News 02/08/05

Eclipsys reduces its Q4 losses by 86%, but warns that Q1 losses will be far more than expected. Revenue was up 32%, but the company still lost $2.9 million for the quarter. They met analysts's expectations of a $33 million loss for the year. Maybe I'm a pessimist, but if they can't make money in a gangbusters market like this one, will they ever? The "subscription model" excuse is a bit shopworn. John Gomez also announces that ECLP is an early adopter of Microsoft's Indigo web services technology, interesting since an ongoing plague of response time problems has kept Sunrise in an outdated fat client configuration with few promises of a quick resolution.

Wisconsin's governor announces a $10 million carveout in the state's budget for grants and loans to encourage EMR adoption. A new government agency will develop a plan to automate Wisconsin healthcare by 2010. The fact that two Wisconsin-based companies (Epic and GE Healthcare) are mentioned by name makes me a bit suspicious of motives.

OR Consultant asked a question about the CHE surgery system deal: "Who made the editorial comment that the CHE press release strongly implies exclusivity?" The anonymous reader who made the comment. But, I've re-read the SIS press release and it sounds that way to me, too. Examples: "CHE Selects Surgical Information Systems as Solution Partner ... The Perioperative Task Force was open to standardization ... CHE needed a solution that could fully integrate each CHE hospital's departmental systems to their enterprise platform  ... it was important that we consider facility and user preferences, while meeting the organization's overall technology and economic goals. It needed to be highly flexible. The answer was SIS ... newly signed corporate contract." Other than the wording, my assumption is that an agreement (and press release) with a multi-hospital operator signals some intention to use the technology in other than a "hospitals can do whatever they want" manner, but that's getting into semantics. If it wasn't an exclusive, SIS went out of its way to avoid saying so, as I read it.

IBM has come up with some kind of software in response to the 2002 anthrax attacks (good thing we weren't in a hurry.) Here's what they say it does: "... help healthcare organizations access electronic networks that provide alerts to unusual medical patterns or crises, and will then enable them to identify the origins and research possible solutions. The software, known as Healthcare Collaborative Network (HCN), will also allow caregivers and government agencies to share medical methodologies that improve patient care, and monitor long-term health problems or unusual drug interactions." Sounds like the same thing that everybody and his brother was working on in 2003, some of which got installed and none of which I've heard much about since, despite its being free in some cases (University of Pittsburgh.) I guess we won't know until the next incident.

The VA wants to know what went wrong with CoreFLS, the $472 million procurement system that nearly closed one of its busiest hospitals. They've hired an accounting firm to give them an answer in four months. Their problems aren't just with developer BearingPoint, according to the article: "The department’s IG [Inspector General] has cited inadequate contracting and monitoring practices as a hindrance for CoreFLS deployment. Most of the VA legacy systems that must integrate with the new financial system contain inaccurate data because they have not been used properly, the IG reported in the fall."

University of Chicago Hospitals will implement Stentor iSite PACS.

LanVision wants to be known as Streamline Health, apparently an all-powerful moniker: "The name change positions Streamline Health for enhanced growth in the healthcare marketplace and allows the Company to capitalize on its specialties ... re-brand the Company and strengthen the focus on new market opportunities involving business process improvement via workflow automation technologies." I'm not seeing anything in these numbers that would suggest that a superficial cosmetic fix is all that's needed, but I can understand the motivation to start fresh. I hope they researched the name carefully, because it certainly sounds like something that someone will object to legally.

Johns Hopkins (home of Stephanie Reel, remember?) will deploy rehab software from MediServe.

Cookie Lawsuit update: it turns out that the parents of the teenaged cookie bakers offered to pay the neighbor's medical bills immediately, but the neighbor decided their apology wasn't heartfelt enough, so she sued. Most of the other neighbors who got cookies wrote letters of support for the girls. Donations have paid the judgment many times over, with excess funds going toward the Columbine victims. The father of one of the teens got a restraining order against the nasty neighbor's husband, who he claims has constantly made harassing calls to the girl's house since the incident. The neighbor, whose name appeared in the worldwide news accounts, says, "This has turned into quite a fiasco. It's something that never should have happened and it's just devastating. My phone hasn't stopped ringing. My life has been threatened and I'll probably have to move out of town." I'm sure we're not hearing all of the story, but I'm glad we've got a poster child for our idiotic lawsuit .... er, legal ... system.

An interesting New York Times essay on "old" vs. "new" doctors. "The young doctor played the computer keyboard like an organist at a Wurlitzer. Doctor and patient often plumbed the Internet for information together. Patients could take home freshly printed data analyses to study for themselves. The young doctor chose tests and treatments based on the premise that there was a single right way to do things. That doctor had yet to learn that absolute trust in any drug or treatment is often a major mistake. The young doctor remembered little about each patient from visit to visit, but typed volumes, and was a big fan of medical software that supplies preformed phrases, sentences and paragraphs - the results of an entire physical exam, for instance - at the click of the mouse. Sometimes the mouse clicked just a little too quickly and erroneous information crept into the charts." Which would you choose? Is medicine a science or an art, and what kind of systems are needed to support whichever it is?

Idiotic hospital lawsuit of the week: a surgeon with a history of bipolar disorder was removed from the hospital and had his privileges revoked when he suffered a manic attack during a surgical case. He's suing the hospital under the Americans with Disabilities Act, even though he is self-employed. The case had already been dismissed because ADA applies only to employers. He wants back pay, punitive damages, and compensation for the "destruction of his career." Says the article: "Wojewski insisted that he be called "the general." He lectured Dr. Charles Hart, Regional's chief executive, on how the hospital should be run and who should be fired." So, how's that different than most surgeons?

Hospital CIO Salary of the Week: Pasadena Hospital, Pasadena, CA: $206,000

Zix's earnings announcement sounds great until you read below the cheery CEO message: $42 million loss for the year on $14 million in revenue. Tucked at the end of the press release was another CEO factoid: " ZixCorp today also announced that John Ryan, chairman and chief executive officer, has chosen to relinquish the CEO role at this time. Ryan will continue in his role as chairman of the board. Effective immediately, the board of directors has appointed Rick Spurr as acting CEO. Spurr will also retain his prior responsibilities as president and chief operating officer."

Physician support for the UK's mammoth healthcare IT project has dropped from over 50% to around 20% in less than a year. "It was meant to be an all singing, all dancing system but it is not up to scratch." Isn't it always, on both counts?

You know US healthcare's in trouble when even the CEO of a drug company complains about it and underutilization of IT is one of his beefs: "... health care must enter the Information Age. A nationwide medical information technology system must be built to reduce errors, promote consumer choice and integrate care. This action is already under way with the Bush administration's announcement of an ambitious plan to develop electronic medical records that would combine public-sector oversight and buying power with private-sector innovation and initiative."  

Stock message board warblings:

Eclipsys
"More deals "slide" - translation, we're going to lose some and the wheels came off our economic model. the only way we made our number was to hold off capital purchases, lay-off people and ship software before it is ready so that we could recognize the revenue earlier than planned."

"Don't get mislead by the past red ink. Frankly, I made the same mistake when I first looked at this company with stock at $14-15. The company made a painful decision to switch to a subscription model last year which will create a more stable earnings model. Revenues are accelerating and earnings will catch up. Their product is decent and with an environment where HUGE sums will be spent on EMR this company is going to participate."