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.

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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. 

Monday Morning Update 10/20/08

From Hoyce: "Re: inkjets. I wonder what these cartridges will cost?" Link. HP licenses its inkjet fluid technology to Home Dialysis Plus for mixing of dialysate and water for in-home treatment of kidney failure, saving the patients trips to the dialysis center. HP had already licensed the technology for administration of vaccines.

From The Blogfather: "Re: Cerner. Never let it be said that Neal Patterson makes idle threats. After bringing up the famous e-mail at the company meeting, he followed through and cut Cerner’s healthcare benefits in the middle of open enrollment. Cerner’s only contribution is $400 to an HRA account, leaving associates to fund the remainder of their care through old school FSA accounts." Unverified.

From The PACS Designer: "Re: Virtual Desktop Infrastructure. With the increased focus on virtualization, a term invented by VMware in 2006 is starting to gain some traction. Virtual Desktop Infrastructure (VDI) will be seen in the news more often now due to the virtualization efforts of VMware, Amazon, and now Microsoft with its soon to be introduced virtual desktop that runs in cache memory as a thin client. As more organizations look to reduce operating costs and simplify desktop application management, you will see more movement toward this thin client concept. The possibility of thin client PACS running on a virtual server that downloads the application to your cache memory could be a new trend in the years to come and would be a good cost saving application for smaller providers." Link.

From Fourth Hansen Brother: "Re: non-competes. They just got killed in California. Are people getting out of those that Epic writes?" Link. The California Supreme Court rules that employers can’t stop former employees from starting businesses or working for a competitor. Let’s face it: no court will stop you from making a living just because your former employer made you sign some questionably binding document as a condition of employment. Your problem isn’t the courts, though – it’s the new employer who doesn’t need the legal headache (or to make Epic mad if they depend on them). They’ll just hire someone else. If a former employee had the time and money to fight the non-compete, they would probably win and potentially set a precedent for everyone. I haven’t heard of Epic’s in particular, but I’ve heard that some Wisconsin attorneys were taking cases awhile back.  

From Lucy Ewing: "Re: physician contracts. Will doctors sign anything someone puts in front of them? A friend mentioned that a practice was getting terrible service from their billing service and planned to change. The billing service’s CEO freaked out and threatened to sue, pointing out that the contract they signed legally obligates them to send all billing through that company." I know doctors hate lawyers, but so does everyone else … until you need one. Like when signing a contract. 

The Raleigh paper just can’t accept the fact that Allscripts has moved the former Misys Healthcare’s headquarters to Chicago. The reporter pestered Glen to the point he finally said, "I wouldn’t rule out the fact that the headquarters may be here at some point in the future," surely just to get the reporter off his back. For some reason, the reporter then checked with John McConnell, who’s not part of the deal, and he fanned the dying HQ embers by saying Glen works for Misys and they’ve always liked Raleigh. My opinion: the important products going forward are Enterprise, Professional, Payerpath, and Connect. Everything else in Raleigh other than product maintenance (sales, administration, non-HealthMatics R&D) is way overstaffed under the new model. As tough as it is to hear, Misys brought little to the table except lots of indifferent customers, so it’s certainly not going to business as usual in Raleigh since Allscripts really needs to put up good numbers right away. I hate that "trim a tree to make it grow" stuff too, but that’s reality.

PatientKeeper’s Suzanne Cogan will speak Monday and Tuesday at MGMA (at Sage’s Booth 615) on "The Physician on the Go: Improving Revenue and Practice Operations with Mobile Applications."

I never heard of company Conceptual Mindworks of San Antonio, TX or its EHR product Sevocity (I must not pay enough attention to CCHIT certification since it earned Ambulatory 2007 in May). The name’s a stretch ("a combination of two words: seven, which signifies good luck or prosperity and velocity, which means speed or journey") but it looks of cool and is cheap ($800 startup per provider, then around $500 a month for EHR; another $200 for PM) with 24×7 support. They seem to have made their money from Air Force contracts.

Here’s a bit of McKesson history that I hadn’t heard. In 1938, its predecessor, drug wholesaler McKesson & Robbins Inc., faced bankruptcy after it was discovered that the CEO had cooked the books (he was actually an ex-con and swindler who used a fake name and medical background to buy the company). At an emergency company board meeting, word got back that the CEO had committed suicide. Said a Goldman Sachs partner who sat on the company’s board: "Let’s fire him for his sins anyway." The same thing happened with the HBOC acquisition, announced October 26, 1998 (maybe McKesson will be providing cake and punch for the tenth anniversary) except that McKesson’s executives didn’t kill themselves (only their careers – they were all canned after the fact) and the numbers were a lot bigger ($14.5 billion). The happy union was frenetically consummated on January 13, 1999 and the cooked books were discovered only three months later, sending $9 billion of McKesson market value up in smoke in a single day, leading to an entirely new meaning for Pathways Accounting. Everyone I knew saw it coming, so either I had smart friends or McKesson had dumb executives. Believe it or not, the adjusted share price still hasn’t recovered from that self-inflicted disaster: shares were around $82 in the fall of 1998 and are a little more than half that now. Cerner shares have tripled since then.

Jim Riley, formerly of Payerpath, joins MedAvant as sales VP, reconnecting with his former Misys boss Andrew Lawson, now MedAvant president.

Picis will be at CHIME’s Fall CIO Forum next week in Lost Wages, so if you’re going, drop by and tell them you appreciate their support of HIStalk.

While I’m on that particular soapbox, show a little sponsor love all around when you get the chance: click their ads to see what’s up with them and tell their executives that you saw the company mentioned on HIStalk. I’m a foot soldier working a hospital job by day, so I need some allies in proving the sponsorship value here. Thanks.

Sisters of St. Francis Health System threatens to cancel its WellPoint contracts because the Indianapolis insurance company isn’t paying on time. The insurance company blames its BlueCard claims payment software. WellPoint has been sued by investors who claim the company knew about the problem but didn’t disclose it. A representative of the company’s Anthem subsidiary says the problems won’t be fixed until February. WellPoint’s former CEO walked away with $23.9 million last year and the current one is getting $9 million a year. Why deliver actual care when pushing the paper it generates pays so much better? Adding value is so 1970s.

Gartner places Sentillion in its Challengers quadrant for Enterprise Single Sign-On.

Alberta, Canada (always reminds me of "Prince Albert in a can") will make health information available online to its residents.

Healthcare IT consulting firm Global Works Systems opens its new corporate office in Colchester, VT, which it points out is near its partners Allscripts and GE Healthcare.

I hadn’t snooped around MEDITECH’s site lately, so here’s your info tidbit: the cafe lunch in Westwood Monday will be grilled steak tips with sweet potatoes and Brussels sprouts. I bring that up because I’m one of the approximately five Americans who will eat Brussels sprouts (as long as they’re fresh and not frozen). I see they’ve posted all new (to me, anyway) color photos of the executives and they look like the kind of people I like (few ties, some are kind of nerdy looking, and everybody looks happy, maybe because they’re wealthy). It’s the most successful company in the history of the industry (which it happened to create – look it up) so I like to pay appropriate homage. The only blot on their otherwise perfect HIStalk record is that I can’t convince Neil Pappalardo to let me interview him even though he’s a rock star to me, but Howard Messing did an inarguably fine interview back in the early days of HIStalk that I really enjoyed.

A huge federal raid in the Cleveland area involves MetroHealth Medical Center. Several companies were searched, among them a local division of Siemens, which got contracts for both public housing and hospital work. FBI agents told the Siemens employees to clear out while they hauled out boxes. "He is an employee at Siemens, which handled a $33 million energy conservation contract with CMHA that Phillips helped shepherd through. McMichael is named in a federal subpoena involving Carroll and Greco. The subpoena indicates that agents are looking into whether contractors, including Siemens, had any financial relationship with the hospital administrators or whether any contractor did work at the men’s homes." Bribery (several billions of dollars’ worth) appears to have been woven into the corporate culture, according to former executives. Somehow they’re still in business.

The preview looks wickedly funny: Children’s Hospital, an Web series on the WB. Doctor in clown makeup: "I’m challenging you to a healing-power-of-laughter-off."

Vendor Deals and Announcements

• InteGreat and Nuance extend their partnership, giving InteGreat the ability to provide its clients with Dragon Medical 10.
• eHealth Global Technologies announces the release of the Image Exchange Service for RHIOs and HIEs. The product facilitates the exchange of medical images utilizing a DICOM-compliant viewer.
• Ingenix acquires business intelligence company Bull Services/Integris. Bull Services also offers consulting services, systems integration solutions, and outsourcing.
• QuadraMed’s former VP of strategic services Vicki Wheatley is now VP of consulting services for HIT consulting firm Just Associates.
• North Hawaii Community Hospital contracts with Phoenix Health Systems to provide IT management and infrastructure services.
• Physician-owned MSO Premiere Medical Resources (Ohio) selects Noteworthy’s NetPracticePM and NetPracticeEHR for its 92 members.
• iMedica signs a sales and marketing agreement with CySolutions, a provider of community health center solutions.
• Munson Healthcare (MI) selects Lawson Human Resource Management Suite and Lawson Business Intelligence to consolidate its administrative processes and support its HR and payroll functions.
• MedAssets announces the release of its Medicare Recovery Audit Contract solution that helps healthcare providers throughout the recovery audit process.

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News 10/17/08

From Jaitar: "Re: McCain. What’s with McCain repeatedly saying he wants to put medical records ‘online?’ Maybe he should also say he wants to put our financial histories online. He should get this straight – I’m not sure he is doing us any favors given the privacy hawks out there who leverage any public sentiment to slow down information exchange."

From HISWatcher: "Re: NextGen. Their buy on Practice Management Partners today and HSI a while back means they want to take athenahealth on in the RCM space. Should be interesting …" Agreed. PMP was doing great covering just a tiny part of the country, so they get a prime time slot with NextGen.

From Monsieur de Groot: "Re: hospital of the future. Here is a story about the "Hospital Room of the Future" that features Cerner products. Some of the entries in the ‘Comments’ page are  interesting." Link. It’s interesting (and scary) to see what’s inside the minds of average Americans when it comes to healthcare. 

From MC Hammersmith: "Re: CAROL. My colleague forwarded me the link. They give price and care information (with online scheduling) for procedures or care bundles. So far it looks like only a few providers have signed on, but I like the interface. I believe that the prices are still fiction, since they can charge whatever they want but will get what insurance pays, but, still looks pretty good for version 1.0." Link. I think I gave it a look and mention right after it launched. Looks pretty good. Actually, it looks very good once you dig into individual provider pages. I would use it.

Greenway launches PrimeResearch, a research solution that connects PrimeSuite EHR to clinical studies, quality and safety initiatives, and analytics. Researchers list their active studies on PrimeResearch, physicians choose those to participate in, and PrimeSuite runs a list of patients (de-identified using PHI scrubbing rules) that meet the study criteria. Now I’m not a practicing doc, but someone who is told me once that the biggest overlooked source of physician revenue is providing electronic information to companies doing drug or other clinical research. This guy, who was a really smart futurist and an MD/PhD, said that those organizations are happy to pay because they need quickly selectable data from big patient populations in electronic form, so it’s still cheaper for them than doing traditional paper studies. Finding patients out in the field, especially those with unusual conditions or demographics for niche drug studies, is nearly impossible otherwise, plus it does patients a favor by getting new treatments to market faster. I think it’s a great idea, one of the big benefits of having electronic data instead of manila folders. Expect that to really mushroom once genetic data is in there and more linkages between genes and disease (and drug responsiveness) are uncovered.

A medical helicopter crashes in the Chicago area while heading to Children’s Memorial Hospital from Valley West Hospital, killing three crew members and a 13-month-old baby. The helicopter, owned by the Air Angels emergency medical transport service in Bolingbrook, clipped an antenna guide wire and crashed in a field, killing the pilot, nurse, paramedic, and patient. The crash is the third involving Air Angels and the ninth in the past 12 months nationally involving medical helicopters. The pilot, Dell Waugh, was a two-tour Vietnam vet with two purple hearts who started a company after he retired from the Army, writing software for hospitals and creating instructional videos for drug companies. Condolences all around.

Mrs. HIStalk was having some impressive coughing fits but couldn’t get an appointment for several days at the practice we use, so I suggested she try the local back-of-the-drugstore retail clinic (because I was tired of hearing the hacking, but it probably sounded caring the smooth way I said it). The diagnosis: her first case of bronchitis, which we already knew since we’re medical types. Total time spent for visit and prescription pickup: 15 minutes. Visit cost: $60, but they took our insurance too, so it was $30 or something. Her grade for the experience: A+. She was the only patient there, the NP was experienced and efficient, and she was treated like an actual human being. She’s happy about it, but maybe that’s the Tessalon Perles talking. She’s cute as a button when she takes the cough syrup and makes that Robitussin face.

If you want to buy a "top of the line hospital information system" from India, this guy is selling one.

Listening: Montrose, hard-driving early 1970s rock with Ronnie Montrose and Sammy Hagar.

MacPractice, the Mac-based practice management system, has a new release and an iPhone interface. I would have told you how it looks since I tried to check out their demo, but of course the wiley marketers make sure you can’t actually see it without first completing a truly massive online form so they can pester you later (do they really need to ask what time zone you’re in when you have to give them your whole address?) You want people to watch your demo. You trust them to follow up if they like what they see. What’s so hard about that? I bet they sit around and moan that more people should be watching their demo.

HIMSS sent out its ballots today. My first rule of thumb: I never vote for anyone who isn’t FHIMSS. If they can’t take the time to qualify for HIMSS Fellow, what are they doing running for HIMSS national office?

Healthcare Growth Partners releases its Q3 HCIT Transaction Report. Download here (warning: PDF).

Rush-Copley Medical Center (IL) will implement McKesson’s closed loop solutions (Meds Manager, PACMED, Robot-RX, MedCarousel, Admin-RX). Notably omitted from the list: Horizon Expert Orders, since I believe the hospital went with Eclipsys SunriseXA instead, leading to some confusion about which loop they closed and what they closed it with.

Someone sent a rumor that Medsphere just laid off 15 people after moving to Carlsbad supposedly because of rapid headcount expansion. Inga asked the company about it and was told they don’t discuss rumor or personnel matters. I have my guess what that means and you’re entitled to your own. I don’t like to see anyone lose a job.

Bravo to the Project On Government Oversight (POGO), which tabulates information to remind government agencies which big contractors and companies have been guilty of major misconduct (hint: drugs, oil, and consultants). #1 by far is Merck ($5.8 billion) and GlaxoSmithKline ($4.2 billion). Surprisingly, McKesson is the fifth biggest offender at $996 million (thanks, HBOC). IBM is way up the list, as is Cardinal Health, Health Net, and the the usual contractors like Boeing, Lockheed Martin, and Northrop Grumman. Somehow BearingPoint came in way down the list with just $54.2 million (heck, CoreFLS was nearly ten times that amount of utterly wasted taxpayer dollars).

Nashville-based onFocus Healthcare, which sells enterprise performance software, completes a round of private equity financing. Here’s what impresses me: the chairman has a Carnegie Mellon doctorate (damn).

Grand Bahama Healthcare System will go live on its first Centricity Pharmacy install in a couple of weeks. You know the GE implementers are fighting to go there this winter.

CSC, new owner of Covansys and FCG, will hire 2,000 IT professionals in the next six months, all of them in India.

Taiwanese hardware vendor Unitech launches a healthcare PDA made from antimicrobial materials and offering both RFID and barcode readers.

State of Ohio CIO Steve Edmonson, formerly of Cardinal Health, will leave his position this week.

Rumor: GE Healthcare Financial Services has cut 30 salespeople, with more to come. And speaking of GE and its sudden problems related to its financial and healthcare units, the credit squeeze will hit GE and Siemens hard, the New York Times says, as hospitals finally have to adjust their capital-heavy ways in a down economy and with shrinking investment portfolios.

UVA goes with AtStaff ClairVia for staff and demand management.

Nuance says users are pumping 1.4 billion lines of medical transcription per year through eScription’s computer aided medical transcription system, with 17 new customers this year. John Halamka says it has saved BIDMC $5 million in transcription cost, while Orlando Health says turnaround time on clinical reports is down two hours just eight weeks after go-live.

Odd lawsuit: a man is beaten in the head with a yard-long log at a party in 2002, mistaken for the guy his assailant really meant to clobber. He is taken to the hospital, waits 90 minutes, and is later transferred to another hospital for emergency neurosurgery. He is paralyzed and  settles with the first hospital and its doctors and nurses for $8.5 million US, coincidentally the precise amount of the hospital’s malpractice coverage. And in Greenwich, Connecticut, eight women are suing the hospital and seeking class action status for allowing a drug-addicted plastic surgeon to perform breast reconstruction surgeries. The doctor turned in his medical license after being accused of injecting a patient’s painkiller into himself and later died of a heroin overdose.

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HERtalk by Inga

From Southern Rocker: “Re: Glen Tullman interview. Congrats on the interview with Allscripts. Seems like quite a coup to have a company of that stature select HIStalk as the forum of choice to communicate directly with the market.” Mr. H was pretty darned excited that Allscripts suggested it. So what if McCain and Obama won’t answer our e-mails? We got Glen. If anybody has suggestions about the format, time of day, etc. let us know so we can decide about future chats.

The X PRIZE Foundation and insurance giant WellPoint team up to develop a $10 million contest to improve health care quality and reduce costs. The finalists will have their proposals tested in state markets. Not to sound like Mr. H or anything, but don’t you just know the winner is going to have a solution that’s pretty health insurance company-friendly?

CTG Healthcare Solutions announces (warning: PDF) it will be providing implementation for a number of Epic Systems implementations. Interestingly, the press release provides such details such as it is providing “services to a major children’s hospital with a large pediatric research program” for $1.7 million, but, doesn’t name of the hospital. Another project is for “one of the nation’s largest faith-based integrated delivery systems… which operates hospitals, physician practices, outpatient clinics, health plans, and related health and human services in seven states.” I bet we have readers that could name those hospitals off the top of their heads.

Dan Nigrin, MD, MS, CIO of Children’s Hospital Boston, is mentioned in this article that revisits the question of which is better: CIOs who come up through the IT organization or those with a more diverse business background? Dr. Nigrin is not only CIO, but also an endocrinologist who went back to school for a master’s degree in informatics from Harvard Medical School and MIT. Obviously those are some pretty strong credentials. I also hear he owns a recording label and is an HIStalk fan. Doesn’t get much better than that.

An Employee Benefit Research study (warning: PDF) finds that 60% of us believe that centrally maintained EMRs shareable by authorized health care providers are extremely or very important. However, 62% indicate they are either not too or not at all confident that such records would remain confidential.

Mediware is expanding its stock re-purchase plan. In addition to the $4 million earmarked earlier this year, the board has authorized an additional $3.3 million. Stock is currently trading around $4/share, down from $7.25 less than a year ago.

QuadraMed is also repurchasing shares, though they are buying from a single shareholder. QuadraMed is buying 620,614 shares at $5.50 for $3.4 million. Though the stock closed at $5.85 Tuesday. It was close to $10/share when the company was listed on Nasdaq in July. The purchase represents approximately 7% of the common shares outstanding.

Teleradiology is the latest service being outsourced to India because of a US shortage of radiologists, particularly those willing and able to work night shifts. Other likely services soon to be offshored include telecardiology, telepathology, teledermatology, telephathology and robotic telesurgery.

Rick Norling, president and CEO of the national healthcare alliance Premier, announces his retirement as of June 30, 2009. The company earned the 2006 Malcolm Baldrige National Quality award under his leadership. His replacement has not yet been named.

According to a blog sponsored by the local paper, Lawrence Memorial Hospital (KS) has approved a five-year contract for Cerner to provide technical hosting services for the hospital’s clinical information systems. The transfer, scheduled to take place in April 2009, is predicted to save the hospital $1.5 million over five years.

Officials from a California elementary school claim HIPAA privacy rules prevented them from informing parents of a teacher’s sexual "reassignment." The music teacher, previously a woman, returned to school this fall asking to be addressed as Mister.

Last call for survey participants! If you are either a physician or a CIO/IS director and are willing to give me 10 minutes of your time, let me know. As a participant, you’ll get to hear about some of our latest scheming and have an opportunity to influence the future of HIStalk. Come on, you know you want to hear more!

E-mail Inga.

NextGen to Acquire Practice Management Partners

NextGen Healthcare Information Systems, a wholly owned subsidiary of Quality Systems, Inc., announced this morning that it will acquire revenue cycle management company Practice Management Partners of Baltimore, MD. Terms of the agreement were not disclosed.

PMP, which was founded in 2001, has 200 employees, handles 16 million transactions per year, and has annual revenue of $16 million from its service area of MD, DC, PA, and VA. Perry Snyder is the company’s founder and chair while Don Good, formerly of HCIA, is president and CEO.

Patrick Cline, President of NextGen Healthcare said "We have been very pleased with the demand we have seen for our revenue cycle management services, and while we remain committed to organic growth in all areas of our business, PMP will help to build out our RCM capability both geographically and with regard to capacity and talent. This acquisition also continues to build our base of recurring, visible revenue. Like HSI, PMP presents a number of strategic synergies." 

Live Chat with Allscripts CEO Glen Tullman – Wednesday, 10/15, 7:00 PM ET

News 10/15/08

Reminder: Allscripts CEO Glen Tullman will be live here in an online chat at 7:00 ET Wednesday evening. Several folks have left comments on his article or weighed in on the merger, so why not let Glen answer your questions directly? I’ll be posting the chat thing right here on HIStalk like any other article. You can set up a reminder for yourself right in the chat thing (I don’t know what else to call it, but it will make sense when you see it – picture above). I’ve practiced a little with it and I promise it’s fun and easy to use. Watch for the link or just go to www.histalk.com and you’ll see it.

From AHIMA IS DEAD: "Re: News from AHIMA – Seattle. One word – DEAD. Needs to be merged into HIMSS. No decision makers, no excitement, no pulse, no attendees." I know QuadraMed is there with some of those more modern technologies you’re interested in (HIM and identity management), so drop by their booth, tell them you’re probably the only HIStalk reader in attendance, and ask to be informed and entertained (no promises, but it never hurts to ask, unless you’re a competitor anyway).

From Duffy Dyer: "Re: Medsphere. The company put out a press release that implied that the VueCentric GUI was open source and part of its product, then had to retract it on Hardhats, saying they intended only to say that VueCentric was used in the Indian Health Service facility that just won the Davies." I’d call that press release a total disaster since it was nearly impossible to comprehend even without the gaffe. It must have been a slip because the others are OK and Schwartz PR is among the best that I’ve seen.

From Wilma Flintstone: "Re: Allscripts. Misys was supposed to be the acquirer, but all the top management is from Allscripts, the Allscripts name replaced the tainted Misys one, and it looks like from the site that the old Misys products like Tiger, Vision, Misys EMR, and even MyWay may be available only from resellers. The orange color might be what you get when you mix purple and red and the logo kind of looks like an M and an A (with the M in the shadows), but otherwise it looks like 90% Allscripts."

From Lula: "Re: Ingenix. You might be interested to know (if you don’t already), that Paul Sinclair, ex-senior VP of Cerner, resigned a few weeks ago and is now the COO of Ingenix Consulting. You can validate this via his Linkedin profile." You are correct. I didn’t know that. He had run Cerner’s professional services business for 12 years.

From Fourth Hansen Brother: "Re: shooting victims taken to closed hospital." I couldn’t find the online story to link to, but the text FHB copied says people took shooting victims to a closed Milwaukee hospital twice in a single night. Two men in their 20s were shot in unrelated incidents and in both cases, friends and family drove them to St. Michael Hospital, which has been closed for two years. Police advised everyone to call 911 instead of driving victims to a hospital.

I was Googling former IDXer Jim Crook to see what he’s up to, having forgotten that he’s now on the board of Vitalize Consulting Solutions. If you’re been around awhile (their employees average 12 years with their particular product) you might want to peruse their job listings, of which they have some juicy ones.

A new article by MEDSEEK president Peter Kuhn brings up an interesting statistic: scheduling a patient appointment by telephone takes six minutes (three each for the patient and the scheduler), while doing the same thing via a patient portal takes one minute (just the patient). That’s the same reason I buy online (and schedule appointments online) whenever I can.

This legal mumbo-jumbo, as best I can tell, is some kind of preliminary argument about definitions in McKesson’s lawsuit against Epic that claims MyChart infringes on McKesson patients. In this round, McKesson was the clear winner, it appears.

Online doctor rating service MDX Medical/Vitals.com gets $4 million in VC funding. Inquiries are free, so I looked up John Halamka. The information is basic (specialty, hospital affiliation, medical school, publications) and the results screen includes ads (one for billing software, one a silly game advertising a drug). Why would regular people checking their doctor’s credentials be hot prospects for buying physician billing systems or prescribing Lunesta? The site has all the cute bubble graphics and the Arial Rounded font that embodies 2.0 anything (and that will be as dated as a ’76 Vega in a couple of years), but I’m not seeing $4 million worth of potential with all the similar sites out there.

Hospira acquires the EndoTool blood glucose monitoring system from MD Scientific.

Iron Mountain, apparently tired of making a ridiculously profitable living hauling truckloads of medical records to its old limestone mine for long-term storage, wants to "shift toward a more consultative approach in the healthcare space" by telling hospitals how to handle paper records. The obligatory President Bush/EMR/2014 boilerplate is inserted as a reference to how poorly hospitals are doing with EMRs. I bet they had a big presence at AHIMA.

TeraMedica wins an imaging informatics value award for delivering ROI to its customers, specifically for consolidating disparate PACS through partnerships and in-house engineering.

Carilion’s struggles to convert from a hospital to a clinic are detailed in the local paper. One nugget: they’ve put aside $66 million for a statewide medical information system.

A new Pennsylvania law bans mandatory nurse overtime. It’s too bad a law had to be passed preventing employers from making people work when they don’t want to (or who aren’t at 100%, increasing the chance of error).

HealthBridge, the Cincinnati HIE company, is considering expanding to other cities. It just extended its relationship with Axolotl.

I’m fairly knowledgeable about the use of barcodes, so I found this entry in Loftware’s blog interesting: how about a color-enhanced barcode that can store 1.2 gigabytes of content? As it points out, that could be interesting for easy, cheap storage of medical records, medical images, or even media. If you ask me, healthcare is just beginning to realize the potential of barcodes.

Now you know why subscriptions are free. Modern Healthcare launches its fancily titled "leadership forum," which it says will offer "unparalleled access to highly qualified healthcare decision-makers." Pieces of meat … uhh, provider attendees … can be happy that "educational sessions will not compete with exhibiting, providing maximum sales exposure and sales opportunities for exhibiting companies." Don’t hospital executives have problems to solve at home without attending the equivalent of a timeshare sales pitch? I’m a little hostile, but only because I thought Modern Healthcare was above that level of overt pimping.

The Raleigh paper moans about losing its Misys Healthcare headquarters to Chicago, also claiming without further reference that 44 jobs will be lost as a result. 

Hillcrest Medical Center (OK) will deploy the CareView bedside TV and workflow application. Looks like it includes patient monitoring cameras and recording, online patient viewing for family, Internet access, basic telemedicine, and movies. Tommy Thompson is on the company’s board.

Jobs: Production Control Manager (MA), Regional Sales Director NE (NY), Customer Support Analyst – EMR (PA), Application Manager, Epic Ambulatory (CA).

Dossia joins the Continua Health Alliance (Wal-Mart PHR meets home device monitoring). I thought Continua was going to be hot when it started, but I haven’t heard much.

Microsoft says it will stick with SpeechMagic for Amalga even though Philips sold that division to Nuance.

If you’ve ever been to a seminar talking about the drug supply chain, this is familiar. A former Cardinal employee pocketed $350,000 in kickbacks from a felon in buying drugs of dubious quality on behalf of Cardinal. Cardinal already settled for trading in the so-called secondary drug market. The article cites a case I knew about: a cancer patient died because someone swapped her Procrit labels to sell the lower concentration drug at full price. That drug came from the same guy the Cardinal employee was buying from, who also made $42 million (!) selling phony Lipitor. The program I attended was shocking: totes full of fake Valium coming through the Miami post office, Mexican dealers who buy the same expensive labeling equipment the drug companies use (even holographic label printers) for making convincing fakes, and thieves who had already cracked RFID just in case FDA requires tracking products. Forget Tony Montana’s crack dealing: the real money is in fake drugs for fake Canadian pharmacies and innocent hospitals who don’t know what they’re getting or where it’s been.

Philips misses Q3 estimates, blaming slow US healthcare business.

MedAssurant, a healthcare data analysis company, moves to Bowie, MD. One of the Roche family just invested $175 million in the company, so it must be hot stuff (and has 2,000 employees besides).

A Thai software company called International Medical Software has developed a large-hospital system in J2EE that’s being used in 12 hospitals. An ISP "pay per use" feature is coming.

Oracle CEO Larry Ellison says he’s on the prowl for acquisitions cheapened by the stock sell-off, expecting to continue the company’s one-per-month average.

Odd hospital lawsuit: an overweight 46-year-old woman arrives at the ED complaining of abdominal pain. The nurses and doctors start her workup, but she asks to use the restroom. Staff later find her 6-pound newborn daughter in the toilet. She’s suing the hospital (actually the newborn is suing) for lifelong care of the baby, claiming the medical staff missed obvious labor signs even though the woman herself didn’t know she was pregnant. She had cocaine in her bloodstream. An outside psychiatric expert summarized, "Chutzpah. This is America. You’ve got to love this country. This woman doesn’t know she is pregnant, but somebody else should."

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HERtalk by Inga

From Janeen: “Re: MGMA. Inga, I had to smile when I learned you were going to MGMA. Your friends from RelayHealth will be there. Should we have an Inga lookalike in our booth again?” For those who attended HIMSS earlier this year, RelayHealth did have a lovely Inga stand-in. Too bad Mr. H and I didn’t get our act together in time to provide our unique brand of Fake Ingas, celebrity galas, and giveaways for MGMA, but it was a last minute decision. Anyway, one reason Mr. H is sending me on this field trip is to brush up on the latest in the ambulatory space. We’d like to be better versed in that area to appeal to our readers from that world. Janeen also reminded me that RelayHealth has a PHR offering, with their model connecting to the consumer via their provider. I do plan to stop by to see their plans for working with HealthVault.

I’ve stopped opening my 401K statements recently because all those down arrows make me depressed. On the other hand, I bought gas for $2.69 a gallon this week, so go figure out what it all means. Last week, before the close of the Allscripts-Misys deal, Dr. Borges asked why I thought Allscripts stock was falling if the merger was suppose to be such a great thing. I asked an expert (and HIStalk fan) Sean Wieland, Piper Jaffray analyst and industry mover and shaker, for his impressions since I clearly don’t have the economy figured out. To paraphrase Sean’s comments, this isn’t the time to rationally explain the movement of any stocks because all stocks are trading independent of their fundamentals right now. However, one factor possibly affecting shares of Allscripts was the trade x-dividend. Shareholders through October 10th are scheduled to receive a dividend. The tax treatment of dividends can be a little messy, so some stockholders may have elected to sell their shares in advance to avoid the tax implications. On Monday, Allscripts opened at $4.40 and closed at $5.47; Tuesday it closed at $5.40.

Ingenix announces the winners of its 5th Annual Top 200 coding hospitals. The award recognizes facilities based on the completeness and accuracy of their medical coding practices to bill Medicare for inpatient medical services.

The Health Resources and Services Administration announces plans to hand out $18.9 million to 25 community health organizations for EHR implementation. It seems like a lot until you remember it’s just a drop in the bucket compared to the billions our government is shelling out to our banks and automobile makers. This latest EMR incentive is in addition to the $290,000 per practice that the CMS promised last week to primary care groups with 20 or fewer physicians.

Alegent Health selects LYNX Medical Systems, a Picis company, to provide outpatient facility coding services to its five Omaha metropolitan area hospitals.

I don’t watch a lot of TV, but I do remember that old commercial (for Vicks-44, I think) where the good-looking guy says, “I’m not a doctor, but I play one on TV.” Maybe advertisers will resurrect it from this statistic: 26% of Americans say they get a big part of the health information from TV, particularly TV dramas (not PBS, not even TLC).

Eclipsys announces that the University of Michigan Health System recently deployed Sunrise Acute Care across its 913-bed system and has seen a 29% decrease in medical errors. Additionally, the health system claims a 40% reduction in the time to administer urgent medical orders.

Healthgrades’ 11th Annual Hospital Quality Study concludes that patients have a 70% better survival rate when treated at one of the nation’s top-rated hospitals compared to the lowest-rated ones. Across the board death rates are declining at the 5,000 hospitals studied, but the drop is faster at the top performing hospitals.

E-mail Inga.

Emageon To Be Acquired by Health Systems Solutions, Inc.

 Health Systems Solutions, Inc. of New York, NY announced Monday evening that it will acquire medical imaging vendor Emageon of Birmingham, AL for $2.85 per share or $62 million in cash, a 37% premium to its share price at Monday’s close.

HSS, traded on the OTC bulletin board, has a market cap of $20 million. Chairman and CEO Stanley Vashovsky was quoted as saying, "This transaction will offer us the ability to leverage Emageon’s best-in-market products as well as broaden and strengthen our management team with some of the industry’s most respected leaders. Our ability to bring together innovators in healthcare technology and unleash their entrepreneurial and creative talents will result in cutting-edge solutions that will improve clinical care and significantly improve customer profitability."

The company announced that it will seek Nasdaq listing following closing of the deal, which is subject to shareholder approval.

Emageon settled its proxy fight with Oliver Press Partners LLC in June, giving the investment manager three seats on its board. It announced evaluation of strategic alternatives at that time, including sale of the company. The company’s share price has dropped by 80% in the past year.

Glen Tullman on the Merger of Allscripts and Misys Healthcare

Allscripts CEO Glen Tullman finished this article early Monday morning to share his Day One thoughts on the newly merged Allscripts and Misys Healthcare with the readers of HIStalk. Completion of the merger was announced this morning. Glen will participate in a live chat on HIStalk Wednesday evening at 7:00 Eastern.

Software Silos – The End of the Beginning
By Glen Tullman, Chief Executive Officer, AllscriptsMisys

This morning we announced that the merger of Allscripts and Misys Healthcare has been finalized, creating a new company with a client base of nearly one out of every three physicians and one of every five hospitals, as well as thousands of post-acute organizations. Clearly, this is a great opportunity for the company and for our shareholders.

However, I look at it in a very different way. I see this merger, not only as an opportunity, but as a responsibility as well. We simply must use our new size/scale, our set of solutions and our reach to radically accelerate the movement to create a truly interconnected healthcare system in order to eliminate errors, improve quality and better manage cost.

But we believe this must be a mandate not just for Allscripts, but for all vendors. While Allscripts and others provide applications that help address the issues I outlined above, the core problem is that healthcare is not connected – functionally, financially or technically. That can’t continue and we collectively have the tools to ensure it doesn’t.

Consider this a call to action to eliminate what I call “software silos.” Now is the time to come together as an industry to create standards, to ensure our systems are actual solutions, and that what we provide is the fix, not the problem.

What do I mean by “software silos?” Simply stated, vendors today often provide stand-alone applications. They are not connected to other systems or to information that is vital to our end users – the equivalent of a computer that’s not connected to the Internet.

Yet connecting to information is the very essence of what we are being asked to do, because healthcare is at its roots an “information business.” Without just the right information at the right place and the right time, providers can’t improve the health of their patients or their bottom line.

Today we have taken a significant step in this direction by bringing together two of the major players in the market. In doing so, we have already spurred additional consolidation. And more is coming.

But it will take more than consolidation. As an industry, we have to begin to move with urgency, because this is not a “problem” we are trying to solve – it’s a crisis. The stakes are too great to wait – 98,000 deaths per year from medical errors, clinical outcomes that are given a “D” on every report card relative to other industrialized nations, and $700 billion wasted every year (ironically, the same amount of the recent Wall Street bailout).

Given what’s at stake, it’s disappointing that there are companies in our market who, when it comes to interoperability, can’t spare the time to help find a solution or lend a word of support to the many efforts that are in motion right now between many of us.  In fact, it’s worse than that. For literally everything that is done, they undermine it, preferring to use a “no, because” approach versus a “yes, if.”  Their attitude shows a fundamental lack of leadership.  Simply stated, walls between systems create chaos for patients and providers. We can’t allow this to continue.

A few years ago, I had an experience that I wouldn’t wish on any parent. While I was running another software company, I was in the operating room with my son Sam. As he was being put under, he looked up at a monitor and said “Hey Dad, isn’t that your company?” When I looked up, I saw an older version of our software and knew that we could do, and had done, better.

At that moment I realized that what flows through our systems is not bits and bytes, but human lives. The lives of our families and of our friends.

When Allscripts partnered with Dell, Microsoft, Google, Fujitsu and a number of other organizations to launch the National ePrescribing Patient Safety Initiative to provide electronic prescribing to every physician in the country for free, everyone thought I was a little bit crazy … including our Board of Directors, who reminded me we were in the business of selling software. But I wasn’t crazy (OK, maybe a little bit) – I was actually still, in a sense, in that operating room with Sam with a promise I made that day, which has turned into an obligation to get life saving technology into the hands of healthcare providers.

And that’s exactly why many of us entered healthcare to begin with and why we wake up every day with the passion to make a difference. But we can only deliver on that promise if we connect our efforts.

I am proud of the work both Allscripts and Misys have done through the years to move beyond software silos. We’ve played an active leadership role in developing standards, demonstrating interoperability in live settings with other Electronic Health Records (IHE Connecthathon, HIMSS Interoperability Showcase, etc.) and connecting patients to a variety of personal health record platforms including Microsoft HealthVault, Google Health and Medem. And, on Day One of our merger, our solutions will connect to others in our portfolio, from Emergency Department physicians who can view a patient’s ambulatory health record to hospital care managers who can share records with home care agencies. We’ll focus on leveraging our footprint to drive connectivity across the care continuum from ambulatory to acute and post-acute.

And just as we’re investing our resources in expanding across all settings and enhancing the interoperability of our solutions, it should be the commitment of every CEO in every healthcare IT company to dedicate the time (not just of their people, but their own personal time) and resources necessary to make their solutions fully interoperable.

We all need to recognize that our industry – and the healthcare providers we serve – is at an inflection point. We’ve succeeded in delivering solutions that help hundreds of thousands of providers deliver safer, more effective and more efficient care. But we’ve also helped to perpetuate the information silos that keep our healthcare system from achieving true connectivity and true health.

To paraphrase Winston Churchill, this is ‘the end of the beginning.’ And now the real fun begins …

We can learn from cell phones and computers, two other technology revolutions that changed our lives, and understand that the basic software and technology are a start, but they are just the first step. The real magic comes when you connect – just as cell phones of different manufacturers and carriers are connected. It seems basic, but it’s exactly what we need to do for healthcare. Not at some point in the future, but right now.

When our industry decides to make interoperability a priority, then we can begin to claim that we are truly delivering on the promise of healthcare information technology. With our solutions connected not only across all care settings but across all vendor platforms, we will deliver higher quality, lower cost patient care through an interoperable system that enables all providers everywhere to Connect to Health. The health of patients, of providers and of healthcare is on the line. The beginning has ended and we all now have a responsibility to deliver.

That’s our goal and that’s why Allscripts and Misys came together. Personally, I can’t imagine a better outcome.