sonitor and PCTS now supports over 400,000 high acuity patient visits a year.

Eighty-three percent of companies have at least one woman or minority on their boards, but only 38% of women are among the five highest-paid executives, according to this survey. At HIStalk, we are bucking the trend, as I am the second highest-paid executive. Furthermore, if we had a board, I bet Mr. H would let me be president (of course, he’d be CEO). Power and money, what else does a girl need?

Baptist Health System (AL) is live on Sentillion’s clinical workstation solution Vergence. By the end of the year, Baptist expects 3,000 clinician users of the SSO solution.

The Loftware guys are recommending a November 11th seminar for anyone wanted to know more about the movement towards GS1 standards in healthcare. The title says it all: “Improving Patient Safety and Supply Chain Efficiency with Data Standards: The Basics of GS1 Standards in Healthcare.”

Sunquest Information Systems plans to expand to Europe following an initial agreement to purchase UK-based Anglia Healthcare Systems. Anglia is a provider of lab connectivity, orders, reporting, and messaging solutions and has a 60% market share in the NHS Acute Trust Hospitals, as well as a presence in Denmark.

MedData, a provider of emergency medicine and hospitalist RCM services, acquires competitor Summit Health Care Services.

Virtual Radiologic announces its Q3 earnings. The company’s $0.21 EPS was $0.09 better than analyst estimates, with total revenue of $29 million versus the consensus $27.4 million. Revenues were up 21% year-on-year, largely due to a 24% increase in the number of hospital and facilities served. Adjusted EBITDA also rose 16% from last year.

Now available from your physician: the HairDX test that indicates if a man is at high risk for pattern baldness. If a man tests positive for a particular gene, he has a 70% chance of going bald. If identified early enough, the hair-challenged man can begin prescription treatment for hair loss prevention. I am sure it will be a huge hit with the 20-something crowd, though personally I find the Mr. Clean look incredibly sexy. I could never figure out why a guy would want hair plugs or a rug or (heaven forbid) a comb-over.

Outcome Sciences is partnering with Greenway Medical to facilitate research and patient registries through Greenway’s PrimeResearch network. Outcome has developed technology that uses EHR’s for clinical research and quality measurement.

A doctor is accused of practicing without a license, and badly at that. Vikas Jain moved to Las Vegas after Ohio revoked his medical license for failing to meet minimum care standards with 22 of his ophthalmology patients. He is now being sued by two patients, each who claim their vision has been compromised following his negligent pre- and post-operative care. One of the patients is his former office manager. Vikas is counter-suing the office manager for removing her personal medical records from the clinic.

Allscripts CEO Glen Tullman and friends presided over the Nasdaq opening bell Tuesday. I say keep bringing him back since the Dow was up 890 and Nasdaq jumped 144. He just purchased an additional $511,000 worth of company stock, which represents a 17% increase in holdings to around $3.3 million.

Troubles with the NHS’s Connecting for Health continue. Health ministers are no longer scheduling new trust installations until existing implementation issues are addressed.

A new study concludes that moving emergency room patients to upper-floor hallways when they are ready for admission does no harm. “Hallway medicine” on the appropriate acute care floor is apparently less risky than leaving patients in the overcrowded ER hallways. Are there still people out there arguing that the US has the best healthcare in the world?

The industry’s leading optimist has to be Mediware president and CEO Kelly Mann. After the company announced that quarterly income declined from $463K last year to $218K this year, Mann said, “During the quarter we continued to gain traction in the U.S. and abroad for our new initiatives that will fuel the company’s growth.” Revenues also fell from $10.74 million to $9.83 million.

E-mail Inga.

Francisco Partners To Acquire API Software

Labor management software vendor API Software, Inc. will be acquired by private equity firm Francisco Partners II, LP, the company has announced. Closing is expected within 30 days.

The Hartford, WI-based API’s product line includes applications for time and attendance, staff scheduling, payroll, human resources, education tracking, and access control. Its Payrollmation and ActiveStaffer systems are top ranked in KLAS.

J.P. Fingado, formerly of Cerner, has been named president and chief executive officer.

Monday Morning Update 10/27/08

From Rose Michaels: "Re: Epic. From a reliable source (you’re probably already aware) Epic will be implementing in Dubai. Not sure of the details but figured if anyone could get them, it would be you. Thanks for doing the fabulous work that you share with us daily!!" I’ve mentioned it a couple of times back when University Hospital first made their selection, but hadn’t heard anything since, other than I saw an Epic user group story that said folks had come from as far as Dubai. More information is welcome. Seems like a lot of big deals are in the Middle East these days, but of course they’ve got the cash and have always been fans of US-style healthcare (at least the kind we deliver to our ultra-privileged patients).

From Al Borges, MD: "Re: Magellan EMR. Jason Murdoch, MD was able to get in contact with John, the owner. The EMR formerly known as Magellan has run into some business problems relating to being a small startup in a vicious EMR world. Magellan EMR has not been scrapped but is on the shelf. John is a reputable guy and took the site down to not mislead people." John e-mailed Inga back after her incessant sleuthing (we help readers however we can). Dr. Murdoch concluded with, "Does anyone know if Inga is a hot, Swedish blonde?" I do, actually, and all I’m saying is that she is indeed hot (and talented, and fun, and smart …) Swedish and blonde? I’ll never tell.

From Cliff Williams: "Re: Lincoln Park Hospital. At a Chicago meeting, I heard the hospital closed up shop, literally an overnight decision. Without warning, they called nurses and told them to come in and get their final check and sent patients to other facilities. Done. Sign of the times?" The hospital couldn’t find a buyer after it failed to find financing due to its $15 million annual losses and high Medicaid patient load. Deteriorating margins and tough credit will take more struggling hospitals out of the picture, although better capitalized groups may take them over if they have a presence nearby. That kind of Darwinism isn’t necessarily a bad thing, but some of the bigger groups got that way by minimizing the amount of charity care they provide. As always, uninsured patients take the biggest hit.

And speaking of closing hospitals, Physicians Medical Center Carraway (AL) also locked the doors on short notice this week for the same reason – it couldn’t get funding. I’ve been warning of that kind of situation for quite some time, but nobody seems to be noticing that it’s happening now (both closings and scrapping expansion plans).

From Al Borges, MD: "Re: HIT stocks. HIT in the USA is still in somewhat of a slump as compared to ‘Other Technology Companies’. HIT companies showed an unweighted YTD average return of -22.4% vs -14.2% for the OTCs." Link. There are probably lots of caveats to the list. Stock price movement within sectors tend to be amplified in both the up and down directions, so looking back one year may not be enough since all you’re seeing is performance in a historically awful market. The companies on the healthcare list are also a lot smaller and more focused than those international giants on the OTC list (Merge Healthcare vs. IBM?) Putting GE, Misys (shouted out as MISYS on the list for some reason), McKesson, Philips, and Siemens on the HIT side certainly muddies the waters since that’s a tiny part of their business and GE and Siemens are highly exposed to general international economic conditions. And, is looks like they simply averaged the individual one-year change, lumping in obvious low-cap losers like Merge (-77%), Emageon (-74%), and whoever I-Many is (-76%) with the big boys (half of the HIT companies have a smaller market cap than the smallest OTC listed). The list is pretty, but I’m not sure it really contains a lot of insightful or useful information. And, lots of the bellwether HIT companies aren’t publicly traded any more because of acquisitions, going private, or preference.

From Mike Donovan: "Re: Bridgeport. Mark Tepping is retiring after a long and successful career, but Bridgeport Hospital does not use ProFit – it uses Eclipsys’ AM/PFM for reg and billing." Thanks for that. I admire anyone retiring in today’s financial thrill ride. I must have confused Bridgeport with a ProFit user, which is surprising since there are so few of them. I don’t know anything about AM/PFM. That’s the old SDK, right?

Welcome and thanks to new HIStalk Gold Sponsor Satyam Computer Services of Hyderabad, India. It’s a big company ($2.5 billion in revenue and 53,000 employees in 66 countries) with a strong US and healthcare presence. Satyam’s services include hospital systems, portals, telemedicine, application development and maintenance, ERP, and consulting services. The case studies on the Healthcare Practice site include a couple from the Centers for Disease Control and Prevention. Thanks to Satyam for supporting HIStalk.

Former Caritas Christi CIO Dan O’Neil is named CIO of Quincy Medical Center (MA). And speaking of Caritas Christi, it gets $100 million in funding from Ascension Health, which probably means they’ll buy it eventually (which is a pretty good example of what I wrote about struggling hospitals being bought by bigger groups, which I promise I wrote before I read this story).

A hospital manager in Ireland quits after signing an unauthorized $1.6 million contract for software that turned out not to work. The hospital found out about it when they got a bill, but could not get out of the contract nonetheless.

Apple takes out Microsoft’s dopey $300 million Seinfeld ad campaign in one devastating blow. And if you’ve missed Terry Tate, Office Linebacker like I have, you’ll like his new Get Out the Vote video (but Palin fans won’t like this one).

Inga and I are curious about 2009 marketing plans of industry vendors. If you’re a vendor marketing or advertising person, please complete our seven-question survey and we’ll share the aggregated results with you (company e-mail addresses only, please, so we know you’re legit). Surely you are curious (like we are) about what companies are doing in a volatile economy.

As a reader reported in an article comment, the FTC’s Red Flag medical ID theft rule has been delayed for six months.

I’ve mentioned the teen metal group Jessica Prouty Band before because her proud mom (who works in the HIT industry) sent over a CD that I liked. Check out the first video on the page from Hard Rock Boston – playing all those gigs has obviously made them tight and confident on stage (remember, three of them are 15 and the other is 13!) Anyway, they’re in a girl-led battle of the teen bands contest, so vote for them here by October 31 and they might get a shot at playing Hard Rock NYC. We could make it an HIStalk party if Fake Ingas are available.

I was watching a video on the Google Android operating system and API and thought the kid in the opening was a bit over the top: big hair, careful grunge look, and not very convincing as someone who would really get it. Turns out it was Google co-founder Sergey Brin, the #13 richest American, who’s worth close to $16 billion. He looks like a guy who might serve you coffee at Starbucks.

CPSI’s Q3 results: revenue up 8.4%, EPS $0.38 vs. $0.30, meeting expectations. Some of that was due to a tax change, but guidance was positive. According to conference call transcript, they’re doing a lot with Linux.

A University of Florida professor develops a "birthing computer" that uses wireless monitoring of uterine muscle electrical activity to advise doctors whether a Caesarean section is recommended.

Dr. Wes isn’t an ICD-10 cheerleader. "Imagine, 290 codes just for diabetes! Yeeeee haaaaa! Diabetes with foot ulcers on the right foot gets one code, diabetes with foot ulcers on the left foot gets another code, diabetes with foot ulcers on both feet, but not involving the shins gets another code… I mean, a new code for every nuance of disease! You get the drift! Isn’t this SPECIAL? Just think of the COST SAVINGS those clever bureaucrats have found!"

I admit I’ve never heard of Pop!Tech, a big-ideas organization (although I see Jay Parkinson was a speaker at its just-finished conference). They just announced Project Masiluleke, which will connect South Africans to HIV/AIDS information via mobile phones (daily text messages, reminding patients of follow-up visits for antiretroviral drug therapy, and patient-staffed virtual call center helplines).

A sad medical error in Ireland, where a resident performing his first unsupervised kidney removal ignores the family’s objections and removes a child’s healthy kidney instead of the diseased one. The doctor relied on an incorrect x-ray that was six years old because all the newer ones were missing and there wasn’t a convenient computer to look them up on.

An English arthritis patient can’t get pain meds or a referral because her specialist’s dictation, which was sent off to New Zealand for transcription, but never made it back to her doctor by mail. Seems like they could have sent the document by secure Internet connection instead of mail.

UPMC will lay off 500 employees this week. If they’re doing it, so will everyone other hospital (and every other business, most likely). UPMC made "only" $5 million in 2008 compared to $612 million the year before.

Shands HealthCare (FL) will close Shands AGH next year, citing anticipated big shortfalls because of Florida’s tanking economy, propped up until recently by unrealistic housing prices. It could be worse: they could be in Detroit, where employees of car manufacturers are being cut loose in giant waves, sure to hit hospitals there hard in uncompensated care.

A nanoengineering researcher at UC San Diego’s Jacobs School of Engineering wins a Navy grant to create a biocomputing "field hospital on a chip" that will monitor biomarkers in the body fluids of soldiers, detect common battlefield injuries, and then administer medications to treat specific conditions.

Varian‘s Q4 numbers: revenue up 15%, EPS $0.62 vs. $0.61, beating estimates.

A former hospital compliance officer is charged with defrauding her two former employers, a Hawaii hospital and a Florida HMO, by issuing millions of dollars worth of compliance contracts (HIPAA, charge master review, compliance training) to sham companies she ran herself. The HMO hired her even though she allegedly applied for the job using a phony name, fictitious work experience, and her former husband’s Social Security number.

Central Washington Hospital (WA) gets a local paper writeup for its use of a tele-interpreter company to provide remote Spanish interpretation via computer screen, cutting cost and wait times.

Vendor Deals and Announcements

• MEDHOST is now offering a patient self check-in kiosk option called Emergency Department Patient Access Self Service (ED PASS). MEDHOST’s first implementation will be at Northridge Hospital Center (CA).
• The Radiology Institute Imaging Center in Puerto Rico is adding Thinking Systems’ ThinkingPACS solution.
• St. John HealthPartners (MI) is purchasing licenses for the Web-based Cielo Clinic software to help manage their patient population and screen for chronic diseases.
• Robert Wood Johnson University Hospital (NJ) is deploying the Eclipsys access management solution. The hospital has been an Eclipsys client for 10+ years.
• Valley Medical Group (MA) has selected athenaClinicals for its 60+ providers. For the last eight years, Valley Medical has used athenaNet for practice management services.
• Arrowhead Radiology Medical Group (CA) is implementing McKesson’s Revenue Management Solutions for its nine physician clinic.
• NaviMedix has acquired TopLine Solutions, a provider of healthcare payment and collection solutions. NaviMedix has a solution that gives providers the ability to perform real-time financial, clinical and administrative communication with multiple providers.
• Olean General Hospital (NY) and Bradford Regional Medical Center (PA) have signed a letter of intent to integrate and create a new parent company.
• HealthFusion introduces a Web-based practice management system that integrates with HealthFusion’s clearinghouse services.
• Billing service Medrium acquires Wilmington Professional Associates. Though no terms were disclosed, Medrium recently raised $10.46 million in Series C funding.
• I like the clever name for MEDSEEK’s December 3rd webinar, “Do eHealth Portals Make a Difference to the Hospital’s Bottom Line: Calculating a Return on Information and a Return on Investment.”
• Presbyterian Hospital of Plano (TX) is laying off 17 people in the face of slower than expected growth. Presbyterian is part of the 18,000 employee Texas Health Resources.

E-mail me.

News 10/24/08

From rbsavage3: "Re: HealthVault. Microsoft scores with Aetna e-records pact. As a member of Aetna and an employee of a large hospital system, I’m not sure I like this. I wonder what the community thinks." Link. The deal connects Aetna’s PHR to HealthVault and adds a connection in the other direction next year. The pitch is that HealthVault lives on even if an employer change requires leaving Aetna’s coverage. I’m not sure how the information is coordinated between the systems, but I’m sure they’ve worked that out.

From Leopold Stotch: "Re: bikers. I know we’re all used to ‘Hospital X lost a boatload of personal information data’ stories, but you never know who you’re dealing with with the Mongols support themselves through identify theft." Link. Federal agents arrest dozens of LA members of the Mongols motorcycle gang on charges ranging from drug sales to murder after undercover agents infiltrated the group (which is an amazing story of bravery on its own). The former Mongols president, who wrote a memoir about his tenure, is a night shift CT tech at LA County-USC Medical Center.

From The PACS Designer: "Re: Web-oriented architecture. You are going to be seeing another fairly new concept gain some momentum in the next few years — Web-oriented Architecture, or WOA. While we have been familiar with service-oriented architecture recently, the move to WOA won’t replace SOA, but will provide an architecture that is resource-oriented rather than service-oriented. Since resource-based solutions are more plentiful, they will give the developers a quicker on-ramp to the Web and provide a easier way to test and use new Web applications." Link.

Inga did a little more sleuthing on Magellan EMR, although I’m not sure tracking down the founder will help if the company is kaput, which seems the case. Somebody put in a ripoff report about a problem with a non-medical software package from them. The founder is scheduled to speak at a technology conference this month. He was looking for a programmer last month. Inga e-mailed the founder and the conference planner but hasn’t heard back so far. She tried both phone numbers we found; one doesn’t answer, the other doesn’t have him in the PBX and the address for the company doesn’t come with their name in Google.

A reader asked about an acquisition rumor earlier this week. We’ll have an answer Monday when "An HIT Moment With …" features the company’s CEO answering five questions from Inga and me (and you just know what one of those questions will be). We haven’t seen the answers yet, so we may all be surprised. Our impression is that readers really like these abbreviated interviews and they are fun to do, so if you have an interviewee in mind, let me know.

I kind of hinted at this when talking about Greenway’s PrimeResearch EHR-to-research connectivity, so here‘s a coincidental prediction that’s similar: a patient’s tumor genes may someday be compared to EMR data to tailor patient-specific treatment, aka personalized medicine. I’m a cynic most of the time, but I think this is eminently doable. With an EMR full of patient data that can be linked to vast databases of other patient records, drug trial results, registries, etc. there is no reason to blindly go down the treatment tree in search of a winner for a given patient. Cancer is not one single disease. Even if you don’t buy the concept that evidence-based medicine works, the idea that looking at one patient in context with a bunch of similar ones to choose the best therapy is pretty compelling.

A Michigan doctor develops a disease database to be used in India, working with the Bill & Melinda Gates Foundation to make it available. NxOpinion apparently suggest a diagnosis from provided data. I don’t really understand parent company Robertson Technologies, but it lists a lot of management people, so maybe it’s big.

If you’re ever in Algona, IA, you might as well drop in and see the EMR you’re paying for. USDA gives Kossuth Regional Health Center $134K for it, calling it a "Distance Learning Telemedicine Grant," which sounds like a stretch. It actually sounds more like an portal-type project, but it’s hard to tell from the political high five-ing.

McKesson launches InterQual in the UK. I always called it case management software, although it’s now a bit more grandly portrayed as clinical decision support (i.e., "are you well enough to go home so we don’t lose money on your stay?")

I’m behind on e-mails, but I still like hearing from folks and, even though my replies are often long in coming (I usually try to catch up on the weekend), I read every one. A few folks have asked about the Brev+IT weekly newsletter and I had to admit that it’s "on hiatus." It was taking up a lot of time I don’t have and the e-mail spam filters were keeping readers from getting it. I may bring it back as a weekly HIStalk post if I can think of some other life activity to give up in its place.

I’ve also forgotten to recently recite the list of stuff you can do here, all to your right: (a) put your e-mail in the Subscribe to Updates box to get an instant e-mail update when I write something new (that list now has over 3,100 confirmed recipients); (b) click the "E-mail This to a Friend" to tell your friends about HIStalk, which I greatly appreciate because I want to be anonymously famous; (c) use the Search HIStalk box to sift through 5.5 years of HIStalk; and (d) click the ugly green Rumor Report button to securely and anonymously send me highly sensitive and scandalous information. And, some of the best parts of HIStalk live in the reader comments below each article, so click Show Comments to check them out.

My guest editorial in this week’s Inside Healthcare Computing, which the publisher said was "very sharp, well-written, and insightful" (I’m preening because I have perpetually low self esteem, maybe justifiably), is entitled Ask the Magic 8-Ball: Who HIT’s Winners Will Be in a Recession, Depression, or Whatever You Want to Call the Crappy Times Coming. Some of the 10 items I listed came from reader ideas here, like # 3: "Consultants of the non-PowerPoint variety. Nobody cares about a five-year strategic plan when financial survival into next week is questionable, so eloquent glad-handers or fresh-faced noobs need not apply for these gigs. We’re talking gunslingers here, the battle-hardened vets who simultaneously impress and scare the bejeebers out of you. When you want a system brought live quickly or a sleepwalking vendor slapped to attention, you need someone who looks and acts like Lee van Cleef in those old Clint Eastwood spaghetti westerns." I don’t put out unless you buy me dinner, so you’ll have to subscribe to see the other nine and to receive my routine literary emanations.

Allscripts posts its last results under the old company. For Q3: revenue up 17%, EPS $0.07 vs. $0.07, missing consensus estimates by a penny (or a pence going forward now that Misys is involved).

Speaking of Allscripts, if you want to support WakeMed in Raleigh, NC, watch this video sometime before Friday at midnight. Allscripts will donate $3 for each viewing to the Just for Kids Kampaign that supports construction of a new children’s hospital.

St. John HealthPartners (MI) signs for Cielo Clinic CQMS software from Cielo MedSolutions.

Bridgeport Hospital (CT) is looking for a CIO. I’m not sure what happened to Mark Tepping, who I’ve chatted with a time or two. Big Cerner shop including ProFit, its seldom-mentioned (and even more rarely praised) patient billing app.

This article describes what’s different about Mayo Clinic ("the Big House on the Prairie"). I like the point that there’s a "firewall" between the money and the doctors, who don’t even know or care what Mayo gets paid because they all receive the same salary after five years’ on the job. "We’re all salaried staff—paid equally. This is very good for collegiality, and people working together. The culture here at Mayo doesn’t encourage egos. There is not the same cult of personality that you find at other places.” I checked its tax forms and the highest paid people, all surgeons, make around $700K. Not exactly starving, but there are lots of boondock quacks swindling multiples of that from Medicare.

Congratulations to Cerner again on some damned impressive numbers. Companies are turning in bad reports left and right and there’s good old Neal chugging along like there’s no economic problems at all while expanding globally. That’s a big story. I noticed in the call transcript that the acquisition of LingoLogix was finally mentioned: "which strengthens our revenue cycle offerings immediately … the NLP component of this technology can change the landscape for clinical search by bringing clinical meaning to unstructured clinical documentation, helping aid research, clinical trials and potentially provide a bridge to interoperability constraints as the personal health record becomes more pervasive."

The local paper writes up McKesson Horizon Enterprise Visibility (which staff call "The View") at Oakwood Hospital & Medical Center (MI).

Patewood Memorial Hospital (SC) goes with Omnicell OptiFlex for surgery materials management, including preference cards and real-time usage tracking. I looked for a good picture but couldn’t find one.

T-Mobile’s G1 phone (powered by Google’s Android operating system) is now on sale. iPhone killer? Too early to say, but the T-Mobile part killed my interest. Medical apps on the iPhone are a big hit (partly because of the "store" concept), so maybe coders are working on stuff for this one.

Speaking of Google, the company joins the Continua Health Alliance personal health group. I should interview someone there.

Natividad Medical Center (CA) chooses the NeoIntegrate integration engine from NeoTool.

Some company is auctioning off "telemedical information management" intellectual property on October 30. Included: a smart card-based EMR, HIM workflow, and a implantable RFID chip reader. Actually, Ocean Tomo seems to be entirely reputable in the IP biz, even partnering with NASA, so maybe it’s worth a look if you’re a vendor. Maybe I should cover it live.

Houston emergency preparedness officials team up with the University of Texas School of Health Information Sciences at Houston, a biomedical informatics school, to develop a medical support system for disaster and to deliver more care by telemedicine. I didn’t know that open source guy Fred Trotter works there on its HealthQuilt project, an HIE prototype. I did know that UTMB has one kick-ass telemedicine program that probably leads the entire industry, yet is rarely mentioned, since we’re talking about the Gulf Coast of Texas.

I must have missed this: a new rule that takes effect in a few days that puts hospitals under FTC jurisdiction in requiring them to check for medical ID theft for patients not paying upfront. That sounds onerous.

Patty Miller, a Sunquest sales exec, is voted president-elect of the Central New York chapter of CLMA.

That’s all I have time for since I’ve now worked directly from the uninspired dinner I cooked for Mrs. HIStalk until boudoir time without a break. She just stuck here head in to see if I was still respirating, so that’s probably a hint. We’ll pick up here Saturday. Have a good weekend.

E-mail me.

HERtalk by Inga

From Janeen: “Re: RelayHealth booth. Did you come by? We were trying to keep an eye out for you at MGMA. We had a theater experience that involved a consumer/patient, physician and an administrator we were hoping you got to watch. Let us know if you saw it.” I did lurk by your booth a few times, and even chatting with someone about how PHR fits into the RelayHealth model. RelayHealth had an “exam room” setup with a cute doctor who explained the ins and outs of RelayHealth’s offerings.

Overheard in the San Diego airport: “MGMA was a really good show for us. Lots of traffic.” Standing in the security line, I stood in front of a guy from Fujitsu chatting with another vendor (sold lab coats, I think.) The Fujitsu guy said that MGMA and HIMSS were their two biggest shows and they were pleased.

On the other hand, I did hear a number of people say that attendance seemed a bit sparse. My opinion was I didn’t go to a single session that was standing room only and didn’t have to push through crowds at the exhibit hall. It wasn’t HIMSS, but there were folks everywhere all the time. With such gorgeous weather, I can imagine a number of folks stepped out for some sightseeing.

Anyway, I am glad to be home. I’m worn out from so much fun and long days in high heels (but I looked good.) I’m trying to tell myself that I’m tired because I am out of practice (not used to all that traveling, walking, sitting, wine-drinking, sleeping in a strange bed, etc.) and not because I am getting to be a 3-letter word that rhymes with cold.

Eclipsys co-founder and Carefx founder Terrence Macaleer joins Allscripts as VP of sales for Enterprise Solutions. I also see that Centra (VA) has selected Allscripts ED IS solution.

The VA contracts with Qwest Communications to provide $60 million worth of voice and data services to connect its 1,300 hospitals and other facilities.

More proof here that healthcare is not totally immune to economic troubles. Several new reports confirm that more of us are delaying doctor visits and tests, and skimping on medicine. Kaiser Family Foundation determined 36% of Americans are skipping recommended tests and treatment, up from 29% just six months ago. The number of prescriptions filled has fallen .04%, the first time in at least 12 years a drop has been recorded. Elective surgeries are falling; ER visits by the uninsured are rising.

Also suffering: Yahoo announces a 64% drop in Q3 profits and a plan to cut at least 1,500 jobs. On the other hand, Google’s are up 26%.

Sentillion adds a record 11 new customers and over 200,000 new user licenses in Q3.

E-mail Inga.

News 10/22/08

From Elsie EHR: "Re: two I’ve not heard of. While reviewing the new 2008 CCHIT-certified EHRs, I saw two products I hadn’t heard of before … MedLink and SmartClinic. The web site of the latter looks a tad (how to put this delicately?) like it was created by someone whose full time job is not in the field of web design (I like the fact that the title of their home page is ‘home’). Oddly, despite being one of only ten 2008 CCHIT-certified EHRs, SmartClinic’s website doesn’t mention the certification." MedLink is here and VIP Medicine (the SmartClinic people) is here. I’ll refrain from snarky commentary on the latter except to say that you have to see it to believe it. I guarantee I could get an ultra-slick version done for a few hundred dollars (including graphics that are attractive and legible), so it seems like a poor investment to leave it hanging out there like it is.

From Ken Malansky: "Re: the former chairman of that fraudulent vendor you mentioned. He is GUILTY! I spent seven weeks of my life on that jury. The one holdout was star struck by his lawyer’s impersonation of Johnny Cochran." I thought they were going to retry him, but that was probably just prosecutorial chest-puffing after the hung jury in 2006. His attorney also represented Scooter Libby (where he parked his aging mother in her wheelchair where the jury could see him fawning over her), Eliot Spitzer, Exxon, Merck, and Philip Morris.

From Dave Dravecky: "Re: rumor. Heard at MGMA that GE is buying Greenway; can’t verify. Supposedly the VC guys want their money, the market is no good for going public, and GE needs a more up-to-date product."

From Salesgal: "Re: Sage. [name removed] got the axe." Unconfirmed. The person named was sales VP for the northeast, but I didn’t feel right about putting his name up here. If he’s gone (which I assume is the case) it’s embarrassing to him, and if he’s not, it’s embarrassing to me. Those who care will know who it is from the position (and whether it’s true or not).

From TalkoftheTown: "Re: Allscripts. I’m surprised you discount what McConnell says about the Allscripts/Misys headquarters situation. The guy has gotten more then 1.2 billion from the two companies for parts of what is left and it’s now valued at about 600 million. Which raises another issue on my mind – what was Allscripts worth when Tullman took over 11 years ago?" I don’t get the feeling that John is involved at all with the new Allscripts, so while his assessment about Raleigh may be interesting, I don’t know if he’s got any insider information now. I could be wrong. Most of the company is in Raleigh,I think I read somewhere.

From GirlGeek: "Re: Epic. Altru Health Systems, Grand Forks, ND, is switching from QuadraMed’s Affinity software to Epic. Altru is one of QM’s oldest clients dating back to the 1980s (or earlier?). Word is that Altru had to beg Epic to take them on since they don’t meet their bed count criteria."

From Al Borges, MD: "Re: Magellan EMR. Anyone know what has happened to them? Their website is dead. A physician who is still using the Magellan Writer can’t get in touch with them." I snooped around starting with the old domain name, registered by John Curtis of College Station, TX under the company name of BTQnet, a Texas corporation (custom software) with an Austin apartment address (the corporation is not in good standing with the state). He appears to have been at Quotient Integrated Solutions afterward (owned by BTQnet, I suspect) but their PBX doesn’t list him (this writeup says he ways still there in July). He’s on LinkedIn. Magellan was going crazy giving away tablet PCs back in 2005 and that’s all I ever heard of them. OK, can someone take it from there?

Just in: Cerner beats Q3 estimates: revenue up 13%, EPS $0.54 vs. $0.37. The company says it will exceed that in Q4. Well done.

A woman who waited 19 hours in Parkland Hospital’s ED and finally left without having her broken leg treated receives a bill for $162. They probably shouldn’t have let Parkland’s revenue VP go on record because he made it an even worse PR nightmare: "She’s not paying for waiting. She’s paying for the assessment she received." No she’s not, the woman says, who has no insurance and says she will not be sending Parkland a check for having a nurse take her blood pressure and tell her to wait.

McKesson will sell its specialty pharmacy business to Walgreen.

Listening: new AC/DC. It’s no Back in Black, but it’s good, straight ahead rock. I saw them live in the Bon Scott years — the guy in schoolboy knickers (guitarist Angus Young) doesn’t look any older even though he’s now 53.

RAND Corporation is all for NHIN and a unique patient identifier, but then again they’re not the ones who have to pay the hundreds of billions of dollars those would cost. The predict great cost savings and patient safety improvements, but they said the same thing about those EMRS that few doctors are using for various reasons unrelated to the quality of the doctors or the EMRs (poor adoption of which make NHIN and the identifier worthless since they add little value to paper charts).

Kaiser says HealthConnect is now live in 12 Southern California hospitals, bragging that its total of 22 hospitals serving 4.8 million members is the US civilian record.

Dr. Wes says it’s not an "electronic medical record," it’s "a sea of electronic medical servers," observing that every system at his hospital requires its own logon. Sounds like they need a physician portal at NorthShore to run Epic and those other applications mentioned.

Talyst announces its medication system (ordering, pharmacy, automated dispensing) for correctional facilities.

CareTech Solutions migrates the 80-server data center of Port Huron Hospital (MI) to its own Troy, MI headquarters in 36 hours as part of its outsourcing contract. The company has 1,000 employees and is bringing on many more. "Pretty much anything that has an electron running through it we are probably working on it," says Jim Giordano, president and CEO.

Arthur Clark is named VP/CIO of Haven Hospital (FL), coming over from John Sealy Hospital (TX).

A survey reinforces what everybody knows already: order sets improve processes and patient safety. The best time hospitals can spend in a clinical systems implementation or improvement is to develop an effective order set review process, starting with automatic inclusion and working toward evidence-based consensus.

Winchester District Memorial Hospital of Ontario, Canada signs for QuadraMed QCPR, document imaging, and enterprise scheduling.

ClearCount Medical Solutions, a Pittsburgh vendor of RFID surgical sponge counting technology, raises $4.1 million in Series A financing.

Daniel A. Krause, formerly of SciHealth, is named head of US business development for Satyam Healthcare.

Millin Associates announces a new practice management billing system for certain clinic types.

A new project named Wareed will electronically  link all hospitals in United Arab Emirates. Cerner is a participant.

A mob with iron rods storms and vandalizes a hospital in India, claiming that a patient’s lab tests were sent to an outside organization because the hospital’s doctors get a cut of the cost. The hospital says techs work only normal office hours and after hours work is always referred.

A man registering his pregnant wife online at Mary Washington Hospital (VA) finds that he can see the files of 803 patients on the site. The hospital said it was "an anomaly." The man got an invalid security certificate warning, then tried to delete some of the URL, which then took him to other pages that showed him the records of every patient who had registered online since December 2007.

Jack McCloskey joins Magruder Hospital (OH) as IT director, leaving a similar role at Floyd Memorial Hospital (IN).

NextGen Healthcare is named as one of the best places to work in the Philadelphia area.

Jobs: Epic Consultant, SIS Project Manager, Cerner PharmNet Consultant.

About 88% of American adults can’t make good health care decisions given the right information, an AHRQ study reports.

HLTH and WebMD cancel their $2.31 billion merger. I can never figure out that corporate mess where one owns most of the other and Marty Wygod is chairman of both companies. Conveniently, I have zero interest in both.

E-mail me.

Inga Live from MGMA

From Nasty Parts: "Re: political correctness. Did not realize the whole Obama thing was a done deal!” A couple of weeks ago I made one remark about Sarah Palin’s bangs and suddenly started getting hate mail from folks who treated that as a political endorsement. Yesterday I quoted someone else who mentioned “a possible role in an Obama administration” and suddenly I have written off McCain. I think everyone needs to take a deep breath and settle down. It will all be over in two weeks.

From Inga Wannabe: “Hi Inga. I am at MGMA and for some reason, several friends insist that I am Inga. I finally gave up and let them call me Inga. And, I actually decided it might be fun to be you.” Yea! We had a fake Inga at MGMA after all! By the way, it is pretty fun to be me. You are welcome to be Tina Fey to my Sarah Palin anytime (note to the crazy politicos: the previous sentence was not meant to be political).

From oneHITwonder: “Re: annoying texting. Man, I am so bummed out that I did not identify Inga in the relatively small CCHIT crowd. I will have to keep looking … hope she was not the annoying lady who was texting behind me during the entire session.” Likely not me since I sat up pretty close and (just like in third grade) would have been embarrassed if the speaker caught me not paying attention. As for the texting people, you have to remember that there are a lot of busy people in this world who believe the world may fall to pieces if they were unavailable to their underlings for an hour.

I got my first LinkedIn recommendation! “Not only does she give us great information, she also gives us humor, fun, and something to look forward to reading every day.” Thank you, Christianne for making my day. Mr. H and I, by the way, love to accept all LinkedIn requests.

It’s Tuesday afternoon in lovely San Diego. There is a reception tonight, but I don’t think my feet can handle any more standing or walking. I think I’ll go for dinner, a glass of wine, and an early night before I head for home in the morning.

Last night was a not an early night. I scored an invite to the Allscripts party, which was in a beautiful outside patio on top of the Hard Rock Café. It was pretty packed. Everyone seemed to be upbeat about the Allscripts/Misys thing, though it’s easier to be happy when you’re being provided all the free drinks you want. The only thing I heard anyone complaining about was the lack of food. Perhaps Allscripts decided to eliminate consumption synergies.

In a session yesterday, the speaker asked who had a hospital-provided EMR. Only about 10% of the hands went up, which surprised me a bit. I wish he had also asked if anyone’s practice had been offered the financial assistance from the hospital but turned it down. That’s the question I want answered.

I touched on this yesterday, but my impression is that the top concern for attendees is improving the bottom line. Hence, vendors are promoting many tools for increasing revenues and/or cutting costs. Even solutions like EMR are being discussed in terms of how it will help with pay-for-performance objectives. When I thought more about it, I remembered that the administrator is the one charged with taking care of the bottom line, so it shouldn’t really surprise me that they are less concerned with finding tools to make life better for physicians, etc.

A cool tool I checked out was from a company named Phytel. As I understand it, their Proactive Patient Outreach program works with any PM/EMR. It scrubs the offices’ data and finds all the patients meeting a particular set of criteria, such as all diabetic patients who have not had an office visit in over a year. Then it will call those patients, thus increasing revenue. Really simple concept, the technology works, and it produces results.

A couple of companies were promoting standalone products that calculate the patient-responsible monies at checkout and then place a hold on the patient’s card for that amount. Thus the patient has no surprises about the costs, does not have to worry about later paying a bill, and the practice is paid faster. Preferred Health Technology and mPay Gateway were the two I saw offering slightly different flavors of this concept. Both claim the PM vendors are lining up to partner with them.

One of the most entertaining moments of my day was a meeting with athenahealth’s Jonathan Bush, who gets excited about everything. He was clearly still pumped by a dawn surfboarding expedition. He’s about 100 IQ points higher than the rest of us, reflecting on recent industry consolidations and Marxist capitalism (consolidation is a predictable result of capitalism). We quickly jumped to his theory on software licensing versus software as a service, which is where he obviously believes the industry is heading. Finally, JB was gracious enough to say that HIStalk is about the only industry publication he reads (the always skeptical Mr. H says he probably says that to all the journalists).

A few other quick tidbits:

• I tried a couple of times to ask someone at the busy NextGen booth to explain more about their recent RCM acquisition. I never got a chance to talk to anyone in the know, but I did get a free t-shirt and a cool little flashlight.
• I spent a bit of time in Greenway’s booth and got the scoop on their new PrimeResearch product (they are excited about it) and quickly met EHRA chair Justin Barnes.
• Tried to check out PatientKeeper a few times, but every time I walked over there were busy, busy, busy.
• I met Sage VP Sharon Howard, who commented they were happy to be done with the turmoil a few months ago when her comments about some layoffs were misinterpreted. She thinks they did the right thing trying to be as forthright with the press as possible.
• I asked several attendees if they had an EMR and if they were on their first one, second, etc. Almost all claimed to still be on the first. Several vendors claimed they had replaced one competitor or another, but admitted that most buyers are on their first install.

Enough on my impressions! My wine is waiting. If you were at MGMA, please send us your thoughts!

E-mail Inga.

Inga Live from MGMA 10/20/08

Greetings from San Diego! It’s been years since I’ve been here and I had forgotten how absolutely perfect the weather is. Although, aside from the short walk from my hotel to the convention center, I haven’t had much fresh air!

I spent Sunday afternoon checking out the exhibit hall. Apparently there are over 350 vendors here to promote their wares to the 2,800 attendees. The traffic seemed pretty slow to me, and actually several vendors agreed. It’s Sunday as I write this, though, so it will pick up Monday.

None of the booths were over the top like you see at HIMSS. Cerner, McKesson, Sage, and Allscripts had some of the bigger booths, but there were plenty of small booths throughout. I also noticed what appeared to be 2-3 vendor no-shows.

One of my first visits was to Med3000/InteGreat, which was handing out cute little teddy bears. It probably would have been Mr. H’s favorite booth because two booth babes in black boots and white shorts were flagging those attendees who didn’t find the teddy bear to be an adequate draw.

Another memorable booth was Health Business Navigators. Everyone was wearing these silly white sailor hats, but they were being good sports about it and people were stopping. Plus if you sat through a five-minute overview of their ad hoc reporting tools, they gave you your own hat plus a $5 Starbucks gift card.

It’s been a few years since I had been to an MGMA meeting, but I seem to recall EMR being the buzz at that time. This year EMR is still hot, but revenue cycle billing services seem to be this year’s "it" product. Sage, for example, had a presentation by RCM expert Pam Moore, who is editorial director for Physician Advisor. I sat through her spiel, which was pleasantly generic and not a straight pitch for Sage. They also had really comfy chairs to sit in, and if you participated, you got your name in the hat for a $500 cash drawing (which, sadly, I didn’t win).

And speaking of comfy chairs, the Panasonic folks had this awesome massage chair. Full body massage. I want to marry the massage chair.

Anyway, my favorite booth pitch was Gateway EDI. If you gave them your card to swipe, they would donate $5 to Susan G. Komen for the Cure. Good stuff.

According to the exhibit information, Misys and Allscripts were each scheduled to have a booth. However, they used the original Allscripts space for all the demos (complete with the new orange, new logos, etc.) and turned the other into private meeting rooms. It’s actually pretty impressive that they had all the new branding in place a mere one week after the merger closed. I am sure the marketing guys were breathing a sigh of relief that there were no more delays in the merger.

Towards the end of my booth trekking, I stepped into the Workforce.com/OnBase booth. Tiki torches, thatch huts, and an open bar made it seem like a good stop (I actually did hang out at one of their tables for a bit, but drank only water). Unlike every other booth I popped into, no one really chatted with me for some reason. I kind of wanted to hear their story, but everyone seemed to be busy putting collateral up or conversing among themselves.

After a short break in my hotel room, I went over to the opening reception. Lots of folks there were using up their free drink tickets (I used mine up, too). They had an assortment of entertainment in place (my favorite was the lady making ice sculptures with a chain saw). I had fun chatting with a few administrators who were trading EMR implementation horror stories. I actually slipped out early lest I be tempted to find some after-party!

On Monday, I sat in on a CCHIT session. Not surprisingly, most of the attendees were looking for EMRs. Besides learning more about the certification process, there was some discussion on what other criteria CCHIT should consider. The audience recommended CCHIT consider adding more more portability requirements to make it easier to move from one EMR to another (when you dump the first vendor). Another couple of suggestions that I am sure would make vendors quiver: coming up with a certification process for physician PM systems and making EMRs more seamlessly integrate with PMs at a nominal cost. 

One session I missed: The Office: Manners Matter and Courtesy Counts.

I also  had a chance to hear Glen Tullman speak this a.m. The conversation was brief, but I heard enough to leave me convinced he really is passionate about this whole connecting healthcare thing. I’m sure he has shared his "connecting the community" vision hundreds of times, but  he still managed to sound genuinely fresh and passionate about advancing interoperability (between Allscripts products as well as other products). Someone asked him if he was making any plans for a possible role in an Obama administration or possibly as a senator. He stressed that he had signed a three-year agreement and wouldn’t have done that if he hadn’t thought long and hard about those options. He also said he has been vocal in his opinion that the HHS leader should be a physician and since he lacked that credential, it sort of hurt his chances. Of course, if that phone does ring, I imagine he’ll at least take Obama’s call. However, my impression is that he believes he has a chance to make a bigger impact in HIT staying in his current role.

I’m sitting in a session but I can’t absorb another fact about the benefits of interoperability. So, a few more notes:

• If you sit through a Navicure demo, you can get into a drawing for an Audi convertible. I am hoping to drive home.
• Magician fans could get their fill at the Greenway and McKesson booths.
• If advertising in the restrooms is appealing to you, you’d best stick to HIMSS. At least the ladies’ rooms were signage-free.
• Even though Medinotes is now part of Eclipsys, you’d hardly know it. Not only did they have separate booths, there was very little signage promoting the marriage.
• I prefer suits over those homogenous golf shirts. Don’t know if it is a trend, but a good number of the vendors wore "real" clothes and not those shirts that never fit the women well and in colors that real men would never wear.