Monday Morning Update 1/14/08

From Kim Chi: “Re: QuadraMed. They are losing people by attrition, layoffs, and cutting CPR development. Word has it Health and Hospitals in NYC decided to look for another solution.” Unconfirmed and assumed incorrect unless someone wants to go on record (anonymously is OK). I’m always cautious about specific rumors involving publicly traded companies, although this one comes from a good and historically reliable source.

From Abigail Papshmir: “Re: Is this El Camino story highway robbery or what? They screw it up with a flawed and now-defunct system, then offer to evaluate the mess for millions.” Link. Eclipsys, which sold El Camino Hospital an interfaced Sunrise to Meta Pharmacy solution since abandoned in favor of Sunrise Pharmacy, says they’ll evaluate the hospital’s medication ordering situation for $3.4 million, requiring 16,000 consulting hours to do so. The end result will be “recommendations and training.” The original implementation, along with some underlying process issues, nearly caused the state to shut the hospital down when its medication error rate tripled. The hospital had outsourced the entire IT department to Eclipsys, I believe, with only the CIO as a hospital employee. The hospital says it needs another $6.6 million for pharmacy system upgrades this year. That’s $10 million, plus the original $8 million that Sunrise cost, plus a previous $2 million in upgrades planned in 2006, plus the cost of outsourcing the pharmacy to Cardinal that was required to keep CMS from padlocking the doors. That’s one expensive medication management system for a 400-bed hospital, especially considering that it still seems dysfunctional judging from this latest decision.

From Wilma Nordberg: “Re: One Laptop Per Child initiative. Intel has pulled its financial support.” Link. Intel joins Microsoft in boycotting the project, which hopes to give the world’s poorest children inexpensive laptop PCs. An Intel salesperson tried to talk Peruvian officials out of buying the nonprofit’s cheaper PCs, which come with AMD chips and open source software, in favor of the company’s own proprietary product. Maybe Craig Barrett can get involved since he thinks he’s already got healthcare figured out.

From Inside Outsider: “Re: Dennis Quaid. All I can say is – NO WAY! He has every right to be outraged and he should be outraged. The simple fact that hospital errors kill people all the time is not a good enough reason to say that the damage done to his kids should not be considered a bad thing. Yes, death is worse than maiming or brain damage or temporary damage, but the day that we look at it as acceptable is the day that we should get into another business. Just my two cents.”

From The PACS Designer: “Re: WiserWiki. TPD has discovered a new free wiki called WiserWiki by Elsevier. Only board-certified physicians can post. TPD browsed cardiovascular disease,diabetes, and COPD and found significant detail. It would be a nice complement to a PHR that would give it precise health information from prominent physicians.” Link.

HISsies voting is open. Thanks for your nominations. Time to vote … now git. I was serious when I said that Inga led the nominations for industry figure of the year, so you can congratulate her even though I didn’t include her on the ballot.

Listening: Big Elf. Black Sabbath meets the Beatles.

eScription earns 2007 Best in KLAS for its #1 ranking in Transcription and Back-End Speech Recognition for the fourth consecutive year.

Jobs: IT Manager, Product Manager, Web Developer. We’re getting lots of hits at HealthcareITJobs.com, so sign up for weekly e-mail updates of new listings.

Speaking of job listings, HIStalk sponsor Intellect Resources has quite a few their site. They’re also listing on HealthcareITJobs.

Delano Regional Medical Center (CA) and Sentillion get mentioned for the hospital’s single sign-on implementation, which it says boosted business because doctors are now willing to use its Meditech, Dictaphone, Cerner, and GE systems instead of sending patients elsewhere because of complexity and the myriad of passwords formerly required.

A former St. Cloud Hospital (MN) programmer pleads guilty to putting a logic bomb in a training program he wrote for the hospital. The code activated after he quit in June 2006 and trashed his program. He probably thought he was pretty darned clever until the FBI’s cybercrime unit came knocking on his door, for which he’s now facing 10 years in federal prison and a $250,000 fine. Doh!

Stratus Technologies is offering (warning: PDF) a free “Fault Tolerance for Dummies” book.

CraneWare announces software that links pharmacy purchasing to CDM pricing.

Missouri’s governor wants $15 million for a Web-based electronic health records system for MO HealthNet, which I think is a cute marketing name for Missouri’s welfare program.

Odd lawsuit: a Canadian drug addict wins a negligence lawsuit against her former drug dealer for getting her hooked on crystal meth and causing her hospitalization for an overdose. “”I sued him for negligence … for selling me (illegal) drugs and getting me hooked when I was vulnerable”. The dealer’s defense said the woman “voluntarily consumed illegal drugs, thus contributing to her own condition. She assumed the risks.”

Sutter Medical Center lays off 49 employees and cuts back on housekeeping services after its divisional profit drops to $111 million. It blamed that financial crisis on salaries and technology investments. Why didn’t they invest in technology that pays for itself instead of laying off janitors? You may recall that its Epic implementation will price out at $500 million or more. They even hired a “transformation vice president.” (Note to providers: any time anyone mentions the word “transformation”, do that little “make a cross with your fingers to repel vampires” thing and run for the hills. All that will be transformed is your money into someone else’s.)

An HHS/OIG report blasts the capability of physician-owned specialty hospitals to handle medical emergencies. The investigation came after two patients died following elective surgery complications when no physicians were in the building. Both hospitals called 911. Findings: less than one-third of specialty hospitals have a physician on site at all times, some had neither physicians or nurses present on some days, and two-thirds include calling 911 as part of their emergency procedures.

San Antonio Community Hospital (CA) gets local coverage for its use of scribes to follow physicians and do their paperwork. It’s the anti-CPOE solution, variants of which I’ve advocated here on occasion.

E-mail me. I’m a busy boy, but I read every e-mail even though I can’t always respond. Thank you for reading.

Inga’s Update

Special thanks to the (female) reader who sent me a note with her opinion on booth babes. “While I’m not a fan of putting a younger, thinner, cuter version of myself in my booth to draw traffic, I’m not proud.” It was such a spot-on comment! While the guys might love the eye candy, it serves as too much of a reminder for us “former” 22-year-old babes that perhaps we’re past our prime! (This is when all you mature guys can send me notes telling me how you much prefer your women to be worldly and a bit more mature).

Meanwhile I have been glued to the latest survey to see what attracts you to HIMSS booths. I’ve been happy to see “free stuff” and “cool technology” pull ahead of “attractive representatives,” proving that not all our readers are as shallow as Mr. H predicted.

As Mr. H noted earlier this week, we have some great new interviews on tap for HIStech Report, just in time to pique your interest about some of the more innovative companies exhibiting at HIMSS. Coming soon: chats with McKesson, Sage, and QuadraMed, to name a few.

E-mail Inga.

News 1/11/08

From Rogue: “Re: HIStalk get-together. Thanks, Healthia. I propose the price of admission be a wrapped/bagged trinket from your vendor company or organization —  a go-live t-shirt, hat, pen, stress ball, Post-It pad, or whatever logo item you have lots of. (And Mr. HIStalk can get rid of the bag of last year’s leftover buttons, too). Drop yours in as you arrive, take one home as you leave. Something fun to talk about later. Maybe a couple vendors will seed the grab bag with a neat MP3 player or two. BTW, the Communities open house is Monday night until 6.30 pm, so I’ll be late. And isn’t the Chapters Open House night on Monday traditionally since Tuesday is the awards dinner and Wednesday is the Universal Studios event? Stagger from one open house to another. Maybe I’ll be lucky and they’re all in the Peabody. Do we use our real names when we RSVP to keep our blog pseudonyms secret?” I like the swag idea, a modified Christmas party idea where you bring a wrapped toy. Would anyone do that? I know there will be conflicts with the time since every HIMSS event is either Monday or Tuesday night, so we figured making it 6:00 to 8:00 would allow hitting the big blowouts afterward (we know our place in the universe). I think you’ll want to use your real name on the RSVP, but we can try to guess each other’s secret HIStalk identity. Inga and I will be undercover most likely, so we can all play.

From Animal Mother: “Re: temper your envy. There is certainly a happy McK rep – or reps, actually – but no one is retiring. McK has a 27-page comp plan: one page on how to earn the money and 26 on how to actually get it. There’s a cap of around $300K on the commission will be paid out in total for any one contract, even if there are three, four, or five reps on the deal. Then you start the clocks on what will be paid when, based on the deal. The result is that the McK retention plan holds around $50-100K from the performing rep. The comp plan is the #1 reason reps leave and leave the money behind. It’s a monthly slap in the face to see that the largest number on the commission statement is the money you don’t get.”

From Willem Seminole: “Re: your free research. I got an e-mail update from [magazine] and it’s obvious they’re just writing up the news you’ve found. Some of your links from Tuesday were obscure and, what do you know, they covered those stories like they found them themselves.” I know. Adds to my legend.

From Leonard Pratt: “Re: ECG. I heard a rumor that ECG, the company that owns CHIMES, shut its doors yesterday. This is third-hand info, but I thought I would see if you heard anything about it.” I assume this is the contract worker firm. If so, yep, they’re toast. Ensemble Chimes Global was a subsidiary of Hollywood payroll services Axium International, which filed bankruptcy and tied up lots of payroll deposits this week when it defaulted on a $140 million loan.

From Lumpy Rutherford: “Re: Allscripts. This was posted on the MDRX message board: ‘Allscripts announced to customers yesterday that they’re halting all further upgrades and installations of version 11.0 and waiting until 11.1 can be released. This is in response to massive technical problems in v11.’ Any truth to this rumor?” According to my internal source, it’s not true. Lots of folks are already live on v11 (some upgraders, some net news) and v11.1 will GA in a few weeks.

From Eightball: “Re: athenahealth. Word is athena’s big win at Harbin was an IDX install and Allscripts lost out.” Here’s an announcement of their 2002 TouchWorks intentions, anyway, so it seems likely.

I’m not naming names, but a reader was looking for some help and someone from HIMSS stepped forward. Enough said, other than thanks.

Listening: Maeder. Also: Zebrahead.

Last chance for HISsies nominations. We have a couple of frontrunner disqualifications already, namely me in the “HIS industry figure with whom you’d most like to have a few beers” category and Inga in “HIStalk HIT Industry Figure of the Year.” We appreciate the support, but we’ll keep it honest. And to think I had my beer alone today while watching a Gilmore Girls rerun and waiting for Mrs. HIStalk to get home. We’ll have no remarks about Inga’s figure, please.

Jobs: Web Developer, PathNet Architect, Senior Account Executive, Epic Consultants.

McKesson claims to be the first vendor to GA software for the Intel C5 tablet PC. Says it will support Admin-RX barcoding, which could use some improvement.

Verispan announces availability of a database of retail clinics.

Jay Miller, president and CEO of Vital Images, resigns (with someone else’s hand firmly forcing his signature on the resignation letter, no doubt.) The guy he hired as COO will take his job.

I haven’t mentioned them in awhile, so here’s a plug for The Revere Group, a big hitter in providing Microsoft services to healthcare providers. Thanks for sponsoring. Ditto for MedMatica Consulting Associates, a fine source for experienced healthcare consultants.

Midwest Regional Regional Medical Center (OK) goes live with SafeScan medication barcoding.

And speaking of a potential SafeScan client, Dennis Quaid is really peeved at Cedars-Sinai now. He found that his twins got two heparin overdoses each, not just the one the hospital told him about. Not to belittle DQ since I’m a fan of his Right Stuff work, but Dennis … hospital mistakes kill patients all the time, unfortunately. Your kids got protamine and are fine, with no lasting consequences. I know actors are self-centered and all, but leave the outrage for someone looking at a headstone instead of healthy, happy babies. Go ahead and sue since that’s the American way, but remember how it could have turned out. Start a foundation or something for those not so lucky.

Speaking of positive ID technologies, Mercy Medical Center (AR) will implement a state-of-the-art RFID scanning system. In its gift shop, along with Camille Beckman lotions.

FCG’s shareholder merger vote on its CSC acquisition forges ahead. The court told a couple of legal firms that always file shareholder class action suits to stick it. Surely no one with any shred of sanity thinks FCG could do better.

Washington Hospital Center, fresh off selling Azyxxi to Microsoft, apparently will turn its ED into a mini-HIMSS, with its technology vendors running around with reporters for the launch party … errr,  “unveiling,” as the press release says. Somebody keep those unsavory patients out of the camera shots, please.

In the UK, a passer-by finds a bicycle courier bag in the street that contains sensitive lab results. He turns them over to the local newspaper, of course, since people who find medical records always seek a media outlet instead of just giving them back.

The remains of shuttered practice managment vendor AcerMed are bought for $500,000 by a newly formed subsidiary of an ophthalmic sofware vendor. Former AcerMed CEO Michael Bina is brought on as CEO of the new Abraxas Medical Solutions, Inc., along with seven other former employees. Could be good news for practices who figured they were stuck with an albatross.

Elekta AB is negotiating to buy CMS, Inc., a St. Louis radiation treatment planning software vendor, from its private equity owner.

Former Summit Medical Systems execs form clinical trials software vendor MedNet Solutions.

Mayo Clinic and IBM announce formation of The Medical Imaging Informatics Innovation Center, whose bulky and voluntarily chosen name is helpfully pushed as MI3C, which they might have picked upfront if it tickled them so darned much that they immediately started using it instead of the real name.

Cleveland is a healthcare investing hotbed, although the local paper doesn’t mention Cleveland Clinic’s doctors who have been caught running up patient tabs for medical devices and treatments produced by companies in which they have a financial interest.

Sounds interesting: a new documentary investigates the massive doping of American children with ADHD drugs. “Ethics, or as Miller reveals, the lack of such, is a central theme of the film. As he investigated the culture of medicine, the producer was shocked to learn that a vast majority of psychiatric drugs being prescribed to millions of children worldwide have never been proven safe and/or effective for the very conditions they are purported to treat. In fact, he uncovered a pattern of collusion between drug manufacturers and their regulatory watchdogs at the FDA, who literally hid evidence of suicidal thoughts and violent acts long before these drugs were approved for the marketplace.” Maybe he should offer CME and a free lunch.

The new drug benefit increased Medicare’s costs by 18.7% in 2006, now up to over $400 billion. Demanding boomers should be able to bankrupt the entire country in a few years at that rate of increase.

If you read this snip out of context, would you guess the article is about EMR software developed by a doctor in Viet Nam? “Medisoft makes things too explicit. Even one dong cannot be concealed. Perhaps that bothers some people.” Maybe it’s just me.

E-mail me.

News 1/9/08

From James Ballard: “Re: checklists. HHS’s ruling on the checklist issue is a perfect example of the loss of common sense caused by excessive regulation. If we call the documentation of the checklist a ‘Nursing Intervention’ and we then call the study a ‘Chart Review’, the Joint Commission would be singing our praises for an effective quality improvement initiative. I can’t help but wonder if I was breaking the law during most of the chart reviews I was asked to take part in.”

From Mac MacGuff: “Re: checklists. Check the credentials of the person the Bush Administration put in charge of the Office for HUMAN research protection (Acting Director). You’ll find he is a veterinarian. Apparently human protection has gone to the dogs. It appears there’s a new acting director now, but I don’t know his background.” Bet he’s driving improvement guru Peter Provonost through the woof. Sorry.

From Sam: “Re: Greenway. I was contact by Greenway Medical about a position. Do you know anyone who worked there or anything about the company?” I’ll need some reader help here since I know next to nothing.

I heard from Mike Quinto and others with clarifications about a reader’s comment involving Mike’s new CIO job at Applachian Regional Healthcare System. Mike says he’s not the only one who sold Affinity deals during his time there, although he was the big gun (he didn’t say it like that, but I spiced up the wording since I always picture sales guys as swaggering former jocks who talk that way). He also mentions that this particular ARH is not the one I was thinking of in KY and  WV — it’s a three-hospital group in Boone, NC (I gave him a barbeque joint tip since that’s one of my core competencies, but he’d just been there the night before).

From The Shelton Shadow: “Re: PACS in NPfIT. Word has come that the PACS installation in the UK has reached conclusion. The positive responses from users are starting to roll in, with many reporting faster processing of patients and quicker access to image files, thus saving money. Another key decision was made by Philips Medical to exit the installing of any further PACS for radiology in the UK, leaving the potential future business for Sectra and others to pursue.”

Mark your HIMSS calendar for Monday evening, February 25, from 6:00 to 8:00 at the Peabody Orlando, right at the convention center. It’s the first ever HIStalk get-together, unbelievably sponsored by the cool folks at Healthia Consulting. This will be first class in every respect — food, drinks, and who knows what else. I just about fell out of my chair when Shawna from Healthia sent me the menus, which just happened to include costs (I’m parsimonious), but they graciously volunteered to make the arrangements and spend the bucks to support HIStalk’s readers. Details to follow (including an online RSVP page so we can reserve those $7 Peabody shrimp, which is about what I pay for one of those barbeque dinners I mentioned). If you’re an outgoing sort, I may need some “ambassadors” to mingle on HIStalk’s behalf (I’m considering hiring cheery booth babes and boys, which even Inga thinks would be fun, although I’d be too embarrassed to have Healthia pay for them).

Speaking of booth candy: I put up a new poll to your right, playing off Inga’s earlier question. What would draw you into a vendor’s booth if you otherwise had no particular interest? I se that “attractive representatives” is doing well, so it’s not just me.

Houskeeping stuff: check the Healthcare IT Stocks page, which displays current (well, delayed 15 minutes, anyway) stock prices of some bit HIT vendors. Also, the Best Practices question is still open, with good feedback from readers about their choice of project tracking and communications tools. There are new text ads to your right — thanks to Dragon Medical, CodeMap, and Patient Placement Systems for supporting HIStalk. And, time is slipping away to get your HISsies nominations submitted, joining 137 of your colleagues so far in deciding who will be on the ballot shortly. I was thinking of unveiling the HISies winners at our Orlando soiree, although that may take more organizational skills than I can muster. Wouldn’t it be cool to have The Pie winner show up to accept? Unlikely.

Nearly 200 jobs are listed on HealthcareITJobs.com, including listings from QuadraMed, Partners Healthcare System, Intellect Resources, and DocuSys. Employers can post jobs at no charge for a few more days.

Listening: Chevelle.

My editorial in tomorrow’s Inside Healthcare Computing electronic update: “RHIOs 2.0 Dying Uglier Deaths than 1.0,  but Hardy Survivors Guarantee Another Round.” I might surprise you with my tiny, guarded RHIO optimism, including this comment about my previous posture: “I was a real buzz-kill, raining rational thinking onto the frenetic, obedient parade of RHIO trough-lappers.” I notice today that Marc Overhage has an editorial in the Indianapolis paper, although he isn’t unbiased like I am since he runs a RHIO.

American Radiology Services Inc. will be sold by its buyout owners for $151 million to CML HealthCare Income Fund. Johns Hopkins owns a big chunk.

Cerner, Microsoft, and Spectrum Health (MI) will partner to develop the Cerner Care Console, one of those combination clinical/entertainment systems that companies keep trying to sell. Cerner’s version will include an Xbox 360, patient-physician communication, patient schedules, surveys, and hospital propaganda.

McKesson signs a big deal with Community Health Systems (TN) that includes its physician portal, EMR, and clinical systems in over 40 hospitals. There’s one happy salesperson out there somewhere who will eventually pocket a fat commission check (How much, since I’m an incentive-free provider sider? A million?)

Provena Health signs up for Misys EMR, Tiger, and Homecare.

Lonnie Johnson joins Zotec Partners as COO.

Goldman Sachs puts money into portable clinical information vendor Epocrates.

The DoD wastes so much money that another $4 million and over 100 employees for a “Military Interoperable Digital Hospital Testbed” doesn’t register, even when it’s in that high-tech haven of Johnstown, PA and paid out to Northrop Grumman. Still, you have to guess this announcement is a lot more about federal pork than technology.

Former Amicore president Richard Noffsinger is named CEO of SafeMed. I couldn’t figure out what they sell from the lofty-sounding press release, but it’s something to do with health analysis and it brims with buzzwords: actionable, empower, architect, etc. According to my trustworthy Bullfighter software, “Diagnosis: You like to hear yourself write. Despairing of the thought of bringing a sentence to a close with something as demeaningly ordinary as a simple period, you shower readers with gratuitous, interminable and often weighty if not impossibly labyrinthine prose. Meaning lingers, albeit awash in a thick tide of metaphor and exposition that threatens to drown the writer’s message. Seek help.” I didn’t think it was that bad, but I don’t question BF.

Sage Software announces go-lives of its Intergy Practice Portal for patient-physician communication.

CalRHIO announces that Cisco will join Medicity, Perot, and HP in developing its information exchange.

InterSystems announces that partner Oleen will provide its Cache’-powered SurgiDat system to the VA.

E-mail me. Inga’s working on some HIStech Report stuff tonight, trying to catch up for HIMSS, so it’s just me.

Monday Morning Update 1/7/08

From Christine Slater: “Re: HIMSS legislative success. HIMSS sponsored 92 healthcare IT bills. Zero passed. Anything wrong? Nah.” And in more bad news for EMRs, fading presidential candidate Hillary Clinton says she’s all for them.

From Is CCHIT Irrelevant?: “Re: CCHIT. The CCHIT home page lists Epic as the only vendor with a certified ambulatory EHR and inpatient EHR system. Is the baseline functionality that CCHIT requires really missing from other enterprise vendors, or have vendors just stopped caring about CCHIT certification and the advantages that it is supposed to bring their customers?”

From Patrick Ayephbee: “Re: new vendors. I’m seeing more get rich schemes and dirty tactics from the usual greedy vendors plus companies new to HIT. Greed, inexperience, and arrogance – great combo. Most of the IT world seems to think that poor industry performance can be explained because we’re in the pioneering stages. No, THEY are in the pioneering stages. The industry is 40 years old and they have not stopped to learn one damn thing. In fact, they don’t even ask. If you heard some of what the [vendor name removed] folks are saying, it would bring a tear to your eye.”

From Gail Pileggi: “Re: real time location systems. The area of RTLS is suddenly the ‘next new thing’. We fail with overhyped CPOE, so turn to nursing documentation and BCMA. Oops, that’s not easy either, so let’s focus on supplies since they can’t gripe. Not a bad thing, just another detour and hype cycle to deal with.”

From The PACS Designer: “Re: 2008 outlook. The outlook for 2008 is rosy for some new software applications. We will be hearing about successes and failures of PHR efforts and implementations of thin client applications Another innovation that will begin to find a home is the ASTM International Continuity of Care Record (CCR). Since TPD was a participant in its creation, it would be gratifying for me to hear that it’s in use and working to improve the information flow of healthcare!”

From Stratto Cumulus: “Re: cloud computing. Reminds me of the late, unlamented ASP model, where clients wanted to outsource everything, lay off staff, and make huge profits. In real life, the vendors were running cloud servers with vanilla COTS applications that they would not modify, which killed the business since enterprise apps always need customization and interfacing. Questions to ask: who’s handling authentication and security? Will the cloud vendor tell you if someone snoops in George Clooney’s records, or if you suspect someone is, how fast will they look into it? How will COTS licensing be handled, or will only open source stuff be in the clouds? Will the cloud be a data repository with local data marts or will local systems collect the data and batch it up to the cloud? Will it be transaction driven and Web-based, and if so, how many critical clinical apps are really Web-enabled? How will APIs and web services be handled? Are you sure you have the bandwidth? Clouds could be great for research repositories, provided authentication and architecture is adequate to handle the multiple query services. It would be great if we could integrate research findings across multiple studies to increase statistical power or see relationships across organizations, genes, etc.”

My editorial in last week’s Inside Healthcare Computing: “How the Layoff Grinch Stole Christmas: Clueless Management 101.” I gave myself some love (is that immoral?) for this line about how suits pick layoff targets: “Extra points are assigned if the victim doesn’t seem like the sort to argue, sue for discrimination, or return with armament (the worst part of being laid off is realizing that management put you in the same league as those losers who got axed with you.)” I’m not claiming it’s Tolstoy, but it sounds like me.

Heard: Lucida Healthcare IT has been acquired by Vitalize Consulting Solutions. Lucida’s execs have taken key roles (CEO, CFO, and CIO) in the new entity, which has the financial backing of some big players that include Bank of America and SV Life Sciences. Vitalize’s Mary Pat Fralick will stay on as COO.

Jobs: Manager of Clinical Informatics, LIS Director, HRIS experts, Sunquest lab consultant. Employers can list jobs free for a couple of more weeks.

Make your HISsies nominations now. Surely you have thoughts on the best and worst HIT vendors, the smartest and stupidest vendor strategic move of 2007, and the HIStalk Industry Figure of the Year. There’s about 100 nomination votes so far and the top nominees will go on the ballot. Maybe the obvious choices haven’t been named, so why take the chance?

I’ve got a few giveaway items for the HIMSS conference and need vendors to make them available to attendees. If you want a little extra booth traffic, drop me a line. These are small items, so they won’t be hard to handle in the convention center. Unlike those damned “I Am Mr. HIStalk” buttons from two years ago, which I can’t believe I found a forgotten sackful of while cleaning out my computer closet this weekend. Maybe they’re reproducing like Tribbles. Unless someone saved theirs, I could wear one myself and have an exclusive (plus they say “I Am Mr. HIStalk”, so I’d be telling the truth).

Former QuadraMed sales guy and HIStalk reader Mike Quinto has joined Appalachian Regional Health System in Boone County, NC as CIO. Fun fact somebody told me: he sold the only Affinity deal made in the last three years and his customer was … Appalachian Regional Health System. He must be persuasive.

Kelly Barland, formerly of GE Healthcare, has joined InfoLogix as senior director of professional services.

Somebody sent me a Medicity Christmas letter of sorts (I always appreciate forwarding!) Revenue doubled again for the third year in a row (notable considering the obvious floundering of their interoperability competitors). They also signed a big deal with HSHS. I always harp on idiotic RHIO business models and Medicity’s customers seem to be a lot smarter about theirs (including CalRHIO, which is hush-hush about their arrangement but promises to spill it someday).

Remember that glowing article about Peter Provonost’s reminder checklists that were saving tons of lives and money, just like a pilot’s pre-flight checklist? They were cheap, easy, and set to roll out in the US and in other countries. Well, make that just “other countries” now because the geniuses at HHS’s Office for Human Research Protections, apparently in need of a moment of bureaucratic limelight, have declared the use of such lists unethical and have shut the program down. They decided that using a safety checklist and tracking the results violates IRB requirements, claiming that using a list is no different than injecting a patient with an experimental drug (huh?) Knowing that patients will die otherwise, that seems like a puzzling decision (who wouldn’t want their caregivers to use a list that could save their lives?) I’m not one to advocate storming the castle with pitchforks, but you could e-mail acting director Ivor Pritchard (ivor.pritchard@hhs.gov) your courteous, well-informed opinion if you agree with me that this seems ludicrous. Peter Provonost (of Johns Hopkins) agreed earlier to be interviewed here once we work out details, so I’m sure he’ll have plenty to say.

Former Navy hospital CIO David Yovanno has been named COO of Internet advertising firm ValueClick.

UK researches think Google’s PageRank technology can be used to identify MRSA hotspots in hospitals.

California’s data breach law, which previously covered only financial information, now requires patients to be notified if their medical information has been exposed.

ONCHIT’s 2008 budget will be the same as 2007’s, about half of what President Bush wanted. Rob Kolodner says they’re on track to meet Bush’s goal of EHRs for every American in the next six years. If Vegas gives odds, go the other way.

KLAS has announced its year-end Best in KLAS report. Since vendors aren’t shy in telling you when they’re #1, I like to focus on those products that are dead last in their respective categories: GE Centricity CDR, Siemens Invision ADT, Cerner FirstNet ED, Cerner Scheduling Management, GE Centricity LIS, Siemens SIENET PACS, Cerner PharmNet Pharmacy, Sunquest RIS, and GE Centricity Perioperative.

Bizarre medical lawsuit: a strip club owner whose penis is tattooed with the words “Hot Rod” is suing Mayo Clinic’s chief surgery resident, who admits taking a photo of it while catheterizing the man and showing it to other doctors.

E-mail me.

Inga’s Update

An Arkansas neurosurgeon pleads guilty to soliciting and accepting kickbacks from a surgical device company. The doctor has agreed to pay $1.5 million, of which $1.1 million will go to the state and to the whistleblower (who happened to work for a competitor.)

Overheard: two Misys operational superstars with over 30 years of combined tenure say goodbye to Misys to work for former Misys VP’s Marc Winchester and Scott Sanner at Digital Healthcare, a retinal risk assessment company. Their resignations come on the heels of at least a couple of senior sales superstars over the last month or so. Guess they’re all choosing the highway over Misys MyWay.

Mr. H and I have had a few conversations about what attracts people to booths at big shows like HIMSS. Let’s say you are only mildly interested in the company’s offering, or perhaps have no clue what the company does. Does a free latte or margarita get you to step into the booth? (my favorite). A beautiful young female with a bit of exposed skin? (Mr. H’s favorite). Pictures of Mr. H and me? (that was what our friends at The White Stone Group want to give away). Or, various trinkets and chances to win some exciting prize? Let me know.

Apparently the bean counters at PricewaterhouseCoopers will begin performing a new type of audit: PwC has been hired by CMS to perform 10 to 20 HIPAA “compliance reviews” of organizations facing complaints.

After an “independent strategic reviews,” MedcomSoft announces an overhaul to its board of directors. They are also looking for a new US-based CEO, if anyone is interested.

Barnes-Jewish Hospital in St. Louis is partnering with iMDsoft to implement MetaVision anesthesia information management system.

Reminder: our new “Best Practices” section of the Forum is up and running with this week’s question: what software or forms do you use to track an active project … tasks, percent complete, assignments, due dates, etc.? Add to your list of New Year’s resolutions to post a message or two to share your wisdom.

At the top of my personal resolutions is regular exercise, especially since I don’t seem to be too good at skipping cocktails or carbs. Happy New Year, by the way!

E-mail Inga.

News 1/3/08

From Lazlo Hollyfield: “Re: AHRQ. It amuses me how some of the health news outlets are highlighting the AHRQ focus groups on how consumers perceive health IT. Besides an area that several market research companies already cover, this is a complete non-story at best and lazy journalism at its worst. NIH budgets have dwindled/been flat and so has AHRQ’s budget. Most of the bureaucracy is leaving before the end of this presidential term and decisions to award money have gone astray. This is probably a case officer at AHRQ who basically had some extra money to throw around. Nothing more. I would be shocked if something truly interesting gets published from it. Probably just verifies existing customer data out there from the various market research firms.”

From The PACS Designer: “Re: Cloudy 2008. TPD took a well-deserved vacation and a break from HIStalk, but is now back in the groove as we approach 2008. Speaking of ‘Cloudy 2008’, it’s not weather or financial predictions, but refers to the emergence of more ‘Cloud’ offerings in the healthcare space, with Clouds being bundled software services which include  automatic upgrades from time to time which will remove the burden and worry from institutions. Since hospital budgets are tight due to reduced Medicare expenditures, you can expect more C-level execs to consider outsourcing many of the more laborious tasks to vendors who offer their services as ‘Clouds,’ which will expand the size and number of clouds employed to get the jobs done in 2008 and beyond. Short term, it will mean lower software revenues for vendors, but longer term will provide stable monthly/yearly business revenue volumes for companies offering this option. Happy 2008 from TPD to all HIStalk readers!”

From Nasty Parts: “Re: rumor. I can confirm your rumor of a British EMR company’s SVP of sales leaving. He came from outside of healthcare, a decision I never understood. Morale is high with his departure.”

From Marge N. Alperformer: “Re: HIMSS. Do you know of any inexpensive way to to attend?” Registration’s going to set you back $740 if you get it in by the 28th and there’s not much way to avoid that unless you: (a) “share” a badge with someone else and split your time; (b) find a vendor to comp you, which isn’t likely; (c) do something for HIMSS that will get you a free reg, but it’s probably too late for that; (d) skip the educational sessions (or assume credentials won’t be checked closely) and buy just an exhibit hall badge for $175. You can save on flight and lodging by using Priceline (I’ve done that), especially since rental cars are cheap in Orlando so you can stay further out and off the shuttle line. Anybody else have ideas?

From Kiera Whitlock: “Re: MGMA. They are very visible in the Medical Group Practice world; their founding fathers practically invented the large multi-specialty group practice. Most of the big groups are members, but MGMA is catering more and more to the smaller practices. Their sectional and national conferences are big, though not as big as HIMSS; but also don’t have HIMSS’ price tag, for vendors or for members. If you don’t know much about medical groups (or even if you do),their training and publications are a good value. If you want to hang around exclusively with the bigger (50+ MDs) groups, you’ll probably want to check out AMGA; their conference is smaller, but the biggest groups and the best vendors are there. AMGA does not (as far as I know) have individual memberships; so if you’re looking for a personal (as opposed to organizational) membership, MGMA is the place to go.”

From Techman: “Re: HL7. I work for a software vendor and I am interested in the way HL7 is used in practice by healthcare providers, like which parts of the HL7 messages are used. Anyone have suggestions for information sources?”

From Grizzled Veteran: “Re: Alteer. The California-based EMR/PM company is being acquired by VisionaryMED, a Florida EMR/PM company.” I saw nothing in the news or on either company’s site, but I’m not doubting you.

From Porchean Cantrall: “Re: HISsies. athena’s insane IPO and ongoing industry buzz around their disruptive SaaS model have got to make it for biggest industry event. Loved Beers with Bush last year in any event – thought that was pretty cool.” Beers with Bush was fun, especially since athenahealth brought out the good stuff right on the exhibit hall floor for HIStalk readers who dropped by. We need another fundraiser for a worthy cause, if anyone has ideas.

And speaking of HISsies, it’s that time again: your nominations for “The Brutally Honest Healthcare Information Systems Awards” in 18 categories are now welcome. Among them: who’s the worst vendor, what’s the biggest HIT news story of the year, who is the HIS industry figure in whose face you’d most like to throw a pie, and who gets the biggest award: the “HIStalk HIT Industry Figure of the Year.” Nominations will run until the end of next week, then voting begins. Don’t discount the importance of voting now: only the top handful of nomination vote-getters appear on the final ballot. If you’re new, don’t think this is a joke just because the categories are cheeky: it draws 1,000 or more voters each time, some vendor always tries to rig the voting by urging employees to vote for them as Best Vendor, and the number of people who read the results announcement is off the scale.

Cardinal Health recalls another 200,000 of its Alaris Medley smart IV pumps. Springs inside the pump were assembled incorrectly, leading to the potential for overinfusion.

Pennsylvania get its usual abundance of federal pork barrel money, including $86,000 each for clinical IT projects at Mercy Hospital Scranton, Moses Taylor Hospital, and Mid Valley Hospital.

Inga mentions her Christmas presents below. Mine: the rest of the Gilmore Girls DVDs (so femme, I know, but I’m addicted); Call of Duty 4; a couple of books, including How Doctors Think; and some Boy Scout popcorn from Mrs. HIStalk’s batty but adorable 90-something aunt.

Let’s get this Best Practices thing going! What software or forms do you use to track an active project … tasks, percent complete, assignments, due dates, etc.? An HIStalk reader has asked, so share your thoughts in this new HIStalk Forum topic. Register to post if you haven’t already.

If you found the Rose Bowl coverage annoying (nearly assured since Brent Musburger was involved), you’ll find this funny.

CPSI signs a deal with NeoTool to use its NeoIntegrate interface engine.

Listening: Blonde Redhead.

Merge Healthcare did some restating and reporting, but I just can’t get interested in their ongoing troubles any more.

Sumter Regional Hospital wins the Siemens MRI with over 260,000 votes, 101,000 more than the second-place finisher. The official announcement will come in a couple of weeks. Congratulations to them and thanks to the HIStalk readers who voted for them.

A Malaysian hospital has developed its own information system using free Oracle software. It includes ADT, ED, surgery, HIM, case mix, and patient accounting, with CPOE and HL7/DICOM integration planned for 2009. Says it costs millions of ringgits to implement (a ringgit is around 30 cents US) and that distributors are interested in selling it.

A former GE Healthcare bigwig, soon to be CEO of a small medical data analysis company, says he wants to sell clinical-genetic information systems to vendors like Cerner and GE.

Jobs: Pharmacy Application Specialist, Epic Trainers, Director of Global Training & Education.

A doctor creates a video e-mail for each patient to explain their lab results.

Allscripts acquires discharge referral system vendor Extended Care Information Network for $90 million in cash.

E-mail me. It’s time to get back in the swing of things.

Inga’s Update

I am back from a week in the land of no Internet access. I loved my time with the extended family, but truly, how does one survive in a world with no Wall Street Journal, one FM radio station, and 20 miles from the nearest manicurist? The highlight was driving into “town” one day and seeing a plethora of beefy country boys in their nice-fitting jeans. They all looked like they spent a lot of time hauling things around all day, though I bet none knew anything about healthcare IT. Next year I am voting for a Four Seasons somewhere (I love their towel boys.)

My best Christmas present is my 320GB external disk drive that I haven’t hooked up yet. Probably next was the 1000-page “World Without End” by Ken Follett. No healthcare IT references at all, though it is Oprah-approved.

I was pretty amused by the number of posts related to Meditech and their technology. To be fair, I should note that I am the one who introduced the MUMPS technology issue when asking if Meditech had difficulty finding employees with expertise in MUMPS (to which he pointed out that the current technology was not MUMPS.) I was a bit surprised by the passion my Meditech friend still had for his company. Whether or not you agree with his opinions on Meditech and its technology, my impression was he honestly believed in the company and their products. On one hand that is commendable, and certainly understandable. How could you stand by your company and its products and people for so long if you didn’t believe in them? On the other hand, it’s easy to get blinders on after a period of time. I know little about Meditech’s management but I hope they take time listening to the market (and not just their clients) since it appears the world views things differently than the Meditech folks.

News 12/28/07

From Bruce Teeler: “Re: MGMA. Does anyone have any feedback on this organisation? They claim 21k members, which doesn’t seem like a lot to me.” MGMA is the defacto member organization for physician practice management. 21,000 members sounds like a lot to me (I don’t recall how many HIMSS has, but I bet MGMA is nearly as large.) If anyone has first-hand experience with MGMA or its conference, feel free to provide an opinion and I’ll run it here.

From Neal’s Pizza Guy: “Re: Cerner. Rumours abound that Fujitsu is pulling out of the NHS contract, leaving Cerner in a prime contractor role for the Southern Cluster of England. Townsend has been spending a lot of time in the UK to negotiate, along with Neal, who presented how they would take on a cluster direct. Get the pizza ready!!!!” Speaking of pies and Neal, I’ll be opening up the HISsies nominations very shortly. If you’re new here, you can check out the writeups for 2005, 2006, and 2007. Neal’s a three-peater for The Pie, of course, the most recognized subset (and least desirable) of the HISsies awards. So if you’ve been anxious for this year’s round, I’ll say just this: tick-tock. Billy “Biff” Jutjaw is getting fitted for a new tux for the ceremony since he’s put on a few pounds since the last one, so I hear.

From EX-Xtenity: “Re: layoffs. It seems that one of the only certain things in this industry is that there will be layoffs. My heartfelt condolences to those who were recently laid off during this time of year. You might want to consider pulling together as a group for the purpose of networking. Best of luck to you all from someone who has been there a few times.” Agreed. It’s not much consolation while the wound is still fresh, but I’ve known a bunch of people who were laid off and nearly all of them ended up better off because of it. The companies doing the deed don’t usually fare so well (how talented are executives who can’t plan far enough ahead to dump payroll expense sometime other than November or after December knowing how bad that makes them look?) It’s a good reminder that, despite feel-good HR talk about being a “valued associate,” we’re all expendable horseflesh. I’m not against that concept at all since it’s a two-way street in our capitalist society, but sometimes companies say one thing and behave entirely differently and I’ve got a problem with that. I’ve laid off a bunch of people in my time and didn’t like it one bit (like a death camp guard, the clueless commandants didn’t exactly give me a choice). One thing I’ve learned: a company that’s laid people off more than once is entirely likely to do it again, meaning think twice before taking a job there no matter how superior you believe your skills are. Those laid off aren’t necessarily the least-capable employees, just the easiest targets because of their assignments or lack of political connections. There but for the grace of God go you.

From Matchless: “Re: St. Joe’s. I don’t think you published this, but St. Joe’s in Atlanta has to pay the government $26m for overbilling Medicare. Case workers of the world unite!” Link. The most interesting part of the story: a nurse whistleblower gets $5 million for documenting that the hospital billed outpatient and observation services as inpatients. Sweet.

From TheCoolerKing: “Re: [British EMR vendor]. Fired their SVP of Sales last week. It took over two years to find him and he is gone in less than a year. 50% of plan will do that to you.” I expunged the company’s name because that would single out a guy who’s out of work (if the rumor is true, anyway). Those who care will easily figure it out. Hint: it’s not Misys.

From Malvern: “Re: selling patient data. The desire to keep patient data confidential is understandable, but we tend to forget what is known about each of us who uses a credit card, takes out a loan, or swipes the grocery store tag to get the store discounts. When you ask the credit report companies what they know about most of us, there is not a whole lot that escapes the electronic eye.” True, although they need to know lots of stuff to gauge your credit risk and there’s no morally acceptable equivalent in the healthcare insurance business. Maybe that in itself is illogical: other insurances are priced by risk (living in a flood zone, driving like a maniac, skydiving, etc.) but health insurance is supposed to be blind to higher-risk purchasers with no cost adjustment for risk factors. If we were designing the concept from scratch, I don’t think we’d come up with today’s system of voluntary participation and employer-based signup.

From Billie Jean Queen: “Re: mining EMR data. Issues include: disparate standards across specialties and vendors; HIPAA and patient consent information, which requires metadata; control of the repository and how it will be secured, since search engine technology is so good that re-identification of patients is frighteningly easy; and getting enough data to make it useful for research (how BP was collected, for example: sitting, standing, etc. and most EHRs don’t capture that). The most useful thing that could be done would be to get device vendors to output all the information about how a signal was collected, such as device name, parameters for the study, methods used, software version, patient ID, etc. and automatically put that in the EHR in a standard form.”

A Washington Post article describes the software-driven ED turnaround at Inova Fair Oaks, with sophisticated applications forming the cornerstone of Inova’s plan to integrate its six Washington-area hospital EDs and several more freestanding emergency centers. GWU Hospital is also mentioned. The software isn’t mentioned by name, but a little Googling turns up that it’s Picis ED PulseCheck at both places.

Housekeeping reminders: you can sign up to your right for electronic updates when I write something new or for the Brev+IT weekly newsletter. New interviews are coming soon to HIStech Report, whose interviews delve deeper into vendors and their products (it will swell right before HIMSS). HIStalk Forum gives you a place to start discussions or participate in them — we’re planning to open up a Best Practices section there with an assigned focus area every couple of weeks for tip-sharing (grateful kudos for Noteworthy Medical Systems for sponsoring HIStalk Forum). There’s a site-specific Google Search box to your right, the first place I look when someone asks a question about a company or person since it covers 4 1/2 years of HIStalk. Lastly, please take minute to read and click those sponsor ads to your left and text ads to your right since they make HIStalk possible (and free).

A group of Paris hospitals withdraws its $110 million contract for patient systems development, awarded to GE and other companies, because the companies struggled to define their proposal. The tender has been reopened and a local paper says Capgemini and McKesson will probably jump back into the bidding.

Jobs: Medical Knowledge Engineer, Clinical Content Production Manager, Corporate Manager of Clinical Applications, Project Manager.

Barring last-minute voter fraud or eBay-type sniping, it looks like Sumter Regional Hospital will win an MRI machine from Siemens. The hospital has accumulated 244,000 votes, far ahead of #2 Grant Regional Health Center with 151,000.

Odd story: the Fiju hospital trust is running its own IT system after its vendor failed to meet its needs. The vendor’s owner is a businessman wanted for questioning over an alleged assassination plot.

Varian Medical Systems completes its acquisition of a radiology equipment distributor in China. Maybe I should study the Chinese HIT market since everybody seems to be looking there for growth unattainable elsewhere.

Idiotic hospital lawsuit: Wisconsin’s governor takes $200 million from the state’s medical malpractice fund to balance the budget. A patient is suing St. Luke’s Hospital for a medication error that occurred before state pain and suffering caps were enacted, with a potentially huge payoff on the line. The state’s medical society has filed a counter claim against the hospital to make them pay their own damages, claiming the hospital’s employee training is inadequate. The state’s hospital association, as you might expect, begs to differ, saying St. Luke’s should be covered by the malpractice fund because that’s why it was created in the first place. Now the medical society is suing the governor. An epidemic of lawyer paper cuts and 30-hour billing days is next.

Healthcare spending in California’s prison system has doubled in two years. Prisoner count is up 8% since 2003, but the budget increased 79% to $8.5 billion and expected to exceed $10 billion next year. The state faces a $14 billion budget shortfall, which surprises no one in the 49 other states who find it hard to suppress a guffaw. Surely The Terminator will blow away the deficit and save El Lay.

Interesting: an electronic stethoscope under development will use onboard Linux despite perceptions that it will make FDA approval difficult.

athenahealth’s IPO was the ninth best of 2007, one of 10 that doubled their IPO price. Implantable RFID chip maker VeriChip was the worst IPO of the year, down nearly 62% from $6.50 to $2.49.

I hope you’re enjoying the holiday. Shockingly, it’s just nine weeks or so until HIMSS. Save the early evening of Monday, February 25th if you’re headed to Orlando. That’s all I’m saying for now.

E-mail me.

Monday Morning Update 12/24/07

From Orthopod666: “Re: selling patient data. This is from an interview with the CEO of the AMGA regarding the AMGA/Anceta National Collaborative Data Warehouse, which provides groups with access to comparative healthcare data. ‘The revenue for the company (Anceta) will come from making the totally identified, HIPAA-compliant data available to third parties.’ If this is true, how can they possibly be HIPAA compliant?” Link. Other references to Anceta indicate that the data in the Collaborative Data Warehouse is de-identified, so I assume the reporter misquoted her source (her freelance articles elsewhere cover everything from beauty academies to LCD projectors to real estate, so she may have been in over her head, but surely the editor should have caught that goof).

From Former Medseek Employee: “Re: Medseek layoffs. Yes, it’s true. I was one of the chosen few who got the boot a week before Christmas. I believe there were 30+ employees shown the door. Cash flow was stated as the problem. Mike Drake is out too. The rumor mill has it that egineering folks are not happy in Jackson with losing their leader. Many are are ready to leave, which will only put Medseek in more dire straits.” Maybe you’ll get separation counseling from Chief Strategy Office Gale Wilson-Steele in the form of a free pass to her upcoming lecture called “Promote the Best, Improve the Rest: The Power of Positive Reinforcement.” Feeling better now?

From MedSlease: “Re: Medseek. Mr. HIStalk, you are a good judge of character and hit the nail on the head. Do you remember? Mr. Grehalva has been shaking the clients’ hands and working his free hand to pass out pink slips yesterday, five days before Christmas. There have been some very talented, seasoned people let go, including an older employee on medical leave whose wife is in intensive care with a brain hemorrhage. Merry Christmas, Medseek, and a Happy Lay Off. May 2008 bring you all that you deserve.” The reader is referring to this mention. Layoffs are part of corporate culture, unfortunately, and not entirely unsavory provided that: (1) companies don’t overhire and then correct their own excesses by downsizing; (2) the decision of who gets let go is made fairly; (3) executives share the pain by reducing their own compensation or benefits; (4) volunteers are first solicited to leave before axing those who don’t want to go; (5) separated employees are treated fairly and professionally without the usual security guard escort BS; (6) executives realize that layoffs are their failing, not those of the employees involved, and take appropriate actions to either improve their own skills or find better managers to replace them; (7) layoff decisions are a rare exception and not a routine management tool; (8) management is open about why the actions were taken and what they plan to do to avoid it in the future; (9) management doesn’t expect the shell-shocked survivors to cheerfully work extra hard to make up for the loss of downsized employees; and (10) employees aren’t singled out just because the company has at some point in the past decided to pay them higher salaries.

From Dr. Elias Kuando: “Re: Medseek. First Healthvision, now Medseek. It would seem that a lot of these size HIT vendors keep getting it wrong. Healthvision was expected. They lacked focus. But Medseek? This one surprised me. In my contacts with them as both a partner and a customer using their product, I always had the impression they had it right. That the CEO has left either by design or request speaks volumes about the company’s stability or instability. We have had discussions with Geonetric, but felt they were too small to be considered a serious player. The impression we got from their demo and functionality was that they aspired to be Medseek someday. Given this recent news, I would rethink that position.”

The SEC creates a Web-based tool that allows comparing executive compensation at 500 big companies, although the only healthcare IT one I could find was GE.

I decided not to send a Brev+IT today since not much is going on. Next week.

Listening: Catatonia, witty Welsh (and disbanded) chick singin’ alternative rock. Also: new Nightwish, icy, cinematic, and operatic Finn prog metal.

James Pennington, former CIO at Blue Ridge Healthcare (NC), joins JPS Health Network (TX) in the same role.

University of Miami’s heart clinic will use Active Ink‘s electronic forms software for patient check-in on tablet PCs.

Your federal tax dollars at work: bankrupt Bayonne Medical Center (NJ), soon to be sold off to a for-profit company, gets $487,000 for an EMR upgrade.

Philips hasn’t run out of acquisition money yet. The company announced Friday that it will buy sleep therapy products manufacturer Respironics for $5.1 billion in cash.

Merry Christmas (or its equivalent for whatever holiday you may be celebrating).

E-mail me.


Art Vandelay on Vendor Project Management

Many days, I feel like a boxing trainer looking at all kinds of boxers but not finding any with a solid one-two punch – a solid product with strong professional services. More and more, I have been focusing on the strength of the second punch – the vendor’s ability to provide technical assistance and manage a project. You have a real contender when you find one who can help with integration into our diverse environments.

The vendor’s ability to provide technical assistance includes application config., getting their product to work in our hardware environments and delivery of standard interfaces. As virtualization and monitoring ( e.g., response time, SNMP) become more prevalent, the vendors need to develop these skills. The challenges in the hardware environment are the lack of standards and number of varied products we all own. We now include information about these topics in our RFPs to set expectations with vendors.

Managing a project includes a flexible project plan and managing scope, issues and risks. Vendors need to leave appropriate “stubs” in the project plan where we can insert our tasks so that we have an integrated plan. This is always expected from our vendors answering RFPs.

Integration into our diverse environments involves more than just technology.  It is about people, processes and other vendors’ technology as well in order to drive real workflow changes. As the number of broad independent consulting firms dwindle, the opportunity for vendors to step into this space will grow. I have yet to see the “heavyweight” vendors really grab this concept and run with it, directly, or through channel partnerships with others. Right now, we operate as our own integrator as the vendors really aren’t looking outside the domain of their products.

Inga Talks to a Former Meditech Director

I had the opportunity to talk to a former Meditech director recently. He had some interesting commentary about the company, its culture, technology, and people. Here are a few interesting tidbits.

Product development

I would say that a very wise move made six or seven years ago was to consolidate all development efforts throughout the company into one organization. Prior to that development had sprouted up and was going on in all different parts of the company. But when the product efforts were consolidated under Bob Gale, the process of developing products matured to the extent that now there are some really good processes in place that have much less in the way of redundancy and reinventing the wheel many times over and also for more rapidly deploying resources to customers.

Orienting new employees to Meditech

The new employee orientation process is either two or three days and consolidates together a large group of people who all start at the same time. Everyone starts at the same time, and there is a certain bond that people have with that group that they started with. They get to know each other and I think that that method of bringing people on board is a good one in terms of not having to individually deal with so many people on common issues such as enrolling in health plans and understanding benefits and just general corporate culture pieces such as how you page people in buildings and so forth. And without that sort of centralized dissemination of the information you’d have all sorts of crazy things going on that would seem small but would make kind of a funny footprint over the whole organization.

Neil Pappalardo and whether he has a hands on or a delegating leadership style

Both – there are certain things he doesn’t get involved with day to day. He is very closely involved with the broad vision of where the company is going and the broad vision of the company’s financial direction but he is not one who would want to see every single detail of what is going on. He just wants to see if the broad vision is heading the way he has asked it to go. He has a very small number of people that report directly to him who would sort of fill him in whether or not we are moving in the direction he has asked for. He doesn’t have an office and sits out in the open in a workstation with other people. He goes right down in the cafeteria with everybody and just grabs his lunch. If you didn’t know who he was you wouldn’t know who he was (laughs) if you know what I mean. If someone didn’t point out that guy over there at that workstation is Neil, you would be likely to think that guy has been here awhile and looks a little older than everybody else. He has always made time for me.

Technology

The products are now developed in a much newer technology than MUMPS. The latest version of their products 6.0 client/server is written in a brand new technology developed by Meditech. Meditch develops the technology that is used to develop the applications and that has always been the case. MUMPS has not been used – I am not sure it was ever used to develop any Meditech products. A close cousin of that is named MIIS was the first language that any product developed by Meditch was written in. Over the years, that evolved into Magic, and Magic evolved into a Magic-based C/S. This newest technology is a brand new development environment that runs in Windows NT and but it also has ability to run in other environments as well because it relies minimally on the server side. They have applications that are used internally for administrative purposes that are running on Linux instead of NT just to give it a test and see how platform independent the technology can be. That is a newer product that is more of a staff scheduling kind of model that’s issued internally.

Why Meditech has been able to achieve such long-term success

Simply the fact the products do work. That is the key thing. It sounds almost like – why wouldn’t they work. You buy a car and expect to drive off the lot, not that they will have to tow it to your house and hopefully in a couple of months you can drive. I think because the products have been written to work together has been is a key to the success of their stability. They have never acquired other companies’ products and tried to put a portal or some kind of other face on top of that product and interface it behind the scenes. It’s true integration. The products were developed with the same technology under the same leadership and that really gives them true integration and not just the appearance of integration.

Meditech’s biggest challenges and opportunities going forward

I think continuing to retain good talent is going to be a critical piece for them. That is really what the company is built on. It’s human capital. You can be financially solid in many ways, but you have to be able to have the people who can carry out that vision and that plan. Another thing that will be a big challenge is getting customers moving forward on new technology. Magic is very solid and I know for a fact there is no plan to scale back or sunset Magic at all. Magic has been moving forward because there are so many clients on it. It would be very difficult from a logistical standpoint envision trying to get more than 1500 customers over to a brand new platform in a short amount of time. It would take a decade or more.

Whether Meditech will lose clients in the migration to newer technologies

I think the cost factor will be far too compelling to leave. And that people would benefit with staying with Meditech because it is only going to be a fraction of the cost to implement a newer technology then it would be to go out and license brand new software from a brand new vendor and do all the conversion. And who knows how much of the data would go with you and now more than ever be able to keep and maintain that data. Staying with Meditech would allow you to keep your historical data. They have migration plans in place that would allow customers a way to do that with minimal effort and maximum retention of historical data. That is an important thing I think to customers.

The biggest misconception about Meditech

That Meditech systems aren’t open. That is a long time fallacy that people have somewhere grasped onto. I think it is because it is not written in a language that they know, the assumption is it’s a closed system. The newer version, the 6.0 version of c/s, is even more open, even with data repository as one of the standard products that Meditech sells, which is a relational copy of their entire data set. That is about as open as you can get by today’s standards. And, even if you think about it, if the technology is different to write or to develop the product, it can be done in such a way that it will allow you to get at data you want to get at if you know the way to do it, and at the same time it can help protect your data from hackers and viruses and other malware that you want to keep away from the software. If you are running an application that is written in a technology that millions of people are familiar with, then millions of people would potentially know how to write something that would do harm, whereas with a Meditech environment you are not going to find that.

News 12/21/07

From Ralph Hinckley: “Re: outage. Any truth that Penrose St. Francis in Denver/Colorado Springs had a four-day Meditech outage? The story I hear is the Colorado Springs location had just gone live and the entire system went down for four days.” I hadn’t heard that, but perhaps someone will elucidate.

From Quilmes Boy: “Re: Medseek. Medseek reduced its workforce by approximately 20% on 12/19/07. From a company with about 140 employees, this is a significant cut which went wide and deep. The reason cited? Cash flow issues – plenty of AR but no cash coming in yet. Note that Mike Drake, CEO, resigned on the same day.” I saw no announcement, although another reader reported the same thing and Drake’s bio is gone from the exec page. If it’s true, giving employees the boot less than a week before Christmas definitely embodies suckitude (and implies desperation to get them off the books by year-end). Condolences to those alleged to have been affected (careful wording, you’ll note, since it’s just a rumor so far).

From HIT Insider: “Re: Eclipsys. Looks like the new Eclipsys management continues to move the company in the right direction with the sale of the CPM Resource Center. Smart move to keep the company’s focus on software and the integration of content and leave publishing headaches to someone else.” CPMRC was Bonnie Wesorick’s clinical content group out of Michigan, now dealt off to Elsevier for $25 million in cash. Eclipsys paid $5 million in 2004 plus up to $12.5 million more based on performance. ECLP will have to pay Elsevier for the content it distributes with Sunrise, but assuming that licensing cost isn’t too high, it sounds like the right move to sell it off and take the cash.

From Holiday Season: “Re: McKesson. Unless I missed it in one of your reports, I heard McKesson (IT business unit) let hundreds of people go. Does anyone know what is happening? Sales down? Revenue down? Competitors pinching in on the cherished customer base? Overburdened org structure finally catching up with them?” I reported a rumor from Keyser Size in November that up to 250 people had been let go, but I’ve seen no announcement.

From Dr. KillDare: “Re: Epic. There is some unverified noise rolling around that Epic is actually laying off some staff, apparently in Web development. Interesting, since the last noise heard about FTE levels there was about adding ‘200 employees a week’ and ‘the new campus is full’. I don’t believe in spreading wild rumors, but the source was reasonably solid. Any way to solidify or shoot this in the head?” The only one I know is if someone tells me, “Hey, I was one of them” and I haven’t heard that. What’s up with all the layoff rumors?

InBusiness runs a story on Epic called Epic’s workplace culture: IB Investigates the mystique. Epic doesn’t hire you without a 3.5 GPA or better, no matter how long you’ve been out of school, and the company believes in “hiring slow and firing fast.” Judy is “enigmatic” and the company is intensely private, stiffing the reporter’s request for assistance like it does nearly all of them (even Epic’s PR person doesn’t give quotes). Former employees complained about the flat management structure (huh?) and overly intrusive management style (free juice, but no free soda because the company has decided it isn’t good for you, and one guy claims the Internet is shut down during certain times of day). Hours are long and everybody’s supposed to follow Judy’s lack of work/life balance (a former employee says she resents sleep because she could be working). A former employee said employees would be snickering if the article concluded that working conditions are great, but another replied, “It’s because, for a lot of employees, this is their first job out of college. Why don’t you get a sucky job and find out what that’s like? Then there won’t be as much snickering … Epic is still kicking the competitors’ butts. They hire the right people and they know what they’re doing.”

Funny timing: Motley Fool adds Visicu to its list of cheap growth stocks on Wednesday, the day after Philips announced that it would acquire the company. They would have looked really smart if the piece had run closer to when it was written, presumably before the announcement.

TeraMedica announces a reseller deal with Dell.

Jobs: CIO (NC), Nursing Informatics Specialist (CA), Radiology Informatics (VA), Senior Network Engineer (CA), EMR/PM Sales Specialist (AZ). List your jobs free.

Save the date — January 16 — If you have strong feelings about the formal definition of five common HIT terms (EHR, EMR, PHR, HIE, and RHIO). NAHIT and BearingPoint will convene a three-hour forum in DC to gather public comments in what sounds like a wild melee of grammarian one-upmanship. Perhaps it’s a bad sign that NAHIT’s press release gave the last term as “Regional Health Information Network,” so maybe it’s forming a subcommittee to talk up RHINs (the love child of RHIOs and CHINs?) Or, maybe they’re slyly illustrating the point that definitions vary, justifying paying BearingPoint taxpayer dollars to settle the apparently contentious terminology issue, which ONCHIT says is the problem that’s causing all five initiatives to flounder (“Our hospital would be tickled to pay to join your unfunded and paralyzed data sharing project that mostly involves our hated competitors, if you’ll first be so kind as to Fedex over a definition of RHIO — or is it RHIN?”)

British government agencies take heat for security breaches, threatening the Department of Health with prosecution for future breaches like the one that exposed the personal information of those applying for medical residencies on a public website. The most heated information exposed seems to be sexual orientation and religious beliefs, begging the question: why were those applying asked about those topics in the first place?

A London hospital that offers a 40-minute 4D ultrasound for expectant mothers makes another option available: a high definition video download to a cell phone or iPod.

A NEJM study says that hospitalists don’t get patients out of the hospital any faster or cheaper than family doctors.

E-mail me.

News 12/19/07

From Saas Man: “Re: athenahealth. Here is a link to a recent CNBC interview with athenahealth’s Bush on other companies doing what they do – all about execution. As someone who follows the SaaS industry, I can say comfortably that athenahealth is light years ahead of any HIT vendor and I would put them up with other SaaS superstars like Salesforce.com. They understand it has so little to do with software except that it needs to be one app and centrally hosted that is how they inject their acquired knowledge into their clients’ workflow to get the results they are known for in the industry and on Wall Street. In my opinion, you will see them connecting to more and more payers and labs etc and then building out their network in ways that traditional HIT software vendors can not with just hosting an app  – it has to all be integrated and centralized. I doubt HIT vendors will jeopardize their software margins to do the heavy lifting.” Link. “Healthcare’s got to get onto a network,” Jonathan Bush says. Good interview, although mostly a quick sound byte sampling since they obviously were in a short segment. On real-time adjudication: “Can you imagine if the Gap had to wait 30 days to decide what to charge you for the jeans?” On traditional competitors: “They can’t keep the knowledge in that software current every day.”

From Art Vandelay: “Re: VISICU. Philips makes another bold move by acquiring VISICU. Both Emergin and VISICU are covered in their press release. Philips is serious about integration and the services they offer. VISICU has a pioneering remote monitoring outsourcing service. Their product has solid data capture and real-time decision support functionality. They lack a broad critical care system providing robust flowsheets, charting, task coordination and orders. Philips has a critical care system in the CareVue product it acquired from HP. Combining the two could position them to extend into new areas ( i.e., NICU, Clinical Decision Units). Too bad the Epic partnership didn’t pan-out. Epic and the Philips applications and devices with the integration could have been a killer offering. SpaceLabs Medical is a common partner of Emergin and VISICU – new acquisition? Another move that could put the competition on-notice would be to buy-out Globestar (similar to Emergin) or Capsule Technologie. Perhaps these are their next steps?”

Stiill need convincing that real-world medical device connectivity is the next battleground (as Laurent Rotival strongly suggested)? Cerner brings 32 medical device to KC to get briefed on its CareAware connectivity kit.

The White Stone Group’s OptiVox communications handoff product is featured in a customer’s presentation at the IHI forum just ended in Orlando, describing their 75% reduction in admission time for ED patients.

Listening: Jessica Prouty Band. Hard-rocking and tight pop-metal, a la Evanescence, Lacuna Coil, or Nightwish. Funny thing is that everybody in the band is aged 12 to 14, but they don’t sound like it. Mom’s an HIStalk reader (she’s in the the HIT industry). Amazon has the MP3 single, coming soon to iTunes. I listen to music like this quite a bit and it’s very good.

New ads to your right: Dragon Medical’s on sale and a discharge referral product is ready for your perusal. Check it out.

Six London trusts finish their rollout of surgery systems from Picis.

Now here’s a fascinating story (unverified for now, but the source is solid and I’m trying to get the technical party involved to go on record with me). A few years ago, Vendor A was selling de-identified patient data to Vendor B. Vendor A found that Vendor B had figured out a way to re-identify the patient data and was selling in that form (!) Vendor A cut them off, claiming they were breaking state privacy laws. Vendor B countersued for breach of contract. Supposedly a security expert who had been called to testify took Vendor A’s file and, using nothing more than a desktop PC and a voter registration database purchased over the Web by credit card, was able to re-identify somewhere between half and 3/4 of the records, instantly destroying the illusion that de-identified data is permanently anonymous.

Another privacy story, coming from another credible source (not Deb Peel, even though it’s about her). Peel was giving a presentation and mentioned a huge insurance company’s plan to sell de-identified patient data to employers without consent. She was interrupted loudly in mid-sentence by someone from that company who tried to argue, saying the data was to be used for all kinds of noble purposes. Trouble is, she’d talked to someone at the insurance company already and was told the sole purpose of the database was to save money for employers (and make money for the insurance company, obviously). Doh! You know those guys have heavy duty data miners looking for fun projects.

I hear that SCI Solutions has moved up to #6 in KLAS’s list of top vendors, a big jump up from #11.

MedMatica Consulting Associates is named to the INC.’s list of 5,000 fastest-growing private companies.

AHRQ gives KP a $600,000 grant to study the role of EMRs (HealthConnect, in their case) in heart disease prevention (do they really need taxpayer money?) The Kaiser guy brags on how HealthConnect lowers medical costs, so expect those premium reductions any day now.

The local newspaper profiles the doc and programmer who developed ChartConnect, a Web-based community patient records system that they say connects 80% of the providers in their area. They’ve already received (and declined) a buyout offer from McKesson (apparently a handful of big companies will own the entire industry in a few years).

Congress is considering a $2 billion IT budget for the VA, creating the hope of an early Christmas present for the usual technology trough-lappers.

Australia will create an integration testing and accreditation lab to verify vendor claims of interoperability.

I know some folks will be taking off early for a Christmas break. I’ll be here as usual, but in case you don’t check back in, have a wonderful holiday.

E-mail me.

Inga’s Update

Former Cerner VP of worldwide sales and business development Michael Mickens is named VP of sales and client services for etrials. Chuck Piccirillo, who previously worked at Hill-Rom, Kodak, and Carestream Health was named VP of product development.

Surescripts President and CEO Kevin Hutchinson is leaving the company at the end of January. The press release doesn’t indicate where he’s going or why, but does have plenty of quotes from board members singing his praises. Rick Ratliff, SureScripts COO, will serve as acting CEO.

McKesson CEO John Hammergren sells a few company shares and nets $3.5MM. I wouldn’t mind being on his Christmas list.

Misys announces that, in addition to selling its MyWay solution as a hosted service, practices can now buy the solution for on-site installation.

Sunquest earns an impressive fourth straight year as Best in KLAS for its Sunquest LIS. Good for them for still being able to deliver strong support, even in the face of the turmoil of an ownership change.

Other notable KLAS honors: eScription earns top honors for transcription and back-end speech recognition, Hayes Management is named overall leader in the Professional Services segment with #1 rankings in Planning and Assessment and Technical Consulting.

Another VC company makes its debut. Santé Ventures has $100 million in committed capital to invest in seed and early-stage companies developing new medical technologies and healthcare services. The managing directors include former Ascension Health president and CEO Douglas French and a former Ascension hospital CMIO Joe Cunningham.

Quadramed’s board of directors authorizes the repurchase of up to $5 million of common stock.

A new report predicts healthcare IT spending over the next couple of years will be greater than investments in service or building expansions or acquisitions. Three out of four of the 464 hospital executives participating in the survey indicated they will acquire or upgrade new equipment worth more than $500,000 over the next two years and 65% will be making major IS investments. If you are selling, the best place to be is in the Northeast, where 96% of the hospitals are investing in new technologies and 89% in IS.

Since my post last week about the Mac O/S, a couple of amusing things have happened. First, all these Mac people have come out of the woodwork to advise me on all things Mac, including its reliability and all the cool features (fortunately I already knew you guys were fanatics). The second (and really not amusing) thing is my latest Microsoft update is giving me fits with Internet Explorer (lock ups, can’t reach sites, etc.) No, I am not ready to dump my nice laptop, but do wonder which one of you secret Mac fans is sabotaged my system.

The Madison, WI paper has an article on the tasty cuisine at the Epic cafeteria. The best perk seems to be the ability to raid the fridge if you work past 7 p.m.

E-mail Inga.

Philips To Acquire Visicu for $430 Million

Royal Philips Electronics NV announced this morning in Europe that it intends to acquire ICU monitoring systems vendor Visicu for $430 million in cash, strengthening Philips’ position in patient monitoring. The company’s offer of $12 per share represents a 35% premium to yesterday’s closing price.

Baltimore-based Visicu earned $9 million on sales of $36 million over the past year. In the 20 months since its IPO, Visicu shares have dropped from nearly $25 to below $9. Its board has approved the acquisition and recommends that its shareholders approve it.

From the CEO of Philips Healthcare: “Today’s deal builds on Philips’ announcement two weeks ago that we’re acquiring another clinical IT company, Emergin. Philips is a market leader in patient monitoring systems in the hospital, so we know the challenges our customers face – rising patient numbers, staff shortages and concerns about patient safety. By investing in clinical IT solutions like those offered by Visicu and Emergin, we believe we can offer customers more attractive patient monitoring solutions that improve hospital productivity as well as patient outcomes. So making these investments we believe will drive further growth in our patient monitoring business.”

Monday Morning Update 12/17/07

From Sterling Moss: “Re: cranky doctors. Docs may be cranky because they are smart and don’t make as much money as the salesmen who push drugs at them (or the lawyers in BMWs, or the venture capitalists, or …). However, cranky or not, just because doctors are ‘smart’ doesn’t mean they are adept at business or money making. In fact, the opposite is just as likely. From my own personal experience as a doctor involved in starting my own manufacturing company and participating in someone else’s startup and working as a sales consultant for yet a third company, I can attest I and my medical colleagues are not very adept at the skills necessary in making money in the non-clinical world. Maybe this is just the best we can be.”

From Grant Beesknees: “Re: physician incomes. I’m a physician and I think Ian Morrison is a little off. Anyone can get earning statistics for the US Bureau of Labor Statistics. On average, physicians out-earn any other career group. Additionally, physicians out-earn their peers practicing in almost any other country you can think of. So, I don’t think there is much for most doctors to be angry about in terms of their total income. Now, if top doctors want to compare themselves only to graduates of the top business schools or top law schools, then they might find that they don’t compare as favorably. However, many in the business or legal world spend years working their way up the ladder until they take responsibility for multi-million or multi-billion dollar organizations, along the way, out-earning physicians. I don’t know for sure, but I think that most physicians’ practices are substantially smaller enterprises. Even so, physicians can reach the higher earning levels of their profession rapidly even if they don’t provide a particularly high standard of care or produce results. In other industries, that is somewhat less likely. In my opinion, in America, doctors earn a good living without too much risk and generally deserve what they earn.”

From Julius L’Orange: “Re: NextGen business services. I think the little announcement you made about NextGen business services deserves some more attention. Did athenahealth think that the ‘standard’ ambulatory EMR vendors were just going to sit and watch them? You can bet Allscripts, GE, and eCW are all gearing up to offer some sort of RCM service via their PM systems in the coming months, thus making sure their current customers don’t feel the pull to AH, but more importantly, capturing other customers who like the SaaS model for RCM, but want a more mature EMR than AH currently has.”

From Art Vandelay: “Re: nurse barcoding. I believe nurses are defensive about the comparison to a grocery store clerk because nothing substantial is being done to change their situation. At least the grocery store clerk’s technology tool belt has grown to increase precision and efficiency. Nurses are working with outdated processes and supported by outdated models of staff roles, training, and technology. We analyze one small area at a time, followed by a rush to introduce technology. Examples include the continued proliferation of individual-use devices and singularly focused decision-support tools in support of metrics. The most promising work I have seen is from the American Academy of Nursing through a Robert Wood Johnson grant. Maybe the momentum from this work can be parlayed into a win for nurses, staff, and patients.”

From DrCool: “Re: selling patient data. In July 2007, Paul Tang said that ‘some electronic health record and personal health record vendors have placed in their contracts stipulations that would obligate healthcare providers to violate privacy rules.’ He further said that he has personally seen the contract language, but declined to identify the vendors or how he came to see the offending contract provisions. ‘That wouldn’t be fair,’ Tang said. ‘It’s just those things are in there.’ I’m sorry – Tang is acting as a patient privacy expert, and is saying that he knows of potential illegal activity, but it would not be fair TO THE VENDORS to reveal who is doing this? The arguments would be more powerful if they were specific. And it seems much more likely these days that the main privacy problems we have are people leaving unprotected laptops full of data in their back seats. Have we ever really had a story where an EMR vendor or any other business entity actually sold identified patient data since HIPAA was passed? Finally, as a minuscule investor in IMS, and even as a physician, I have to admit that it does not surprise me, nor even bother me, that the pharma companies know what I prescribe. It is not like they have access to specific patient data (apparently, they used to, but that has changed). I’m a capitalist by nature and every other business gets to use data intelligence to figure out how to do things better. I have no problems letting the pharma people do the same. If it bothers a doc too much, they can ban pharma reps from their office. No one is making them see the Pfizer barbies.”

Speaking of selling data, guess what companies are among those trying to block a Maine law that would let physicians decide individually whether to allow data-miners to sell their prescribing information to drug companies? McKesson, Wolters Kluwer Health, SureScripts, Cardinal Health, NAHIT, and the eHealth Initiative. Money certainly drives the first four, but why are non-profits and supposed industry advocates NAHIT and eHI weighing in on a practice that shouldn’t concern them? Ditto, probably: some of their members are data-sellers and buyers who profit from the practice by pushing high-margin but not necessarily optimal drugs. Too bad patients themselves aren’t profitable – they might have more advocates if they were.

Sumter Regional is looking good to win the MRI machine, but give them some votes just to make sure. They’ll know in a couple of weeks.

EnovateIT moves to its new headquarters in Ferndale, MI.

Misys says its healthcare division showed slight growth in the six months ending November 30.

CDC is developing technical standards for sending healthcare-associated infection data to its National Healthcare Safety Network.

IBM is running several healthcare IT projects in India: data sharing, wireless hospital access, medication sensors, and drug supply chain tracking.

athenahealth kicks co-founder Todd Park upstairs, creating a Chief Athenista position and giving him a board seat, but removing him from the management team.

E-mail me.

News 12/14/07

From Diablo Cody: “Re: HITSP. Does anyone expect interoperability in that real world on which HITSP touches down infrequently? In a recent presentation, there was a massive number of acronyms, 250 organizations involved without any real accountability, conflicting agendas, and success that depends on volunteerism. They must have got their advice from HIMSS, who has a lock on the well-paid generals and a volunteer army.”

From TheInsider: “Re: Azyxxi. I believe Azyxxi is playing ‘hard to get’ for a good reason. I hear Azyxxi is only a work in progress that’s not ready for delivery. If you offered to pay the full price for having it delivered tomorrow, Microsoft would probably not be able to deliver. The announcements about new ‘clients’ are basically development partners which are not paying for the product (and might even be getting something in return for their participation in Redmond’s productization efforts). BTW, this is not a new approach for MS. In other industries that they entered as an ISV, they usually created premature hype to slow down the market (put it into a kind of holding pattern) as a strategy to hamper their potential competitors’ efforts before they actually have a product to deliver.”

From Betty Grissom: “Re: Meditech with another vendor’s clinicals. This idea floated for a decade, with vendors starry-eyed about 25% of market share in the US and 40%+ in Canada. At least three vendors tried. Eclipsys had a dedicated team for several years, working with Osler and SHAMS group. They branded the solution ECA (Eclipsys Clinical Advantage) and gave it a big marketing campaign and sales blitz. They didn’t get a single sale. Plus, the price points couldn’t work. 90%+ of the Meditech base bought integration (not interfaces), low cost, and simplicity and would have lost all three. Clinicians may be frustrated with Meditech’s ‘good enough’ approach to clinicals in a CFO-driven selection, but ECA was actually the worst of both worlds, losing most of Meditech’s good points with the work and cost of a bolt-on.”

From The Shadow Chancellor: “Re: Linux. Looks like McKesson is planning on jumping off the Microsoft bandwagon and on to Linux for its users as well as for its backend applications.” Link. McKesson VP Michael Simpson says hospitals will be ready to run Linux on the desktop in 3-4 years, following good success with McKesson’s Red Hat Linux server option for most of its apps.

From Fish n’ Chips: “Re: Sutter. Sutter nurses on strike again. Management’s solution? Free food (breakfast, lunch, dinner)for those who don’t strike.” The two-day strike started today, but some hospitals will lock nurses out for three more days afterward. Interesting: full-time nurses at Marin General earn $104K a year, but 96% of the nurses aren’t full-timers. Part of their beef seems to be a health questionnaire, which the union claimed could be sent to the employees’ insurance carrier without consent.

From Rhio D. Dollaro: “Re: tanking RHIOs. HIMSS disbanded its RHIO committee and turned it over to eHI, which has completely different goals, to wither. The techies were running the asylum. When asked about business case, all they could come up with was, ‘it’s good for all’.

From Art Vandelay: “Re: RHIO failures. I attended a set of meetings for our local health information exchanges (HIE). The first stumbling blocks were the politics and the leveling of the data competitive advantage a few organizations experienced. These issues weren’t resolved before the lack of a sustainable business model and funds for initial investment seem to have really impacted the project. We never really got around to the privacy concerns. Without a government mandate or a realignment of incentives, this just isn’t going to happen soon. I see this concept coming-back in about 5-10 years, once the vast majority of the country has baseline clinical data repositories installed and functioning and the standards committees have had time to meet and align. Very localized initiatives where hospitals exchange data with their affiliated physicians’ computerized medical records are likely to start springing-up in the place of HIEs. This scope can be managed. Vendors to watch include Novo Innovations, Medicity, MedSeek and dBMotion. The technologies and services of these vendors seem to set them apart from others in the pack.”

From LW: “Re: selling patient data. One of your readers posted that Paul Tang keeps talking about vendors doing this, but there is no actual evidence. There actually is. At the August 2-3 meeting of the NCVHS Ad Hoc Workgroup on Secondary Data Uses, a testifier (Dr.Jeff Goldwein, from an oncology software vendor) said, ‘We also have external commercial partners that take the scrubbed de-identified data and sell to, and these are consulting and health care research firms that have significantinterest in real time patterns of care and the management of cancer patients. And our program members are cognizant of this, and they fully participate in this partnership. Since Dr. Tang sits on that committee, it may be exactly this that he apparently keeps referring to.” Link. I’m beginning to worry less about sellers of de-identified data. All that’s lost there is a chance to share profit with those selling it, but I expect that’s minimal since, as a reader commented, standalone data of uncertain quality isn’t worth much. I’m not really appalled by the practice, although I’d still insist on careful contractual wording. Since no one has mentioned selling identifiable data, I’m assuming that’s not happening. Maybe we should be most upset that physician prescribing data is sold to drug companies with doctor information intact, allowing target marketing by Pfizer Barbies for questionably cost effective drugs.

From Pat Watusi: “Re: barcoding. The new 2D imagers can parse through the mishmash of data held within the bar code. Given a little effort, the new readers can parse and display the desired information. Additionally, by implementing a bar code solution in association with the existing pharmacy or CIS application, adverse drug events can be reduced to zero.”

From Dingus McGee: “Re: barcode editorial. Your recent entry made me think of the attached article from Paul Harvey.” Interesting! I couldn’t find any reference to it on the web, so I copied the clip below that Dingus sent in. No copyright infringement intended in running it because I can’t even verify that it’s real. I didn’t see it before I wrote my editorial, but we make similar points.

Listening: Crash Kelly, new, 70s-sounding arena rock.

A reader sent a link to a good editorial by Ian Morrison called The Doctor Conundrum, which deals with unhappy physicians. “Let’s start at home. Consultants and futurists are paid four to five times what they would be in other countries; hospital CEOs, three to four times; administrators of all types, two to three times; and so on. CEOs of health plans who rack up $100 million-plus in compensation over the course of a career are well ahead of the cumulative earnings of all the ministers of health in the developed world. And then there are the sales men and women of America. I want my son to be a salesman because America rewards sales more than almost any other profession. There are armies of sales people in American health care, many of whom are making much higher incomes than the doctors they are calling on. These are just estimates: I urge someone with access to all these numbers (such as the compensation consultants) to publish them. Just wait and see how angry the doctors will be then.” Say, sounds like something a muckraker like me would enjoy running.

A couple of readers also sent a link to this piece, The Checklist, from The New Yorker. Peter Pronovost of Johns Hopkins created a simple checklist for preventing line infections, containing the same stuff everybody knows already, with miraculous results. “Within the first three months of the project, the infection rate in Michigan’s I.C.U.s decreased by sixty-six per cent. The typical I.C.U.—including the ones at Sinai-Grace Hospital—cut its quarterly infection rate to zero. Michigan’s infection rates fell so low that its average I.C.U. outperformed ninety per cent of I.C.U.s nationwide. In the Keystone Initiative’s first eighteen months, the hospitals saved an estimated hundred and seventy-five million dollars in costs and more than fifteen hundred lives. The successes have been sustained for almost four years—all because of a stupid little checklist … I asked him how much it would cost for him to do for the whole country what he did for Michigan. About two million dollars, he said, maybe three, mostly for the technical work of signing up hospitals to participate state by state and coordinating a database to track the results. He’s already devised a plan to do it in all of Spain for less. ‘We could get I.C.U. checklists in use throughout the United States within two years, if the country wanted it,’ he said. So far, it seems, we don’t. The United States could have been the first to adopt medical checklists nationwide, but, instead, Spain will beat us. ‘I at least hope we’re not the last,’ Pronovost said.” This is a great article. Those of use who believe that the greatest value of CPOE is simply getting doctors to agree on order sets and common doses before arriving at the point of decision will be thrilled at the power of simply making and using checklists, the kind we IT types use all the time (anybody ever think of doing formal change management for patient care? I just made it up, but why not?) The list idea isn’t anti-IT, either. Why couldn’t systems link to Web pages on which lists (with visuals) are maintained to provide just-in-time advice and reminders? There’s an HIStalk interview slot waiting on Peter if he’s interested.

Add to the list of Computerworld’s 100 Premier 100 IT Leaders for 2008 Phil Chuang, CIO of Telecare Corporation. I missed him on the first pass because the company name didn’t register as being healthcare-related, but the company does behavioral healthcare. Congratulations.

Serial entrepreneur and visionary Scott Shreeve, now serving as CMO of MyMedLab, asked me to try the company’s services and report back. Now I’m not going to trundle off to get phlebotomized for just anyone, but in the interests of participative journalism and since Scott is a darned nice guy, I signed up on the site to have a General Health Screen done. It was slick: you choose the tests you want from a list of what’s offered, check out and pay online by credit card ($54, in this case, but Scott comped me), and then print out the lab requisition, instructions, and directions to the draw station. Off you go to Labcorp to get stuck, which in my case involved a short drive and exactly 19 minutes from leaving the car to getting back into it. The next day, your test results are online in a PHR-type application. Minuses: you don’t get an e-mail notice when your results are ready and the PHR application is pretty basic. Pluses: you don’t need a doctor’s order, it works just like you’re used to, Labcorp is everywhere, and the results display has some very good info on what your results mean. I don’t know how large the market is for people who want (or should have) a serum creatinine or drug level without a doctor’s involvement, but the price and convenience should make self-payers pay attention. Verdict: it was easier than I expected and with no drawbacks, with the added benefit of getting your own results and explanation for online access at any time.

Delano Regional Medical Center (CA) goes live with Sentillion’s Vergence Clinical Workstation.

NextGen announces its business service division, which will offer revenue cycle management services to physician practices via web-delivered software.

Catholic Health Initiatives chooses PatientKeeper’s physician system.

MedAssets raises $213 million in its IPO, selling at the top of the announced $14-16 range and popping up another 30% in today’s first day of trading.

Osler Health Centre installs Swisslog’s PillPick drug management system.

Medsphere finishes its OpenVista implementation at two state hospitals in West Virginia.

Some of the 119 jobs on HealthcareITJobs.com: Director of Clinical IT (MA), VP of Research Services (NC or PA), VP of Informatics and Reporting (FL), CDR Manager (CA), Pharmacy Clinical Support Manager (CA). Employers can post listings free through January.

ABC News does a story on the VA’s IT systems. “This hi-tech care isn’t just a godsend for patients; nobody loves it more than doctors. So why do VA hospitals, even with all their challenges, do this and private hospitals don’t? The difference is the VA’s life-long relationship with patients. It gives them a strong financial incentive to invest in technology that aids preventive medicine.” It says that only 5% of hospitals have electronic medical records, which is surely a mistake (sounds more like the CPOE or ambulatory EMR percentage).

Odd story: Easton Hospital was going to lay off its chaplain, but decided not to.

A Florida State University study says that IT-using community hospitals have better patient outcomes.

Ron Latta is named IT director at Rockingham Memorial Hospital (VA).

E-mail me. Where do you think all those cool reader comments above came from?

Inga’s Update

I loved Mr. H’s “Want To Anger a Nurse?” piece. I agree with Anonymous that the issue is less about how much more difficult it is to be a nurse than a grocery clerk, but how little hospitals and technology have done to make their jobs easier. Never having worked in a hospital, I learned a bit about some of the minutiae nurses must deal with. I bet they don’t teach a lot of that in nursing school to the wide-eyed youngsters who think nursing is all about saving lives. No wonder nurses get burned out so easily and we have a shortage.

Henry Ford Health System will use eHealth Global Technologies to digitize medical records and images from referring providers.

The VA places a $21.8 million order with QuadraMed to renew its Encoder Product Suite license plus training services.

The New Mexico VA Health Care System selects Picis perioperative automation. Picis president and CEO Todd Cozzens says the company is “quickly becoming the de facto standard for automating high-acuity areas of Veterans Affairs hospitals.”

From JimMac: “Quick thought on the Mac mystique you mention in your HIStalk posting today. If you’ve never used a Mac – especially Mac OS X – you can’t really be expected to understand it. It is kind of like walking around town in a bad pair of shoes with a pebble in one. Sure, it’s uncomfortable, but you don’t know any better. You figure that everyone has that discomfort. That’s Windows! Now, suddenly someone gives you a pair of shoes that are as comfortable as slippers, perform like the best running shoes, and look as good as a pair of Pradas. That’s the Mac.” You had me at Pradas.

E-mail Inga.

News 12/12/07

From Todd Taylor, MD: “Re: Azyxxi. Yes, Microsoft Azyxxi is for real and supported by 700 members of Microsoft’s health Solutions Group. There is an e-mail link on the www.azyxxi.com website above the tabs at the top right of the page (‘Contact us’).” Todd’s a Microsoft doc, so he might want to cover his ears while I slam his employer on behalf of the prospect who tried to explain nicely how clunky the site is instead of just taking his business elsewhere. Clicking the “Contact Us” link on the site takes you to a page for signing up for updates (what if I just want to e-mail a human being, not sign up for an autoresponder?) Click that link to get to a signup page. But, here’s the kicker: you can’t sign up without having a Windows Live ID! OK, let’s review: I’m a customer with an RFP, hot to send Microsoft some money. I nose around the Azyxxi site looking for a telephone number or e-mail address and finally notice the microsopic “contact us” link as my only option. I click it, and now I have to click again (after reading that I’m about to sign up for spam). Then, three clicks deep, I find that Microsoft doesn’t want to hear from a prospective customer who doesn’t have their crappy Windows Live ID. You’d think of those 700 people, somebody would recognize this as utterly arrogant and clueless. No wonder Google rules the world.

From Dana Moore: “Re: Centura. Since you have mentioned us on your site, I thought you would like to know that Centura Health has implemented MEDITECH at all 12 hospitals, effective December 1. We brought 11 hospitals live in 5 months.” Nice. Congratulations on a rapid-fire rollout. Big-hospital CIOs sniff at MEDITECH, but it works, it’s cheap, and it’s integrated. If it wasn’t for MEDITECH, the penetration of IT in hospitals probably wouldn’t be much better than it is in physician practices. And speaking of which, I’ll have a CIO interview soon that talks about bolting on more sophisticated specialty apps on top of MEDITECH to get the best of both worlds.

From Phineas Tutwiler: “Re: selling patient data. I’m surprised that you all are having this discussion about selling de-identified patient data. Somebody — the vendors or the hospitals — is currently selling identified patient data. My wife got dozens of catalogs from wig and breast prosthetic companies after breast cancer treatments/surgery. Any parent is inundated by hundreds of advertisements for baby formula, baby magazines, etc.” I thought most hospitals stopped that with HIPAA, although some felt there was a loophole based on the level of opt-in from the patient.

From Mr. Whipple: “Re: selling patient data. I am surprised that no one has brought up the fact that CMS licenses MEDPAR data back to vendors for various reasons, including distribution as part of the vendor’s application suite.”

From DrCool: “Re: selling patient data. Long time listener, first time caller. I remember signing a contract with Cerner years ago and seeing the language allowing them free access to sell de-identified data. We said no. They laughed and said most people don’t read the fine print and notice it, so they agreed to remove it. But, this should be no surprise. The HIT vendors want to figure out how to leverage things and this could be reasonable with appropriate safeguards (true de-identification), agreement from the customers, and compensation (either we get access to all de-identified data for our own research or we get a percentage of whatever money they make). If the privacy advocates want to focus on the issue of ensuring data is truly de-identified, that is great. However, Paul Tang and others are simply being fear-mongers when they claim they ‘know of’ companies selling identified data or have contracts allowing them to do so. If Paul actually has evidence, then he is an embarrassment to the HIT community if he does not share it. That goes for any of the privacy advocates. If they have evidence, let’s see it. If not, then focus on the real issues.”

From Kanye Diggett: “Re: barcoding. Given your past support of barcode solutions to improve patient safety, I thought you might find this article interesting. I was surprised to see that they quoted a past error rate. Not something hospitals typically volunteer to the public.” Link. Hopkins facility Howard County General Hospital resolves specimen labeling mistakes with barcoding, reducing errors to zero from 11 in the month before they started. A little Googling turns up the fact that the vendor was Iatric Systems and its MobiLab handheld phlebotomy system.

From Merriweather Tishman: “Re: demo data. The story of a customer recognizing their data in a demo smells strongly of urban legend. The companies I’ve worked for use strictly fictional patients created by their clinical staff for demos.”

Speaking of barcoding: why isn’t there outrage that drug manufacturers don’t follow any format when putting NDC numbers on their packages? They whined forever about having to comply, but suddenly became overachievers by inserting other junk within the bar code (because FDA wimped out on specifying a format, I suspect). Result: scan a drug’s bar code and the NDC is in there somewhere, but not predictably. Thank goodness the FDA and drug companies didn’t design UPCs or you’d never get through a grocery store checkout.

The folks DB Technology sent over information on their RAS and RASi products, which collect, aggregate, and distribute information from existing systems. A quote: “Today Siemens Invision automatically forwards the 35 Siemens reports to RAS. Once there, the RAS Data Extraction Module exports specific data elements from the reports to individual spreadsheets. Excel Macros, that automatically launch at the time of report capture, update the Master Daily Monitor spreadsheet.” Now I admit that I’m a sucker for tools like this that can solve many kinds of problems, but I still think this is pretty cool. I don’t know much about the company and I don’t usually give plug about stuff I haven’t used, but I see my bud Rod Neaveill is there (he used to be at Picis and was very nice about volunteering to hand out the “I Am Mr. HIStalk” buttons at HIMSS) so they deserve a little shout-out.

Computerworld’s 100 Premier IT Leaders 2008 includes Asif Ahmad (CIO, Duke University Health System), Eric Cowperthwaite (CISO, Providence Health & Services), David Dillehunt (CIO, FirstHealth of the Carolinas), Michael LeRoy (CIO, Detroit Medical Center), Michael Long (SVP, Siemens Medical Solutions), Marc Probst (CIO, Intermountain Healthcare), and Rick Warren (CIO, Foote Health System).

Lots of jobs at HealthcareITJobs.com: VP Client Services, IT Director, VP/CIO, Millennium analysts, and sales executives, to name a few.

Chris Perkins, former COO of Per-Se, will replace Grady Floyd as COO of Emageon.

Noobs: to your right is a Google search box that will scan 4.5 years’ worth of HIStalk for your desired keywords. Sign up for site updates and the Brev+IT newsletter over there, too. Check out HIStech Report for interviews about vendors and products (lots of those coming right before HIMSS). If you want sponsorship info, e-mail me, and if you want to tip me off to news or rumors, use the secure Rumor Report button to your right (which can hold an attachment if you’ve got super-secret documents of some kind). Lastly, please click the sponsor ads to your left and support the companies that support HIStalk since paying the bills out of my day job paycheck kind of sucked, making me crankier when I wrote.

WSJ runs a story on mobile VPN software that can maintain a connection under adverse circumstances that would kill a traditional VPN connection. St. Luke’s Episcopal is mentioned for its use of NetMotion‘s mobile VPN software to keeep laptop apps from crashing between access points.

MedAssets will IPO this week.

Dairyland Healthcare, fresh off its sale to Francisco Partners, brings in an executive team to work with new CEO James Burgess: Kevin Fahey as CFO (from Premise), Paul O’Toole as SVP of operations (from Mediware), Angela Franks as SVP of market development (from Lawson), and Mark Middendorf as SVP of sales (internal promotion).

Dell will ship its first tablet PC within the next few weeks, but will continue to sell slates from Motion Computing.

E-mail me.

Inga’s Update

Frost & Sullivan announces their Healthcare Opportunities industry excellence awards. There is a lot of excellence out there, so check out the link if you want to see the winners in about 30 different categories.

The CEO of a Connecticut nursing home chain is accused of taking $15 million in assets to purchase a yacht, three apartment buildings, a record label, and a lakefront home. The Haven Healthcare chain now finds itself in financial trouble and may be unable to recover.

MacPractice announces the availability of an EMR solution that is fully integrated with their practice management and runs on Mac OS X. I have never understood the Mac mystique, but know that there are a bunch of Mac fanatics out there. I thought it was interesting they included pricing information in their press release ($2500 though the end of the year plus $500 for annual support and updates.)

The Health Affairs folks release findings from a study on RHIO’s. The news is pretty bleak. Of 145 RHIO’s surveyed earlier in the year, 25% are now defunct. Only 20 were at least of moderate size and exchanging clinical data (mostly test results). Thirteen of the RHIOs received regular fees from participating organizations in order to support themselves and another eight relied heavily on grants.Their conclusion: It is unclear whether or not the current approach of offering small grants and waiting to see if they survive will work. My conclusion: Time for a different model if we ever want to see wide-scale HIEs.

Maybe Lee Barrett simply views the state of the RHIO world differently. He was just named to the board of directors for HTP, a company specializing in connecting healthcare communities.

eClinicalWorks is selected by the Mount Auburn Cambridge IPA in Massachusetts for their 230 physician members. They already have 18 sites and 70 doctors live.

Picis names Melissa Cruz as its new executive vice president and CFO. She replaces R. Scott Lentz, who will become senior vice president of business development.

Bright Medical, a 55-physician multispecialty group in Los Angeles, selects MED3000’s InteGreat EHR.

E-mail Inga.

Constance Gervais, RN on Nursing Information Systems

Constance (not her real name) followed up after writing this to observe that she had probably misunderstood one of my editorials, in which I argued that today’s systems weren’t designed to benefit nurses directly. She did, but I liked her response anyway.

I am a nurse who has been involved with clinical information systems for 25 years. I was very surprised at the commentary regarding HIS systems and their alleged negative impact on nursing. The reason I changed my career to information systems in the first place was that as an ICU nurse, I saw what information systems ‘could’ do to save nurses time, provide needed information to physicians in a timely manner, and reduce medical errors. I can remember at least three times when I administered the wrong medication dose to patients, nearly causing a fatality. Twice in my ICU, nurses made medication errors that actually ‘did’ cause patients to die; one was an overdose of insulin, the other an overdose of potassium.

Information systems at the bedside could have prevented ‘all’ of these errors. In one hospital in Virginia last year alone, eight patients had to be removed from the operating table after being anesthetized because information was not provided when and where it was needed prior to surgery. That issue was resolved with technology. I’m just one nurse. If you talk to any nurse, they can tell you about similar stories.

Not only can information systems save patients lives, they can also help standardize clinical practice and save cost for the healthcare organizations. Some nursing professionals may think that cost is not their problem, but I believe it is. After all, we are in the ‘business’ of delivering patient care, and that begins at the bedside. As a nurse, it always amazed me that we spent so many years developing financial systems, yet never controlled cost at the bedside where the decisions were being made. Unnecessary treatments, supply costs, and the cost of clinical errors significantly impact the profitability of a healthcare organization. Perhaps if we could save money by standardizing patient care practice, capturing supply usage, and preventing clinical errors, healthcare organizations would be able to afford more practitioners and support personnel at the bedside, thus making nursing a more attractive career path. I know from my experience as a recruiter that nurses and physicians prefer an organization with advanced clinical technology in place.

I walk into ORs in so many hospitals and see rooms stacked with supplies that are not being tracked or charged for appropriately, empty OR rooms during prime hours due to poor scheduling practices, nurses working overtime because rooms are not being utilized appropriately during the day, and surgeons not conscious of hospital cost using the most expensive implants designed to last 60 years on a 90-year-old person. You must understand that we cannot improve processes that we cannot measure. Management reporting without information systems is time-consuming and ineffective. Evidence-based analysis of clinical practice cannot be accomplished and improvements cannot be measured without information systems.

The problems arise when hospitals attempt to implement clinical systems without changing process. Many simply automate old processes, and yes, when that happens, it takes more time. Technology changes the way we practice, and processes have to be examined and re-engineered to take advantage of the new technology. Many hospitals do not take the time prior to implementing a system to examine current processes, understand what the issues are, and what define what they want to accomplish with the new technology.

Healthcare is a business. A significant factor in helping hospitals keep the doors open and afford staff is the ability to control cost. As a nurse and as an information systems professional, I take issue with this article and would challenge anyone who believes that it is a waste of time and money to use information systems technology to help manage patient care where patient care happens (at the bedside), prevent medical errors, and provide information when and where it is needed to support physicians clinical decision making process.  The biggest complaint I hear from physicians is “I don’t know what I need to know”.  I find that very disturbing.

Monday Morning Update 12/10/07

From Datamus: “Re: selling patient data. it is incredibly important to distinguish the use of properly de-identified data from identifiable data. Having worked to improve patient safety and quality, properly de-identified data for benchmarking and analysis is essential to study practice and improve performance. If we categorize the use of patient data without making this distinction, we risk a crucial tool in work to make care better, safer and more efficient. That said, if anyone is selling IDENTIFIABLE patient data without proper authorization from the patient, they should go to jail.” It would be interesting to see how de-identification works, given that it’s not a set of hard and fast rules (as I understand it, anyway). Example: a rare diagnosis in conjunction with ZIP code might make a patient identifiable, so that’s PHI even though those data fields usually aren’t. Same for an unusual treatments, lab tests, etc.

From Dan Devine: “Re: selling patient data. In 1994, when I signed a contract with [vendor] for their remote hosting option, they had language in their contract about taking de-identified data for studies and analysis. I added verbiage that required them to inform me and get my consent before doing so. I was never asked. That’s no guarantee that they didn’t, of course, but I never actually heard of a case where they had pooled data for anyone to study. Second, the state hospital association signed a deal with [vendor] a few years back which required state hospitals to install [vendor’s product] and then report ER data to them, which would then be utilized by the state for various biosurveillance reasons. However, the contract gave the vendor the right to sell or otherwise use for their own purposes all of the data collected. The CIOs were very upset with this, but the CEOs who make up the hospital association didn’t really think through it and signed the agreements. So, it was really the state hospital association that gave our data away. Many CIOs attempted to rewrite the contracts. Some may have been successful. Others I know were not. I can’t tell you that [vendor] ever sold or used the data, but they had the right to, unfortunately. But, it would have been de-identified, so that’s something.”

From Ms. Bankhead: “Re: selling patient data. I negotiated a contract with [vendor]. There was a clause in the contract that said that they had the right to obtain de-identified information and basically sell it. I have the contract with the terminology.”

From Rogue: “Re: selling patient data. God help any vendor proven to be doing that. It would be national news instantaneously (and thrusting Mr HIStalk into the national spotlight). Come to think of it – to heck with national outrage. I’ll strangle them myself. But maybe I should wait until AFTER I get them to speak in Orlando and try to justify such abhorent behavior. Hope it isn’t true.” We’re branching into two different answers to that question, it appears. So far, no one has said that vendors are selling identifiable patient data. But, it appears that the door is open for selling de-identified data. Theoretically, that isn’t a patient privacy risk specifically, but it does mean hospitals may not be aware of the practice and certainly aren’t being compensated. Contract terms either don’t specifically prohibit it or, in some cases, explicitly permit it.

• One HIT vendor that runs a clearinghouse is actively selling de-identified data, a reliable source tells me.
• Here’s a link (warning: PowerPoint) describing a GE program that uses client-provided, de-identified data for quality improvement work. I e-mailed the presentation’s author, Mike Lieberman MD, and received no reply.
• I also e-mailed Paul Tang MD of Palo Alto Medical Foundation since he had made it clear he knows of vendors that sell data, but I didn’t get a reply from him either.
• A former vendor sales exec shared this: “[Vendor] has it in every contract. It’s boilerplate stuff. At least several years ago, we would remove it if the client insisted, but in internal contract classes, we were told to really try to keep it in. The pitch was that it would really help the client because they would have access to the aggregate information collected (but of course they would be paying a fee to see the results of their own data).”
• I found this clause in a vendor contract: “Nothwithstanding the provisions of this Section 8, [vendor] and its subcontractors may disclose non-personally identifiable information provided that the disclosed information does not include a key or other mechanism that would enable the information to be re-identified.”

So, are vendors selling hospital data? Yes, so it appears. Some definitely reserve that right in contractual small print. Properly de-identified? Hopefully. If you’re signing a contact, I recommend not only looking for clauses that allow data selling, but insist on inserting one that prohibits it (or at least mandates disclosure to you case by case). Not just PHI or confidential information … anything. Why shouldn’t you know? It’s your data (or more precisely, your patients’ data).

From Lurker: “Re: patient data. Not exactly selling of patient data, but [vendor] regularly used their customer’s data in their demo system. Things came to a head some years back when they hosted many major customers at their new site for demos and training. In showing a patient, one of the customers in the audience recognized the data as their own. Not from the name, which had been changed, but from the date of birth and clinical details. Needless to say, the solids hit the fan.”

From Warren Treesmiter: “Re: Azyxxi. Is Azyxxi for real? I’m trying to send them a substantial RFP. Nice website, but devoid of any contact info. I sent the RFP to a few ‘health**@microsoft.com’ type of addresses, but no response.”

From Jonny Yokel: “Re: Philips/Emergin. I could not agree more with Art’s comments. He should, however, include HCTSi on his list. They are clearly a thought leader in the field. Just ask any of the Epic, Cerner, McKesson, Eclipsys, etc, sites that are talking with them.”

From Billy Joe Mantooth: “Re: Kaiser CTO. Remember Dave Watson, Kaiser Permanente’s last CTO? He was second fiddle to CIO Cliff Dodd and left very quietly during interim CIO Bruce Turkstra’s brief tenure. He’s joining MedeFinance. Any bets on when or where Cliff or Bruce will resurface?” Link.

The author of Dalai’s PACS Blog finds himself in hot water. He’s a radiologist who writes about PACS/RIS products, honestly and therefore not always positively. Someone from a big vendor supposedly complained about his criticism to the business manager of a clinic that uses Dalai’s radiology group. The BM told Dalai (via one of his partners) to pull those posts and if he didn’t like their equipment, maybe he shouldn’t be reading there. He did so (“a kinder, gentler blog”) but the vendor is taking intense heat from sympathetic radiologists who vow to boycott them on an Aunt Minnie discussion (registration required).

Parkland Memorial Hospital (TX) gets a restraining order against Document Management Systems, a paper medical records company that lost its contract with Parkland last summer. Parkland says the company demanded $2 million to keep its 3 million records organized until the contract expires in February. The company says that’s the cost of the software it developed for handling Parkland’s records.

Optio’s Q3 numbers: revenue down 10%, EPS -$0.01 vs. $0.05.

Convergence CT, a Hawaii software vendor, signs a deal to make its software available in Japan. Its data warehouse product identifies patients for clinical trials from provider data.

The government of Nigeria blacklists Siemens following bribery allegations.

An HIM employee of Rice Memorial Hospital (MN) has died of injuries received in a filing system accident.

Idiotic hospital lawsuit: an anesthesiologist facing 122 counts of medical malpractice files suit against a hospital, its parent company, and 17 individuals, demanding payments he says he earned before his privileges were suspended. His earlier suit was dismissed. A peer reviewer called him “a snake-oil salesman” and “criminal.” He’s asking for $531 million. His attorney is a physician-attorney who lost his own medical privileges for providing substandard care.

E-mail me.

Inga’s Update

As expected, no one sent me a note saying they agreed it was time to legislate electronic Rx!

Dr. M posted some thoughtful comments that suggested doctors would start using IT tools when the tools made their lives easier.

BigNurse said, “The only problem with mandating eRx is that it can be incredibly cumbersome and inefficient. I visited a major eRx company’s reference site and found 1) totally redundant paper and electronic processes running concurrently, 2) significant technical problems that had resulted in end user non-adoption, and 3) on the staff side, little understanding of system functionality and no system “ownership”. Further, there was no evidence that the eRx system had improved anything, in fact, after 2 years of use, their productivity was still hurting. Again, I wish eRx were the answer, but without improvements in implementation, I’m afraid it’s not.”

So, will the tools ever be efficient enough? I remember my first job where I had to start using a PC instead of a typewriter (ok, I am not 25.) I remember thinking how much more time it took to boot up the computer and save and print, etc. I would have been able to type the same thing on the typewriter in half the time. Did word processors and computers get better or did I just get used to the new technology? Or both? Was the turning point when I realized that if I found a typo I could correct it on the PC much easier than with White-out and retyping? I certainly don’t have the answer here and am not a clinician, but, I do believe that at some point the resistors will need to just jump in the water.

Apologies to the Indiana Medical Society and athenaHealth. A reader was gracious enough to inform me that my statement that the organization has over 840 member doctors was “correct” although they actually have a total of 8,400. I love being correct, though I guess correct is different than perfect. Hope none of those Hoosier docs feel slighted.

Dr. Blake also refrained from telling me I was wrong when quoting the Denver papers about Gregory Burfitt’s “resignation.” However, the official Centura press release actually said the board “terminated its contract” with Burfitt. The real version definitely sounds more scandalous.

A reader forwarded me a link to a new blog by TX Health Resource CIO Ed Marx (I liked Ed’s first post to CIO Unplugged, especially since he mentions his first job in healthcare started at 16 as a “sanitation engineer” in a medical clinic). My first job at an amusement park was equally glamorous and similar in function (though will a less lofty “sanitation engineer” title.) I thus see Ed as some sort of new soulmate, not to mention I enjoyed interviewing him about Soarian when he was leaving University Hospital in Cleveland.

E-mail Inga.

Lazlo Hollyfield on Revolution Health

I was surprised about the big deal that was made of Revolution Health’s two recent acquisitions. The feedback was “this was a savvy strategic move to add on to their existing services.” I beg to differ.

I don’t know if Revolution Health is pouring gasoline on Steve Case’s money, but I bet their cash burn rate is bleak. I see a company that is still pretty much a jumbled mess that is struggling to figure out what will make money, i.e. Healtheon, circa 2001.

They laid off a bunch of people recently (25% of your staff is nothing to blow off) and sold ConnectYourCare to ExpressScripts in October to raise cash and get rid of an asset that wasn’t getting enough traction in sales to banks, health plans, and employers due to the slow growth of the CDHP market.

As for their other businesses, I don’t see one area where they are excelling or making enough revenue. Extend Health isn’t getting enough customers and Revolution doesn’t pose any serious threat to eHealthInsurance in the individual health policy market. Revolution throught it would be so easily to sell individual health policies, but they were dead wrong. You really need to know the broker market well and be prepared to deal with all of the underwriting issues and myriad of regulations in 50 states.

As for CarePages and the most recent acquisitions, Google has actually gained market share in health search recently despite the emergence of a number of vertical health search engine companies and forays by IT companies like Microsoft and a few large media companies. Google is like a 50,000 degree sun right now in search. Companies in this space will either find some shade by focusing on a niche (e.g., Healthline’s recent attempts to focus on providing data to Medicare patients on benefits), become a small part of a bigger arm (e.g., Medstory as part of Microsoft’s overall health IT play), or wither and die. Maybe Revolution is counting on driving page views through user-generated content sites like CarePages, but that seems like a tough play too.

RediClinics is making some good headway as one of the leaders among retail clinics. But, even with the low startup costs, most retail clinics just don’t generate a ton of revenue. Most patients aren’t willing to pay $50-$60 OOP for a visit to a retail health clinic when they might only have a $10 or $20 copay in comparison to a visit with their doctor. Most retail health clinics have realized this and now have begun to accept the normal insurance carriers. The real kicker, though, is the diagnosis and treatment codes used to bill for retail health clinics are pretty low hanging fruit. Overall,it doesn’t just add up to a ton of dollars and basically is taking longer than expected to break even on retail health clinics. Optimistic break-even point right now is 18 months and in some cases much longer (say 27-36 months). Not the kind of revenue numbers you want if this is a core area of your business.

Basically I don’t see Revolution Health’s situation improving much in the near-term unless they really concentrate on one or two areas enough to challenge their principal competition in those spaces.

News 12/7/07

From Art Vandelay: “Re: Emergin. Nice move by Philips. Why build when you can buy the best? This puts a crimp in the competition’s next incremental strategy for their products. The strategy was to continue to increase safety by sending alarm notifications outside their systems – integration. This move will allow Philips to focus on creating a next-generation architecture for their products and leapfrogging their competition. Hey, what do you know, a big fish acquiring a value-added bolt-on. I am very surprised Emergin lasted this long as an independent without receiving an offer they couldn’t refuse. GE, Siemens, Johnson Controls, Draeger, Cisco, Ascom, or SpectraLink could also have been interested suitors. Now let’s see who tries to one-up the move by acquiring Capsule Technologie or vendors also playing some role in the integration market, such as Global Care Quest, Nuvon, Sensitron, LiveData, iMetrikus, Cain Medical, Delphi Medical, or Pervasa. Best wishes to Michael and the team. Now, only if Philips-Epic relationship would have worked-out (AnswerMan – there is one more for the Epic quota).”

From Dr. Lisa Cutty: “Re: Agfa. Agfa Pulls ORBIS From Dutch Market. According to the Dutch ehealth portal ICTzorg, Agfa decided to resign from the Dutch market. After a fit-gap analysis, Agfa learned that the international version of ORBIS HIS is not ready for the Dutch market. Where are the European next generation HIS products? Lorenzo delayed, Soarian delayed, ORBIS delayed … will the U.S. help Europe once again?” Link. She also mentions that General Atlantic sold only about a million of its 4.7 million Eclipsys shares, reported earlier this week as a potentially larger number.

From Lacey Underall: “Re: vendor support. When you’d call the vendor in the 80s, you’d get transferred to a techie who would resolve the problem on the phone. Now, vendors require that you learn how to use their software for problem tracking. Attach enough supporting evidence to take the case to the US Supreme Court, and they will come back and ask you for more. Last week, we installed code that didn’t work as we had hoped. I opened multiple cases and was invited to a conference call, during which the vendor’s person asked for case numbers. I told them I used their case reporting tool, so look them up. The response from a manager: ‘I don’t know that techie stuff. Please just send a list of the case numbers.'” I’m with you. First, customers of some vendors end up being their outsourced QA department since they don’t bother to test otherwise. Then, you have to log on to their clunky web tool, slogging through cryptic fields that a customer should never have to see. Then, they insist on working from that system, which you invariably download to Excel since they speak no other language when you talk to them, or they dump it into an RTF and e-mail it. Lastly, you not only better be able to repeatedly duplicate the problem and provide ironclad evidence if you don’t want your ticket closed immediately as ‘working as designed’ or ‘unable to duplicate’, you then have to explain it to the clueless help and test the usually dysfunctional and sloppy fix that results. The obvious goal: to put the burden of their mistake and its rectification (no pun intended) on the customer. You prove it, you help them fix it, you test it, you pay big maintenance fees for the privilege. I should name my vendor right here, which I’m betting is the same as yours since our experiences are identical.

Kaiser CIO Phil Fasano is interviewed on video by ZDNet. I asked Justen Deal for his impression just to get the counterpoint. Here are a few of his excerpted thoughts. “The interviewer says Fasano ‘parachuted in to fix some big problems.’ Interesting. KP has never really acknowledged that there were problems when he came. This interview doesn’t talk about any of them. It’s a lot of fun talk about Web 2.0, RFID, mobile computing, and social networking, all the glamorous buzzwords. The interviewer was excited about remote and mobile computing, but the extent of KP’s remote access infrastructure is its Cisco VPN Concentrator and the RSA SecurID tokens it rations out to worthy IT employees, managers, and a few doctors. As for mobile computing, KP is notoriously un-mobile. Tablets and PDAs just aren’t used in clinical settings at any of KP’s medical centers. Finally, I estimated last December on my blog that KP was spending $2.6 billion per year on IT, which KP disputed to anybody who would listen. But Fasano says in the interview it’s $3 billion a year. So, $330 per year, per member. The VA is at about $296 per individual, but has more than four times the number of medical centers and double the number of clinics. And, the UK’s NHS spends less than a third of what KP is spending per citizen (including NPfIT).” And speaking of Justen, a reader (someone from Kaiser) liked his scathing, well-research comments about Kaiser’s CEO.

OK, I need your help. Several folks who should know have told me that they’re sure that specific HIT software vendors are selling the patient data of their customers. Logistically, those vendors would need contractual permission and (for non-hosted systems) remote data access. If you have any (anonymous) proof of that practice, I’d sure like to hear about it. Contract terms would be good, first-hand knowledge even better. I’ve never heard of that happening, but I figure it’s a good time to either prove it or put it to rest.

GE, McKesson, and Microsoft are rumored to be interested in buying Canadian HIT applications and services vendor Emergis, but telecom company Telus may get it outright.

Former QuadraMed VP Michael Lanza is named EVP and general counsel of Selective Insurance Group.

Some idiot blogger is involved in a new online HIT job service.

Ronald Crall is named CIO of Quincy Medical Center (MA).

A group of healthcare companies will develop and use security practices developed with Health Information Trust Alliance.

Red Hat and HP will collaborate to facilitate healthcare data sharing in India. Interesting …

AHRQ releases 17 patient safety toolkits created from its research projects.

Cedars-Sinai, stung from being front-page tabloid fodder, abandons any pretense of offering a non-punitive culture. Everyone involved in the heparin overdosing of Dennis Quaid’s twins has been suspended and a reported 1,400 nurses will be required to attend special training. One story said that nurses have been warning the suits for years that staffing cutbacks and poor labeling were causing increasing numbers of medication errors.

Singapore’s HIE will be extended to community hospitals in the next few months, allowing public facility records to be viewed in community hospitals.

Survey: 60% of US adults think EMR benefits outweigh privacy concerns; 40% don’t. 75% want to be able to e-mail their doctor, but only if it’s free (apparently 25% don’t want that option even at no cost, proving that only idiots are sitting at home during the day, people willing to take a break from Jerry Springer to do telephone surveys).

The CareSpark RHIO chooses Wellogic’s physician portal.

Sunquest announces plans to expand its CoPathPlus anatomic pathology software.

Erie County Medical Center (NY) says the PeriOptimum wireless surgical patient tracking system is saving it big bucks, boosting OR utilization from 55% to 92%. Hospital CEO quote: “Think of it as a kind of air-traffic control system … You have 10 runways, 10 planes landing or taking off, 10 queued up waiting to take off, X-number in the air waiting to land. The rare commodity is the runway. The closer together you can get them landing and taking off, the more business you can do.”

Steve Case’s Revolution Health buys HealthTalk, a social network for those with chronic conditions (should it be called a social disease network?) and invests in fitness goal website vendor SparkPeople. Overnight futures prices were up for companies whose unimaginative names were created by simply jamming two words together (the company’s other businesses are CarePages, RediClinic, and Extend Health … how did they miss that last one?) And lest you think the companies are just a hobby for Steve to spend his AOL money, the young parent company gets serious and lays off a quarter of its staff, explaining “What you will see is a flatter organization, with a greater emphasis on revenue generation.” Aw, that’s so 1.0.

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Inga’s Update

“Differences in management philosophy” have led to Gregory Burfitt’s resignation as CEO of Centura Health after just over two years.

I have given up on Congress to pass any meaningful legislation about healthcare IT. (Now that I think about it, I am not sure about Congress’ ability to pass much meaningful legislation on anything, but I digress.) Despite my pessimism, I liked the new proposal that would require all doctors seeing Medicare patients to e-prescribe by 2011. It would also “bonus” doctors who use e-prescribing starting next year, although the bonus will likely be wiped out by lower Medicare reimbursements. Regardless, I say let’s get some legislation on the books and start forcing the HIT issue. E-Rx is probably one of the easiest tools to use in any EMR. If you have doctors resistant to technology, e-Rx is a great way to dip their toes in the pond. And obviously if you are able to convince a doctor that one aspect of an EMR is easy, then maybe the doc will move to other functions. E-Rx is also one aspect of automation that has great returns in terms of patient safety. It’s harder to argue that it’s not worth the money/effort. And if you get more doctors using e-Rx and the products are deficient, then there will be more voices crying for enhancements.

Meanwhile, check out Martin Jensen’s comments about the topics (especially if you want a totally different perspective!).

MedcomSoft adds James Haveman to its board. His background includes a stint as Senior Advisor for Health to the Ministry of Health in Iraq.

Statcom names Jim Rosenblum as executive vice president, products and chief technology officer. Rosenblum comes from Emmi Solutions and Allscripts before that.

athenahealth agrees to provide its practice management services to Indiana State Medical Association members. The organization has over 840 member doctors. Interesting that the press release doesn’t mention EMR. If athena is able to get a physician’s billing business, then its more likely to get the EMR as well. And, without having to discount.

E-mail Inga.

News 12/5/07

From Jill Purity: “Re: Epic. Lots of prestigious organizations have bought Epic, run wildly over budget, and don’t get all sites live. Have they got a full inpatient site live or not? It seems that with Epic, the hospitals get blamed and not the vendor, where for everybody else, the reverse is true. Why does Epic always emerge squeaky clean?” I’m just riffing here since I don’t know for sure, but Epic’s contracts put most of the burden on the client (wisely, if you ask me). If things go sour, Epic can say they did all they promised. Epic is the only vendor doing so well that they can put that in a contract and get the customer to sign. Their competitors are so desperate that they’ll guarantee all kinds of outcomes outside their control, like physician use of CPOE, cost savings, and improvement in turnaround time. Also, why would a customer who’s already spent the money broadcast their dissatisfaction to the world? They’re big and well-known enough such that a little extra push won’t help them get anything out of Epic anyway, arrogant enough to not want to look stupid, and rich enough to just swallow the cost no matter what. Also, keep in mind that Epic is head and shoulders above all its competitors in KLAS, where its users could blast them anonymously if they chose, so let’s not discount that maybe Epic has a better product and methodology even though its customers, big names aside, are at least as clueless as hospitals with less cachet (or Cache’, for you merry punsters).

From Seth Davis: “Re: Eclipsys. The primary investment firm behind Eclipsys, General Atlantic, dumped a lot of their stock this week, maybe all of it. They still have a board seat, at least for now. Probably not a near-term Eclipsys crisis, just a feeling that now was a good time to get out.”

From Dan Panama: “Re: Misys. Vern said at the business update yesterday that an overwhelming number employees in the employee survey said they are not having fun any more. Vern’s response: ‘You have to earn the right to have fun.’ He also said that the banking division had a tough first half because of housing woes.”

Dennis Quaid and his wife file suit against Baxter Healthcare, manufactures of the heparin vials with which their newborn twins were overdosed at Cedars-Sinai in a drug mixup. Oddly, they aren’t suing the hospital for making the mistake, maybe because the babies are fine. Even though Baxter sent providers a warning letter that the hospital supposedly ignored, the Quaids say that wasn’t enough and they should have recalled the vials. Says they aren’t looking for money, but that’s standard ambulance-chaser boilerplate. Baxter’s response: “Company spokeswoman Deborah Spak says the issue is not product-related, but instead concerns improper use of a product. She says no amount of differentiation in packaging will replace the value of hospital staff carefully reviewing and reading a drug name and dose before dispensing and administering it.” I’m with Baxter on this one. If anyone should have learned from the Indianapolis deaths, it was Cedars. And there’s no need for the Quaids to “save other children from this fate” since the packaging was changed earlier this year. Cedars made the call to keep using the old stuff and their employees gave the wrong product.

Lots of HIT jobs (75 or so) have been posted at HealthcareITJobs.com in its first few days, everything from ambulatory system analysts to sales execs to CIOs. The five most recent are listed to your right and the first Hot Jobs e-mail has gone out (sign up here).

Ambulatory systems from Epic and e-Medsys earn CCHIT 2007 certification.

Sage Software joins the e-Prescribing Controlled Substances Coalition, which is trying to get federal laws changed that prohibit e-prescribing of controlled drugs. The ban is kind of silly given the immense problem with forged handwritten prescriptions and the retrievability of those prescriptions for DEA audits. The government wants providers to eat the cost of automating, but won’t make the same requirement of its own departments, apparently.

Fred Trotter has started a blog about healthcare IT in Houston. He’d appreciate getting any local stories and a chance to meet folks there in a monthly meeting he’s planning to set up. I’m sure there are lots of HIT’ers there, at least judging from the massive healthcare canyon that is Fannin Street, so say hi to Fred.

Lucida Healthcare IT brings on Cheryl Alpert as director of marketing. She’s been marketing VP for several companies, including Yahoo and DataBroadcasting. Also joining the company is Mike Lucey, director of business development, who has held positions at Forrester Research, Meditech, and McKesson.

Privacy advocate Deborah Peel advises residents of Lufkin, Texas to avoid the local hospital, which just implemented McKesson’s clinical systems, until they research how the hospital and/or McKesson will handle their data. “People from Lufkin should really think twice before going into the hospital until they know whether their health data will be disclosed without consent and until they know whether the technology vendor contract allows data mining and sale of their sensitive health records.” She claims by name that GE, Siemens, and Cerner reserve that right in their contracts. “This is a way that vendors and hospitals use to help pay for expensive technology infrastructure — they turn around and sell sensitive patient records. The records are sold to employers and insurers, that then use the data to discriminate against people in jobs and insurance coverage.” Assuming those vendors aren’t selling records, I’d protest vigorously for being characterized publicly as such. Sometimes her comments are kind of over the top, reminding me that she’s a psychiatrist.

In what must be the highest software version level in history, Siemens announces INVISION 27.

Omnicell announces SinglePointe, which isn’t defined until the fourth paragraph of the press release. If the conjoined word name wasn’t enough, the oh-so-Brit E at the end raises the annoyance bar, like those cutesy, woodsy-sounding names for cookie-cutter subdivisions in which all flora and fauna are ironically destroyed to erect boring beige boxes, like “Heron Pointe” or “Rivermonte.”

Guess who’s going paperless with their medical records retrieval and management? Some Chicago ambulance chasers.

The Raleigh office of Sunquest Information Systems leases new office space, presumably to vacate the Misys building. Seems odd to have a Raleigh office when the company is in Tucson and odder still to have the CEO working from there.

A Massachusetts entrepreneur is offering a $10 million prize for anyone who can come up with software that can map the genetic codes of 100 people in 10 days for $10,000 or less per genome. “There’s a lot of talk about personalized medicine … But to get there, we’re going to have to be able to do rapid and cost-effective genome sequencing. And for that, we’re going to need a new technology. People are going to remember who did this.”

HHS secretary Mike Leavitt says doctors should have to adopt EMRs to avoid a 10% reimbursement drop scheduled for January 1.

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Inga’s Update

From Randy: “Re: cell phone death. It has now been discovered that this report was inaccurate and a fellow worker ran over the man that died. The cell phone had nothing to do with the death.” Link. Guess we all feel safer taking calls. Another reader pointed out my poor choice of words when noting that “fortunately” the phone was only sold in Korea. I actually wouldn’t want the Koreans or anyone else to risk death by cell phone.

Automated pharmacy system provider ForHealth raises $9 million in new capital funding. The company announces its new IntelliFlow IV Room Workflow Manager solution for managing and tracking I.V. dosing.

A new must-have tool for every road warrior: a service you can launch on your mobile phone browser to help you find the nearest bathroom by city and street address. Brilliant.

eClinicalWorks makes a sale to Redwood Community Health Coalition, California’s largest network of non-profit community health centers.

Desert Regional Medical Center in Palm Springs will purchase the Cerner RxStation for medication automation.

Wyndgate Technologies, a division of Global Med Technologies, licenses its SateTractTX transfusion management system to Sheridan Memorial Hospital in Wyoming.

Annals of Internal Medicine publishes the results of a survey on physician professionalism. One particularly troubling finding: although 96% of respondents agreed that physicians should report impaired or incompetent colleagues to relevant authorities, 45% of respondents who encountered such colleagues had not done so.

The Christ Hospital in Cincinnati signs a multi-year contract with Care Tech Solutions for IT infrastructure outsourcing, help desk, and web services.

E-mail Inga.

Philips To Acquire Emergin

Royal Philips Electronics NV announced this morning that it will acquire medical alarm and event notification software vendor Emergin of Boca Raton, FL for an undisclosed sum. The transaction is expected to close by the end of the year.

See also: HIStalk’s June interview with Emergin President and CEO Michael McNeal.