News 02/16/06

It's catch-up time after HIMSS. I will have much to say, then it will be back to normal. This would be a great time for your guest article on what you did at HIMSS, what you liked or didn't like, what you saw from the vendor side, or anything else that I would find interesting. Why not e-mail me?

From Jay: "Last time i checked, Microsoft still makes software for Macintosh systems. If you cure cancer on a Mac, and use Excel to do it, I'm sure they'd consider your work, too..." Could be, although use of the desktop stuff doesn't seem to warrant their awards. Hey, I sometimes use Word to write my HIStalk interviews ... think I could get named?

From West Coast Ron: "An associate tells me any reference to Bob Pickton's connection to Baylor was removed from his CHIME listing. Rumors abound as to why he is gone, but apparently there were some irregularities on the part of his cabinet. Will Bob join the ranks of his also gone CIO's and become a consultant (a la Ward Keever) or rent-a-CIO (a la Larry Blevins)??? Stay tuned." You are correct ... his CHIME info now includes only his name. What cabinet are we talking about?

From Alias from Maryland, on my comment that I felt like a gay man coming out when wearing my HIStalk button: "Welcome to our world....yes I am a gay man, so save the criticism." No criticism from me. I was serious when I said that, although my experience (and the lack of personal pain it causes me, limited to just an ego shot in my little case) makes the analogy less persuasive. I have something that defines me (HIStalk) that I'm not sure I can divulge to at least some folks who wouldn't accept it (my employer being one that I'm not sure about) and it felt great to have the button out there, although I confess that I put it away when meeting with folks who know me just in case they were better equipped to put two and two together and I didn't want to have to explain or defend. Anything that leads to love and commitment is fine by me since both are in short supply. If I offended, I apologize. I'm also considering becoming less anonymous because I'm jealous that my fellow bloggers had such a good time in San Diego hanging out with their readers while I ate alone in the hotel restaurant like a big loser.

From Fish N' Chips: "Meditech... 'good software' (from previous posting). I’m not sure I have ever heard Meditech being referred to as good. Sure, it works. But there is more to a major HIS then being able to display data on a screen or produce reports. For sure I would never call the application fault-tolerant. You want that? LastWord/Carecast is the answer. I make these statements as a developer, but also as a business analyst. I've worked on both IDX and Meditech platforms." I'll defer to KLAS, in which MEDITECH is typically at a respectable mid-level (scores in the 70s) and above LastWord in some but not all.

From Anonymous Reader: "Damn, you're good... if I was in a pay grade that allowed me to go to HIMSS, I certainly would have worn an HIStalk button. And, I would have found you as soon as the floor opened to shake your hand." Thanks to all who bolstered my spirits on the buttons, of which I saw none except my own (and thanks especially to those who wore theirs, apparently some in booths, where it must have taken a bit of insouciance to attach a button to your yellow badge.) Maybe I should have offered a Mini-Cooper to whomever logged the most spottings (like the hard-hitting investigative team over at Health Data Management, who'll be sending one to HIMSS drawing winner and Rockford CIO Dennis L'Heureux, paid for undoubtedly with ad revenue and not subscription funds.) As for missing HIMSS, I honestly can't recall even one small piece of knowledge that justified my employer's subsidy of my attendance, not that I didn't enjoy it anyway and get a few ideas for HIStalk. But, as I said before, you could ask 500 people what HIMSS was like and there would be little overlap.

Maybe I'm jaded, but perhaps this booth-and-car madness should be stopped by HIMSS. Back in the dark ages, HIMSS limited booths to 20x20 feet. The giveaways, the two-story behemoths, the C-list celebrities like Dr. J hanging around, the booth babes ... all of that is paid for by cash-strapped providers, who unfortunately have come to expect it (it's like having a consultant take you to lunch and then billing it back to the hospital.) Any responsible vendor unwilling to burn cash like its hyper-marketed competitors is branded as a small-potatoes leper. Allow me to go on record as calling out HIMSS to put some dignity back in the proceedings and stop the cost escalation: go back to actually offering quality education, remove the pressure for attendees to be on the exhibit floors during every waking hour, reduce the competitive expense that vendors shell out for stupid giveaways, and tone back on the cheerleading rags whose air-headed reporters are so enamored by their personal flow of goodies and spin that they honestly can't cogitate even one bad thing to say. If you were a patient dying of cancer whose insurance wouldn't pay for your experimental, last-ditch effort treatment, would you be pleased to see highly paid healthcare executives jostling each other for vendor raffles and free pens?

From HIS Cynic: "KANSAS CITY, Mo. — Feb. 14, 2006 — Cerner Corp. (NASDAQ: CERN) today unveiled its plans to enter into the healthcare device manufacturing and connectivity markets. P.S.  I'm wearing the button proudly and telling everyone that hasn't read your blog that they need to. Readership should soar." That was an interesting announcement ... Cerner is getting into the automated dispensing system business. Bravo to them, if it works. Those offerings from Cardinal Health, McKesson, and Omnicell are too expensive, particularly if you lease them (as most cash-starved hospitals do.) Plus, they haven't been innovative, especially on the software side (beyond interfacing.) Notice what happened when HIT vendors realized that 90% of what electronic MAR products like Bridge Medical did was just accept interfaced information and display it differently through somewhat specialized hardware (barcode readers?) Cerner bought them for a song. The same could be true of automated dispensing machines. They're really just simple mechanical hardware run by comparatively crude software that has almost no intelligence other than what it brings in from the pharmacy application. If the software hooks into CPOE and nursing documentation were stronger, this would be real medication management (McKesson is working on this, too.) I should be consulting instead of writing.

From Anonymous: "Medseek and AccessPT are merging." I wasn't all that familiar with either firm, which were content management and clinical integration focused, respectively. The combined companies will keep the Medseek name and offer integrated clinical portals. Thanks for the heads up.

I don't usually re-post comments left on the articles directly, but since you can only see the five most recent without clicking More Comments (which most folks don't notice,) here's one that made my day you may have missed. From Stewie Griffith (obviously a Family Guy fan): "I wore my button proudly in San Diego and told everyone I could!!! But, I have to be honest I am catching people off-guard with all the information I know and I look like a genius! Like rumors and company acquisitions. I used to tell everyone at my company about your blog, but now I am withholding a bit because you make me look good. Keep up the great work...I see a raise and a new title on the horizon because of my (your) healthcare insight :)" I confess that the same thought ran through my head. If I knew about HIStalk, would I tell anyone about it? Not if it made me look smarter to that the guy I might be telling. No wonder it's such a struggle for me to figure out how to make money or get famous.

I get a lot of postings like these, most of which I use. Not all, however. Some are too vague on the points being made, some are too wordy (so I either edit them down or leave them out,) and some seem to just be spoiling for a fight with someone. That's not censorship, it's editing with the reader in mind. Whether I run your comments or not, rest assured that I read and appreciate them.

Was that really John Glaser who posted a comment saying he was an HIStalk fan? I had no idea. I forgot to mention his freeform topics at the session ... he went off on a "just give me the trinkets" rant about the exhibit hall, said that he and Dave Garets just make up the hot topics at HIMSS each year and no one's the wiser, and that RHIOs were one of those things in which no one is really doing anything (including his neighbor at MA-SHARE, although I'm not sure if he was serious or not.)

I'm amused that a vendor put a Garth Brooks lookalike in their booth. I'm sure that wasn't the only "looks cool, but isn't real" item being pitched out there on the floor.

A short de-briefing from HIMSS -- people I liked more after seeing them present: Denni McColm, John Glaser, Buddy Hickman, John Halamka. I didn't really have any experiences all that positive in the booths, mostly because I avoided them. How about you? Did anyone impress you? Was anyone especially unlikeable? Tell me.

I checked HIStalk stats after being away and I'm amazed. Projected monthly volume based on a full month's statistics: 41,388 page views and 22,942 visits. I have no idea who's reading, so feel free to tell me about yourself. On my end, HIStalk is just an empty computer monitor that consumes lots of time.

Emdeon is looking to unload its Business Services and Practice Services lines, which I believe includes the old Medical Manager product now called Intergy EHR, once a force to be reckoned with (if you could stand your local dealer, which most couldn't) but now a mid-pack laggard in KLAS. It is a good time to be shopping it, I expect. The company hasn't done well and early optimism about ambulatory EMRs (not EHRs, no matter what clever vendor marketers call it) means the price could be peaking.

 CIO Field Report

• Hospital type: Community, Single Hospital, <200 Beds, South.
• IT Operating Budget: <$2 million.
• Most important IT projects now underway: PACS, wireless, ED, RIS.
• Systems you’ll be buying within the next three years: Data repository, nurse call - staff communication
• Best application vendors: MEDITECH, Kronos, Medquist
• Worst application vendors: Pyxis, GE, SSI
• Hottest IT skills in the market: Scripting - Visual Basic, Boston Workstation

I didn't read the report in detail (I wasn't $980 worth of interested) but Cerner is crowing about its showing in the KLAS CPOE report. Apparently they led in ubiquity and value. Just like McDonald's, the first thing I thought of when I read that. Nonetheless, that's a great showing.

Former Cernerite Ron Jones is named COO of SoftMed.

Still more on Cerner: was it a happy coincidence that Missouri's governer pitched for a $25 million Healthcare Technology Fund in his State of the Union speech, followed by Neal Patterson's newspaper editorial that I skewered a bit here? Some KC reporters suspect strongly (but can't prove decisively, due to shadowy campaign financing laws) that Cerner's lobbyists touched the governor, followed by Mrs. Patterson's large contribution to his campaign, followed by his sudden interest in government spending on healthcare technology. Well, that's how government works, unfortunately.

In Australia's EMR contracting, Cerner beats iSoft in New South Wales, iSoft beats Cerner in Victoria.

Industry longtimer Scott Harper joins MPI vendor Initiate Systems as SVP.

MercuryMD announces its ability to deliver patient information to BlackBerry devices. I'm sure they cursed the timing of the negative publicity around their new platform provider's impending shutdown, although I expect RIM's workarounds will keep the service running. On the other hand, lots of companies, including Microsoft, are gearing up to steal its business. That's a competitor you don't want.

CCHIT's handbook on EMR certification will be available in a couple of weeks and applications for certification will be accepted in early April. This is pretty big, with all of those sketchy vendor claims will have to be proven to gain certification. Sort of like a detailed RFP on which you actually have to be honest. On the other hand, I said the same thing about ISMP's Field Test of pharmacy systems, knowing that most vendors perform poorly, but people keep on buying those anyway.

Here's an article on the IHE-Connecting for Health RHIO connectivity presentation I mentioned before.

Former Jewish Hospital (Louisville) CIO David Pecoraro takes on the same role for Denver's Exempla Healthcare.

While everyone is trying to hype RHIOs, consider this from the HIMSS Leadership Survey: 76% of hospitals don't have a fully functional electronic medical record system. Hey, here's a business idea: an incoming fax portal to RHIOs, so all of that crappy paper chart can be faxed into those shiny new RHIOs that congested the HIMSS educational sessions. If you agree, you might check my editorial in today's Inside Healthcare Computing electronic update.

So I get the latest Computerworld and it seems to be mostly healthcare news. CDC will gather real-time data feeds from hospital EDs. An Indiana clinic gets hacked and its electronic chart developer is being investigated by the FBI. Prudential Financial has been faxing medical histories by mistake to a Canadian drug distributor. Blue Cross Blue Shield of North Carolina printed Social Security numbers on mailing labels. Johns Hopkins outsources call center support to ACS.

A 20-year-old is indicted for bringing down the network of Seattle's Northwest Hospital and Medical Center. The little pissant's botnet was designed to generate false advertising commissions and has brought down up to 50,000 computers since 2004. The hospital called the FBI, who tracked him down. I'm thinking he's in some richly deserved big trouble.

Per-Se buys one of those shift bidding applications that seem to be everywhere.

I like this idea: a wireless-powered staff locator and emergency alarm system for hospital employees. As everyone always said, once you have wireless in place, there's all kinds of stuff you can do with it.

President Bush made a speech from the headquarters of Wendy's this week. I knew only because I was channel flipping in San Diego and ran across live coverage. Here's what he said about technology (long, but important for you to know, I think): "Third policy that's important is to apply modern information technology to our medical system. Doctors practice 21st century medicine, they still have 19th century filing systems. And this is an important issue. One reason it's an important issue, because when a doc writes their files by hand, you generally can't read the writing. (Laughter.) That leads to inefficiency and error. In hospital there is more risk of preventable medical error when records are handwritten, instead of being cross-checked on a computer. Oftentimes doctors duplicate expensive tests because they do not have access to previous results. In other words, the medical system has not taken advantage of information technology like I'm sure Wendy's has, or other industries around the country. And so I set a goal in 2004 that most Americans would have an electronic health record within 10 years. You'd have your own health record on a chip. And we're making pretty good progress toward that goal. Mike Leavitt is the Secretary of Health and Human Services. He's got a whole division inside HHS aiming towards getting information technology spread throughout health care. First thing is, they've got to have a language that kind of can talk between a hospital in Dublin and a hospital in Crawford, you know? Well, they don't have a hospital in Crawford. (Laughter.) How about a hospital close to Crawford? (Laughter.) And that's important, because there's a lot of different -- the language needs to be standardized. And Mike is making pretty good progress on that. We're developing solutions for a nationwide health information network. One of the things I've insisted upon is that it's got to be secure and private. There's nothing more private than your own health records. And so any system that works is one that is -- it's your record -- you decide the disclosure of your health records. So let me give you an example about how such a system can work and what I'm trying to explain to you about how to help control costs and reduce medical errors. After Katrina hit, there was hundreds of veterans that had to be relocated. What's interesting is, is that the Veterans Department has already started this information technology modernization. There are medical -- electronic medical records for veterans. And so when these poor folks got scattered around the country, the doctors and providers had access to the electronic records of our veterans. So if a person had a diabetes issue, up pops on the screen the information, the latest test, the medicine being taken. It was an incredibly efficient way to make sure that the health care needs of our veterans were met during this time of catastrophe. It helped people fill out the prescription drugs of our seniors without fear of error. It helped a local doc say, well, gosh, look, you've been taking this medicine in the past, I'm going to prescribe it for you in the future, in order to make sure that your health care needs continue. If you have your own medical record, your own electronic medical record, and you get sick in a remote part of our country, people instantly see your blood type, the issues that you've faced in the past, really important information about who you are and what you're going to need to help you. And we're on our way to providing a nationwide information network. It's going to help save maybe 25 percent of the costs in medical care. I told you that one of the important things we've got to be worried about is how to deal with the cost drivers, how to come up with ways to, practically, with a common-sense solution, deal with rising costs. One way is to modernize health care. Another way is to put consumers in charge of making decisions with transparency in pricing."

GE launches an "integrated suite," described in a buzzword-rich press release. What it means: in the month since the IDX takeover, the products are now called Centricity by the marketers and some screens actually display that name. This passes for integration in healthcare, at least since HBOC pioneered the concept.

Speaking of GE, their partner Intermountain Health Care will implement Centricity RIS and, PACS in 21 hospitals. CareCast too. GE's also spending a fortune on a new marketing campaign called "Healthcare Re-Imagined."

News, rumors, ideas: e-mail me.