News 05/11/07

From Bobby Unser: "Re: McKesson Series. QuadraMed does a great job of replacing Series with an industry leading revenue cycle product and clinicals that are proven above and beyond the vision for Paragon. I admit that I'm a QD employee, but I think we ROCK! I have seen Horizon bundled with Paragon to complete the offering. Not any live on CPOE with Paragon because it does not exist."

From Very Rural CIO: "Re: McKesson Series. We have just completed the process and have decided on HMS. We took a cursory look at CPSI and Dairyland. Didn't care for either, especially the problems with the new Dairyland product. It shows well, but has a lot of functional holes. CPSI just didn't scale out enough for us and we didnt' like their business model. We looked very hard at four other products including Clarus, Paragon, Meditech, and HMS. Clarus looked NICE. But we are a small rural hospital and didn't feel the product was mature enough for our resource capabilities. Paragon ... well what can I cay. Yes, it is a very robust product, had everything we were looking for, as did Meditech and HMS. But during the RFP process, we got the same song and dance from them that we have endured for 12 years with their Series product. And the quotes were full of smoke and mirrors. We couldn't pin them down on pricing and what we were getting for our money, not to mention they were half again as much as the HMS product, which included many more modules. So we steered clear. Meditech is too equipment intensive and the site visits we less than impressive. The nurses didn't like the clinicals so they didn't use it the way they should. Everywhere we looked they had 'shadow' IT folks doing lots of work to get the users what they needed. We would have needed 24 Intel servers to run the Client Server product. Too resource intensive for our capabilities. My estimate was we would have needed 4-5 additional FTE's to support it. Finally, we chose HMS. Their sweet spot is around 100 beds, but they scale out to 350 very easily and can be price competetive for us little guys. It is a very tightly integrated system, (INTEGRATED, NOT INTERFACED). It runs on the iSeries, and the price included a new model 525. Contrary to popular belief, the iSeries is not an obolete platform, but then you know that. It's security is unparalled, and with healthcare data involved, that helps me sleep at night. High Availabiity is easily accomplished so DR is covered and there is no downtime. HMS supports everything but the MIMIX HA solution, hardware included, and they do it across a VPN. It's a one stop shoping deal no he-said-she-said about who's problem it is. The HMS system includes just about everything and they were very above board about what works and what doesn't. The site vists revealed very satisfied users, both the technical and the clinical users. The hospitals we visited averged .5-1.5 increase in IT FTE's to support the HMS system, we'll probably get it done with 1 more. The implementation plan is very organized and they come to you and train your folks; no train-the-trainer sessions in some far distant city. With an average of around 50 installs per year over the past 3 years, including several Series hospitals, they have it down pat. To be honest, we went into this looking mainly at price. We are a small facility and don't have millions to burn. But in the final analysis, they not only had the best price, but in my opinion, the best product."

From Bud Fox # 2: "Re: stock options. I find no sales person worth the money mentioned by Bud Fox. Most of those guys hop around to various companies and milk them with stock options and bonuses for not delivering. When will these companies learn about pay for performance? Think about the shareholder value that is being wasted, the customer satisfaction that could have been gained with the money, or the satisfaction that could have been gained by sharing those bonuses and stock options with the hard working employees in the trenches."

Medicity will implement its MediTrust platform at Memorial Hospital of Belleville, IL, staging information from MEDITECH, PACS, EKGs, and document images.

I mentioned a supposed Allscripts customer complaint yesterday, giving it minimal exposure because I didn't find it all that interesting, questioned its source, and wondered why it had been sent to other sites in addition to HIStalk. Anyway, it was also posted in its entirely to an EMR discussion site that later heard from Allscripts' attorneys and then pulled the posting offline. The site admins took a beating from readers crying censorship (Allscripts is that site's sponsor.) Glad I kept that one at arm's length. It may or may not be authentic, but it was a little bit questionable and I'm trying to be more responsible.

Speaking of rumors, I've been holding back some of the more far-fetched ones that have been sent in. I love getting stuff, but please give me some proof about who you are or what you're claiming. It makes it much easier for me to run it in good conscience. All I need is some way to verify what you're telling me and I'll go with it. Use the Rumor Report link to your right and send it my way. You will stay anonymous, of course -- I've been doing this for four years, so if I were irresponsible, you'd know by now. I'm lonesome, so talk to me and let's expose some juicy stuff.

Here's how to see all HIStalk reader comments nicely listed: when you go to HIStalk's home page, you see the five most recent postings, but you don't see any comments. But ... click on the story name. The comments do display at the bottom of that page, neatly numbered and formatted. That's also what you see if you click on the incoming e-mail alert. For example, yesterday's post has 13 comments and you can see them all here. I forgot to mention that when moaning about how comments don't display on the main page.

One of those 13 comments involves a vendor's rumored use of one of its employed physicians to host site visits at a local hospital. The doc supposedly works there, too, but doesn't tell prospects that he's drawing a paycheck from the vendor he's touting. I've heard this a couple of times and am trying to pin down names, so if you know, tell me.

The VisualMED folks sent over a refreshingly honest Q&A they had with some German investors. They're planning to install 11 sites (hospitals and clinics) in the next year. They want a critical mass of 10-15 customers that will cover their operating costs, then they expect to expand. They plan to get 60% of revenues from the US, 30% from Europe and Asia, and 10% from their home country of Canada. It's a tough chore to try to get traction in a market with well-financed competitors. The company's hoping for revenue of $1.8 million. I interviewed CEO Gerard Dab a year ago. "The customers I’ve had are hospitals who want to compete more aggressively with local competitors. The old rules of 'cover your ass' and 'don’t take any chances' don’t apply. Our Kansas City surgery hospital has 40 beds but does more surgery than a 600-bed Canadian hospital. They don’t fool around, there’s not an IT director covering his ass, and they don’t wonder if something will work or not."

Lots of brave, insightful investment professionals have suddenly publicly professed their undying love for McKesson stock, completely coincidental with its unexpected profits just announced. And in other news, I'll sell you a guaranteed winning Lotto number ... from last week.

We're trying to test a new vendor software release at our place, unfortunately riddled with such plainly obvious errors that it's pretty much a pointless exercise. Which reminded me of a saying we programmers had at my previous vendor employer: "The program compiled, so my job's done." My observation from my experience with a couple of obviously sloppy HIT vendors: everybody's an Alpha site.

I have a new Platinum sponsor finishing up their ad, an organization I was surprised to see on board with HIStalk. As always, my heartfelt thanks to HIStalk's sponsors:

Design Clinicals (Gold)
EnovateIT (Platinum)
eScription (Gold)
Hayes Management Consulting (Gold)
Healthcare Growth Partners (Gold)
Healthia Consulting (Platinum)
Inside Healthcare Computing (Platinum)
Intellect Resources (Gold)
InterSystems (Gold)
Lucida Healthcare IT Group (Platinum)
Medicity (Platinum)
Noteworthy Medical Systems (Gold)
Novo Innovations (Gold)
Picis (Platinum)
R. Gaines Baty Associates (Gold)
SCI Solutions (Platinum)
SolCom (Gold Banner)


GAO criticizes (like it did two years ago) HHS's issuance of a bunch of healthcare IT contracts without having detailed plans or timelines. GAO checked eight hospitals implementing IT and found only one whose electronic records were complete enough for an abstractor get quality reporting data. One of those hospitals had no electronic information at all.

Modern Healthcare and HIMSS recognize three big-budget hospital CEOs who buy a lot of stuff from their IT vendor advertisers. Congratulations to everyone involved, I guess. Here's a thought: how about a HIStalk award series? Why not? It would be equally credible and the HISsies are a lot more entertaining than a breakfast ceremony, I bet.

The former mayor of Madison is quitting his Epic Systems job to go into consulting. Of course, he's launched the mandatory blog. I'll say this: damned impressive hair and mustache, especially for a guy of 62. Actually the blog is pretty good as blogs go, although I steer a wide berth around political ones.

Merge Healthcare announces Q1 numbers: revenue down slightly, EPS -$0.30 vs. -$0.15. Ken Rardin utters CEOspeak about how great things are in every way except those involving revenue and profit. Still, the stock is up nearly 16% today for some bizarre reason, even though the loss was worse than consensus estimates.

Claims processor MedAvant turns in sorry numbers, too: revenue down slightly, much higher losses due to some kind of accounting error they found. Their CEOspeak: "We continue to take pragmatic steps toward improving our business model ..." Good idea.

An interesting study: 97% of physicians say they'd disclose their medical errors, but only 41% said they had actually done so. Apparently more than half the docs think they've never made a mistake. Probably about the same percentage who are surgeons.

Ex-IDXer Jeff Kao is named sales SVP for Hill-Rom.

HHS seizes the $200,000 Rolls of a Medicare scam artist billing you and me $869 for air mattresses. They also nailed one of Bill Clinton's advance men in the Medicare cesspool of South Florida. All you need to know about fraud, abuse, and blatant healthcare crime can be learned within a few miles of Miami.

Strange medication error: a transplant patient leaving the hospital stopped by Eckerd's for her prednisone prescription. They sent her to CVS, who somehow changed her 250 mg daily dose into 1250 mg. She took it, had lots of problems, and is sued everyone. Her pill bottle told her to take 62.5 tablets per day, with the pharmacist's excuse being that she was getting off in 20 minutes and wouldn't have had the time to find someone in the hospital to clarify the prescription. The patient was awarded $13 million. Keep in mind, though, that a retail pharmacist is working completely without context, having no information on diagnoses, lab results, or previous orders. If anyone needs the kinds of information that a RHIO claims to provide, it's them.

News, rumors, haikus: e-mail me.