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.

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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).

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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.

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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.

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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.

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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.

News 6/21/07

From Seimore Skinner: “Re: Piedmont security audit. On the front page of this week’s Computerworld is an article on the HIPAA Security Audit at Piedmont. No real new information, but I thought it was cool Mr. HIStalk scooped ’em. They also provide a link to the auditor information request list. Keep up the good work!!” Thanks. A reader sent me the OIG’s list of requested documents, which I ran on April 20. I’m not bragging (well, maybe a little), but loyal readers make it nearly certain that, when it comes to healthcare IT, you’ll read the good stuff here first. Test that theory for the information you’ve valued over the past few months: how many times did it come from elsewhere? I’ve even got great sources in Europe, so you were able to read about the Misys announcements here (in the discussion forum) at around 8:00 this morning (which I hastily posted from work), long before those sleep-in journalists got around to it.

From Blindsided Vendor: “Re: the consultant you mentioned. Many folks in the industry know he has had his particular favorites for years. I know of many of his own projects that are currently faltering. When we become involved in an account he’s consulting with, we run for the hills as his choices are always the same.” I removed names and comments because it’s not really fair to single anyone out, but you know the usual consultant caveats like these. Inga’s comment: “To your point suggesting consultants may have a bias towards one product or another … well, of course. But if a consultant doesn’t have an opinion (bias) then what value is the consultant?” Ah, the condundrum.

Thanks to Matthew Holt, who took up for HIStalk in his mention of some top 100 healthcare blog list (congrats to his The Healthcare Blog at #8.) “More seriously, it’s a fun list, but probably the leading blog in all of health care (certainly in term of revenue generation), HIStalk, isn’t on it.” Thanks, Matthew. Returning the favor, don’t forget about the Health 2.0 conference Matthew’s putting on in San Francisco on September 20. He’s got all kinds of big names on the agenda, including folks from Google, WebMD, Microsoft, Yahoo, Kaiser, and Allscripts. Pssst: register within a week and put in code HISTALK and you’ll get $50 off the registration fee, plus Matthew will owe me, which is always good.

Speaking of blogs: a grateful nod to Paul Levy for mentioning HIStalk in a recent posting (“full of news and opinion from the domain of health care information technology.”) Why that’s impressive: Paul is President and CEO of Beth Israel Deaconess Medical Center in Boston (John Halamka’s boss). His blog has really cool stuff, which I like to think he writes himself since it’s so folksy and smart. He actually responds to blog comments. A classic post: Do I Get Paid Too Much?, openly talking about his million-dollar salary. And you CIOs might become jealous of John Halamka: does your boss proudly put your IT annual report on his website and conclude with “Now you see why I love this guy.”?

Now here’s an unusual item, which I’ve got many reasons not to post (it’s a free ad and takes advantage of an unpleasant situation.) On the other, it may help some of the folks who have left Healthvision recently. “NextGen is recruiting top sales, marketing, project and product management, training, and product development talent for our interoperability team. We would be interested in fielding resumes of those recently displaced HealthVision employees. Aside from our well-known NextGen ambulatory EHR product, NextGen also offers an award-winning suite of RHIO/interoperability tools. The NextGen Community Health Solution (CHS) enables the exchange of patient data between providers, specialists, hospitals, payers, labs and pharmacies. Our NextMD product provides patient to physician connectivity including secure messaging, patient driven data entry, and medication management. Resumes may be sent to: jobs@nextgen.com.” This is a special case, so please don’t ask me to post other listings here. I was torn, but decided to err in favor of those who are out of work.

The Misys news wasn’t good this morning, other than fairly healthy margins. Healthcare sales are in a freefall and Mike Lawrie is still saying the products aren’t competitive. Worst of all, whatever R&D money that the stepchild hospital division was getting will be cut even more to try to save the physician practice business. Rumor: the ClearPractice offering was canned because of the effort that would have been required to make it CCHIT-certifiable. Must have been way out there.

EHRConsultant is offering a free download of EHR Scope Summer Edition (warning: PDF). Very nicely done.

Gartner places the Ensemble integration system from InterSystems in its Magic Quadrant for application infrastructure.

New Hanover Regional Medical Center (NC) is kicking off some McKesson Horizon projects. For some reason, their IS business plan (warning: PPT) is posted on their website. If you’re a CIO looking for ideas on how to communicate IT strategy and tactics to colleagues, it’s worth appropriating. Good job by Avery Cloud’s team. The swimmer’s lane analogy was a bit overwrought, but it gets the point across. CIOs need to be able to articulate strategy this clearly to non-IT types uninterested in the ugly details.

QuadraMed announces the M5 release of its products. The stock bucked a down-market trend today after that news yesterday, rising 1.6%.

William Beaumont Hospital chooses Advanced Clinical Software’s StudyManager software for clinical trials management.

Sutter Health gives CalRHIO $1 million, meeting part of its bond requirement to donate $8.5 million to small and rural networks.

Millionaire self-proclaimed man of the people Michael Moore’s healthcare film “Sicko” is (or was) available all over the Internet in its entirely, including YouTube. If your hospital isn’t bracing for public outcry, you might want to prepare just in case. I’m not a fan, but he has many, just like pro wrestlers and Jackass movies.

Pro basketballer Dikembe Mutombo is buying a smartcard-driven EMR for a hospital in the Congo. The supplier: Inter-Card Biometrics of Washington, DC.

News, rumors, chit-chat: e-mail me.

Discuss today’s HIStalk.

News 6/20/07

Wednesday morning update: Misys just announced results. I’ve posted details in the discussion forum. 

From Duuude: “Re: HIMSS Summit announcement listing the accomplishments of keynote speaker Michael Murphy, Sharp Healthcare CEO and winner of the CEO IT Achievement Award. Shouldn’t it also say, ‘ … and kicked IDX out due to poor product interoperability’ as an accomplishment?” Not by HIMSS, but the rest of us can feel free to do so.

From Lefty’s Lament in PA: “Re: Verus data breach. Rumor has it that Verus, Inc., vendor of on-line bill payment and Emdeon partner, has e-mailed its customers to tell them they are closing their doors due to insolvency. Apparently, investors fell through?”

From Irritated in Iowa: “Re: Allscripts. We recently went on a site visit for Allscripts Healthmatics ED to North Fulton Hospital in Atlanta and we were under the assumption that the ED medical director there was leading the site visit. He was actually an Allscripts employee who left the hospital several months ago! This seems very deceptive – no wonder we don’t like people in sales!” I omitted his name, but checked it out: he used to be North Fulton’s ED director and still has staff privileges there. He’s also consulting with Allscripts. No problem there as long as he wasn’t passed off as still being in charge during your visit, although some clarity about his role would have been appropriate. He’s still listed on some Allscripts material as being the hospital’s ED director, but that could just be outdated information or referencing the position he held during the implementation he talks about. Thoughts?

From Benny Hill: “Re: interviews. I really enjoyed the NYU and Allina interviews. They provided insight into what is often times the misrepresented world of implementations and go-lives (misrepresented by the vendor trying to see you what you have to implement). Any Cerner or Siemens Soarian clients stepping up to the plate? I think a Cerner client would have an interesting story. It would be even better if you could interview a CIO from ”across the pond’ on how their Cerner implementation fared.” Thanks! Inga and I enjoyed doing those interviews, too. If you’re a hospital CIO, we’d be happy to interview you (we’ll tag you as anonymous if you insist, although we’d rather not.) You may not think you have anything interesting to share, but we can always turn up fun stuff to talk about (and make you semi-famous in the process.) Since Benny wants to hear from Cerner and Soarian shops, we’ll give you high priority. E-mail me. We promise to make it fun.

From Ilich Ramaraz Sanchez: “Re: FCG. why is it a surprise that they might go after some old employees? Consulting vendors and HIS vendors have done so for years. If you have signed a non-compete and then take a list of current and former company employees and start contacting them, why wouldn’t they go after you? They have sent cease-and-desist letters – it’s nothing new. Some former employees have been pretty blatant in their new businesses. Competing against your former boss utilizing their former employees takes serious cojones. Yet, at the same time, one wonders perhaps FCG does not want to make waves, considering they have people lurking in the shadows of their own hallowed halls waiting out their non-compete from rival companies.”

From The PACS Designer: “Re: Azyxxi. Dr. Bill Crounse’s HealthBlog site has a new post on Azyxxi. Since it has been awhile since there have been any discussions on the subject, it now looks like activity is picking up with the announcement that Johns Hopkins has jumped the the Azyxxi bandwagon. For those that are interested, the site has an audiocast with the key players comments on why they chose Azyxxi.” I was supposed to see it awhile back, but that never panned out. I haven’t heard much lately, either, although I’m sure work is being done to bring it up to Microsoft’s standards.

From Russell Casse: “Re: Healthvision. Major layoffs at Healthvision appear to be happening today (20-40 total). That leaves just three people on the executive staff. Verisign is not giving them any more cash and VHA seems to have all but disowned them, as they sent a memo to their members stating that they are no longer affiliated with HV.” Confirmed: restructuring occurred today on the low end of your range. I’ve redacted the names you mentioned since I sure wouldn’t want mine put up on some idiot’s blog after I’d already suffered the indignity of losing my job. Nobody likes layoffs, but it’s a fact of life, unfortunately, even though both employees and management are doing the best they can. Otherwise, life goes on: the company still has customers and work to be done. Condolences to those affected (and to those who had to orchestrate the unpleasantness.) There are plenty of jobs out there for the displaced. Some of the sponsors whose ads are to your left would love to talk to you, I bet.

Reader Matt wrote this response to a New York Times article called Who Pays for Efficiency? “In Steve Lohr’s examination of the costs and benefits of electronic health records (‘Who Pays For Efficiency’, June 11, 2007), he addresses physicians and payers, but he is missing the most important stakeholder – the patient. While insurance carriers may bear the greatest financial benefit from the use of electronic health records, patients experience safer care and improved outcomes – all of which help to defray overall healthcare costs. When combined with recent efforts in healthcare information exchange and the ability for physicians to see a patient’s record along the continuum of care – all enabled by electronic health records – the benefits to patients extend beyond the physician’s office to other venues of care including the hospital and most importantly to the emergency room where quick access to a patient’s medical history is critical in providing timely and accurate care.”

Misys will provide a trading update Wednesday that should tell us how healthcare is doing.

Healthcare companies on this year’s Computerworld’s 100 Best Places to Work in IT: Sharp HealthCare (#3), VHA Inc. (#16), Sutter Health (#18), Norton Healthcare (#34), Partners (#37), Memorial Long Beach (#42), Cerner (#59), Palmetto Health (#62), Moffitt (#68), Englewood Hospital (#94), and Duke University Health System (#100).

Fred Trotter has posted a guide to sharing medical software via FOSS licensing.

eScription recognizes its customers who have saved big money through the use of its products. Lots of familiar names are on the list: Carle Clinic, Charleston Area Medical Center, BIDMC, Brigham and Women’s, and UNC Health Care (those are the ones I know very well.) One winner said they’d chopped transcription turnaround time from two weeks to 24 hours. Speaking of eScription, the Columbus paper mentions that a local hospital improved transcriptionist productivity so much that it’s doing outside work for doctors. Said one of its customers: ‘When Mid-Ohio Surgical Associates signed up with Mount Carmel as a customer for the service, the company was told that turnaround time would be 24 hours, said David Hafler, administrator for the practice. ‘We were like, we’ll believe it when we see it,’ Hafler said. ‘Well, we see it.'”

Sumter Hospital update: they’ll move to the interim hospital just over three months from now. The oncology clinic has seen its 1,000th patient since its relocation. Some NFL players helped out with a charity golf tournament – the winning team from Depot Car Wash donated its winnings back to the hospital. They held a silent auction and black tie dinner this week, raising $16,000 from the auction alone. Pictures of Sumter Regional East are here.

Housekeeping issues:

To your right (on HIStalk2 only) is a new “Subscribe to Updates” box. That gets you on the “new” e-mail update list. The old one may go away eventually, so I suggest signing up (the new one is more powerful, so that’s why the change.)

I’ve heard from a few readers that IE7 is giving errors when displaying this page. It’s apparently common because of the way the sponsor ads are formatted, but it gives no errors in Firefox and only minor errors in earlier IE versions. If you’re having to click OK a bunch of times, you can turn off script error checking and debugging in IE (or download Firefox.)

I added a link to HIStalk Discussion at the top of the page (Inga’s good idea.) Also, notice that if you hover your cursor over the discussion topics to your right, you can read the first part of each item without clicking (I just discovered that.)

Why post to HIStalk Discussion instead of leaving a comment? Better formatting, automatic quoting, polling, your title shows up on the main HIStalk page, and you can easily include links. Best of all, you don’t have to wait for me to approve your message – since you’re registered, your message comes up immediately.

Today is HIStalk’s fourth birthday, an obnoxious little hellraising toddler with the sweetest face you can imagine when it’s asleep.

As Inga reported on the discussion board, Misys Healthcare names Gary Larson to run its homecare division. He was CEO of a Kodak subsidiary.

Here’s another excuse for physicians to keep paper-based records: a law journal says EMRs raise malpractice liability risks. Reasons: data loss, inappropriate corrections, inaccurate entries, unauthorized access, and problems when transitioning from paper. All sound like advantages of EMRs over paper to me, but I’m not a smart lawyer. One reason that does make sense (rightly or not): EMRs provide a permanent record of overridden clinical warnings that could be used as evidence. I know I’ve had to cough up electronic evidence of such warnings and responses in the past, but I don’t know if it ended up being important to the case.

West Virginia Governor Joe Manchin writes a good newspaper piece on EMRs.

News, rumors, e-mail me.

Discuss today’s HIStalk.

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Inga’s Update

Last week I mentioned that Mark Anderson and the AC Group just released the 2007 PMS and EHR Vendor Functionality and Company Rating Report. For those not familiar with The Healthcare IT Futurist Mark Anderson, he is CEO of the AC Group, which publishes rankings of PMS/EMR/EHR products. The evaluation is based on surveys with several hundred questions on product functionality. Unlike some other rankings (such as KLAS,) the emphasis with the AC Group rankings is functionality, though client satisfaction and company viability do come into play to some (unclear) degree.

For grins, I cross-referenced the KLAS rankings with the AC Group rankings and determined that strong functionality does not always equal client satisfaction (assuming that KLAS rankings really do represent client satisfaction – and I am not going to address that already well-addressed topic here.) Not all the products were assessed by both rankings, by the way.

The takeaway, I guess, is that if you are looking for an EMR solution, best not to depend too heavily on just one set of rankings.(Which brings up another topic … do you think there is a need for some sort of on-line vendor guide that compiles various rankings and commentary from users – such as HIStalk readers?)

Anyway, back to the AC Group. Here are a few takeaways from the rankings.

Who is hot

NextGen stands in a league of its own, with top ranking in all the categories in which it was ranked (which was everything except for 1-2 doctor solutions and “charting systems”- in other words, EMRs that were not considered full-fledged EMRs.) Note that in the KLAS rankings as of the end of 2006, NextGen ranked 12th for 1-5 doctors and 6th for 6-25 and 25+ docs.

The also-hots

Allscripts, with strong functionality rankings for both TouchWorks and HealthMatics. The HealthMatics products were ranked between 3 and 8 in various categories; TouchWorks 2nd and 6th. Predictably, HealthMatics was higher ranked for solutions for fewer physicians and TouchWorks did better in the large solution categories. There was some similarity in KLAS and the AC rankings for the Allscripts solutions. TouchWorks was ranked 2nd in the KLAS 25+ category. HealthMatics was ranked 6th for 1-5 doctors and 3rd for 6-25 doctors in KLAS.

eClinicalWorks had solid rankings and good KLAS numbers. Others with relatively strong functionality ratings included Streamline MD, MCS- Medical Communication Systems, and McKesson Practice Partner. Streamline and MCS were not ranked by KLAS; Practice Partner had average KLAS scores.

Middle of the pack

Others with solid though not outstanding rankings included Omni-MD, Bond Technologies, Misys, Greenway, GE Healthcare, and Epic (although Epic was #3 for FQHC and >100 doctor solutions).

Charting systems

The top charting systems included MediNotes, SynaMed, Medinformatix, Cerner, and SSIMED. Again, charting systems are considered to be those EMRs that are not full-featured EMR’s.

I am curious what others think about the value of these rankings, so please share!

I have enjoyed talking to a few of our sponsors over the last couple weeks. If they did a KLAS ranking for sponsor satisfaction, I think HIStalk would be Best in KLAS. Take note, all you potential benefactors who are considering joining the coolest sponsorship group out there … our sponsors love us because they get great exposure, personal attention from Mr. H (and me),  and the rates are a lot less than many, many other options out there! And Platinum sponsors have the opportunity for a personal interview by Mr. HIStalk to introduce you to our big audience (come on, you know you have always wanted to talk to him!) Let me know if you want to hear more.

Speaking of sponsors and KLAS, congrats to Hayes Management Consulting for their #1 KLAS rankings in the categories of Planning & Assessment and Implementation Supportive. Hayes was also ranked second in Technical Consulting and Overall Professional Services in KLAS’ Mid-Year Top 20 Report.

Also, kudos to sponsor InterSystems for Ensemble’s #1 ranking in Other General Market Software and Interface Engines.

A round of applause for sponsor eScription for EditScript’s top honors in Transcription and Back-End Speech Recognition.

Anyone care to comment on the recent KLAS rankings?