News 7/25/07

From Meat Beat Manifesto: “Re: Misys. Misys will be announcing a sales leader to take over the Misys Connect product. He is a former Cerner guy who has been with Misys less than a year. If they want to sell more EMR, they need to give Connect away or sell it as a subscription with a low monthly cost. Similar players (Healthvision and their competitors) already have a foothold, the community market is soft, and RHIOs are broke. All these things will make it hard to sell Connect like in the good old days (for $250K and up). By the way, conference calls are being held today to brief sales teams on the recent changes. Everyone had a fit when things started popping up in HIStalk.”

From Nick Cave: “Re: Sunquest. Who gets the name? Lab had it first so, it should go to Vista. The name is worth something since it used to be a great company to work for and to be a client of.”

From Oldtime Sunquest: “Re: Sunquest. Now the lab, rad, and pharm business can move forward and not back. Now the profits from lab can be reinvested in lab. The new owners know software and there is still a place for growth in the diagnostic software market. The software is still good, even though Misys tried to run it into the ground. It feels good to call them Sunquest once again. Sid must have a smile on his face today. I know the users and employees do. I agree that GE should look out.”

From Terence Hogan: “Re: Misys. Keith Hagen actually came from Sunquest first, then moved to Misys Transaction Services to be groomed for bigger and better things (like being CEO of QuadraMed, ha!) Lab and rad are good products, but weren’t selling well due to outdated technology. CPR was indeed hard to install and, although CPOE was very strong, the integration that was supposed to happen never really did.”

From Misys User: “Re: CPR. QuadraMed needs to get rid of the CPR Client Services management. The few users who attended the recent conference agreed that the last twelve months have been the worst in the history of the CPR product. We aren’t going to give QuadraMed as much time as Misys to make it work.”

From MrMisyster: “Re: Sunquest. There is very little question that the original Sunquest group in Tucson have reason for celebration today. Misys did nothing for them but take the profits and throw them away on a failing acute care business comprised of every lackluster product Tom Skelton could buy. The real question is who will lead this group since all executives are in Raleigh (Atkin?)  Also, what about infrastructure: marketing, HR, and a few others that all got compressed into the milieu that was Misys? What a six-year mess, but at least there’s some hope for the future of the Tucson group.”

From Enumerator_of_Beans: “Re: Misys. Looks like what’s left of Misys Healthcare is running about a 13% operating margin. Not the loss-maker some think, but hardly a punchy, software-type margin, either. For the $400 million, I would expect them to acquire an ASP-based physician product and save some cash for share buybacks to keep shareholders happy for the short term since the dispositions will negatively impact earnings unless they do something sensible with the proceeds.”

From Mia Hottie: “Re: Cerner. The iNet monitoring system that competes with Visicu is rumored to be at risk of being de-installed in a handful of hospitals.”

From Lane Kimchee: “Re: Google. Google announced a bunch of healthcare advisors, mostly big-name talking heads and luminaries, and not a single RN, much less anyone who’s ever actually taken care of a patient. Is there another industry where the #1 user group would be ignored? Google may just be another clueless big company trying to get into healthcare like those that failed before them: Amicore (IBM, Pfizer, and Microsoft), Dossia, and Cisco.”

I missed this: the interface engine part of Quovadx is bought by – who else? – a private equity firm. Cloverleaf will live on under the Quovadx company name, but the company will be moved to Dallas under new owners Battery Ventures, who also put their CEO at the helm.

If you had problems reading HIStalk on Monday or Tuesday, I’ll apologize yet again. I knew the server was going to get pounded when I noticed that over 100 readers were on during the early hours of both days (I can only see the first 100, so I only know it was some number bigger than that). It didn’t drop below for long on either day (mostly due to a crapload of stock analysts reading up, judging from incoming addresses). HIStalk was the only source of full coverage of both the Misys and Picis events (sleep-in reporters don’t like working Sunday afternoons and the wee hours of Tuesday morning like I did, even though I have another day job and they don’t).

Anyway, as Inga pointed out when I bemoaned possible site slowdowns, the user volume and feedback seem to indicate that HIStalk has become the primary source of industry news, both breaking and routine. For that, we say thanks. We really do work hard to get information, thoughtful opinion, and industry reaction in front of you. It’s easy for me to lose sight of that fact since all I see is a keyboard in an empty room for several hours a day, never talking to anyone about HIStalk or acknowledging that I’m behind it. I really appreciate the support of readers and sponsors. It wasn’t nearly as much fun with I had neither. As several folks have noticed, we’ll get our 1 millionth visit to HIStalk soon. Nobody wants HIMSS Hummers these days, so maybe I can get one cheap and give it away.

If you read HIStalk on the HIStalk2 site (with the pipe-smoking doc), you can click Archives at the top of the page to find your way around.

Cerner is speculated as a possible bidder for a big Australian hospital IT project.

HLTH Corp. (the stupid name WebMD chose voluntarily) and Emdeon Practice Services are suing nine insurance companies to force them to pay the estimated $58 million legal bills of their nine indicted former officers and directors. I bet it didn’t even cost that much to keep OJ golfing.

New CIO: Tom Pagano, Carondelet Health (MO), moving over from Truman Medical Centers. Boy, the paper really botched the name of the HIMSS chapter of which he was president.

HITSP seeks public opinion on its next recommendations to AHIC: emergency responder EHR specs, security and privacy, quality use case, and consumer information access case.

Discuss today’s news here: Misys, Picis, or even non-rhyming newsmakers.

Impress me with your knowledge or speculation: e-mail me or use the Rumor Report to your right to spill secrets or educated opinion. We like both.

---

Inga’s Update

Last week, Mr. HIStalk mentioned that Acermed was perhaps closing its doors. I was able to connect with Acermed’s Anoush Tabriz in Client Relations. While Tabriz wanted to make it clear that AcerMed is continuing to provide clients with support with their “skeletal staff,” the rest of our (short) conversation had several “no comments”. So officially no comment as to what is going on with the company, why the reduced staff, whether or not they are still selling new products, if the situation is temporary, etc.

Millennium Research Group announces results of a study that nearly 18% of physicians had an EMR in 2006 and the number is expected to rise to over 30% by 2011. System costs and the disruption of implementing a new process are the two biggest barriers today. To increase acceptance vendors are introducing more streamlined versions of their products. While these adoption numbers seem lower than some I have seen, I am inclined to believe they are fairly accurate.

Compare that to the recent AAFP survey that indicated that half of doctors that responded to a survey said they had either fully implemented an EMR (37%) or were in the process of implementing (13%). That suggests that either family practice docs are more advanced than other specialties, or, that the study was not as scientific as it could be (since it was based on respondents versus a random sample.)

Anyway, all interesting data points, but in 2005 some “experts” predicted that by now 24% of the docs would be using EMR. And about a year ago, the predictions suggested that by the end of 2007 25% of the 1-2 doctor groups would have EMR and as many as 78% in the larger practices. There are obviously varying interpretations of what it means to utilize an EMR and that likely lends to a wide range in the percentages. Bottom line – regardless of whose survey you look at, the market is still pretty unsaturated. Once there are more easy to use products and possibly hospital or government subsidies, the market will see some rapid growth.

eClinicalWorks was chosen by the DC Primary Care Assocociation (DCPCA) to provide EMR/PM solutions for their six community health centers. Four additional centers may be added in the future. No mention of the size fo the deal.

Not sure I have anything to add to all the comments regarding Misys. I actually have had fun reading what readers have had to say. Guess my only thought is that at one time Misys (at least the old Medic piece) was considered the Mercedes product in the industry. The good thing about an old Mercedes is that, even with age, they tend to still work. The problem with an old Mercedes is that there are a lot of other options that do the job as well or better and happen to be sexier and cheaper. I am sure that there are still a number of great employees left and I hope Misys will take care of them.

A MED3000 client forwarded us a letter that was apparently sent to all their clients. Chairman and CEO Pat Hampson announced the finalization of the InteGreat acquisition and the “vision” for how it was to become a “critical component” of MED3000’s and their clients’ success. There is acknowledgement that they are large users of multiple vendors’ software (Misys, GE, Sage, Allscripts, etc.) but Hampson point outs that they have “only limited influence over the direction of their software development.”  MED3000 plans to continue to expand development of IC-Chart and IC-MyHealthRecord. A cynic (like Mr. HIStalk) might suggest that clients watch out for a push to move everyone over to the InteGreat products.  However, if you take the four-page letter at face value, Hampson is trying to enforce the idea that they will continue serve the needs of their 9,500 physicians, including those on other systems, while at the same time channeling additional efforts to promote the InteGreat products. As Hampson rightly says, “the proof is in the pudding”.

Chat up Inga.

Picis to Acquire LYNX Medical Systems, Will Announce Goldman Sachs Equity Investment of $155 Million

High-acuity hospital information systems vendor Picis of Wakefield, MA will announce later today its intended acquisition of LYNX Medical Systems of Bellevue, WA, which markets revenue cycle management software and services for hospital emergency departments.

While terms were not disclosed, Picis President and CEO Todd Cozzens told HIStalk that Goldman, Sachs, & Co., advisor to Picis, will provide the company with a financial package worth $155 million. A portion of that investment will fund the Picis purchase of LYNX from its private equity firm owner, Francisco Partners.

Cozzens says the deal will combine the clinical expertise of Picis with the financial managment offerings of LYNX, both targeting the hospital emergency department. “LYNX Medical Systems focuses on revenue cycle management in the ED. It’s a huge revenue opportunity for hospitals. CMS [Centers for Medicare & Medicaid Services] rules in the ED are much different. There are so many areas in the food chain from patient encounter to patient disposition where charges can get lost or mis-coded. It’s a $25 to $35 per case improvement with this product, which will be even more when integrated with our clinical product.”

Picis offers perioperative and intensive care information systems in addition to its CareSuite ED PulseCheck emergency department information system, which it acquired from ibex Healthdata Systems, Inc. in August 2004. “It does for ED what we did for OR in putting anesthesia and clinical and administration together,” Cozzens told HIStalk. “We have a highly differentiated solution for these areas. It’s a big trend. It’s not good enough to just have clinical documentation and flowsheet information. You have to tie it to factors that are hard dollar, with a proven return that will stand up to scrutiny.”

The LYNX software suite includes ED and clinic modules for patient tracking, documentation, visit level assignment, and CPT and ICD-9 coding. Its health information management application provides browser-based electronic records management, remote access, and coding workflow.

“LYNX is software as a service,” Cozzens told HIStalk. “It’s a great per-click business model. The content and algorithms have been through CMS audits. If you over-code, it’s fraud, and if you under-code, it’s lost revenue. LYNX has been tried and tested with CMS. This is not software you can build in a day. It’s a great little company, a great little business, compatible with our clinical focus in ED. Picis will offer the first end-to-end solution for ED from clinicals to financials. LYNX sells to CFOs and has some great customers like Partners, Vanderbilt, Montefiore, Triad, and Yale-New Haven.”

According to Cozzens, LYNX is profitable, with revenue of over $30 million that has increased by 800% in the past four years. Its 200 employees serve 350 healthcare organizations representing over 15 million encounters. Additional LYNX offices are located in Waterloo, IA and Tampa, FL. No management or location changes are planned.

HIStalk asked Cozzens about integrating the product and company culture into Picis, which is located on the opposite coast. “We’ve been good at merging,” he told us. “It’s not like GE, where they don’t like domain experts and they bring in the plastic and lighting people. We love the domain experts and invest in them and, hopefully, they will multiply. We know this will be one of our easiest integrations. It’s easy to run companies in other locations if you have good management systems in place. Since I talked to you last, we’ve really beefed up our senior management team, people who know the enterprise software business. Big ERP went through what healthcare is going through 10 or 15 years ago. We’ve found that they’re invaluable in driving better practices and stronger management systems.”

The combined organization will service 1,350 hospitals in 19 countries, with reported annual revenues in the $125 million range.

Cozzens disclosed that Picis placed its initial public offering on hold three weeks ago so it could complete the LYNX acquisition, which had been in discussion since early spring. “It could not have happened with the IPO,” Cozzens told us. “We wanted to raise money to do this. The timing wouldn’t allow us to go out and then do the deal. There was too much space in between and it was time-sensitive. The company was going to be sold.”

Goldman’s investment eclipses the estimated $84 million the Picis IPO would have brought, Cozzens told HIStalk. “Private equity valuations aren’t too far off of public valuations. Our shareholders didn’t leave much on the table here.”

Picis will eventually continue with its IPO plans, Cozzens told us, but with the critical mass and momentum that the acquisition will provide. “We never viewed the public offering as a seminal event, just a financing event,” he said. “It was a no-brainer when we could arrange financing through strong terms, be a good deal for our shareholders and Goldman, and not be public at the same time. Critical mass will put the IPO at a different level at a higher market cap, with more analysts folowing and many different revenue streams.”

Goldman’s private equity financing makes it a major investor in Picis. According to Cozzens, the deal is Goldman’s first direct investment in healthcare IT and the largest healthcare deal in Massachusetts this year. “At $155 million, it’s nearly twice what we wanted in an IPO,” Cozzens said. “Goldman is an investor, very close to being the major shareholder.”

Goldman managing director Chris McFadden was quoted in a Picis press release. “The opportunity to invest in Picis is consistent with our long-standing desire to invest in companies with strong growth and earnings potential in healthcare. This investment underscores our belief that Picis has the strategy to meet this opportunity.”

The acquisition is expected to close later this summer.

Mr. HIStalk’s Cheap Seat, Hastily Thought Out Conclusions

• I like the deal. The only unknown is how much Picis paid. Goldman wouldn’t have put in its own money if it didn’t look good. It gives Picis a nearly unbeatable ED offering, something that no mainstream vendor can match.
• This must have been a complex set of three-way agreements to hammer out, especially with two of the parties being private equity firms.
• Picis is smartly sticking with areas in which the big boys are weak instead of trying to fight an expensive, ill-advised CPOE-and-orders ground war. Plus, revenue-related systems are back in vogue again after lots of money was wasted on unused CPOE applications.
• How did I miss LYNX? I’ve heard the name and mentioned them a few times, but really knew nothing about them.
• When Picis put its IPO on hold three weeks ago, I wrote: “Related to Picis (but written before the IPO news came out) is my editorial in this week’s Inside Healthcare Computing electronic update: ‘Private vs. Public Vendors: I’ll Take the Former,’ in which I argue that the now-trendy private equity investment is replacing IPOs as the primary way for companies to grow. I have to admit that I felt traitorous when I wrote it because Picis is my sponsor and my argument is that current customers historically have fared worse after a vendor goes public (my vendors, anyway) but now I can feel OK about it. I still have confidence in Picis and I bet there’s a positive reason they changed their IPO mind.” Score: Mr. HIStalk 1, lots of other pundits, 0. Lucky guess, I admit.
• Goldman Sachs, $155 million. Damn! No wonder Picis passed on the IPO for now. Why hamstring yourself with all the publicly traded drawbacks and expense when you can get liquidity and financing needs without opening your kimono to the world? Plus, that’s an impressive name to hang alongside your own.
• Assuming Picis sticks with Goldman for its eventual IPO, Goldman can’t weave itself too deeply into the Picis operations. While I’m sure they’ll be involved in strategic decisions, they can’t load up the Picis board and management ranks with insiders and then float the IPO.
• While Goldman will reap management fees and a cut of the profits, that at least that aligns their interests with those of Picis, i.e. they make money together or not at all.
• Francisco Partners flips LYNX after holding it for just 18 months. They just bought Dairyland Healthcare Solutions a few weeks ago, you may recall. The trend of private equity investments in the HIT industry is full steam ahead. It won’t end here, but the real question is how long those companies will sit patiently while waiting for a big payday. Will they buy and hold or slash and burn? It would be fun to know how much they made on LYNX (and how much of Goldman’s interest in Picis ownership hinged on that piece of the puzzle).
• Todd Cozzens is among the best businessmen in the industry, especially given his role as co-founder of a relatively small, privately held company. He just got a $155 million vote of confidence from the Cadillac of investment bankers and hasn’t even IPO’ed yet. Who would have guessed he’d be that much of a star after starting up a fairly unexciting niche vendor in 1994 and sticking around all these years?
• It was cool of Todd to contact me personally in advance of the announcement. I bet his marketing people thought he’d lost his mind in trusting an anonymous blogger with an embargoed story (meaning I was on the honor system not to run it before 12:01 a.m. on July 24). He also offered a potential follow-up to our interview awhile back, which I think you’d enjoy.

Misys Sells Off Sunquest, CPR, Exiting the Hospital Systems Business

Lots of Misys news to report as announcements are made in London:

• The so-called Diagnostic Information Business, i.e. Sunquest, is being sold to Vista Equity Partners for $382 million. That includes pharmacy, lab, and radiology systems.
• The Misys CPR hospital clinical system is being sold to QuadraMed for $33 million.
• Rumors are that Misys will introduce an open source, EMR-related product (along with other open source products in its banking divisions).
• Vista will try to market Misys EMR as part of the deal.
• Both new owners have agreed to support the Misys Connect strategy.
• UK rules require Misys shareholders to approve the transaction.

Thoughts

• From QuadraMed’s announcement of the CPR purchase, it appears that Quadramed’s motivation was known weaknesses in its own Affinity clinical offferings, particularly for larger hospitals: integration and CPOE.
• Misys bought CPR from Per-Se (as Patient1) for $30 million in mid-2003 and spent a lot of money ($20 million?) tinkering with its technology underpinnings. So, QuadraMed gets an even better fire-sale price than Misys got originally, although with a few more layers of accumulated tarnish. It’s now nearly 20 years old with few installations.
• Misys CPR was once a great product, but it has languished for many years under two unfocused owners.
• Current KLAS rankings: CPR # 6, but notably one notch ahead of Cerner Millennium and two above GE Centricity Enterprise (Affinity had much higher numbers, but too few installs.) Lab: a strong #2 (good job, Sunquest.) Pharmacy: mid-pack, but too few customers to score officially. Radiology: #3 of a four-horse race, but once again the last-placer was Cerner. In other words, if you believe KLAS, QuadraMed gets an instantly competitive clinical product line for $33 million.
• QuadraMed CEO Keith Hagen is familiar with both products: before becoming CEO, he was with QuadraMed and left for Misys (although he was involved in their transaction services, not software).
• One rumor is that the old Sunquest name will be revived. I like that idea.
• Misys took on 200 Per-Se employees when it bought CPR. I can’t imagine very many are left. Ramping up staff isn’t something QuadraMed has done a lot of, so that will be a challenge (as will trying to move the office from Tucson if that’s part of the plan – QuadraMed struggled with that in moving everyone to Reston a few years back.)
• Vista is the same private equity company that bought Surgical Information Systems in February 2006.

Reader Comments

“Affinity was not designed for larger, multi-facility organizations and lacked technical infrastructure to support needed enhancements. Their interfaced, acquired pharmacy product was never going to work. CPR has an excellent integrated pharmacy system and an OK lab solution. Much deeper nursing and CPOE capability. However, CPR is hard to install and most of the knowledgable staff are long gone. It needs to be configured for out-of-the-box installation.”

“I need some help, as a business-ignorant techie. Misys just sold of PLX (Pharm, Lab, Xray) to an investment firm. CPR is probably going to QuadraMed based on another rumor. What I don’t get is this: Verne keeps telling us that Hospital Systems is making money and keeping areas like Physician Systems (that he said is bleeding) afloat. Why sell off the very unit that is keeping the other units afloat? I just don’t get it.” Misys Myopia is an interesting phenomenon caused by bringing over a bunch of Medic people who never bought into the inpatient thing and just assumed their gravy train had endless track in front of it. The old, unprofitable product line wasn’t Sunquest or CPR, it was the ambulatory business, but they couldn’t see that. The cash cow has been sold for a low price to try to plug a few of many lifeboat holes. While this strategy isn’t a bad idea, they need to show far more brilliance and vision in trying to save the only remaining business than they did deciding to sell this one off.

Mr. HIStalk’s Cheap Seat, Hastily Thought Out Conclusions

• CPR was always a better product than the market acknowledged. The problem was the incompetent vendors selling, installing, and supporting it (Health Data Sciences, then Medaphis/Per-Se, then Misys). Several years ago, when I last looked side by side (casually) at all the available products (except Epic), I ranked it #1. Very nice user interface, great for physicians and nurses.
• Affinity Clinicals are pretty good and, despite technology criticisms (MUMPS and Cache’, not much different than the original CPR technology). Epic is obviously a poster child to prove it’s sellable despite the nuts and bolts. Still, QuadraMed’s purchase of Australia’s Detente Systems never really worked out – nobody does real integration via that route and McKesson is much better at convincing a gullible market to the contrary than QuadraMed ever was.
• QuadraMed paid $4 million for Detente in 2004. It paid $14 million to get Tempus Software the same year, a much better investment.
• Affinity Clinicals are best suited for small- to mid-sized hospitals, while CPR’s few customers seemed to indicate a big-hospital preference. Keith Hagen’s video statement about the announcement clearly says they’ll offer both products. That’s been tough for those who’ve tried it before – trying to merge cultures, technology, and sales is a lot harder than just hanging a new name on it.
• I don’t know how many good clinical product people are left at QuadraMed since Affinity Clinicals were doing pretty much nothing. Ditto CPR. Who’ll be involved? It had better be folks with clinical backgrounds who can come up to speed quickly.
• Misys management seemed almost openly contemptuous of the Diagnostic Information Business, but the sales announcement painted a far rosier picture, with margins of nearly 30%. Need proof they didn’t get it? How about this from the press release: “The Diagnostic Systems business has been run largely as a stand-alone operation, and therefore will experience minimal impact in day-to-day operations.” In other words, Misys was adding no value whatsoever and, most probably, actually hampering that division from succeeding due to its own corporate- and division-level bungling. And even then, it was bringing home big profit margins.
• Misys is selling the former Sunquest for slightly less than it paid: $404 million in 2001. Not much value-added there.
• Misys Connect never amounted to much and will be irrelevantly straddled across three companies. The only remaining assets of Misys Healthcare, i.e. the physician systems, will have to make it on their own with fierce competition. Divesting the other businesses will let them focus on trying to salvage that struggling product line.
• Misys finally acknowledges that, grand proclamations about its vision aside, it lacked the execution and vision to play in the hospital market. It’s first and foremost a banking software company that happens to own a troubled physician practice software division hanging on for the ride. It has finally gotten ride of one of its two unaligned albatrosses.
• QuadraMed has had its share of rough rides, too: wildly faulty acquisitions, survival without vision under Larry English, the slow and painful demise of Affinity, and what looked like a wise retrenchment into the company’s only strength: the HIM product and service market. Will the market accept their re-emergence into acute care clinical systems?
• The industry needs another strong clinical systems player, with the odds going down by the minute that a GE-retooled Carecast will be it.
• Tucson employees of Misys, as Gerald Ford said, your long national nightmare is over. Your were already an abused step-child, so it can’t get much worse. The announcements proved what everyone suspected: Misys Healthcare didn’t respect its only successful product lines and the people producing them.

Post Your Thoughts on HIStalk Discussion

Since I have to work for a living on Monday, I won’t necessarily be able to post HIStalk updates as any news breaks and to get your comments online quickly. Post here! You can bet that Misys, QuadraMed, Vista, investment analysts, and everybody else in the industry wants to know what you think.

Monday Morning Update 7/23/07

From Hamrick: “Re: Misys. Misys will announce the sale of Misys CPR to QuadraMed on Monday, July 23.” QuadraMed already has a clinical product that nobody’s buying, so I’m not sure why they’d want another one. However, since Misys was making big changes Friday (supposedly), maybe the timing was intentional if this is true.

From Wompa1: “Re: CHI. Christopher MacManus, Sr. VP of IS at Catholic Health Initiatives, has moved on.”

From Duuude: “Re: Mayo and Cerner. I’m wondering if Mayo feels left out of with Intermountain being the development partner. They used to hold IDX by the gonads when they were truly a development partner. In my experience with Mayo, even though they can be a big pain in the derriere, they did know their stuff. Even with all of that holding and pain caused by Mayo, they are worth keeping, even just for the perks of having them as a named client. When will GE take notice and stop the bleeding? If I was GE, I would be trotting out Hogan, the executive GE Healthcare board, and whatever is left of Seattle management to keep Mayo.”

From The PACS Designer: “Re: iPhone clones. TPD wants HIStalk readers to know that the iPhone is not the only choice when it comes to ‘combo phones’. The iPhone is getting all the attention, but there are other all-in-one phones to consider. There’s the RIMM Curve, the Motorola Q9, and the Helio Queen. They aren’t truly clones, but they offer more traditional functionality. I’m sure we’ll be hearing about more companies jumping on the bandwagon.”

From TwoDogMom: “Re: Mediware. What does anyone out there know about the Mediware vs IHC lawsuit?” They’re suing each other, it appears. Intermountain bought Mediware’s blood blank system in 2004 with a three-year support agreement ending June 30, 2007, with rights reverting back to Mediware on expiration. Mediware told Intermountain it wouldn’t renew the agreement, so Intermountain is arguing it should be able to keep using the system. Intermountain had already sued Mediware in April for breach of contract. An unhappy, high-profile customer is just the icing Mediware’s cake needs.

Rumor: physician practice vendor AcerMED has abruptly ceased operations.

Jon Philips of Healthcare Growth Partners asked me to clarify that the number of deals I quoted the other day was of the principals, not the company itself. They’re doing great, of course, but he didn’t want anyone to think they were trying to mislead.

iSoft couldn’t even get a date a few weeks ago, now it has two marriage proposals: Germany’s CompuGroup trumps IBA’s bid with a $329 million cash offer of its own, a 19% premium to IBA’s offer that iSoft’s management is urging shareholders to accept. Part of their offer: CompuGroup will sell off the NPfIT business to CSC and both companies will own the Lorenzo product line.

Mediware shuts down its OR business line and fires 20 employees under the new COO. They announce their focus on so-called closed loop systems. Well, good luck with that. That’s bad news for GE: Mediware’s exit frees up the dead-last KLAS surgery spot for Centricity Perioperative. Doh!

I didn’t hear first-hand about the scheduled Misys bloodletting on Friday. Did it happen? Maybe you’ll be offered another position, like this one: Misys needs a PR specialist. Desperately, some might say. Guess the layoffs freed up some salary dollars.

CPSI announces Q2 results: revenue down 3.5%, EPS $0.31 vs. $0.38, falling short of expectations.

Emergin sent over their latest newsletter. It includes an Emory neuroscience CCU case study on alarm integration.

My editorial this week in Inside Healthcare Computing: “‘Best’, ‘Most Wired’, and Other Hospital Surveys: Good for Selling Stuff and Not Much Else.” I won’t spoil the suspense by revealing my opinion.

Speaking of the Most Wired BS, even H&HN had to punt when it came to the obvious: “The analysis shows an association between IT adoption and key quality measures, but association is not causality.” That wasn’t on the cover, of course. Those paying for the survey: the magazine, Accenture, AHA, CHIME, and McKesson. All but AHA have a vested interested in encouraging the “buy more stuff” bandwagon. Just another meaningless award given to customers by their vendors.

eScription announces the release of a new version of its speech recognition software, AutoScript. They casually mention in the second paragraph that it’s twice as fast at processing dictation as the prior version. I’m thinking there was little debate about whether that justified a new version number.

El Camino Hospital creates a CMIO position and recruites Eric Pifer from the University of Pennsylvania Health System.

Charles Wagner leaves IBM/Healthlink to become SVP of professional services for Eclipsys.

Discuss today’s news here. Lots of you have registered for HIStalk Discussion, so why not use it? I rented the hall and brought the band, but I can’t make you dance.

E-mail me. But only if you want to.

News 7/20/07

From Joey Cheesesteak: “Re: CHOP. Regarding your 7/13 item: their outage was due to loss of power in the Primary Data Center. Operations did not shift to the remote data center because the SAN was not configured to cooperate. This outage was not an Epic problem (not to say that the Epic implementation is going smoothly). Also, three of the four CIO direct reports have left recently. One moved to a different department within the hospital and the other two have found other employment. The CIO will hit a five-year anniversary in January 2008. What’s the average tenure of a CIO after an Epic implementation?”

From Dr. Mark Bellows: “Re: Cerner. Look for Cerner and Mayo to make a huge ‘Kaiser-like’ announcement soon. Also, Clarian is looking for an out in their Cerner contract (it’s not looking good AT ALL over there …) I have always enjoyed reading your blog and have laughed at times when rumors are stated about Cerner well before they have made them public. You and your readers have been on the nose 90% of the time with most things.” Unverified, but, from what seems to be a good source.

From Lance Le Gault: “Re: Cerner. The funny talk around here is that Cerner would take any temp, put ’em in a suit, and say, ‘We are sending you a VP.’ Cerner losing 20 of those VPs means very little.”

From Nancy Greenly: “Re: Cerner. It’s obvious that Neal is putting the company up for sale with all the cost-cutting and moving everything to centrally-based KC for an easier transition. Sales are slow, but the stock price keeps going up. The Indian outsourcing is in place and a European presence makes them a ‘global’ company. I’d bet a non-current player picks them up within three years.”

From Sean Murphy: “Re: non-competes. That was nice of Mike Etue to ride out his non-compete from the other folks in Malvern on someone else’s dime and then jump ship a few months after it expired. Wow, that Epic document is brutal. Too bad the federal government says that you can’t prevent someone from earning a living. It would never stand up a real court. Do we have any legal readers that could lend an opinion of the language?” I asked a non-compete attorney I ran across to chime in, but he hasn’t replied so far. The bottom line is that non-competes are almost always unenforceable, but unless you take the company to court to obtain a summary judgment (kind of like a class action suit), each employee has to spend their own money fighting retainer lawyers in court. That’s assuming you can even get a job offer, that is. You’d be proven right, but not before you went broke. The threat alone is enough to tilt the landscape to the company’s side.

If you’ve had problems accessing HIStalk recently, my apologies. It’s hard to believe, but even after my big upgrade in May, the site’s server red-lined on memory this week and killed the Apache service several times (that causes “Page Not Found” errors). Inga tells me some of the notification e-mails may not have gone out either, although they looked OK on the server. I thought the May upgrade was overkill that would guarantee enough horsepower for years. Well, two months later, a punishing number of HIStalk hits maxed it out again, so I’ve doubled the memory and had extra bandwidth allocated. I’m not complaining – it’s a great problem to have.

The LA Times writes up Prem Reddy MD, a cardiologist turned for-profit hospital entrepreneur who claims to be worth $300 million. He tools around in a $1.4 million helicopter and has a 15,000 square foot mansion with gold-plated toilets formerly owned by Roy Rogers. How he does it: he buys struggling community hospitals, cancels their insurance contracts, dumps services that don’t have a big profit, (allegedly) turns away patients without insurance, and (allegedly) lets quality slip. He does that Bob Dole thing in referring to himself in the worshipful third person: “There isn’t anybody like Prem Reddy that can face so many challenges in the medical field.” I mentioned him two years ago, when his brother, a CEO of one of his hospitals, fired the CNO and HR director after they claimed he (Prem) was drinking while working in the ED and using a triage system based on insurance coverage.

Reminder: use the sign-up to your right to get e-mail updates when I write something new. I notice that list is up to 527 subscribers in a very short time, plus the 1,843 on the “old” e-mail list.

Jason Baker has joined Healthcare Growth Partners as Managing Director. He comes from Cerner, where he was head of corporate development (high-level strategic stuff like investments and acquisitions, not programming-type development.) I didn’t realize that Healthcare Growth Partners has been involved with over 100 deals worth over $1.5 billion in just two years. Nice.

Some Misys folks have been asking about severance (wonder why?) Typical for the company is supposedly one week per year of service. They also don’t go after non-competes too hard, rumor has it, which is to their credit when folks leave under something other than their own volition.

Off-hours teleradiology provider NightHawk Radiology buys Midwest Physician Services, a radiology business process company, and another off-hours teleradiology company. Total price: $62.5 million cash. They’re creating NightHawk Business Services, which will offer services for revenue cycle, HR, transcription, and other back-office stuff for radiology practices.

Someone who should know tells me that Cerner is indeed slimming down implementation teams as Bedrock gets built out, running implementations from the KC Accelerated Solutions Center. Apparently it really does work and they won’t need virtual implementation staff any more. Another tidbit: supposedly Paul Black left because he didn’t like how the customer-facing employees are being treated (accessibility to client, work-life balance, etc.). Unverified, of course.

Comanche County Memorial Hospital (OK) signs a $13 million deal with McKesson for Horizon Clinicals.

The Most Wired list is out. I don’t care, so I won’t mention it or the winners. It’s meaningless, was created by vendors solely to encourage the “buy more IT” bandwagon effect, and keeps going only because the “winners” pretend it shows how excellent they are. I’ve worked for winners and all those I spoke to laughed about it behind closed doors, but it’s better to win than not, they always figured (harmless CIO resume expansion and hospital chest-puffing).

Bizarre lawsuit: a nurse changing clothes in a Kentucky hospital’s anesthesia office finds a hidden camera in the ceiling tiles. She says the hospital then tried to throw her and her surgeon husband off the property for trashing the camera, also threatening to revoke their privileges. Another nurse was fired. The hospital says the camera was there to monitor controlled substances that are kept in the office and that the women should have used unmonitored areas set aside for changing. The nurses are suing for voyeurism.

News, rumors, changing room video: e-mail me.

News 7/18/07

From Inside Outsider: “Re: heart images on iPhone. TPD will be happy to see this.” Web-based image management company Heart Imaging Technologies is offering iPhone access to their browser-based imaging application. Sample images here. Looks cool.

From Malvern: “Re: Misys. Mike Etue is the new Senior VP of Sales for Misys. Mike Etue resigned five days before the Eclipsys ‘announcement'”. Deady convinced Mike to hold off for a week, then claimed he fired Mike.”

From Hatchet Guy: “Re: Cerner and Paul Black. Now Mike Valentine has nobody to blame. Pay close to the number of employees in KC. Compare the number they announce on the earnings call to the annual report. It is shrinking fast. Instead of severance, negative press, and stock reaction, they told a large group of implementation folks they have to move to or stay in KC, knowing that will cause turnover. That’s the plan – that Bedrock will install Cerner’s app without implementation resources needed. In the last 45 days, more than 20 VPs have left the company. One more thing to watch in the coming days in KC: the FDA.” Unverified, as I always add, so if you can verify or contradict, e-mail me.

From Wayne Frake: “Re: Lawson. Is Lawson looking for something new to buy and/or merge with? I saw an email from Debes to Messing. Messing’s response was no interest.”

Epic Escapee sent me a copy of the non-compete agreement he or she signed a few years back. It is quite broad, probably not enforcable legally. Some terms: (a) you will “neither accept nor conduct any other business or professional activities while employed by Epic”; (b) for two years after leaving, you can’t contact any Epic customer in a sales capacity; (c) you can’t have anything to do with companies it has defined as competitors: Allscripts, Cerner, Eclipsys, GE Medical, Healthvision, IDX, McKesson, Misys, NextGen, Per Se, SMS, or WebMD for two years after you leave; (d) you can’t join a business or start your own during that two years if it competes with Epic; (e) for two years, you won’t try to convince any Epic employee to quit; (e) for three years after employment or six months after leaving, whichever comes first, you won’t work for any Epic customer or prospect, except in a role not involving software. It’s pretty smothering, but on the other hand, you don’t have to sign it. You won’t get the job, but maybe that’s best if you’re thinking about your post-Epic career.

From Roscoe Dexter: “Re: Epic. I’m waiting out my non-compete. I’ve heard a rumor that Epic once called customers who were courting a recently fired implementer to tell them not to hire them. I’ve studied non-competes and I know they’re essentially unenforceable, but I’ve heard of Epic blacklisting people from Epic certification who circumvented the clauses. I’ll call these rumors since I didn’t hear them directly from the people involved.”

By the way, if you’ve ever wanted to send me something anonymously like Epic Escapee did, remember that the new Rumor Report form (link to your right) allows attachments. I keep forgetting to mention that.

For you Misys folks, especially those in sales, reliable sources tell me that major changes will happen late this week. The new guard is taking over and much of the old one will be dismissed, including many dozen who will be offered severance to leave quietly. Nearly that many will be marched out, I’m told. I have names of a few high-ranking employees who will be affected (good and bad), but I don’t see any point in plastering them here since it’s unavoidable at this point. Condolences to those about to be negatively affected and tepid congratulations to those who’ll be sliding into the still-warm chairs, at least temporarily.

McKesson will buy Birmingham-based patient throughput software vendor Awarix Inc. St. Vincent’s of Birmingham was their development partner, as I recall, and much of the management team came from Emageon.

Speaking of McKesson, they’ve got offices in good places, according to Money‘s new Best Places to Live list. #2: Louisville, CO. #3: Lake Mary, FL.

Since this isn’t an ad-packed magazine, I don’t have to waste your time writing unimportant stuff just to separate those ads. You are now current on the industry. Congratulations and see you next time. If you are so moved, e-mail me. How’s your summer going?

Monday Morning Update 7/16/07

From Tommy Pischedda: “Re: Epic’s non-compete. Didn’t Carl Dvorak give an interview awhile back in Inside Healthcare Computing saying that those didn’t exist? They’re actually pretty nasty about it. Even if an employee is moving because of a spousal employment change, the clause is still enforced. There are some customers who don’t have that in their contracts. Epic has still gone after ex-employees trying to get jobs there.” He told the newsletter the agreement is basic, of limited timeframe, and involves only a few direct competitors (more specifics are in their October 16, 2006 issue).

From Mick Shrimpton: “Re: Epic. I heard that there is a lawyer in Madison that specifically works with ex-Epic employees and HR issues.” I’d enjoy speaking to that person if anyone has contact info. I also heard from a former Epic employee who broke the chains in going to work for a customer and offers help to those who need it, so I’ll forward your contact info to him if you like.

From John “Stumpy” Pepys: “Re: Illinois nurse staffing bill. I haven’t heard any word about Illinois Senate Bill 0867, Nurse Staffing by Patient Acuity. Any thoughts in the industry about this?” I’m not a fan of the article itself since it clearly favors the nurse’s union that supported the bill and refers to nurses as “her” (like male nurses don’t already have enough ‘splainin to do). Its sponsors were Democrats, of course. It requires hospitals to use a patient acuity tool, an idea that’s come and gone at least ten times since the early 1980s. I’m not a fan of prescriptive lawmaking where the government gets involved with how businesses operate, but the sad thing is that hospitals were so lax on staffing that it came to this.

From Grapevine: “Re: Initiate Systems. Mark Battaglia, SVP of worldwide business development, is no longer with the company. Initiate is pursuing IPO and one has to wonder why a top executive would exit the company at this time.” Looks like he was nuked off their Web page sometime after May 14.

From The PACS Designer: “Re: best hospitals. TPD closely follows the annual release of America’s Best Hospitals by US News and World Report, which happened today.” The honor roll: Hopkins, Mayo, UCLA, Cleveland Clinic, MGH, NY Presbyterian, Duke, UCSF, Barnes-Jewish, and Brigham and Women’s, University of Washington, HUP, UPMC, University of Michigan, Stanford, Yale-New Havel, Cedars-Sinai, and University of Chicago. Hey, how come the Vandy informatics rock stars didn’t propel VUMC onto the A-list? Kidding. Just popped into my head because we were talking about it earlier.

From Ronnie Pudding: “Re: Andy Corbin. My theory as to why he left Sage was that he’s being indicted. After all, the Forbes article was an embarrassment to the Justice Department. Anyway, he wasn’t much of a leader and surrounded himself with people who don’t know the industry and who don’t listen to their subordinates who do. He also pushed the selling of Emdeon to Sage, so maybe Sage is feeling ripped off at this point.”

From Angela: “Re: Verisign. I read yesterday where the CFO of Verisign resigned. This and the recent departure of their CEO and the failed investment in Healthvision would lead one to believe that they have changed their minds regarding the health care space.” The CFO bailed after yet another options-dating scandal that will cost the company $160 million and force it to re-state earnings. The CEO high-tailed it in May. You have to expect them to retrench back to core business, which healthcare isn’t. How that will affect Healthvision is anyone’s guess.

From Viv Savage: “Re: Misys. Mike Etue is the new Senior VP of Sales for Misys.” Well, if so, then I’ll pat myself on the back for near-psychic ability for taking that wild guess strictly on the basis of timing. If it’s true, that would pretty much dismiss the implied claim by Eclipsys that they fired him, unless he was darned fast at lining up a new gig.

I’d like to introduce you to The White Stone Group, Inc. of Knoxville, TN, an HIStalk Platinum Sponsor. They’ve been around since 1991, with over 400 hospital customers and three major products: TRACE (revenue cycle communication tracking, like precertification, to improve denials management); OptiVox (handoff reporting for shift changes and transfers, of obvious Joint Commission importance); and VoiCentral (automation of incoming telephone calls with information templates for pre-registration, scheduling, etc.) They offer lots of case studies and articles on their site. It’s pretty cool that they’ve found some unusual yet much-needed healthcare IT areas of focus. I always Google companies before I take them on as sponsors and I ran across this interesting article about White Stone’s struggle with providing employee health insurance. Back in 2004, the wife of one of the company’s 70 employees gave birth to quintuplets, racking up a $2 million hospital bill that increased the company’s premiums by $90,000 per year. “For a company with $8 million in revenue, that extra $90,000 was going to hurt. ‘Willem said he was sorry,’ says [CEO Guille] Cruze, who tried to reassure his employee. ‘I told him that it was okay, that we would live and die as a team.'” Welcome and thanks to The White Stone Group for supporting HIStalk.

A regular reader chimes in with some Mac comments that make me want to give it a run. “As a non-zealot who’s used both a Mac and a PC since 1992 (as well as a UNIX machine), I recommend an iMac. OS X is elegant, works very well, learning curve not high if you do Windows, and an iMac is an elegant piece of hardware, besides, that is quite a change from the usual ugly metal box. Kind of like a Camaro Z28/SS being the opposite of your neighbor’s minivan. And now that Macs use Intel inside, you can have your cake and eat it too.” They look cool, but I was most intrigued by the Mac mini. I don’t know anything at all about Apple (I lost interest 100 or so years ago with the Lisa flop) and their commercials seem to aim to a different demographic than mine, but maybe I’m missing out.

Cerner COO Paul Black will retire on August 31, the company announced Friday. Sorry for the redundancy for you regular readers: I said this would happen on February 28 (courtesy of Private Ryan), May 7 (PezMan), and again on June 27 (Hatchet Guy). Given their production cycles, the trade journals will have this scoop by Labor Day or so (if they run it at all, since it isn’t advertiser-friendly), so that means you read it here six months early. The COO position, which Paul assumed in February 2005, won’t be filled. Isn’t 48 a bit young for retirement?

Eclipsys announces KLAS results indicating that it has the highest nurse satisfaction rating of fully rated vendors and the highest positive commentary percentage. That last stat is beginning to annoy me: how valid is a comparison of percentages of positive commentary when all comments are voluntary, unattributed, and of wildly dissimilar relevance and importance? And, in the interest of fairness, I note that the “fully rated vendors” part was tacked on by Eclipsys because Epic annihilated them in the nurse satisfaction score, but with too few respondents to meet KLAS’s validity standard. They were also fifth in the eight-horse race for adoption scores. Still, I’d place it above most of what’s out there, with the very bright spot being Knowledge-Based Charting. Had they rolled out a pharmacy package earlier to gear up for medication dispensing and bedside barcoding, they’d be sitting pretty right now.

Sentillion announces nine new Q2 customers. I like their tagline (assuming it’s true): “The company that created healthcare single sign-on.”

The president of a corporation that ran nine San Francisco-area nursing homes gets 30 months in jail for failing to pay $10 million in payroll taxes. He also owned Skilled Logic Systems, a software company (without a web site, so I’m guessing tax dodge.) His genius attorney tried to keep him out of jail by citing Scooter Libby’s get out of jail free card. It didn’t work. “Easterday ran his business on the government’s tax dollars, buying a six-bedroom home now valued at $2 million, sending his children to private colleges, funding his mother’s monthly pension and buying a sailboat and jet skis, Assistant U.S Attorney Jay Weill wrote in a sentencing memorandum. ‘He used the withheld payroll taxes like an ATM machine for working capital for his business activities,’ Weill wrote.” I made up some amusing lyrics, sung to the tune of Yesterday, but that kind of humor is beneath me.

Modern Healthcare had a pretty good editorial going called Scrap the National IT Plan, at least until toward the end when it advocated smart cards for data sharing. Other than that one ill-conceived paragraph, I liked it.

University of Rochester claims that labor savings from reduced chart pulls gave them a 16-month payback on TouchWorks.

Bye. E-mail me.

Sage Software Healthcare CEO Andrew Corbin Resigns

Andrew Corbin, president and CEO of Sage Software Healthcare, has resigned, the company announced this morning. Sage North America CEO Ron Verni will assume his responsibilities until a successor is hired.

News 7/13/07

From TalkOfTheTown: “Re: Allscripts. Executive changes in the small business unit of Allscripts (A4). VP of sales is leaving there is some indication that the president of the business unit is leaving as well.” Unconfirmed.

From Bill Blazejowski: “Re: Eclipsys. Much as Eclipsys would like you to believe they let Mike Etue go, he in fact resigned and will be joining another vendor next week. After all, Jay Deady has to pretend to do something to justify his $2.3M 2006 paycheck (see proxy). Demonstrate action by reorganizing over and over again, which Andy seems to like – progress through attrition and bringing in sycophants to make you feel good.” I wondered if Etue might end up at Misys, since the rumored source of their new sales VP was either Kodak or Eclipsys. Coincidental timing, maybe, but jobs don’t open up every day at his level. I hear from reliable sources that Misys named the new VP Tuesday, but I don’t have a name yet.

From Scot Silverstein: “Re: ‘I only wish those similar types might go back to being physicians full time and stay out of informatics, where they DON’T belong.’ I agree with that. Informaticists need to be intermediaries between different healthcare factions, not primadonnas. Your audience might like a presentation I gave to ARMA last year on this issue.” Most of the informatics people I know, docs included, are pretty down to earth. From reader comments, Vandy’s aren’t, apparently, despite the tiny domain they’re lording over. I guess it’s like Star Trek conventioneers feeling smug when one of their ilk doesn’t know which actor was missing a middle finger.

From Edward Koogle: “Re: Epic employees. What do you know about ways around hiring Epic employees? Does the whole industry really pander to Judy so much that they let her get away with harboring and controlling all the Epic talent in the marketplace? We aren’t an Epic partner and we want to hire a current Epic employee, but is there any hope of getting a client to contract them from us? All the clients seem to be willing to stay in the corner that Judy puts them in without a word of dissent. It’s un-American to stand by passively while the spirit of free competition is quashed!” I’ll allow those who are more knowledgable of that particular situation to respond.

From In the Know: “Re: Bronx Lebanon. Eclipsys and Medsphere are being dragged along to keep Cerner honest on price. The CIO drank the Kansas City Koolaid. It’s Cerner’s deal to lose … and GE’s, too.”

From Dewey Oxberger: “Re: sponsors. You’re getting a lot of sponsors. Are you and Inga doing some kind of marketing blitz?” No. All we do is reply to e-mails when someone asks for information about sponsoring. Nothing’s changed since I started HIStalk in 2003, other than I’ve got a ton of readers and that gets the attention of sponsors (as does the presence of the lovely Inga as my Queen). I’m still the same irascible, annoying, cynical blowhard that I’ve always been, although I’m hoping to mellow into a lovable curmudgeon at some point. I sure do appreciate the support, however. I’ve worked harder on HIStalk than anything else in my undistinguished career, so it’s nice to get some recognition (which is hard to come by when you’re sitting alone in a room writing anonymously).

From Francis Soyer: “Re: Sentillion. Someone told me that Sentillion laid off 30% of the company a few weeks ago, although they tried to take care of those affected. The person said that competition from Carefx, Improvada, and the big vendors is cutting into sales.” Unconfirmed, but I’m sure someone will update me.

From Bob Saccamano: “Re: CHOP. I just heard from a frustrated physician at Children’s Hospital of Philadelphia that Epic has been down in the clinics for two and a half days (since Monday) and they’re back to paper. No idea if it’s Epic or IT issues, would love to know if any HISTalk readers have more info. Keep up the great work, it’s much appreciated. Also, love HISTalk2 and the weekly email summary concept and can’t wait to sign-up.” Thanks, Bob, Anyone got the scoop on CHOP? I heard the same thing from another source. And thanks for the HIStalk2 kudos – having a new design and platform is like wearing a shiny new pair of tennis shoes. The weekly e-mail update is imminent – my graphics guy is working on a logo and fine-tuning my crude HTML e-mail format as we speak. HIStalk is great for those of us knee-deep in the industry every day who know all the companies and people. The weekly update will be more accessible to executives, non-IT provider-siders, and those who just want a no-nonsense quick read with background information and opinion (printing it off will be a one-click option – I know you travelers love that).

Some thoughts on Allscripts stock, which Forbes called one of the most dangerous. Price-to-book ratio and return on invested capital were mentioned, which aren’t that meaningful for acquisition-minded tech companies. Old news, in other words, and presumably built into the stock price. Software companies don’t have many assets on the balance sheet (or so you hope, since they probably wouldn’t really drive revenue all that much anyway). Cash flow is more important than paper writeoffs, although Allscripts needs to improve cash flow since the share price is pretty much NPV – a price reflecting future cash flows. The bottom line: these measures don’t move share prices up or down. For growing companies, it’s all about shareholder expectations and growth. Supply and demand of shares, in other words, to use my favorite economic principle. Pull the back issues of Forbes and see how often they’ve hit the nail on the head before following their advice mindlessly.

A reader tried to explain the Apple thing to me. Summary: (a) Windows is a cheap imitation of Apple’s good ideas; (b) OS X is far more secure than Windows; (c) reboots and OS reinstalls are nearly unheard of on Macs and reboots are nearly instantaneous compared to Windows; and (d) DLL Hell is a Windows-only disaster. He mentioned that journalists given Apples to try rarely went back to Windows afterward. Since I’m not a Windows slave anyway, I’d try a Mac if Apple gave me a freebie (especially since the reader mentioned that Macs now run Windows apps at full speed and can also dual-boot). My bias against Apple is because of whiners form my previous IDN: the half-dozen or so marketing hippies and pain-in-the-ass docs who hit you over the head with their Apple evangelizing every time their stuff didn’t work on our network. Those self-proclaimed rebels mindlessly followed every oppressive hospital rule except the “PCs only” one, using that pitifully insignificant rebellion as a proclamation of their individual freedom over corporate control. Sounds good until you can’t get on the network and no one in IT knows squat about Apple.

Please welcome to our happy little band MedMatica Consulting Associates, of Chester Springs, PA. They just signed on as a Platinum Sponsor of HIStalk and offer IT strategic planning, application evaluation and selection, operational improvement assistance, HIPAA, contract negotiation, implementation of most major systems (Siemens, Epic, Cerner, Eclipsys, Lawson, etc.), and technology consulting (database, e-commerce, COBOL, and SAS). Pay attention to their value proposition – highly skilled consultants deployed regionally with a very competitive fee structure and flexibility for the client to structure whatever services meet their needs. Check out their client testimonials, with real names of hospitals and people, several of whom I know. MedMatica has been named as the 12th fastest growing company in the Philly area, so they must be doing something right. Click over, take a look, and tell Bruce Generotti or the folks there that you appreciate their support of HIStalk and its readers. They could have thrown away ad dollars running glossy pages in free magazines that no one reads, but instead they chose to support an independent blog and its “think for yourself” readers, which Inga and I truly appreciate.

I didn’t hear anything further on the rumor that Meditech is buying the rest of LSS. A couple of readers asked. Sorry, I don’t know (yet).

The former Surgeon General says that the Bush administration compromised public health by stifling him on politically charged issues like contraception, global health, and secondhand smoke. He was also told to mention President Bush three times per page of his speeches, ignore Special Olympics because the Kennedys are involved in it, and make partisan fundraising appearances.

A House bill would create independent health record trusts, giving patients ownership of their electronic records and allowing them to assign trusted parties to manage them.

Billie Waldo is named chief nursing officer of McKesson.

A little problem in HMS’s billing system: each patient’s bill was the cumulative total of all bills that printed before it. The highest for a Northern Cochise Community Hospital (AZ) patient: $49 million. The hospital said HMS told them they were busy that day and didn’t notice. Funny quotes from hospital staff, among them, “If enough people pay them, we’ll keep the nursing home open longer!” Hey, it happens, might as well laugh and move on.

Sanford Health (SD) chooses EnovateIT for mobile and arm-mounted devices for their EMR rollout.

MedAssets keeps buying: they acquire revenue cycle software vendor MD-X Solutions.

Blue Shield of California announces $11.3 million in nonprofit grants, including rural IT and telemedicine.

Two Sioux Falls (SD) health systems will use Meditech.

Big news: the Dossia PHR project, whose corporate members include Wal-Mart and Intel, is falling apart. Dossia has filed a restraining order against Omnimedix Institute, a 13-employee nonprofit headed up by J.D. Kleinke. He says Dossia did it to prevent an Omnimedix suit of its own. Omnimedix wanted paid, but Dossia says it hadn’t met deliverables. Omnimedix was supposedly getting $15 million to build the PHR system, which is behind schedule. Dossia is considering other vendors. Fine reporting by InformationWeek. I’m sure our intrepid HIT rags will catch up eventually.

Memorial Hospital of Rhode Island will partner with ICW America to create a PHR based on that company’s existing LifeSensor PHR.

GE won’t buy Abbott’s diagnostic testing business for $8 billion after all.

Baylor complains that one of its hospitals was declared worse than average in heart attack deaths, saying they missed the cut by just one patient. CMS said it was one of the worst in the country. As usual, the hospital howls that its widely recognized excellence drives dying patients to seek them out, skewing their numbers. CMS wasn’t impressed: “There are other hospitals who said the same thing.” Among them: fellow cross-town bottom feeder Huguley Health System. Baylor trotted out a list of its own wonderfulness, including the fact that its $240 million EMR system will reduce post-surgical deaths, ignoring the fact that hospitals that beat the pants off it have no such system.

According to this newspaper, HIPAA stands for “Health Insurance Probability and Accounting Act”. That’s 60% right for you “glass half full” types.

If you have anything important or scandalous to say, e-mail me. I’d do it for you.

News 7/11/07

From Cernerguy: “Re: RemedyMD. RemedyMD acquires EZHealthcare Inc.” Good catch. I interviewed RemedyMD CEO Gary Kennedy just a few weeks ago and he didn’t drop any acquisition hints, although as I re-read what he had to say, I really like his “make some bets” philosophy on building a company. Back to our regularly scheduled programming: EZHealthcare Inc., a Salt Lake neighbor of RemedyMD, does revenue cycle and practice management automation for over 1900 medical practices.

Art Vandelay left a question for Cindy Dullea about her interview: “Are you saying AHLTA (CHCS II) is behind the commercial products? If so, why?” Cindy was gracious enough to volunteer an answer when she noticed the question: “ALTA is a good core HIS product and works well in the military health system. There are many commercial clinical products that I have personally worked with that have a high degree of sophistication. The most important element is how well a product feeds the EMR so we can track care across the continuum. This will be key to case managing our service men and women.”

From TheRunner: “Re: GE. GE will lose yet another Lastword client to Cerner or Eclipsys. Bronx Lebanon (Bronx, NY) will make a decision shortly.”

From Anon: “Re: Vandy. Interesting someone comments about Vandy. I’ve never  had much love for their arrogant ways from the informatic blokes. I think he just moved on, or retired from Vandy, but that [name expunged by Mr. HIStalk, fearing litigation] was a masterful SOB, with his nose so damn high I about involuntary puked every time I had to talk with him. I only wish those similar types might go back to being physicians full time and stay out of informatics, where they DON’T belong. On a non-pandering note, when will we realized healthcare has pandered to the physician, when it should have been to the patient? Now we’ll spend a lifetime fixing that.” Now this is my kind of e-mail: leading off with a scathing personal attack, then jumping right in with a profound comment on the physician-centric healthcare model. (Obviously, someone sees how we work here.) If the model is physician-centric in a negative way, some would say we’re undoing it gradually. It sure seems that way to me, given that I started in a day where you just about had to kiss the ring of every quack doctor in the house, many of them with absolutely horrid medical training obtained from a handful of specific countries that treated them as an exportable fungible good. I tangled with quite a few of them, trying to at least slow down their rate of incompetence. I lost every time (I worked for a for-profit hospital, so even bad medicine paid well as long as you practiced a lot of it.) I sat on the hospital’s Death Committee for awhile and that was quite a whitewash.

From Ex-Sunquester: “Re: Misys landlord lawsuit. Did you know that the owner of Any Travel Inc. is Sid Golblatt’s daughter? BTW, the buildings were in pretty bad shape when we moved in in 1994.” Several readers tipped me off. Any Travel is the company that owns the old Sunquest buildings in Tucson and is now suing Misys for $1 million for leaving them in bad shape. According to Arizona public records, Any Travel Inc.’s president is Jodi B. Gottlieb, one of Sunquest founder Sidney Goldblatt’s three children. Other corporate officers are the usual interlocking directors from Pittsburgh that Sid used for all his companies (he sold Sunquest to Misys in 2001 for $400 million in cash, a 63% premium to the share price.) So, in essence, she’s suing her father’s former company since they were the tenant for much of the time, although claiming the damage was done when Misys moved out.

From I Heart Misys: “Re: Misys landlord suit. First, it is likely no coindence that the suit is filed two days before MHSUG. Nothing like giving the Misys clients one more thing to worry about! Second, when Misys was Sunquest, they used Any Travel as its travel agency and landlord. Any Travel was of course owned by Jodi Goldblatt, Dr. Godlblatt’s daughter. In essence, it was a shell company. The buildings were leased to Sunquest by a Goldblatt. When Misys came along, they took over the lease. Who in their right minds signs a lease that really gives the landlord (Any Travel) no obligations whatsoever? Cracks me up for sure!”

From Rumour: “Re: Misys. It is true that Misys is getting reorganized. They are getting lean and more efficient. Payerpath is getting functionally realigned with the Physician Systems. The hospital division will be getting realigned in the second phase.”

From Maggie DuBois: “Re: Misys. We signed up for Payerpath and were surprised to find the training being outsourced. But, to be frank, the experience with the trainer was just great. She was from India. She was extremely polite, very Knowledgeable and highly professional.”

From The Great Leslie Gallant III: “Re: Eclipsys sales re-org. Here’s the e-mail from Jay Deady.” I won’t run it all, but here are a few high points (no guarantee that it’s authentic, but it appears so, and thanks for sending it over): Steve Schroeder and John Sage are promoted to Senior Regional VP with expanded Mid-America new business and New England client business. SVP Kristin Lenahan gets South existing business, Dustin Whisenhunt goes back to new business in the South, Bill Shuman adds midwest sales. Jay Colfer and Mike Smeraski split the country as sales SVPs. Mike Etue and Tom Dunn get the axe. Steve Carper goes full-time to international business and Greg Lusch gets Canada. And speaking of Eclipsys, they’re on World Business Review, some kind of infomercial hosted by 15-minutes-over Norman Schwarzkopf.

From The PACS Designer: “Re: convergence. With the release of the iPhone, the trend toward convergence only gets more news stories about improved connectivity. One thing healthcare can use is more connectivity options to enhance the chances for improved patient care. With many new software platforms being debuted, you would think that healthcare applications would also benefit from the increase in convergence solutions. Only time will tell if the increased convergence will benefit healthcare institutions.” Is anyone really following the iPhone as anything other than a wildly overhyped and overpriced consumer toy fad? I admit that I don’t get the whole Apple thing, so I need someone who does to explain it, especially when it comes to business computing. I’m a beige box kind of guy.

From Hezekia Sturdy: “Re: Sage. Interesting article about Andy Corbin, CEO of Sage Health.” The article rips the former executives of BISYS, which paid $25 million to make SEC charges of a $179 million income overstatement go away (plus another $66.5 million to settle a shareholder class action suit.) The CFO running the books at the time the financial fiction was being written: Sage Health’s Corbin. What the article finds amusing is that the former CEO of BISYS is now a part-time accounting professor and an anti-fraud consultant. Both men got to keep the money and neither were charged criminally, although SEC says it may not be finished with them yet.

From Henry Goodbody: “Re: HIMSS junket. According to this letter, a bunch of specially selected HIMSS members should take their spouses on a trip to India since HIMSS is an international organization. I can’t imagine who has time for this, let alone the $6,500 per person to travel. I shudder to think someone might try to get their employer to pay for it (or their time off).” According to the invitation letter’s co-signers Victoria Bradley and John Wade, HIMSS is inviting “only select members” and a spouse or guest, leaving March 30, 2008. I can’t get too worked up about it since everybody’s paying their own way. If I had the money and time off, I’m not sure I’d pick a trip to India with a bunch of HIMSS people. Do you really need to see the outsourcers eye to eye to understand them? How about we have a Webinar, with each attendee sitting in from his or her local Indian buffet restaurant? Since I like Indian food very much and $7.95 is more in my price range, I’d be up for it.

Discuss today’s news here.

Speaking of those go-go, pre-dot-bomb days: how about this quote from then-Misys chairman Kevin Lomax on the Sunquest acquisition in 2001: “The acquisition of Sunquest consolidates Misys’ position as a leading provider of healthcare information systems, extending Misys’ presence into the acute-care market making it well placed to exploit the expected growth in clinical systems.” Well, one part was right: there was growth in clinical systems. The rest wasn’t: Misys watched the action from the cheap seats. The Sunquest acquisition was announced the same day that Misys PLC shut down two dot-bomb businesses of its own: theformula.com and Screentrade. Hmm: suppose they knew they were losing their dot-com shirts and figured healthcare was the safer way to grow? The timing makes me wonder.

Sorry if you got double e-mail updates this morning. The hosting company had a little problem (with Exim, for you server software geeks). That reminds me: if you’re getting one update from Blog City and another from Mr. HIStalk, you can click the unsubscribe link to that first one (the Blog City one.) The one from Mr. HIStalk is the one I’m considering to be primary, so I wouldn’t un-sub that one. On the other hand, feel free to click both and read everything twice if you’re so inclined. And if that didn’t scare you off, sign up to your right to get an alert when I write something new. I might say something about you, after all, so you’d want to know first.

I’m very pleased to introduce to you HIStalk’s newest Platinum Sponsor, Pring|Pierce Executive Search of Hampstead, NH. Managing Partners Troy Frank and Mike Delisle wanted to support HIStalk and reach out to its readership, for which I greatly appreciate. These guys have over 300 successful HIT executive searches under their belts. They place sales and marketing VPs, product management executives, national sales team development, and other executive positions for early-stage, high-growth, and mature companies in our industry. They’ve developed a very cool ad over to your left. I’ve sat here and watched it run through several times just because it’s dramatic. I like to think of Troy and Mike up there in that lighthouse turned recruiting office, working tirelessly to reach out nationally to the industry’s best and brightest talent like a shining beacon … well, clearly the dramatic ad got me carried away. Anyway, thanks, guys, glad to have you on board.

It’s really hard to figure out what Forbes thinks of the stock of Allscripts in their July’s Most Dangerous Small-Caps story. Help me read between the lines: “A complete mess, in our opinion. MDRX holds the distinction of the stock on our most dangerous stocks list with the most negative price-to-economic-book value ratio at a mind boggling -151.6%. This bottom-quartile ranking in ROIC and negative free cash flow yield only make this stock more of a dog.” Well, if they were all that smart, they wouldn’t be giving away swell stock tips in magazines. Do your own homework.

Inga was tittering at this story: President Bush performs an aortic aneurysm repair (simulated) at Cleveland Clinic. Since all the witty comments I thought of were sure to offend one group or another, I’ll let you fill in the blanks: “The best thing about having President Bush perform your brain surgery is …” Feel free to e-mail me your best line and I’ll run a few of them here (but keep it respectful, please: politics aside, he is the President).

Guess outgoing NPfIT head Richard Granger won’t be asked to join the happy customers manning Cerner’s HIMSS booth: “Sometimes we put stuff in that I’m just ashamed of. Some of the stuff that Cerner has put in recently is appalling.” Maybe he needs a reprogramming trip to the Vision Center. Like him or not, he sticks up for the taxpayers when it comes to vendors, which to me offsets any perceived negatives. Good article in CIO. I bet he’d be a fun HIStalk interview, at least before he puts on some new employer’s muzzle.

Congrats to long-time HIStalk sponsor eScription, whose software earned the highest ratings in the back-end speech recognition category of KLAS’s 2007 Speech Recognition Report, winning in 39 of 40 categories, a 97% “would buy again” score, and 85% positive commentary (29 percentage points higher than its closest competitor.) And this, in KLAS’s comments about eScription’s win-loss record: “There was insufficient loss data to report percentages for eScription because most of the respondents who considered eScription selected them.”

You have to hand it to those no-nonsense Chinese: when their equivalent to the head of FDA was caught taking drug company bribes, he got slightly more than a few months in a miminum security golf resort. He was executed.

Eyes right: see the text ad? Yours can join it quite cost-effectively. I’m just mentioning that because it looked cooler with more ads running.

The VA buys Picis CareSuite for anesthesia for five big-name West Coast hospitals, where it will pair up with Picis’s ICU software already installed.

AHIP (America’s Health Insurance Plans) launches a professional certification program, apparently aiming it at employees of offshore business process outsourcing firms. Maybe the HIMSS cadre can drop by. In fact, maybe AHIP should send some of its own people: its former IT manager (an Indian national) pleads guilty to stealing $1 million from the organization by ordering computer products from a sham company he set up. Say, if it’s the BISYS model, he could teach an accounting class in their certification program.

Milton Hospital (MA) goes live on Meditech’s bedside barcoding verification.

Connie D’Argenio, formerly with Siemens, joins Visicu as sales VP.

iSoft’s shareholders vote nearly unanimously to have IBA Healthcare take the company over. All that remains is regulatory approval later this month.

SureScripts is fully supportive of Medicare’s decision to disallow computer-generated faxing as an e-prescribing substitute. The company, as you might surmise, sells e-prescribing stuff.

News, rumors, amusing anecdotes: e-mail me or use the anonymous Rumor Report to your right. Thank you sincerely for reading.

---

Inga’s Update

Health benefits provider WellPoint has entered into an agreement to acquire American Imaging Management (AIM), a radiology benefit management and technology company with health plan clients representing over 20 million consumers. WellPoint is paying $300 million in cash for AIM and hope to reduce imaging claims expenditure by 15-30%.

An interesting study published by the Archives of Internal Medicine looked at whether or not EHR use and quality of care performance. The study looked at data from 2003 to 2004 and determined that “as implemented, EHRs were not associated with better quality ambulatory care.” I guess that is a little disappointing. I wonder if results will get better when someone examines more current EHRs that presumably have more quality care tools? It might also be interesting to see if coding and reimbursement varied much between EHR and non-EHR users.

MedQuist update: last week they filed a 10K report for the year ending December 2005. This is their first SEC filing since a whistleblower accused them of improper billing practices and the SEC required mandatory accounting reviews. Meanwhile, Philips is considering selling their 70% stake in the company.

I have to admit I have done a bit of drooling over the new iPhone. Somehow I think my life would be more complete with one, but I can’t quite justify the expense yet. However, I have figured out a great solution for anyone wanting an iPhone but who has Sprint (rather than AT&T) and is worried about early termination fees. Sprint has discontinued service for about 1000 clients who have called customer service excessively (an average of 25 times a month.) Those folks are not being penalized with early termination fees. So, start making those excessive calls today!

A special thank you to the anonymous consultant who enjoyed reading the comments from Mark Anderson (and says he loves our site). He also suggested readers might be interested in learn more about what EMR products are being de-installed and why. Anyone care to comment?

A computer error is blamed for a $962,120 bill for a four-day hospital stay in Glendale, CA. Hope the patient wasn’t suffering heart problems when she first opened it.

Whisper to Inga.

Monday Morning Update 7/9/07

Rumor: Misys continues to reorganize. They’ll soon name a new SVP to take over all of sales, an outsider who’s coming from the same big company that provided other Misys execs.

Speaking of Misys, they’re being sued by their former landlord Any Travel Inc., owner of the vacated El Dorado Office Buildings in Tucson that Sunquest/Misys occupied from 1994 through 2006 for annual rent of $788,655. The landlord claims that Misys let the place go to pot knowing they were moving out, including ruining the fancy “water feature” system by shutting it down instead of repairing it, peforming shoddy roof repairs that caused leaks and interior damage, and allowing sidewalks and parking areas to deteriorate. Repair estimate: $1 million. The landlord claims they had a potential buyer for $8 million who bailed when they saw the condition of the property. Also claimed: Misys didn’t pay real estate taxes as the lease requires, sticking the landlord with the bill. That’s only one side of the story, of course.

Healthia Consulting is named one of the “101 Best and Brightest Companies to Work For”, which recognizes employers that treat employees well (communication, compensation, diversity, employee development, work-life balance, and community initiatives.) Worth a look if your employer doesn’t exactly shine in those areas.

BrainLAB’s software may not have been at fault in Belgium, where several patients received radiation overdoses. The company provided hardware only, not software, for University Hospital Ghent, despite earlier reports. The company thinks the system may have been implemented incorrectly by the hospital.

A just-published article in The American Journal of Managed Care says outpatient visits and telephone calls are reduced when patients can contact their doctor by e-mail instead. Kaiser Permanente did the study. That’s the conclusion you’d expect, but it’s good to have it documented. Unfortunately, those on the other end of the communication (doctors) don’t want to swap e-mails with patients for a variety of reasons (reimbursement, liability, and time pressure), but perhaps that will eventually change.

Rumor: MEDITECH will acquire the rest of its practice management system partner LSS.

Rumor: Eclipsys has restructured its sales function yet again.

New UK prime minister Gordon Brown may be distancing himself from NPfIT, as several ministers who supported it have moved on.

Intel’s Digital Health Group is working on projects related to eldercare, such as wearable monitoring systems and sensor-enabled “magic carpet” that analyze walking patterns to prevent falls.

Clearly the heat and summer distractions have kept relevant news to a minimum. Good stuff: e-mail me.

News 7/5/07

From The PACS Designer: “Re: iPhone. TPD wants HIStalk readers to be among the first to see the developers’ site on how the iPhone works and how it can be a good tool for accessing healthcare information and image files. Link.”

Also from The PACS Designer: “Re: AdoptWeb 2.0. TPD was reading the eHealth weblog and came across a posting on AdoptWeb 2.0 and thought it would be good reading for HIStalkers this Holiday Week. TPD wishes all Americans a Happy and Safe 4th!” The link didn’t work for me, but it may be down temporarily. And, I’ll add my holiday greetings as well, flag flying and John Philip Sousa-ing on my end.

From Ingo Montoya: “Re: Vanderbilt. I was watching ESPN2 when who should appear on my TV screen but Jim Jirjis, CMIO of Vanderbilt University Medical Center, in a propaganda commercial for the cable TV industry. Dr. J talked about how (paraphrasing) ‘we tried to bring doctors and patients together online for years, but there was one thing stopping us [makes mouth noises imitating the sound of a dial-up modem connecting].’  He goes on to explain that broadband Internet connectivity provided by cable TV companies was the missing link in Vanderbilt’s ability to do e-health (one direct quote that I caught: ‘Competition from cable revolutionized medicine.’)  I’m glad that e-literacy issues, the digital divide, privacy, security, determining responsible provider for each patient, handling provider cross-coverage, and oh yeah, interoperability across multiple platforms were non-issues for Vanderbilt. Apparently the biggest challenge they faced was having to look at the top of some cable guy’s butt crack while he installed their cable modem. On the other hand, it IS nice that health IT now has a high enough profile to make us attractive whores for feel-good testimonials for the likes of the National Cable & Telecommunications Association, who (in small print) paid for the ad. NCTA, me love you long time – call me!” Vandy’s done some good informatics work (the stuff they turfed off on McKesson being a notable exception) but they’re not shy about horn-tooting. I’ve known a few folks from there and they speak of “Vandy” in reverential, Ivy League-wannabe tones, causing an anticipatory autonomic reflex (gagging) just from the sight of them gearing up for pontification. Actually, that’s probably overly harsh, as I’ve met a couple of them in leadership roles who were pretty cool. I usually root for them in football in any case.

From Jolly NC: “Re: Misys. Former Misys Healthcare Physician president Rob Kill is now president and COO of Virtual Radiologic, a MN-based company that provides virtual radiology interpretations.”

From Russel Ziskey: “Re: Healthvision. It seems that Healthvision is laying off some of its people. Do you know why? Good or bad for the company?” Covered here last week, but I’ll repeat. Healthvision hitched its wagon to RHIOs, which are nearly universally fizzling out (HIMSS hoopla to the contrary.) It’s bad that Healthvision had to lay people off, but carrying too many FTEs when revenue isn’t up to snuff is worse. When I interviewed CEO Scott Decker in February (after correctly predicting VeriSign’s investment in the company per a reader’s report) he was perhaps overly optimistic about RHIOs, but sold on the connectivity concept: “I wouldn’t say Healthvision is wed to RHIOs, but to disparate groups sharing information. RHIOs brought it back up to the attention of boards and providers. We see all kinds of hybrids – health systems, IPAs, payors. There are a lot of RHIO-like models that aren’t the Washington, DC model, and that’s good for us and good for healthcare. Our pipeline of opportunity is ten times what it was 24 months ago.” The $64,000 question: can Healthvision get that other business now that its most highly targeted prospects aren’t buying and with far larger players elbowing them aside? Scott’s a good guy, but I wouldn’t want his job.

I like to check out the sites of sponsors and wandered over to that of R. Gaines Baty Associates. An idea for candidates: “Create an RGBA Career Connection for consideration for opportunities (immediate and future) that fit your desires and criteria. Be advised of outstanding career opportunities without actively ‘looking.'” They’re also offering a free electronic newsletter. Just thought I’d give them a shout-out.

Several folks are e-mailing me that Picis has withdrawn its IPO request (right before the trading holiday.) Since I posted that very item on the Discussion Forum at 8:00 Tuesday morning, I’m concerned that I haven’t mentioned the “Latest Topics from HIStalk Discussion” headlines to your right enough times (only if you go to www.histalk.com or www.histalk2.com and not the Blog City page since I haven’t made it work there so far.) Inga and I will sometimes post new stuff there early in the day, so it’s worth checking those headlines occasionally (or setting up to read in your RSS reader.) And if you post in the Forum, your headline will show up there too.

Related to Picis (but written before the IPO news came out) is my editorial in this week’s Inside Healthcare Computing electronic update: “Private vs. Public Vendors: I’ll Take the Former,” in which I argue that the now-trendy private equity investment is replacing IPOs as the primary way for companies to grow. I have to admit that I felt traitorous when I wrote it because Picis is my sponsor and my argument is that current customers historically have fared worse after a vendor goes public (my vendors, anyway) but now I can feel OK about it. I still have confidence in Picis and I bet there’s a positive reason they changed their IPO mind.

And speaking of sponsors, at least four new ones are coming online very shortly. I’ve hooked up with a graphics person who’s pretty darned good at creating Flash ads, so I’m now offering that at no extra charge for Platinum sponsors who need some graphics help.

Nice gesture: someone pretty high up in Cerner invited me to their big barbeque contest that will be held on July 20. I probably won’t go (the anonymous thing is always a problem) but I appreciate the thought, barbeque being my favorite food and my past experience with Cerner bash-throwing being entirely positive. Thank you.

HIStalk nearly always scoops the other so-called news sources because loyal readers keep me informed, to the point that I don’t even go back and check any more to see when I first reported something. However, I was Googling for something on Dairyland and ran across these entries, giving you several months’ advance notice despite company denials. Bet they were mad.

• December 1, 2006: “From Anonymous: Dairyland is being shopped around to potential buyers, so I hear.”
• February 5, 2007: “From Venny: Re: Dairyland. I have heard from more than one source that the Dairyland principals are looking for potential suitors. I haven’t heard any reasons, though.”
• February 12, 2007: “From HITman: “Re: Dairyland. I met with some Dairyland folks today and they denied any talks or that the company is even on the market. DHS is an ESOP company and some folks stand to make a lot of money if the rumors are true, but it is all denied as of now.”
• February 14, 2007: “A reader who should know confirms that Dairyland is (or at least was) shopping itself for sale, their previous denials to the contrary.”
• June 29, 2007: Dairyland announces that it has been acquired by Francisco Partners.

Tragedy in Belgium: at least 17 patients received incorrect radiation doses because of malfunctioning software in Brainlab‘s Novalis oncology radiation aiming system. Nine have died, but not necessarily because of the problem. Also confirmed: Cleveland Clinic and Valley Medical Center (WA) use the same model (stopped since, I’m sure.)

Former Fairview CIO-turned-COO Gary Strong joins competitor Allina as chief administrative officer. Met him once, nice guy, a rare case of a CIO’s excelling in a bigger chair.

I struggled with this press release‘s headline: “Thru Executive Thought Leader to Serve on DFW HIMSS Board.” Was it missing some punctuation or maybe some words? And exactly what is a Thru Executive – a spelling-challenged C-leveler who’s been fired? Nope – the company’s name is the ever-so-precious Thru. Which I did – up. I really hate gibberish company names, especially those created around a misspelled word (although I save much of my wrath for those indecisive merged entities that give up and simply jam their previous separate names together to create an ugly conjoined twin, i.e. McKessonHBOC or PricewaterhouseCoopers). Another reason to hate lawyers – fear of lawsuits drove us to making up names.

Police are investigating the deaths of two University of Chicago Medical Center patients after excessive insulin levels were found post-mortem. If I had to bet, I’d put my money on an incorrectly compounded IV. Happens quite a bit, especially with insulin. The value of all traditional clinical information systems in preventing that error: zero.

Coming shortly: a weekly HIStalk e-mail update for executives, with the top five healthcare IT stories of the week with background and opinion. Inga and I did a trial issue and we think it’s cool – about a five-minute, portable read that can make even non-IT experts fluent in industry developments. We’ll have the sign-up form online soon. Here’s a sample entry I wrote yesterday (one of five) as I developed the format. Your suggestions welcome. We figure it will be free since we like giving stuff away (it makes us feel important).

---

Headline
Mediware CEO Resigns

Facts
James Burgess, president and CEO of Mediware Information Systems of Lenexa, KS announced he will step down by September 24. The company sells systems for blood bank, operating room, and medication management. Also announced: VP John Damgaard of the blood bank division, is promoted to a newly created SVP/COO position, effective immediately.

Opinion
The company’s institutional investors are losing patience with this industry laggard. Damgaard’s division was its only bright spot, so he gets his turn in the hot seat. Plus: decent earnings and a PE of just 25. Minus: a market cap of only $58 million, cost and transparency of being publicly traded, and a product line made up of mediocre specialty products when the market shows a vast preference for integrated offerings from Cerner, Epic, and Eclipsys. The stock is down 40% from December 2005 in a healthy healthcare IT market.

Musings
Revolving door executive turnover continues.
Forced customer upgrades have created revenue at the expense of goodwill.
Going private might be an option.
Prospects are bleak.

---

Florida-based medical products distributor PSS World Medical buys a 5% stake in athenahealth for $22.5 million and gets the rights to distribute the company’s physician practice software. PSS signed a deal with GE in 2003 to resell that company’s EMR software. I don’t know how that deal turned out.

The Irish government is still shoveling millions on the PPARS healthcare payroll and personnel system that was mothballed two years ago. The system, estimated to have cost at least 30 times its original budgeted amount, was provided by SAP and Deloitte and Touche. Great things happen when you mix government, ERP, and consultants.

Huge non-profit consulting company RTI International will host a free July 26 Webinar describing its creation of a perinatal EMR for a Zambian teaching hospital, funded by the Gates Foundation and now available under a free and open source license. Nice.

The Feds put up a new NHIN website covering CCHIT, HITSP, NIST, and ONC. According to the metadata, Booz Allen Hamilton did the design. Wonder what that cost? Just for fun, I ran it through an accessibility checker (that’s why government web consultants get big bucks). It failed.

Banking security guy Troy Moritz joins Allscripts as chief security officer.

---

Inga’s Update

Greenway Medical announces their EMR product is now integrated with DrFirst’s Rcopia e-prescription technology. Last week, Greenway also made news for being one of the first two products to receive 2007 CCHIT certification (NextGen was the other).

Toothpaste alert: McKesson Corp said it was recalling its China-made EverFresh brand after it was identified as containing trace amounts of the chemical known as diethylene glycol, a compound used in anti-freeze.

More hospitals are allowing cell phone use, according to a recent CHIME survey. 23% of the respondents said the benefits of improved patient care and satisfaction outweighed any negligible effect of interference with medical equipment.

CMS is considering no longer allowing providers to e-prescribe to pharmacies. If the new ruling is passed, providers will require all e-prescriptions to be in the Script standard as part of the 2008 physician fee schedule. So how would this affect providers (and their vendors) who are don’t offer this format? Well, the providers go back to paper scripts. (All together now … isn’t faxing a little outdated anyway? Who – besides those in healthcare – fax much of anything these days?)

A couple of weeks ago there were a few postings after I mentioned the recent AC Group Functionality Ratings that are published twice a group by Mark Anderson. There were a couple comments that suggested Mark and consultants in general tended to favor certain products over others, to which I said that of course consultants have a bias – that is what an end user pays for. Blindsided Vendor also that his company “runs for the hills” when they learn the AC Group is involved.

Well, I was able to catch up with Mark Anderson and asked him if he cared to provide us with a comment – to which he graciously agreed.

“The best way to respond is to ask our clients if they thought we were fair and impartial. We do no marketing and 80% of our business comes from references from our clients. If they were not happy, they would not refer us. As far as favoring vendors, they are right. We favor vendors that prove that their company and products are strong. We will tell our clients the plusses and minuses of each vendor and our Top 10 matches everyone else’s Top 10.

A number of vendors do run away because we challenge them to perform. When they cannot perform, it’s easier to run and to blame the consultant. My Top 10 vendors are listed in my published report that comes out twice per year. The Top 10 has changed slightly in the past seven years, with five new vendors added and five removed. We have found that vendors “do not always tell the truth.” However, if you ask the right questions, you can get to the truth. The problem is, most people do not know the right questions to ask.

If the vendor runs away, it’s because they cannot meet the functionality requirements. My point – let them run. My clients would not be happy with them anyway.”

Talk to me.

Mediware CEO Resigns

James Burgess, president and CEO of Mediware Information Systems, has resigned. He will leave his position on September 24. The company also announced that John Damgaard, VP of the company’s blood management software division, has been appointed to the newly created position of chief operating officer and senior vice president, effective immediately.

Burgess joined the company in 2005, Damgaard in 2003.

Monday Morning Update 7/2/07

From Anonymouse: “Re: Cerner. Unsubstantiated rumor from a third party vendor: Cardinal to acquire Cerner. Have you heard any of these whispers?” I haven’t. Anyone?

Thanks very much to old HIStalk friend eScription, an early-on sponsor. The company is now the exclusive sponsor of HIStalk Discussion as well, while continuing as a Gold Sponsor. I was cruising around their newly redesigned site and I notice they’re hiring: software engineers, account managers, Java developer, and other technical positions. I can’t imagine that working for super-cool Paul Egerman is anything but great (not to mention they provide over 400 pounds of free fruit each month for employees to munch on!) Continuing my cruising, I see that my sponsor contact Lauren Richman has a Penn undergrad and Columbia MBA, which is impressive even among the educational credentials of her peers: Princeton, Brown, Dartmouth, Harvard, Carnegie Mellon, and MIT. Smart company, nice people, kicking butt and taking names in their market. That’s how it ought to work.

Speaking of Penn, UPHS awards CSC a five-year, $67 million contract for IT infrastructure services.

And speaking of old friends of HIStalk, my first-ever sponsor Medicity sent over their electronic newsletter this week. The company has taken over two new floors in the Medicity building, employment will increase 50% this year, they demonstrated at MUSE last month, and several new sales were finalized in the past few weeks. All due to their sponsorship, at least when I’m telling the story.

Wisconsin State Journal is running a fancy series on medical errors, including an online game where you try to staff a nursing unit given ever-changing conditions. From a reader who wishes to remain anonymous: “Interestingly, they don’t mention EMRs at all, or CPOE. They talk about pharmacy robotics and barcoded med administration, but that’s pretty much it. They included some ‘patient safety’ tips, such as writing down your allergies, writing down what meds you’re on and what you take them for, and taking these lists with you to clinics, hospitals, etc. Isn’t that sort of the point of an EMR, so you don’t have to remember? Clearly technology doesn’t solve everything, but I would have thought it worth mentioning in their ‘technology improvements’ article.” It is somewhat surprising, although they seem to focus on the sharp end of the stick, right down to the patients themselves.

Cerner gets 510(k) clearance for its new transfusion and specimen collection system that will be marketed under the Cerner Bridge Medical name. The party must be on: Cerner gets North Kansas City approval for a big blowout, including a barbeque contest, at their headquarters on July 20. I’m positive I’ll be invited so I can report to you live.

Former HealthSouth CEO Richard Scrushy and former Alabama Governor Don Siegelman became former free men after being sentenced to seven years in prison for bribery and corruption yesterday. The judge wasn’t impressed by the chorus line of character witnesses the defense paraded in, with Scrushy even dragging his nine children in to meet the judge (triggering a Groucho Marx thought: “Hey, I like my cigar, too, but I take it out now and then.”) Anyway, the judge sent him straight to jail.

CPSI is named to the FSB100, a fast-growing small company list compiled by Fortune Small Business.

This 29-year-old newly graduated Canadian doctor (Melissa) has gotten a doctor job, written a diet book, and helped design a Web-based EMR system that may be ad-supported later.

Akron Children’s Hospital sues its former foundation director, claiming she downloaded donor information to start her own business.

Imaging vendor Emageon has cut 10% of its workforce so far this year.

Bizarre, only-in-California lawsuits: an LA fire department captain gets $3.75 million, much of it for pain and suffering, because his supervisors retaliated against him for not giving women firefighters easier training. In another case, the city offered a firefighter who was fed dog food by colleagues $2.7 million.

News is slow. If this were a HIT magazine, I’d keep writing crappy stuff just to fill up space. Since I value your time instead of my need to pad out the ads, we’re done here. Have a good July 4th (and fly your flag, please).

News, rumors, my own private Idaho: e-mail me.

Discuss today’s HIStalk.

News 6/29/07

From The PACS Designer: “Re: Internet tools. TPD has noticed that the number of new tools for implementing an Internet strategy is expanding at a rapid rate. This expansion of tool options is attracting more inquiries about how to best deploy information over the web. Since healthcare has been slow to adapt an Internet strategy, it might be the time to give web solutions another look since funding new purchases could be difficult with the current declining revenue base. Since web strategies can be cheaper than thick client applications, it deserves consideration by procurement planners.”

From Rolly NC: “Re: Misys. In addition to the departure of Jim Brady at PayerPath, Betty Feth, another 20-plus year SVP at Misys, has left her job in implementation and service. Kelly Ross, the former sales SVP for Hospital Systems who was recently named by Vern Davenport as sales VP for community sales, resigned two days later and was asked to leave immediately. Paul Lewis, hired by Mike Lawrie to run all of sales and service, no longer has sales and only half the services side. Sales VPs and directors are reporting to Vern until someone new is named.” Partially confirmed so far.

From CCHIT and Die: “Re: 2007 certification. NextGen and Greenway are the first two vendors announced to have earned 2007 CCHIT ambulatory compliance. Those standards are supposed to be harder to pass than the 2006 ones, where it appeared that they were handing them out to anything that could remotely labeled an EMR. It will be interesting to see which 2006 products don’t pass 2007 muster, although at $30,000 a pop, it’s in CCHIT’s best interest to certify everyone.”

From Jim the Waco Kid: “Re: HFMA. Have been at the HFMA-ANI show and heard HMS and SSI are now partners.” True – announced this week. HMS will enhance its revenue cycle products with SSI’s EDI offerings.

From Nasty Parts: “Re: Sage. Rumor of Sage layoffs is true. A non-visionary bean counter is trying to cut his way to profitability. Operational regions have been cut from four to two. Layoffs were senior leaders of the consolidated regions and special project staff. The company had two decent quarters of revenue because of inside sales slamming NPI upgrades. It’s a shame – Intergy is a well-built system.”

From Hedley Lamarr: “Re: Dairyland Healthcare Solutions. Heard it from a solid source that DHS was bought out by Francisco Partners. Big changes to come…” Confirmed. The private equity firm has acquired Dairyland, a community hospital systems vendor, and changes are already underway. CEO Alan Grundei is gone. FP has brought in John Trzeciak to replace him (he was a co-founder of Health Systems International and was installed as interim CEO of LYNX Medical when FP bought that company.) I’ll have to talk to Jon Philips again – I’m intrigued that, other than athenahealth’s impending IPO, all the action is all private equity instead of the public market.

Check your web address above. If it’s http://histalk.blog-city.com, here’s what I recommend: go to www.histalk.com, which will take you to the new HIStalk page. Put your e-mail and name in the Subscribe to Updates box to your right there and click Subscribe. That will get you on the new update list.

Welcome and thanks to brand new HIStalk Platinum Sponsor EHRConsultant, a free EMR consulting service for medical groups ranging from one to 1000 physicians. EHRConsultant follows over 200 EHR products and provides free assistance to practices trying to narrow down those they should consider. They offer several resources, including an EHR discussion board, the EHR Scope magazine and resource guide, and physician speech recognition expertise. Cool offering: one- and two-physician practices looking for an EHR system for under $5,000 can use their Self-Serve function, which will lead them to suggested systems in less than 30 seconds. Thanks to EHRConsultant for supporting HIStalk.

And speaking of sponsors, let’s pay our regular tribute to those brave companies that invest their marketing dollars with a flaky blog. It takes guts to splash your ad on a page that, at any given moment, could contain any sort of irreverent mayhem. Most of them at least claim to love my work, although they may want me only for my 75,000+ monthly page views (or the chance to exchange telephonic pleasantries with the lovely Inga, a benefit that I craftily dangle to get their attention):

Design Clinicals, LLC
EHRConsultant
EnovateIT
eScription
Hayes Management Consulting
Healthcare Growth Partners
Healthia Consulting
Inside Healthcare Computing
Intellect Resources
InterSystems
John Muir Health
Lucida Healthcare IT Group
Medicity
Noteworthy Medical Systems
Novo Innovations
Picis
R. Gaines Baty Associates
SCI Solutions
SolCom

Pitt County Memorial Hospital (NC) gets a $3 million Duke Endowment grant for HealthSpan, a clinical system spanning both the hospital and Eastern Carolina University’s school of medicine.

Two DoD medical agencies are trying to stifle military use of the Joint Patient Tracking Application so they can spend millions building their own, this article claims. The system’s developer criticized the agencies in front of a House committee, after which he was transferred from Washington to “bureacratic Siberia.” “At stake are billions of dollars. Through fiscal 2006, AHLTA alone cost Defense $775 million to develop and deploy. The system’s fiscal 2007 budget is $392 million. By comparison, the Joint Patient Tracking Application system cost less than $1 million to develop and $2 million a year to maintain. In addition, the Web-based patient-tracking systems are more useful to doctors, according to a paper prepared by a team of combat clinicians serving in Iraq. The system ‘is the only record that has visibility throughout the evacuation chain,’ according to the paper. ‘It is easy to access anywhere that we have Internet, it is easy to enter key progress [notes, X-rays, lab and operation] report data in a quick read stream that answers most coordination of care issues at a glance.'”

Companion Technologies will acquire Smart Document Solutions of Alpharetta, GA.

Two medical practices are suing Bond Medical Group and Bond Technologies for a refund and damages. They say Bond Clinician didn’t live up to the company’s claims that it could reduce paper and improve billing accuracy.

CCHIT’s inpatient EMR certification criteria have been approved. Applications for certification will be accepted starting August 1. Information and detailed criteria documents are here.

News, rumors, scandals: e-mail me.

Discuss today’s HIStalk.

News 6/27/07

From SpiderMan: “Re: Payerpath. The recent Misys announcement highlighted Payerpath as an area of success. Apparently not successful enough, as it was announced to the staff last week that Payerpath will cease to run as a stand-alone unit. In addition, founder and president Jim Brady will be leaving Misys.” Consider this to be conjecture until I receive confirmation, as usual.

From Roy: “Re: Mirth Project. We’ve been looking at Mirth closely for several months and are about to deploy it in some projects. If you want to use it without paying for support, you’d better be pretty technically astute. But it works, is pretty powerful, and is adding features fast. I’m impressed, and I think we’ll likely standardize on it, if things continue to go well. I always felt like interface engines were overpriced, so these guys have correctly spotted an opening in the market, IMHO.”

From Art Vandelay: “Re: open source installations. Having worked with OpenVistA, your depiction is accurate. Very few open source applications have straightforward installations. If a for-profit third party cannot create an single-step installation executable (i.e. Medsphere), you know you are in for a fun time. Even Oracle can’t seem to get a clean application installation without having to read at least three technical bulletins and a few tech support forum posts. Microsoft and IBM do a great job of offering usually pain-free installations. You won’t get adoption without a straightforward installation.”

From Hatchet Guy: “Re: Cerner. Paul Black will go when they announce Q2 earnings in late July. His recent exercising of options is one more sign.”

From Grizzled Veteran: “Re: Sage. Layoff at Sage last Thursday. Various departments, big losses in Professional Services (training). Laying off trainers can only mean lack of new business.” Not yet confirmed here. Anyone?

Vince Kuraitis has well thought out speculation on what Google Health will be and what impact it will have. Some quotes: “The personal health URL and the supporting infrastructure is the cornerstone of the GH offering … Google likely will use a combination of carrots and sticks to encourage and cajole various parties to help PHI flow freely into and from Google’s repository that feeds the patient’s personal health URL … GH will make the CCR standard the MP3 of Personal Health Information.” Even if it turns out he’s wrong, this is a fun and compelling article. One thing to remember about Google: they’re in the eyeballs business. Whatever they develop has to attract lots of well-targeted eyeballs attached to folks willing to respond to online advertising. To a marketer, the information in your PHR might be the most valuable information about you because it (a) targets you as a customer; (b) allows identifying customer groups not easily reached until now because of privacy issues; (c) provides endless opportunities for fine-tuning targeting and messaging; and (d) involves high-priced products and services, with a correspondingly high value to the companies selling them.

Good quote, too from a reader’s comment to Vince’s article: “… all of us who have been around this industry and have seen numerous failures of ‘the next great thing’ delivered by the non-healthcare IT world that promises to finally bring healthcare into this century. Nonetheless, we will root for the effort. While institional resistance to change will be a huge barrier to the GOOG, we may find that consumer apathy and fear (of loss of privacy) may be even more important. GOOGLE’s business success has been founded on fast consumer uptake and that source of energy will not drive this effort. GH will indeed have to demonstrate persistence until payors mandate electronically accessible records as a condition of participation and payment, and then the world will change.”

Frankly, I thought Vince’s stuff was more interesting than the report by California HealthCare Foundation called “Perspectives on the Future of Personal Health Records.” It’s a collection of six “what do you think about PHRs” write-ups provided by experts. I expected something more collectively insightful, intellectually challenging, and predictive. There’s nothing wrong with it, but a quick skim seemed ample.

Mediware will delist itself from the NYSE Arca stock exchange, citing “regulatory and administrative burdens,” but will continue on Nasdaq.

Michael W. Carelton is the new CIO for HHS, reporting to Mike Leavitt and coming over from GSA.

The HIMSS Summit is over. If you went, tell us about it.

“Millennium Research Group (MRG) has conducted a detailed and thorough analysis of the acute care clinical information systems (CIS) market and finds that a major driver in the US is the demand for improvement in patient safety.” If you find that sentence to be loaded with insight and startling revelation, you’ll no doubt want the full report for just $5,000.

TheraDoc will offer multi-hospital IDN capability for its Expert System Platform in September.

Accuro says it sold BI and revenue management software (cost of care estimator, denials management, contract management, and coding and compliance) to 239 hospitals in the first half of 2007.

Managed care company Molina Healthcare announces the resignation of its CIO. I don’t care about that, but his name made it interesting: Rick Click.

Smart: IntelliDOT announces a barcode solution to make sure NICU babies get breast milk from their own mothers, not someone else’s (although in our odd world, adult humans drinking milk from another species of animal … cows … doesn’t seem weird until you spend five seconds thinking about it.)

Bravo: GE Healthcare is urging its employees to stop screwing around with their electronic toys when someone is trying to hold a meeting. I think meeting rooms should have a designated box for BlackBerries and the like, with the occasional TSA-like inspector patting attendees down to find those idiots whose limited attention span lures them into reading routine e-mails instead of paying attention.

LA Times editorial headline: “Close King-Harbor. After years of warnings and last chances, it’s time to shut the hospital down.” And comments: “Certainly a hospital can be fixed, can’t it? If there is inadequate funding, get more money. But, as The Times reported three years ago, the medical center is flush, with more money per patient than other county hospitals. If the problem is poor management, bring in management consultants to shape up the place. But the county spent more than $17 million on a firm to do just that, and the problems remain. Fire the employees? Done. They interviewed, and nearly three-quarters of them were rehired. Turn it over to a successful hospital, like Harbor-UCLA? Tried that. It turns out that, when Harbor-UCLA was supposedly running the place, the same personnel were still in charge.”

A big healthcare accomplishment for Barack Obama: he brings home $350k of your federal tax dollars to help a Kankakee, IL hospital pay for CPOE.

Healthcare Growth Partners will help Optio Software review strategic alternatives for its healthcare division, including its potential sale.

News, rumors, bon mots: e-mail me.

Discuss today’s HIStalk.

---

Inga’s Update

Gateway is now offering PC solutions that include MedicWare® Electronic Medical Record software. I am surprised that more software and hardware vendors haven’t partnered to provide pre-packaged solutions. Sure, the MedicWare and similar low-end charting systems aren’t going to work for the majority of practices out there, but there are definitely opportunities at the low end where money is tight and high product sophistication isn’t a requirement.

GE Healthcare will provide more than $30 million in equipment and services to a new hospital and cancer center in British Columbia.

The Healthcare Solutions business of JPMorgan Chase and RelayHealth, the connectivity services company of McKesson Corporation, announced today that they have formed a strategic relationship to offer an integrated set of claim and payment processing solutions. This relationship will transform the way that insurers, healthcare providers and consumers interact to settle claim payments, moving to a fully electronic model. The revenue processing cycle will become electronic and develop a single portal that can be accessed online by all key constituents along the revenue cycle. Anyone care to comment about this? Ultimately who benefits by this – the patient? Provider? Insurance companies?

Monday Morning Update 6/25/07

From CIOShawn: “Re: Mirth Project. Searched your site for any post on the Mirth Project, an HL7 open source interface engine, but found none. Interesting concept, just can’t find much independent info. You always seem to get the scoop. Any interest in getting info on this project and whether anyone has used it successfully?” I hadn’t heard of it. It’s sponsored by WebReach, which offers services and even a Mirth Appliance. And this teaser: “If you think Mirth is cool, wait until you see Azzyzix.” Sounds awfully close to Azyxxi, doesn’t it? (lawsuit news to follow, no doubt.) That company’s site says little about the company. I’ll see what I can find out. If anyone knows, chime right in.

From The PACS Designer: “Re: more 2.0. The 2.0 trend is growing in leaps and bounds. Scott Shreeve, MD is calling the trend a ‘Bandwagon,’ while TPD likes to  call it ‘The 2.0 Train’. Whatever you want to call it, the genie is already out of the bottle! TPD was in a bookstore last week and right near the front door was a book with 2.0 tacked on the end of the title. It was the second edition for the book and what better way to attract the readers attention? Since mainstream media is jumping on this Bandwagon/Train, are we going to see movies with the 2.0 extension?” We almost did in 2003, when the working title of the sequel to The Matrix was The Matrix 2.0, later changed to The Matrix Reloaded. Since some of the worst movies ever made have been Roman numeral-bearing sequels, maybe a 2.0-type naming convention would fool potential moviegoers for about five minutes. In fact, is Health 2.0 just a badly planned sequel to what we have now?

New Kaiser Permanente CIO Philip Fasano is interviewed. Nuggets: (1) Kaiser will be developing home care monitoring tools; (2) HealthConnect availability was 99.57% last quarter and the new goal is 99.999%; (3) the IT department will reorganize yet again, swing the never-stopping pendulum back to regionalization vs. centralization; (4) the annual IT budget is $1.7 billion. Justen Deal is critical: “Lastly, the article says that Carol Rizzo, who specializes in ‘establishing offshore business processing operations and IT development,’ has (apparently) replaced poor David Watson as chief technology officer. Indeed, Ms. Rizzo, like Mr. Fasano, has a nifty LinkedIn profile. Like Fasano, she also has held a bunch of quick jobs over the past few years, and she also comes from the financial sector.”

athenahealth announces IPO plans. Big name companies are taking them out, with a maximum share offering of $86 million. Mentioned: the company lost $9.2 million last year on revenue of $75.8 million.

Reminder: sign up for the new mailing list in the box to your right (on HIStalk2). The old one’s being phased out, so that will assure your getting e-mail updates when I write something new. It seems inevitable that HIStalk2 will become the primary site, so consider reading there (another reason to get on the new list: the link from the new e-mail will point to the new site.) Also, the new site has capabilities the old one doesn’t, so I admit that I read only there these days (but appreciate having the original site as a backup in case something goes wrong.) Type www.histalk.com into your browser and you’ll end up there.

McKesson and JPMorgan will work together on a fully electronic claims and payment system.

Based on stock price, the market doesn’t like Nuance’s $265 million acquisition of a developer of embedded software for mobile devices, the latest in a handful of similar acquisitions.

Interesting, free newsletter: VistA & Open Healthcare News (warning: PDF).

Unfortunate hospital lawsuit in the making: a hospital agrees to perform a $100,000 brain surgery for free on a Russian teen, warning of possible complications. He died. The family has hired a lawyer. They claim the hospital offered the free surgery only because they wanted to use him in a commercial. The doctor says the teen was dying already and he did the best he could.

NHS IT contractor Atos Origin launches a healthcare consulting business.

Medsphere announces OpenVista Appliance, a preconfigured demo package. Great idea, although from the instructions, you’d still need to borrow a geek to get it running. That always seems to be an open source limitation: it’s never a Windows-like straightforward installation. 95% of casual tire-kickers will move on.

News, rumors, blasphemy: e-mail me.

Discuss today’s HIStalk.