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  • 5 yrs 16 wks 4 days old
  • Updated: 8 Oct 2008
  • 915 entries
  • 2,013 comments

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HIStalk Quotes

Monday Morning Update 2/19/07

posted 02/17/2007
HIStalk
From Michael Florimbi: "Re: our company. HISTALK is, in my opinion, the best source of information on healthcare of any blog out there, keep up the good work! I am the founder and chairman of LingoLogix. Our specialty is the interpretation and codefying of unstructured medical digital records." I'll cut his plug a little short since that's what sponsors pay to run here and I'm not feeling all that pro bono-ish at the moment, but since he led off with a play to my ego (good move!) I'll include the company's web address.


From Alan Stanwyk "Nobody made fun of the flying good time Cerner is having with its aircraft? I know that this kind of deal is fairly common, but man, what a convoluted read to figure out who is paying whom for what!" Link. Cerner is paying for the operating costs of Neal and Cliff's BeechJet 400, which seems to be priced at $3-5 million and up. Or at least that's how reads to me. Hangaring is $8,000 a month and pilots run $850 a day.

Rebecca Onie, Executive Director of Project Health, re-sent her response to the "Beers with Bush" fundraiser whose proceeds will benefit their organization. "Wow! This is fabulous. Athenahealth is a long-time supporter of Project HEALTH. Interestingly (given your blog’s focus on healthcare technology), one element of the partnership is customizing athenahealth’s technology interface for Project HEALTH’s Family Help Desk programs, which use the doctor’s visit to connect low-income families with the community resources they need to be healthy. I’ve included a photo of a child from the Asthma Swim Program, which is the program where the funds would be used. All funds raised will be used to provide goggles, swimsuits, towels, and other equipment for participants in Project HEALTH’s Asthma Swim Program, which provides low-income asthmatic youth with disease management education and safe cardiovascular exercise, including swimming. Participants learn asthma control habits, such as avoidance of triggers and proper use of medications, that reduce their symptoms and allow them to manage their disease with confidence. Thank you so much for arranging this. We are eager to see the results!" Rebecca co-founded Project Health as a Harvard sophomore, went to Harvard Law, clerked for a civil rights law firm, then came back as Executive Director a year ago. The proceeds will help kids and I appreciate all who have bid so far. I'll contact the winner after the bidding closes at 6:00 p.m. Eastern on Wednesday. And if you want your name and employer left off HIStalk, that's OK - just say so.

NY asthma swim

From Union Jack: "Re: Beers with Bush. What's all this then? It's not very 'affirmative action' of you, is it? How do you suppose your loyal readers across the pond will be able to meet Mr. Bush, even if they wanted to? And what about poor student researchers who would love to bid but can't, their bank accounts being less healthy than radioactive sushi? To make matters worse, what about student researchers across the pond, eh? For shame. Mr. HIStalk, for shame. I'm joking, I'm sure you've realised, although it's a shame I can't bid (for the aforementioned reasons), but I will continue to participate vicariously in the US healthcare industry. Thanks for doing such a marvellous job, I've been reading your blog for about 2 years now, and it's definitely made a difference. Over the past week, it seems you've been working overtime, churning out posts with remarkable regularity, and hats off to you. It makes us students, who take 4 years to come up with a 100 page thesis look really bad." Thanks for the nice comments, especially the "what's all this then", which is my favorite (favourite?) Monty Python line of all time. I did think about the bidding advantage that large wallets have over small, but since it's for charity, decided to let my beloved supply and demand curve work as nature intended. Maybe we should have arranged a scholarship, although you'd still have the travel cost. Don't worry about being a poor student - most of who are old and relatively well off financially would give it all up to trade places (hair, coeds, hell-raising capacity, and lack of creaks and aches.)

Art Vandelay
(another great Seinfeld-inspired phony name!) sent a detailed, thoughtful comment about Epic that I thought deserved to be in the main body of HIStalk instead of as a footnote. It's long, but worth a read: "Re: Epic - their product is highly configurable and has many intersecting points of configuration (ex: masterfiles, picklists, installation choices). This causes challenges for many organizations because there is rarely a single and central vision for this large of a system. Groups will ask for conflicting installation choices, create conflicting processes, and it takes a long time to sort this out. Be clear about the costs that get out-of-line = hardware, software, consulting, Epic professional services. I believe the out-of-line costs are caused by organizations under-estimating the upfront analysis, time it will take for consensus-building, the complexity of business process redesign, the complexity of changing an organization's old habits, and the complexity of interfacing. In my experience, every organization's decision-making hierarchy, culture, consistency in processes and commitment to a set of common non-conflicting strategies (ex: make the safest environment possible, increase revenue capture) and technical and project management maturity is vastly different. You can have a basic framework and a set of tools but all this requires tailoring to the organization. No one wants to admit how much work and challenges an organization will face when striking the balance between changing processes to work within the system's capabilities. If you believe my hypothesis, how much is caused by Epic, how much is caused by consultants working on a by-the-hour contract, and how much is caused by the issues within the organization (ex: lack of project management skills, lack of strong leadership and a small set of non-conflicting focused goals for the installation, commitment to breaking-down organizational barriers to change/optimize processes)? Furthermore, I believe many CIOs are guilty of not telling the truth (or they can't because they fear they will lose their job) with the rate of change they believe the organization consume. In other words, the organization's eyes are bigger than its stomach. The Epic Product Line is MASSIVE (ex: CPR, HIS, Practice Management, Enterprise Scheduling, OR, ED, Intensive Care, Call Center, Oncology, Cardiology). Everyone wants everything first and no one is willing to accept a long-term transformation AND stick with the plan. It took "x" years to get the systems entrenched into an organization, it will take a long-time to retrench the new systems into the organization. As Mr HISTalk has said, CPOE and documentation don't necessarily provide the benefits that other functions do. All the preachers in the organization want these fringe functions but they have no clue the maturity of these functions and the dedication it takes to make them happen. The organizations that are successful with CPOE took 5+ YEARS to get there, not 1-3. Implementing these consolidated applications is a long-term commitment and it will take a long-time to assimilate the functions and benefits into the organization. IT leaders need to help make this understood and clinical and administrative leaders need to listen, be realistic and partner to with the vendor, IT and the front-line users to work through the challenges in a consistent manner." Well, that summarizes just about everything you need to know about a large-scale clinical systems implementation. You can't blame the vendor for the customer's irrational exuberance about how much better their organization is at managing change, gaining consensus, developing ROI and success metrics, and pushing every day for years to make improvements. Thanks for the post. I've seen these exact issues come to life more than once.

From Napoleon Dynamite: "Do you have an RSS (Atom) feed?)" Yes. The link is to your left, with feeds for RSS, Atom, My Yahoo, Google, and My MSN.

From HitMan: "Re: VeriSign investment in Healthvision. I don't quite see the synergy." That came right before I ran my Scott Decker interview, so I'm hoping it answered the question.

From Disappointed: "Re: your HIMSS quick poll. This poll is trash. Why bother polling for such garbage information. Who cares? This blog is for healthcare IT and not a dating service. Right?" I care! I want to look at the surging throngs at HIMSS, intense and focused, dressed to the nines, sporting frozen smiles of fake collegial good will, and I want to know: what's happening back in those hotel rooms? Am I the only one going home alone to TV and room service, or is debauchery widespread and I'm just missing it by being steadfastly and quaintly faithful? I'm comforted by the 65% of 112 respondents who are in my cohort in saying there's no chance of shenanigans for them in New Orleans. Therefore, I can spend my evenings writing HIStalk without feeling like a loser. See, that's relevant. Say, maybe I should run a poll about the New Orleans hooker environment.

From Hey Soos Patines: "Re: CHW CIO. Has left 'unexpectedly'. No information on a replacement or process was give to the staff." Couldn't find out who that is in from Catholic Healthcare West's federal forms, but boy, do they reward their executives richly: Humble servant CEO Lloyd Dean made $5.8 million in compensation and benefits in 2005. Read that again slowly ... the guy running a nonprofit hospital group out-earned most publicly traded company CEOs. So much for a vow of poverty. Even their HR VP made $1.9 million. What the hell is that all about? You're telling me that a Catholic-run hospital group has to pay $1.9 million a year to get someone to run HR? And they're supposed to be a non-profit? Ridiculous. Excessive. Embarrassing. I'm not out of adjectives, but I'll stop.

From Sonomaca: "Re: New Orleans violence." Link. Nine people shot in less than seven hours as Mardi Gras gets going. Police make the best of it: they say the shootings did not occur on parade routes and were not random. It's like any city, with bad neighborhoods and dangerous hours to be running around. I plan to avoid both.

From MH: "KLAS is not what you think. Several (more than 10) of our clients have called to tell us that while being interviewed by KLAS, they felt guilty about saying anything positive about Cerner, McKesson, or vendors other than Epic. The phone interviewer would follow up with 'are you sure you want to rate them that high? No one else has.' I know the KLAS folks and they are very biased toward Epic." If anyone in the know wants to add their comments, feel free.

The number of HIStalk readers continues to astound me. I see that, in the first 17 days of February, it had 78,325 total hits, and that's without writing any more often than I usually do. The all-time record was during the Kaiser excitement in November, with 133,004, so I humbly expect the record to fall this (short) month. Just one year ago, it was 68,295 for the month, and the year before that, 17,528.
Projected visitors: 46,354 per month. Total pages views since I started HIStalk in mid-2003 will hit 1 million in the next few days (and that reader will get a brand new Ford Mustang! Well, maybe not.) Next month or so, I'll run the reader survey again and hopefully will learn more who's out there and what you want (other than smut polls.) One thing I've learned, though: I can never keep everyone happy. There's no fine line I can walk when talking about a vendor, technology, or person that won't elicit cries of favoritism or bias from both sides. My biggest lesson learned in these nearly four years: it's hard work. No wonder most blogs lie fallow, starting with great promise and commitment but quickly going to seed with less-frequent and less-informative posts, finally petering out entirely as a monument to human weakness. If HIStalk fails, it won't be because I didn't work at it.

Australian HIT vendor IBA is in the running for iSoft. You may remember IBA's deal to provide clinical software for Kodak to resell, which kind of fizzled out.

Tick Tock e-mail sighting! Forbes features Neal Patterson as a case study in "Are You An A$&*@^?" They said: "Another example is when Neal Patterson, the CEO of Cerner, wrote a nasty e-mail to people in the company telling them they weren't working hard enough and that he wanted the parking lot filled with cars from 6:30 a.m. to 7 p.m. and half-full on Saturdays. The note was leaked to the media and the stock went down 22% in three days." Maybe he should take their quiz. As I read the questions, I couldn't help but think of one of the creepiest, saddest movies ever made: In the Company of Men. The Chad character is completely psycho. I always think I want to watch it, but then I turn it off after a few minutes because it's just uncomfortable.

Rob Fahy joins HTP, Inc. 

Now what's this about? Joe Petro is announced as the new SVP of Product Development for Eclipsys, with John Gomez now CTO only? Is that a downgrade? I'd gotten a couple of Rumor Reports suggesting he was on his way out (one was from TenaciousD, who I'd put in temporary time-out for his erroneous layoff report) and I'm just not sure what this change means. Lots of new guard there.

David Brailer pops up from obscurity, telling a magazine that IT could cut healthcare costs in half, but only after a decade of implementation. Seems optimistic, but he's talking about major redesign, not just hooking up EMRs.

Rockingham Memorial Hospital (VA) names Mike Rozmus as VP of IS and Richard Haushalter as CIO. I don't believe I've ever seen those positions separated, but the new CIO was formerly the CFO.

UPMC's co-development deal with Alcatel-Lucent is announced in France, with each party kicking in $25 million of seed money.

Some New Zealand HIT vendors visiting Canada warn that docs need a reason to use EMRs. In NZ, 95% of GPs use computer-based records, apparently encouraged by a combination of financial assistance and outcomes-based payments. Money alone failed there, he said.

Siemens already pleaded guilty in the Stroger phony bidding scandal and now the three individual defendants do the same. Two of them work for Siemens (one being their attorney) and the other owned the company that pretended to be a minority-owned Siemens partner in return for cash.

The US patent office will re-examine Visicu's patent after a request from iMDsoft. Here's an HIStalk flashback from December 7, 2004: "Maybe Visicu should have kept quiet about its claimed ICU monitoring system patent. Israeli company iMDsoft asks the patent office to validate that their 1996 patent trumps Visicu's 1999 one. Visicu's legal ambitions may gain them nothing except the pleasure of writing royalty checks to a company that appears to have just one US customer." Visicu prevailed - then, anyway. The stock hasn't reacted much, but the announcement got little attention so far.

News, rumors, invitations for that cookies-and-milk pajama party at HIMSS: e-mail me.






1. Joe Mayo left...
02/18/2007 1:36 am

It's unfortunate that the founder of a fledgling company gets front-and-center placement on HIStalk and manages to misspell his firm's alleged specialty in the process! It's a good thing I'm so good at interpreting and codifying unstructured English, otherwise I might have been confused.

Of course, I'll still invite him to my parties in spite of his gaffe. I need someone to watch the fish tank and make sure no one taps on the glass.


2. Art Vandelay left...
02/18/2007 9:10 am

Hey Joe Mayo - preach-on. Don't forget, I've got the music-covered and will "Turn This Mutha Out"


3. Newman left...
02/18/2007 9:41 am

RE "Rockingham Memorial Hospital (VA) names Mike Rozmus as VP of IS and Richard Haushalter as CIO. I don't believe I've ever seen those positions separated, but the new CIO was formerly the CFO. "

Jim Krauss replaced Carter Melton as RMH's President and CEO http://www.shenandoah-valley.biz/v.php?pg=46&articleID=384 'Heard Rozmus promoted to VP, CIO (he wasn't a VP previously) and Richard Haushalter was formally CFO and became COO, Krauss' old role.


4. Here Comes the Win left...
02/18/2007 3:59 pm

Liked the poll for HIMSS New Orleans...I'll speak for the minority who pull shadiness while on the road (I'm single!)...last year in SD I met up with a cute number from one of the "e" companies, I think eClinical Works...well our interoperability was just fine that night :)


5. Dave Dillehunt left...
02/19/2007 9:24 am

RE: KLAS. I was very surprised to read the comments about KLAS. Based on my experience with KLAS over many years, there is a real disparity between what I encounter and what MH reports above. In my opinion, all of the questions I've been asked were appropriate, and basically designed to better explain my own comments. I've not felt prompted or pushed to praise or rant about one vendor or another, but asked about my experience with them. Maybe there was a new interviewer who had a personal bias. Or, perhaps this is just the difference of perspective between a CIOs and a vendor. Either way, I find the KLAS data very useful, one of many tools that I utilize, and yes, I take the comments with a grain of salt, too, attempting to interpret them, and their source, as best I can. But I've not seen any evidence of bias in their process.


6. Technical Ed left...
02/21/2007 4:12 pm

Re: Disappointed. I am pretty sure the HIMSS poll was more of a joke for our blogger and readers. Lighten up. Re: Sonomaca. I am really sorry to see you spreading negative information about New Orleans to those who will visit next week. All parade goers, myself included, enjoyed the revelry this past weekend at Mardi Gras and I am sure all convention goers will do the same. Unless you 1) owe someone money for drugs, 2)have killed someone yourself, or 3)pass out alone in an alley after too many hurricanes, you are probably safe from crime.