HIStalk Quotes
News 11/10/06
posted 11/09/2006
I'm dividing HIStalk into three sections: the usual stuff, Kaiser, and an update from Scott Sanner, who some of you asked about. The usual disclaimers: anything in blue was said by someone else, so I can't vouch for its accuracy.
From Dallas Analyst: "Parkland's Epic system went down on Monday and will likely be down the rest of the week. IT isn't disclosing what caused the system to go down and patients are being turned away at some of their clinics. I wonder if any of your readers have more info about what happened."
From The PACS Designer: "Re: PACStalk. So far there have been no questions ask of TPD so far, so I think it is a bit premature to creates a PACStalk section within HIStalk until we have a significant number of questions being asked that would educate HIStalk readers." This counterpoint from New_to_PACS: "I would be very interested in a RIS/PACS blog since I am new to this area of HIT. Until you decide to tackle this topic, if you can point me to any other blogs, sites, etc on this topic I would be very appreciative.Of course I love HISTalk!!!!!!!" I'll leave it to TPD to recommend good sites. I only read Dr. Dalai and I barely understand that since PACS definitely isn't my sweet spot.
From Anonymous: "Cerner had Kaiser in the bag. It was considered a done deal: locked, sealed and delivered. Cerner was hiring new people to staff the Kaiser project and was concerned they would have to bring people back from the UK project in order to staff it. It was a situation where the others were just invited to 'make it seem fair.' The word is that Cerner botched the final presentation. They went into it so cocky and sure that they had the deal, they just blew it. And Epic came in and snatched it away from them. The Epic selection was a total shock to Cerner and everyone else in the industry. The rumor is that the salespeople were fired or re-assigned to different parts of the country. Up until that time, I thought Epic was only an outpatient application. That's is when it first hit me that Epic was a major new player." I've heard more than once that Cerner has blown a late-game lead as the favored vendor by performing poorly in the executive pitch department, most recently at University of Iowa. They need a Neal lookalike actor who can sound more sincere, thoughtful, and caring.
From Anonymous: "Two conflicting messages from the same vendor on user security/privacy (from their FAQs): First they encourage users to share logins: 'The concurrent user pricing model gives you maximum flexibility to setup as many users as you want. Many partial and part-time users can share a single login' and then under User Agreement it states 'Users will be required to accept the terms of our user agreement the first time they log in to the XXXXXX system. These terms primarily deal with individual security and privacy matters and the users personal responsibility to protect the information being made available to them.' How do all the 'Partial' users sharing a logon accept responsibility for handling confidential data? I guess their lawyer didn't review their FAQs."
From Raleigh1776: "Having been a hospital system employee at Misys, I can tell you that that Tom Skelton is a dishonest leader of a failing business. His interview remarks mask the truth. He rules with passive aggressiveness and assures that change and advancement is crushed if not associated with him. He surrounds himself with cronies from Pittsburgh. And now, even they (Scott Sanner SVP Sales) are finally getting out because they recognize he cannot create shareholder value. It all stems from a lack of self-confidence and lack of business experience. That worked well under his old boss, Kevin Lomax, because Lomax did not hold him accountable and was easily snowed. Lomax had no real desire or capability to run a company of this size in the US. Skelton has chased off every leader who brings competencies and energy that he does not posses. Each business unit has seen horrible turnover at the highest ranks. This is because he refuses to act honestly and instead reverts to spying, collusion and sabotage. Product and processes at Misys are losing ground while the people will never develop under Skelton. Hopefully Mike Lawrie will recognize this quickly and put a strong leader in place who has the experience and self confidence to build a strong team, rejuvenate the old product architecture, improve execution and rebuild customer relationships. In the mean time, stay away from this company and their products; the risk is too high."
Listening to now: The Vincent Black Shadow: good-natured female crooner pop named after a motorcycle, rather No Doubt-ish. Eminently listenable and lookable (the one I'm looking at, anyway.) Try "Metro" and "Bullet on the Tracks" on their Myspace page. Highest recommendation. Same label, another hot singer, and also great: Bif Naked.
My editorial in this week's Inside Healthcare Computing electronic update: "HBOC 1, Everybody Else 0." Here's a one-sentence sample: "The frenzied transacting caught the attention of drug wholesaler McKesson like the mating dance of a spider, which paid a mind-boggling $14 billion for the company in January 1999." Who says poetic allegories don't make business writing interesting?
Hoo, boy, did IDX co-founder Rich Tarrant get his political clock cleaned in Vermont's election for US senate, and by a non-incumbent and self-proclaimed Socialist at that. His $7 million got him a third of the vote, spending "more than $100 for each vote, more than any candidate has ever spent for any office in the country."
Mike Lawrie's old employer ups its stake in Misys to 5.13%. Perhaps you didn't notice that the company, ValueAct Capital, was also a big Per-Se shareholder (15.5%) and had to pledge its vote to get the sale to McKesson approved this week.
Medsphere gets an Indian Health Service deal for implementation, training, development, and support services for 67 existing sites and 40 new ones over coming online the next year. Nice.
MedAvant announces Q3 numbers: revenue down 10%, EPS -$0.12 vs. -$7.78, but that last figure was due to a one-time charge. Without that, the loss was $0.8 million vs. $2.5 million, still improved, just not as dramatically.
iSoft shares keep dropping, down 92% YTD, on fears that it can't afford payments on loans it took to stay afloat. Investors also seemed to expect offers to buy the company, although who would want it isn't clear, other than maybe BT or CSC for a fire-sale price that would be cheaper than paying them as a subcontractor.
Visicu announces Critical Care Without Walls, an extension of the eICU that allows monitoring of critically ill patients in other hospital areas. Christiana is using it in the ED, the release says.
Picis and Capsule Technologie (no, that's not a typo) cross-license patents. Picis was suing them before (along with SIS) for stealing secrets, so maybe they've smoked a peace pipe.
Emageon's Q3 numbers: revenue up 65%, EPS -$0.01 vs. $0.09, but all of the difference was due to Camtronics acquisition expenses.
Allscripts is added to the SmallCap 600.
Cerner finally has a signed deal with BT to replace GE Healthcare.
QuadraMed announces sweet Q3 numbers: revenue up 10%, EPS $0.08 vs. -$0.13. The stock broke through its 52-week high today and currently sits up 4% for the day at $2.70.
Sorry if I haven't had time to reply to your e-mails. Been busy. News, rumors, your opinion of the hot chick singers I like: e-mail me. Thanks a bunch for reading. You should see all the stuff I ignore doing to peck endlessly on this darned keyboard.
For readers interested in Kaiser: please make sure to read the comments below each of the two HIStalk articles that contained Kaiser memo text. Only five articles display on the main page - you have to click the "More Comments" link to the right of the last one to see more. Readers have provided some good opinion and information that you'll want to read. As I write this, the first article has 18 comments and the second has 30.
From Anonymous: "More KPIT. The CTO has had his direct reports go from approximately 4,000 to less than 100. Internally, people are really hunkered down and the rumor is Halverson was out to get Dodd for months and brought in consultants to put together a case and take it to the board. The irony is that the new CIO was leading the HealthConnect install, not Dodd. Louise Liang, who is responsible for HealthConnect and is the boss of Turkstra, is in Modern Healthcare this week and it is enough to make you hurl. Also in MH is an article on the Misys Advisory Board and the potential for conflicts of interest."
From HighTechRedneck: "Re: KP and Epic. I have been working on Epic projects since 1998. It's an outstanding product, very integrated, and Epic is the best vendor I have worked with to date. The problem here is not Epic, it's the way KP installed Epic. Too much overhead, and teams were too stovepiped. For instance, the Orders Team does not touch the system, but has to hand their work off to the build team that does not implement. I have been involved with major installs at Allina, Univeristy of Chicago, etc. and really never ran into these issues, as we had a flat hierarchy. In other words, enough managers for oversight of each team. Integration, Orders, Ambulatory etc. were responsible for Design, Build, Validate, Test and Implement and did not hand off to one-deep or dimensional teams. Each team had soup-to-nuts and communicated with each other and a CORE team (which handled all the major master files, integration etc. across applications). Justen Deal, along with many others, only knows Kaiser and had very little experience with Epic prior. These are not Epic problems."
From Anonymous: "Looks like the reality is starting to come to this Epic Nirvana that we have seen the last couple of years. Kaiser cost overruns and multiple instances-lack of scalability, Parkland Hospital in Dallas Texas has been down since early this week due to an Epic crash, Allina still has not figured out how to scale correctly with Epic - looking to IBM and Intersystems to provide some type of answer. I get the fact that their software looks good, but I do not believe they deliver better than anyone else in the marketplace. Must be nice to not have to provide any type of implementation people and instead point the figures at companies like FCG or Healthlink when things don't go right."
From Anonymous: "HealthConnect may appear to be successful. What HealthConnect/Epic brought to KPIT however was, nightmare. Servers being put into production with little or no testing, outages and problems galore, innumerable issues and problem tickets. There were two Data Center outages where entire data centers went completely dark due to poor planning on expansion of infrastructure to support HealthConnect/Epic. HealthConnect's ridiculous 'toss it out and fix problems later' planning has cost KPIT many good resources. Pressure from KPIT management and HealthConnect has sent more than one System Administrator to seek medical help to deal with the stress and at least one to long-term disability due to mental breakdown after working 110 hours straight with no more than 15-minute breaks each day. KPIT is losing valuable trained employees due to management's not understanding what is really going on down in the trenches. Perhaps that's the goal -- make up budget deficits by forcing employees to leave without collecting their severance. KPIT is in serious trouble and it needs help now. Uptime was much better with KP was a regional organization. The dedication and expertise of the technical staff has not disappeared, so what has changed? Mostly management."
e-Week interviewed Justen Deal, who continued to demonstrate loyalty to Kaiser and, surprisingly, to defend former CIO Cliff Dodd, who quit just after Deal's e-mail surfaced although Kaiser says the two events were not related. "I think it's a shame we lost his abilities. Cliff Dodd didn't make this decision to tie the success of EMR to a single vendor. He is a very talented man. Kaiser has lost his ability to help remedy the situation. Our physicians have been adamant that they need an EHR system. We need one, but this is not it. Every day that we try to make system work is a waste."
Computerworld got through to Justen, too. "I've had access to internal projections that show that we could lose $7 billion over the next two years. Losses of even a fraction of that amount could be destabilizing to the organization ... On Friday I sent an e-mail to my colleagues pointing out the reliability and scalability issues we're facing with our HealthConnect system. The big issue for me are the financial repercussions of trying to launch such an ineffective and inefficient and unreliable system across the organization ... It's chilling for anyone in the organization to see how far off-track this project has gone."
So did Modern Healthcare. Some quotes from their interview (the best one so far): Justen again expresses his sorrow that Cliff Dodd left, especially worried that his e-mail caused it. He defends his information, saying all of it came from the documents of others. He says he intended his e-mail to be circulated internally only, but that colleagues forwarded it to the media and anti-Kaiser sites. He continues to defend his claims of HealthConnect/Epic's unreliability on behalf of physicians, questions Kaiser's Q3 numbers because of a one-time liability reduction, and says he doesn't want to harm HealthConnect. "I agree with Louise Liang that HealthConnect is a necessary project and idea that we have to pursue -- not only because of the money and lives we can save -- but because our physicians are demanding EMRs as a tool they want and need. But this is threatening the very stability of the organization, and I would not be able to live with myself if I knew these issues were coming and I didn't do anything about it."
I can't believe this is a 25-year-old talking. He's more eloquent and persuasive than the Kaiser suits who are dismissing him as an uninformed troublemaker. If they really do fire him, they are completely, certifiably nuts from a PR standpoint (which is not a common accusation made of Kaiser.) He's unintentionally painted them into a corner: does a company often portrayed as heartless and bureaucratic really want to publicly fire an earnest, likeable kid who loves the company, speaks like a scholar, and risked his relatively low-level job to speak up without using his newfound limelight to rip the company that's now trying to discredit him? Free PR advice for KP from Mr. HIStalk: if you fire him, you may as well buy a puppy to abuse in your "Thrive" commercials and maybe kick a homeless, pregnant woman out of your ED. The backlash will be just about the same, I expect.
How about this condescending "little people" slam from George Halvorson about one of his employees (Justen)? "The person who wrote the e-mail is a young man relatively new to KP whose job involves publications. I suspect he hasn't evaluated very many Boards." I don't know the man, but that sounds like something that only a pompous jerk would say about his employee (especially since I'm sure it was toned down before it was sent to the masses by careful HR types.). So much for all that "we're all on the same team as equals" BS, huh? Now it's "My paycheck is a hell of a lot bigger than yours, so obviously I'm smarter."
A mini-interview by e-mail with Scott Sanner, a former Misys executive that a couple of readers asked about:
Why did you leave Misys?
I made the decision to leave based on a new business opportunity within the HCIT space that I found to be challenging, new and, I hope, rewarding. I resigned about 6 weeks ago but we held the announcement and my actual departure until October 31.
What will you be doing?
I am now Senior VP, North American Operations for Digital Healthcare. We provide digital imaging and workflow optimization solutions to physicians in community as well as acute care settings. My primary responsibilities will be building a distribution channel and implementation group as well as helping build the Digital Healthcare brand in the United States.
Any thoughts on Misys?
I worked for Misys Healthcare Systems for 17+ years. I was fortunate enough to have been there through some terrific growth periods. I helped start up three significant initiatives during my tenure and held the role of VP of Sales for four years. At the time of my departure I was General Manager for a new initiative that will launch shortly. Leaving this position was the most difficult aspect of my decision to go, but I was excited about this new opportunity. I see it as a great way to broaden my perspective and my horizons. I have confidence that Misys will be very successful with this new venture. They've put together a world-class team of people to build it, and I can assure you that they are passionate about their work and have an undying will to succeed.
All of my time was spent within the Physician Systems part of the business. I think that Misys more than any other company has one of the best (if not THE best) positions in the physician practice space. Misys Healthcare is, and always will be, a physician practice focused organization. If I were running the business, I would work to put the entire emphasis of the business behind the physician space. Automating the needs of physicians in the community is without a doubt the core competence of Misys Healthcare systems.
The team of people that Misys has working on the physician side is second to none. It disappoints me to see some of the comments made on the blog by readers that remain anonymous. I fail to see the value in negative commentary that is rarely based on fact. The employees of Misys Healthcare are a talented, proud group. I would ask that anyone that feels compelled to make a negative comment have the chutzpah to identify themselves in order to allow all of us to make sure that we're dealing in facts. Dispelling some rumors:
Tom Skelton and I did not go to high school together. Tom is quite a bit older than me. We did, however, go to different high schools together at different times. I think the comments out here about “IP sniffers” are interesting. I know the Misys CIO pretty well and I’m confident that he has much more important things on his “to do” list. However, as in all companies, I am certain that Misys does have another type of “sniffer” among its ranks (of the human variety.) I’d encourage any Misys employee to speak their mind openly if they think the management team has it wrong. I would suggest that their feedback would be welcome. If they don’t feel comfortable doing that, then I’d suggest they seek out a new place of employment. Life is too short. Spend your time doing something you can be passionate about and, do it somewhere that you’re passionate about as well.
comments (11)
1. current misys employee left...
11/09/2006 10:18 pm
Misys has not delivered shareholder value. As Sanner leaves Misys, having
been friends with Skelton for years, what conclusion do you draw? If Misys
has future value, why leave? If Misys has value, why so much turnover? If
Skelton is good leader, why so much controversy? Rumors are viscous; facts
are fair. And the facts are Skelton cannot keep a strong team that
delivers results because he cannot gain the respect of strong leaders. He,
as history makes evident, cannot take advantage of the market. As a
shareholder, I hope the new Misys CEO can do what's right...find a new
leader and invest in the products.
2. Matt Helm left...
11/09/2006 11:15 pm
I find it amusing that you think there is any way that Justen Deal might
not be fired. The dude set up a public web site to challenge the CEO and
the board members (www.fixkp.org). On that site are internal
communications with sensitive business information. That is an automatic.
If one of my employees did that they would be greeted by security who would
hand them their boxed belongings. It didn't matter if he had the passion
of William Wallace, the intellect of Archimedes and the eloquence of
Shakespeare.
3. prairiesky left...
11/10/2006 1:01 am
Don't look now but long time software maverick University of North Carolina
has bought the GE Healthcare Centricity product suite for their academic
physician practice plan. Another southern school will soon follow. GE's
biggest problem in this space is that the EMR sales force for the old
Logician product have no academic experience and botch sales presentations
as a result. For now, this is all good news for Allscripts who has at least
3 southern schools in it sites for 2006 Q4 EHR signings - all GE customers.
4. Matthew Holt left...
11/10/2006 2:27 am :: http;//www.thehealthcareblog.com
MrHISTalk--A great post, especially about KP. But readers take a step back,
and ask yourselves this:
5. HCIT Observer left...
11/10/2006 9:28 am
Based on the current market and companies thinking and doing new things
with integrity, I think you should introduce Jonathan Bush/athenahealth to
Justen Deal.
6. PTSD left...
11/10/2006 11:26 am
I visited the website and read some of the letters in absolute
astonishment. I can't believe that he didn't expect it to go mainstream
outside of KP, especially since this wasn't written over a weekend at a 24
hour restaurant with coffee by the pot. This was a prolonged battle back
and forth as his concerns were escalated up the chain. I am surprised that
no one rode with him as I would expect someone to have a conscience.
However, I don't want to lose my job either and I am sure he received
support from those afraid to take a stand.
7. Does the truth matter left...
11/10/2006 9:55 pm
With over 26,500 concurrent users, more than half of their 10,000+ doctors
live on a full EMR (HealthConnect), 24 hospitals live on several apps and 2
completely rolled out (including CPOE) - this is more than most HIT
professionals will bring live in their lifetimes. No wonder they picked
Turkstra, who led the Epic install, to be the new CIO. He gets things done!
8. Filtering the Truth left...
11/11/2006 12:59 pm
I work on HealthConnect, and I have to tell you that the 26,500 concurrent
users figure isn't anywhere near accurate (it's more like 9,000 to 13,000,
on average). Saying 24 hospitals are live on "several apps" means they're
live on check in and registration, and maybe a few people are echarting.
Those two hospitals that are "completely rolled out" regularly (at least
every few days) drop to Code White (back to paper). And Bruce is interim:
as soon as they can find someone outside who will take the job, Bruce is
gone, too.
9. Current Misys Employee left...
11/12/2006 5:57 pm
The comments on Skelton are dead on. He has chased off, fired or demoted
anyone ever challenging him. How can a company win when the leader is so
feared, disrespected and dishonest? I hope our new boss can see through
him else we have no chance. I'm sure the HR team is trying to find my IP
address now and my next comment maybe from "former misys employee"!
Seriously, there is value in this company; why does the board let Skelton
continue to manage this business so poorly?
10. Anonymous left...
11/12/2006 11:53 pm
Andy Weisenthal confirmed the 26,000+ concurrent users on his interview on
theHealthCareBlog - listen to the .mp3. Maybe the difference between peak
(Monday morning at 10am) and average (factoring Friday night at midnight)
and adding it up across all 8 regions?
11. Spin the Numbers left...
11/20/2006 1:28 pm
I heard the 26,500 figure again this morning, and decided to get some
clarification. The acu figure KP uses, average concurrent user, is based on
a KP-IT-developed formula, heavily weighted towards normal 9 to 5 usage
(not skewed by late night shifts). The 26,500 figure does exist, though, on
peak days during shift change, when one shift is logging out and another
shift is logging in. That's also when the KP HelpDesk sees its calls surge,
because of the inexplicable, non-proportionate (even to 26,500) incident
spike. So, it seems like Wiesenthal and others are using the 26,500 figure
to trump up HealthConnect, when the 26,500 figure isn't normal or realistic
at this point, and that 26,500 count actually kills the system. Talk about
spin.
