News 04/19/07

From ONCHIT Insider: "Re: Deputy National Coordinator opening. Two weeks ago, ONCHIT interviewed the finalists at HHS HQ. Several industry folks were interviewed, such as Orlando Portale, a fellow blogger who has contributed to HIStalk. ONCHIT is expected to make a final hiring decision in the next three weeks." I can confirm from my sources that Orlando and a handful of government insiders are the finalists. Backgrounds are being checked now, I hear, and a decision will come shortly. Kolodner will want someone in place quickly, I'm sure.

From California Dreaming: "Re: Sutter. Most of that $587M may be end up in the 'bit bucket' as Sutter goes Epic."

From Hermey: "Re: Reign Over Me. Thought it was interesting that there was a full Pyxis station in each scene in the dentist's office as well. Missed the MEDITECH binder." I looked up filming locations, thinking maybe they used an old hospital like Scrubs does, but the dentist's office scenes were supposedly shot on an LA soundstage. Maybe they grabbed some hospital accessories for set decoration, not realizing that few dentists use MEDITECH or Pyxis.

From WallBanger: "Re: Piedmont. Can you ask your readers if they have heard ANYTHING regarding the Piedmonth HIPAA audit from OIG?" Inga's been trying to get an update, but the hospital isn't talking so far. We'll stay on it.

Larry corrected my math on the eClinicalWorks deal with New York Department of Health and Mental Hygiene. The press release said 1300 physicians will use the software, but a later article gave a figure of 1500 practices that range from small offices to large clinics. So, even if the average is only two docs per practice, that's down to $6,600 per seat and it's probably a good bit lower than that. The deal also seems to include eCW's practice management system and probably some training as well. So, it's a huge deal for eCW and good pricing for the city. Thanks, Larry. 

Microsoft is reviewing developers' feedback on Connected Health Framework Architecture and Design Blueprint, a service-oriented architecture project announced at HIMSS and underpinned with SQL Server, BizTalk Server, and .NET. On the current state of integration using HL7: "You're trying to pull together systems that really weren't meant to interoperate. Yes, they can exchange clinical messages using industry standards, but it's really a monolithic application that's informing other systems that there's something for them, and they need to carry on some work. It's very hard to integrate."

AMICAS acquires the IMAGINEradiology platform from Technology Partners, Inc. They'll combine the billing and practice management system with their RIS and PACS solutions.

University of Utah Health Care says its HP desktop blade computing and server virtualization provided a big return: 346% ROI, $4.8 million in savings, and IRR of 146% over three years. One might quibble with some questionable math that led to the statement that desktop staff were reduced by 100% when they actually had the same number as before by my reckoning, but I understand what they're trying to say. I think we can safely conclude that server virtualization is a big deal that CIOs should be looking at. You're soaking in it, by the way, as HIStalk's ads are hosted on a virtual private server. I was sold on the benefit of scalability and cost-effectiveness. It's cool that I can reboot my server even though it's not a physically separate box and it really smooths out the CPU demand.

Tim Welch is named SVP of sales for CareMedic Systems. He was formerly at EMC and GE Healthcare.

MedPlus, now owned by Quest Diagnostics, gets a subcontractor deal under Sun Microsystems to develop a lab portal for British Columbia's physicians.

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Inga's Update

MedAssets Inc. of Alpharetta , Ga. has agreed to acquire XactiMed, a Richardson, Texas-based provider of Web-based revenue cycle technologies and services to the healthcare industry. No financial terms were disclosed for the deal, which is expected to close next month. MedAssets partners with healthcare providers to improve operating margins and cash flow.

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I asked for some thoughts about so-called Health 2.0. Is it real or blown out of proportion? Here's what I've received so far.

Health 2.0 Response 1

We keep hearing about costs, quality, and outcomes providing the answers to the problems of health care of the future. I just keep scratching my head, as what I see is:

1) THERE ARE NO OUTCOMES DATA

We believe the evidence is widely touted but non-existent for most providers and provider organizations. We can find few compelling examples.

2) MOST FOLKS CONFUSE (CONFLATE?) QUALITY WITH CONVENIENCE

In the absence of understandable outcomes data, it is impossible to assess "quality" and most folks equate quality with convenience and how pleasant the customer experience was for them. And even if outcomes data existed, I now realize I don't know enough to evaluate it, even though I've been practicing for many years. There is just too much to learn and know in modern medicine to expect to have good judgment outside one's narrow area of expertise.  

3) HEALTH CARE ECONOMICS DON'T NECESSARILY FOLLOW THE FREE MARKET MODEL

In virtually every other industry, technological advances "reduce unit costs;" but in health care, many advances in technology only *increase* costs, and non-uniformly (and often "non-proportionately") improve the quality or quantity of life for those who can benefit from them. For example, drug-coated stents add cost to the health care system, but they benefit only those who need them. I have no idea why this behavior of health care costs isn't more widely discussed -- instead of the endless pap about technology, quality and free market economics.  It could be that this is the elephant in the room that no one wants to talk about, as there is no apparent solution. The more I think and learn, the less I know what to do. :-))

Health 2.0 Response 2

Health 2.0 is the real deal.

Remember, it is not only the enabling Web 2.0 technology (social networking, blogging, mashups, rapid development of functionality), but also the healthcare reform stuff (transparency, interoperabilty, incentives, and focus on value ) that will truly redefine healthcare.

Examples of the movement are already viable. It is still sporadic, piecemeal, etc - but I believe real change is happening nonetheless. So while the proof is in the pudding, the ingredients are coming off the stove as we speak (and you can certainly smell it coming!).

Health 2.0 Response 3

I think this is absolute nonsense. I liked the synthesis approach, but the term is so meaningless it can't possibly stick. Arguing about what it includes or means is a total waste of time. Please stop typing it.