News 11/7/07

From Clarisse O'Shaughnessy: "Re: CCHIT. Here's a new article on inpatient EHRs." Link. CCHIT announces the first six inpatient clinical systems to earn its approval: CPSI, Eclipsys, Epic, and HMS. Two products were given conditional approval waiting on their first live site (as I interpret it): Prognosis Health and Siemens Soarian. Not on the list, obviously: Cerner, Meditech, McKesson, GE, and several more. The next round will be announced in January. Soarian gets outed in the process: it earns certification, but has to admit to having no live sites for its "pre-market" product (it seems like ten years' of HIMSS Soarian PowerPoints, but is probably less). 

From Merrick Jamison-Smythe: "Re: Phoenix. Phoenix Technologies just announced HyperSpace, treading on the toes of Epic Systems' portal." Link. I'm not getting the Epic portal connection. Looks like a way for PC makers to create instant-on applications that work like mini-appliances, independently of the operating system (you can run e-mail by pressing one key, even if the PC is off). That would change the paradigm of portable computing, where waiting for Windows to churn through all its startup steps is like watching paint dry. Did anyone really expect that, even with rocket-speed CPUs and mega-memory, bootup still takes longer than it did on a Commodore 64? It's like hand-cranking a Model T.

From Curious: "Re: products. Which in your experiences is the best health IT product ever? Could you please run a poll on it?" That's always hard because each product has different audiences, so finding someone who can knowledgably vote across all of them is uncommon. Plus, vendors stuff the ballot box. If someone wants to nominate a "best ever" product, send in your reasoning and I'll consider a poll.

From Oliver Pike: "Re: Gartner. I am suprised no one has written about the Gartner CPR and Magic Quadrant report that recently was released. Similar to the last CPR, Cerner and Epic are the highest rated solution for broad functionality with all other major vendor's being a generation behind (according to Gartner). I am never quite sure how much impact these Gartner reports have on hospitals' decisions regarding these EMR vendors. Have you ever talked to Gartner about their view of the vendor market? What do your readers think about these reports? Worthwhile, or generally ignored?" I've been in healthcare IT for a long time, mostly in big IDN IT management, and I've never seen any Gartner report. I've never heard their reports discussed, don't know anyone who works there, and don't really know what services they offer to hospitals. I stopped by their HIMSS booth once, took forever to get someone's attention (it was all guys in suits engrossed in each other), gave them contact information so they could delivery a bounty of wonderfulness to me, and never heard from them again. From that personal experience, I consider them to be irrelevant, which is too bad since the Hype Cycle is pure genious. Your mileage may vary.

From LBMC: "Re: Misys. How much longer will I care about / read the HIStalk website, now that I can do so without fear of corporate reprisal? Signed, LMBC (Left Misys By Choice - I know, not the usual exit path)." Need a little danger to spice up our liaisons, do we? Want Inga to wear a maid's outfit? You can pretend that I send reader logs to Misys, thus raising the possibility of a bad reference downstream. That's the best I can do. Besides, it's the former employees who have the most fun reading here. Maybe they're just a lot happier being elsewhere.

From Ralph Hinckley: "Re: new job. Scott Decker, former Healthvision CEO, is now SVP at NextGen." Glad to hear that. 

From The Alchemist: "Re: health record trust. If rumors had legs, then this one would undoubtedly walk up to you and bonk you on the head. Wake up! Your legislators will take good  care of you ;)  H.R.2991 Independent Health Record Trust Act of 2007 (introduced in House)." Link. Health record trusts are going to be a hot topic, I'm pretty sure: independent, non-profit organizations that would house your electronic medical records just like a bank houses your money. Benefit: the bank analogy is easy and attractive for everybody to understand. Interesting snips: the patient controls who can access their information, the IHRT can charge account fees to participants or access fees for data users, and IHRTs would be certified by the Federal Trade Commission. Cerner's all for it and has a summary of the bill. If you're an expert, write up the pros and cons and I'll run them here. I haven't thought about IHRTs enough to have an opinion yet, but there's an appealing quality about an independent, trusted fiduciary, especially if insurance companies, employers, and the government can't poke around. Bill Yasnoff has a pretty good bank analogy. Drive-through PHI deposits?

From HIS Fan: "Re: concierge medicine. Here's an interesting blog post." Link. Here's my foolproof medical practice idea: just give cash-paying patients whatever they want since they're the ones paying. No one likes going to the doctor, so charge $1,000 a year for never allowing (much less requiring) the patient to come in, wait, undress, and fidget. No physicians, no preventive care, no ongoing monitoring. Just send that check and your prescriptions will come back in the mail in a Netflix-like practice model. By the time the patient figures out they were ill-served by not getting care, they'll probably be dead (or seeking another doctor, anway). Wouldn't it be refreshing to refuse to get on the scale, to say no to anything that hurts or is embarrassing, to demand several years' worth of undated prescriptions to have filled whenever you damn well please, and to take whatever drug samples interest you from the goodie box? Now that's consumer-driven healthcare.

From Doodles Dendritis: "Re: CIO. Peter Garrison, the CIO and a Senior VP at St. Vincent’s Catholic Medical Centers (now just one hospital), left the hospital as of October 30. A new CEO joined over the summer and reorganizations were announced last week. The role of the CIO was eliminated. Sounds odd, but that’s what I heard. The health system just emerged from bankruptcy, so cost saving does not appear to be the motive. Four executives were let go."

The Jay Parkinson interview went over big (thanks, Jay, for squeezing me in before Colbert!) I saw incoming hits from StumbleUpon (which I've used and liked), from the FormSpring site (the forms tool he mentioned), and from Chris Webb's media site. That boy's going to be a star.

The White Stone Group announces OptiVox Advisor, which documents the quality, accuracy, and consistency of information hand-offs as required by the National Patient Safety Goals. It works with OptiVox, of course, which is a telephone-based, voice-prompted system for automating the exchange of information between caregivers.

The Kaiser IT layoffs in Pleasanton are confirmed. That's old news for regular readers, of course. Justen Deal wrote about it, along with an interesting piece on rescission (the cancelling of a patient's insurance after the fact). Regulators forced the non-profit Kaiser to reinstate an insurance policy: "The woman and her family had Kaiser coverage through her employer for 20 years. When she left her job, the family purchased from Kaiser a continuation plan commonly known as COBRA that is protected by a federal law. After that expired, the woman and her family bought individual coverage from Kaiser. Four months after the switch, the HMO dumped her. Kaiser claimed she omitted information about her health from the application the HMO required her to fill out when it sold her the individual plan. Kaiser also threatened to report her to law enforcement for fraud and billed her for $13,000 worth of treatment." The punch line: the woman's condition that Kaiser claims it wasn't told about was being treated by its own doctors (allegedly).

I was checking the website of HIStalk Platinum Sponsor MedMatica Consulting Associates. Nice testimonials, including this one from Reading Health System: "MedMatica Consulting Associates delivered exactly what they proposed; experienced personnel, based locally at a very competitive professional service fee." Do me a favor: click on their ad to your left and visit their site. Nice folks.

The Fall 2007 edition of EHR Scope is now available: 240 EHR vendor listings, SaaS discussion, pediatric EHR coverage, and a Fred Trotter article on open source. It's a free PDF download.

Cerner says KU Hospital let the city of Kansas City down by picking Epic. CIO Gregory Ator said that's tough, the docs liked Epic a whole lot better, even at a higher price.

Cardinal Health's Q1 numbers: revenue up 5%, EPS $0.82 vs. $0.66, but missing estimates and resulting in the firing of the supply chain CEO.

Microsoft fires its CIO for violating unspecified company policies (running Google Apps? Peeking at Bill Gates' HealthVault records?)

Montefiore Medical Center picks Picis CareSuite for periop.

Doctors are feeling the heat to run EMRs, that is, if you believe a doctor survey that talked only to those already running EMRs.

EMR vendor PracticeIT promotes CIO Rich Steinle to CEO.

AMA picks up on the work of our pals at Healthcare IT Transition Group, who dared state what now seems obvious: RHIOs are overly reliant on hospitals and federal grants to pay their bills instead of tapping into foundations and other local charitable support. The boys even gave a shout out to Inga and me in honor of the millionth HIStalk visitor. They're fun because, in addition to being healthcare geeks, Marty is a poet and Michael is an expert on opera and a cartoonist. It's good having a few characters in the biz.

So, who is this Prognosis Health Information System whose inpatient EMR earned CCHIT certification before some of the big boys? I found a link to their site from CCHIT's, which had little info, but then I found this one from Googling their Houston address. Clients listed include St. Vincent's Manhattan (Jay Parkinson's residency site) and Midland Memorial (which is on Medsphere now, as far as I know). Execs are listed on the page and I don't know any of them. Sounds like a behavioral system primarily, judging from the emphasis on the security of comments in their FAQs. Well, they made a little history yesterday, anyway.

Another virtual bud, Ross Koppel at Penn, gets quoted on the sociotechnical aspects of healthcare. Example: a hospital bought a bunch of COWs for nurses, then put in new patient room sinks that were too big for the carts to get around (doh!). He also mentions an IT system that required 22 screens to see all of a patient's meds. TDS, no doubt, since that app's character-based screen featured huge uppercase fonts, short text lines, and a short display length, meaning anything you wanted to enter took several ugly screens that were originally designed for light pens, not mice or keyboards. I've argued for years that TDS would be alive and kicking today if Eclipsys could have somehow reformatted the screens to better utilize the real estate and minimize the flipping.

E-mail me. I live for it.

Inga's Update

Some of the suggestions for HIStalk’s big HIMSS splash have been quite funny! There are a lot of creative people out there (many with obviously too much time on their hands). And while they may make Mr. H laugh, I am automatically sending to my spam folder any emails that have the words have “Inga” and “stripper” in the same sentence.

Mediware announces some good revenue numbers. Their fiscal Q1 numbers are up 27% over last year and income. Net income for the quarter was $463K versus $164K last year (5 cents a share vs. 2 cents.)

An increasing number of patients are losing faith in the health system and are concerned about the risk of infections while in the hospital. Those are the results announced by a UK-based organization that asked British patients their opinions of the UK health system.

If you are interested in voting in HL7’s survey for PHR standards, you have until December 1st. Not an HL7 member? You can still vote, but have to pay a $50 “administrative fee.” Seems to me if you are a stakeholder with a particular agenda and lots of money, you can pony up some cash and have some votes work in your favor.

Kaiser Permanente announces its own PHR, My health manager.

Cerner wins a nine-year contract with the VA to provide Millennium PathNet to 150 hospitals and 800 clinics. It will be Cerner’s largest Pathnet installation.