Monday Morning Update12/4/06

From Anonymous: "Re: FCG. Since Luther left (months), the stock has gone up from 5.85 to 10+. Since Heck left (weeks), it has gone from 11.20 to 12.44. Maybe no correlation, but it looks like good moves by the Board. All the employees I have talked to are positive, but wondering what took so long to correct massive managerial ineptitude. BTW, you won't be disappointed in St. Elsewhere. Look at the cast and what they have done since! WOW!" I'm happy to report that, having watched the first four St. Elsewhere episodes on the 22-episode Season 1 DVD, it's even better than I remembered. Just hearing the theme took me back to the early 1980s. The writing and acting is just mind-boggling; it's like watching a movie instead of a TV show, except it's better than most movies. The scenes flow from one set of characters talking into another using hand-held cameras and complex direction, making you feel you're walking the halls of St. Eligius. The medical details are highly realistic, the picture quality is just as good as a new show, and the overall brilliance makes you realize how vapid today's shows are in comparison, shot on crappy video with idiotic TV audiences howling at thinly disguised "jokes" passing for plot line or slo-mo gross anatomy lessons led by crime-stopping, low ranking pathology techs who lead investigations and elicit confessions based on one hair (like rooms aren't full of them.) I didn't care much for the Jack Morrison character back then (too sensitive, always crying and getting homo-raped) but even he was excellent in these first eps. Dr. Craig is exactly what you'd expect of a highly skilled, big-ego doc with short man syndrome ("Napoleon's got nothing on him," Victor Erlich says).The only negative: bad synthesizer background music other than the main theme, taking me unpleasantly back to the years of Christopher Cross and Michael McDonald. $27 well spent.

From Anonymous: "Re: 3M's SoftMed purchase. 3M partnered with Intermountain Healthcare for many years to develop a 3M product called Clinical Workstation. After DOD rejected the Oceania Wave solution for documentation, 3M tried to interest them in Clinical Workstation. DOD was not interested, IHC bailed on it and, all of a sudden, 3M was reduced to peddling their Health Data Dictionary and some coding products. IHC then announced a partnership with GE to build the ultimate system (stay tuned to that channel for entertainment value), and just announced a clinical content initiative. Now, as terminology standards start to emerge, I think 3M sees the relevancy of their products being threatened and are looking for a strategy. Their biggest challenge is that they have never understood the clinical user and the needs of the clinician at the point of care. They are strictly coding and data dictionary 'geeks' and I don't see SoftMed as changing that. SoftMed has a grab bag of methods for data input and 3M has a grab bag of data.  Yikes." I was a big fan of 3M's Care Innovation, although the Stockell order entry piece may have doomed it. They didn't sell many, and I bet they left their few customers PO'ed when they canned it.

From Silicon Valley: "Re: Oracle/Cerner. IBM Healthcare G.M. Neil de Crescenzo left to join Perot, but left after only three weeks after being recruited by Oracle. Word on the street is that he was brought in to look at potential acquisitions. You won't see any public announcements from Oracle regarding Neil's appointment, as he is currently operating in stealth mode." You're right on his Oracle job. I found a document in which he's listed as Group Vice President, Global Healthcare and Life Sciences for Oracle. So, if you think about the kind of company that would interest Oracle, I'd expect: (a) either big market share or rapid growth; (b) use of Oracle's technology; (c) someone who can play in interoperability; and (d) a company whose culture has already been neutered enough to not pose problems working for an odd and ever-changing bureaucracy like Oracle's. I wouldn't expect them to be very interested in consulting, hardware, or FDA-approved devices. Anything that pokes a finger in Microsoft's eye is even better. So, to readers, who would you expect to be on their acquisition list? (and remember that they already had Cerner on their short list, as I reported two years ago.)

From Anonymous: "Re: why vendor staff hate their jobs. Low pay, long hours, inexperience co-workers right out of college, only a small group of insiders can make big money, high turnover, and Koolaid. Companies know what goes on at other firms and have made this the cost structure of the industry. So, (a) wonder why your software sucks; and (b) what happens when they can't hire, as colleges don't graduate enough good IT folks. The baby bust is here." Looking at it optimistically, now's the time to hang out your own shingle. It's easier to turn your back on a crappy job and risk it on your own, paying yourself what your efforts are really worth instead of what someone else wants to begrudgingly dole out to you. You probably aren't giving up future promotability, pensions, or stock options since those aren't common anyway. There are tons of software niches out there, the technology is simple enough that smart people can build usable software right away, and those same mediocre products that are bad news for customers are great for would-be competitors. On the other hand, it's easier to hide under an employer's wing, convincing yourself that you're tragically oppressed but doing nothing about it. It's a great country that's full of opportunity for people willing to work hard, stay focused, and defer gratification. There aren't many of those, unfortunately.

From Small-Town CIO: "I would back a ban on employee rants unless there is a credible and verifiable story behind them. The information may be accurate, but there are always two sides. We've all worked with less than stellar employees who are free with their complaints and nearly every company is subject to negative rants at one time or another, especially since everyone's perception of happiness differs. Everything else presented on HISTalk has been great and is a service to us - your work is greatly appreciated by everyone!" Well said on the employee complaints. My problem is that I have no real way to find out if there's fire underneath the smoke. Even if I verified the identity of a ranter, how do I know their opinion is widely shared within the company and what's behind it? I doubt that's the best use of my time trying to find out. It's also not fair to a company to give complainers an unlimited forum, leaving the company to either suffer in silence or come hat-in-hand to a blogger to ask for equal time. I'm going to be selective with what I run since a large part of my job is to not waste the time of readers, thus leaving time for far more important healthcare IT topics like how great St. Elsewhere is and which nearly naked hot-chick singer has earned my undivided attention.

From The PACS Designer: "TPD would like to enlighten HIStalk readers about archiving, since it was on Maughan's list. Past archiving efforts focused mainly on specific department needs, with each department acquiring direct attached storage (DAS.) These early forms of storage were magneto optical discs (MO's), digital linear tape (DLT), and medical grade compact disks (CD's). In the early 90s, digital video disks (DVD's) started to be used in healthcare institutions. In the late 90s, you saw a transition to online and long-term storage solutions. The online storage took the form of a redundant array of independent disks (RAID) and was SCSI, which stands for Small Computer System Interface. The long-term archive was typically linear tape technology, primarily DLT or digital serpentine tape (DST), which had a better recovery possibility if a tape became defective. Now we have even more options for storage and the cost of archiving drops each year. A new online storage option is iSCSI, which has the name Internet Small Computer System Interface for RAIDs, used with today's web-based systems. In the long term storage area, we now have the Fibre Channel Protocol (FCP), which is the interface version of SCSI for Fibre Channel Systems. The RAID configurations allow for disc mirroring to provide proven capture techniques to reduce the chances for data loss and cover many different types of configuration to solve all storage needs of the users.  When considering your storage needs, it is important to plan for increased storage in future years, as the file sizes from modalities are growing exponentially each year and the migration to virtual storage solutions such as Network Attached Storage (NAS) is just starting to take hold in healthcare institutions, replacing DAS. In the next few years, you will be hearing more talk about Grid Storage Networks (GSN), which is a remote storage solution with guaranteed uptime in a distributed network environment." Another great Bicentennial minute on PACS (took you back there, I'll bet.) I like these small-bite TPD pearls, don't you? I see the voting is heavily against PACStalk, which is a relief since I'm already stretched, so this series is cool, for which I thank TPD.

From The Gut Guy: "A little trivia question. What company developed the orginal Epic product that was eventually sold to Epic? KPIT!" OK, a little more info, please. Kaiser developed the original Epic system? I sure haven't heard that and it doesn't sound right, so tell me more.

From spaghettiking: "I just heard that a Last Word to Carecast upgrade costs $10-20 million. I'd appreciate any insights on how much an upgrade or overhaul costs these days? When is it time to shop for something new?"

Dan Costello, an LA Times reporter, needs contacts for a story he's working on who have experience (good or bad) with Kaiser's HealthConnect (on or off the record.) E-mail Dan or call him at the Times at 213.237.7442.

Let's say, who annoys me more? Tyler Florence (ribeye with chile garlic shrimp) on the Applebee's commercial, or Ty Pennington (bullhorn) of Extreme Exploitation: Home Edition (that's what I call it, anyway.) Tough call. I wouldn't have brought it up except I just heard Ty #1 pitching his crappy, pretty-boy food on TV ("Eatin' Good in the Neighborhood", they say, eliciting images of Deliverance-like inbreds slopping right by the hogs at the feed trough.) Here's Ty #2's show's "creepy wish list" of illnesses. Lucky for them we have 500 channels looking for anything that passes for entertainment.

Sanjay Shah, the former Porter Hospital CIO turned fired-and-suing whistleblower, turns up at Cabell Huntington Hospital (WV), who's signed with Cerner for a $20 million Millennium implementation. He eventually dropped the suit after receiving a $425K settlement.

Parata Systems, purchaser of McKesson's APS prescription system, lays off 65 Louisiana employees this week with 45 more upcoming in the next couple of weeks as the company shuts down the plant.

Emageon will resell Allscripts Touchworks to physicians with its hospital customers to take advantage of Stark relaxation.

An NHS trust is looking for a pharmacy computer system, says this contract notice.

Humana will offer Brain Fitness, a $400 "neuroplasticity" computer game that exercises the brains of senior citizens and even reverses memory loss, to its members (not free, though.) I'm fascinated that a study showed those aged 61-94 improved memory by an average of 10 years, suddenly able to remember phone numbers. Brilliant. I took their online brain speed test and scored a smokin' 32 milliseconds, beating the crap out of the average for even those in their 20s. High-five me.

Odd: refrigerator magnets can interfere with heart devices, causing an embarrassingly tacky demise.

News, rumors, refrigerator magnets of death: e-mail me.