News 09/12/07

From The PACS Designer: "Re: ILM. One of the tools that can be used to better manage archives for data parameters is to employ 'information lifecycle management' techniques. Through ILM, you can prioritize data and image files by time periods so that you more effectively manage the speed of accessing those wanted recent files. As older files become less relevant, they can be compressed and stored in less expensive storage spaces, either onsite or at a remote storage facility provider. TPD will be highlighting the features of a new software database from Oracle, so watch for more postings on database management solutions."

From Gwen Fabin-Blunt: "Re: that physician EMR company you keep mentioning. I hear that, in an attempt to reduce financial liabilities, management is trying to negotiate paying certain sales reps a reduced percentage of commissions owed if payments are made today, versus when clients pay. Additionally, management wants to reduce the number of vacation hours that can be rolled each year, again to reduce liabilities." Doesn't seem too harsh since employees still have the option. What I really dislike are those vendors that demand long hours or personal sacrifice like it was somehow your obligation to bail them out and keep management in bonuses. If they don't have profit sharing, why is their lack of planning or resources your problem? If they need more than 40 hours a week of your time without paying for it, then they need to hire more people. Think WWCD (What Would Contractors Do).

From Byron Davies: "Re: codeine overdose. Turns out it was an unusual genetic profile (1% of Caucasions) that caused the mom to metabolize codeine into morphine. She was at home, not in the hospital." Link. Few hospitals have systems that will catch drug-pregnancy and drug-lactation problems, not that it would have helped here. Maybe this will spur interest.

From Dominique Adikadika: "Re: Acermed. Dead and shut down for good. Got the letter today. The cause was lawsuits against them and the illness of one of their executives." There's always that risk when dealing with a non-publicly traded company or conglomerates. Of course, those larger companies could screw you as equally and quickly by sunsetting your product or by choking you slowly through ineptitude or lack of product focus. No matter who certifies, recommends, or guarantees a product, in the end it's just you and your vendor because only they know what goes on behind their closed doors. Caveat emptor, especially in this consolidating physician systems market.

From Real World User: "Re: AJAX. The simple AJAX Solitaire game posted here seemed impressive for a web page, but was sluggish compared to the real thing. As a regular user of Yahoo Mail and Gmail, my sense is that at its best, AJAX makes web pages great, but it is always slower and more sluggish than a real program. This kind of sluggishness is fine if I am just checking e-mail, but it would drive me crazy if I had to see it all day in an EMR." The Solitaire game is unusually graphics intensive since it shows large, full motion graphics. I don't find it any worse than the usual Citrix front-end to healthcare apps and certainly better than the usual "click and wait a couple of beats" browser applications.

From Philip Rivers: "Re: QuadraMed. Here in San Diego. Just beat the Bears, so I stopped in on the QuadraMed User Group at the Harbor Sheraton. Looks like a good turnout and lots of buzz surrounding this new thing they call CPR. Clients are really saying nice things about what they see. As a player, I am impressed with the CPR clients and their presentations. I think we may have something here!!" I, too, am cautiously optimistic. QuadraMed has had its own troubles not unlike those of former CPR parent Misys, but at least not under current leadership. Whether they're too late to save the aged patient remains to be seen.

From Glenn Welsch: "Re: Allscripts. When Allscripts makes a sale that isn't an interface to an existing IDX installation, then you can consider them a player. That will show that the overall product is what the market is looking for. How many times do they sell a unified solution to a new client? Not many."

From Tucker Livingston: "Re: McKesson. News about McKesson and First DataBank inflating drug $ seems to be few and far between. If the accusations are true, wouldn't it be Medicaid fraud? Where are the feds?" Good question. If the government pays based on AWP, then they're a customer like those others who could join the class action suit. Are criminal charges possible? I'm not sure, but I bet somebody out there does.

From Dr. Allan Pearl: "Re: physician systems. How well does hospital-small office system integration work? Have there been problems with compatibility when affiliated practices use different EMRs? Are EMRs in office practice really the next best thing since ballpoint pens, or just a way for number-crunching administrivia units to get physicians into the corral of quantified performance measurement? Sometimes the numbers seem to obscure more than they reveal, especially when demographics of patient population are not taken into consideration. Having the same health insurance plan, age and sex does not make for comparability of patient groups, nor does process measurement necessarily correlate with clinical outcome. These may be obvious public health research principles to some, but not to the majority of health administrators, in my experience." My knowledge pales in comparison to that of some HIStalk readers, so I'll invite their comments. What motivates hospitals to integrate affiliated docs into their systems and how well does it work?

From PMGuy: "Re: (company). Word on the street is that (company) is close to going away. As a client, this concerns me. I heard the entire consumer group quit after the contract with (company #2) was canceled due to non-payment. Heard it Friday from the support desk when I called to ask for help resetting a password." I'm uncomfortable naming names, but it's a struggling vendor who bet big and early on interoperability. I hope this is a false alarm, but I wouldn't be surprised either way.

From John Wheelwright: "Re: Epic. Ian MacDougall will be the keynote speaker at Epic's UGM." Link. Starts September 17, 6,000 attendees expected, 5,500 of them from Kaiser (kidding).

Brev+IT top five stories this week:

#5 - Ingenix Acquires Healthia Consulting
#4 - Former Hospital Employee Sues After Data Loss Firing
#3 - SEC Interested in Germany's Siemens Investigation Records
#2 - Report Says RHIO Market is Small Unless Philanthropy Kicks In
#1 - Mr. HIStalk Says Subscribe Here Free So You'll Know Next Time

AmerisourceBergen will pay $21 million to former Bridge Medical shareholders who claimed it paid less than promised when it bought the company,sold in turn to Cerner in 2005.

VeriChip shares take a pounding after reports that federal regulators overlooked data suggesting that the company's implantable RFID chips caused cancer in animal testing.

Speaking of VeriChip, here's a picture of a guy with one stuck in his arm, John Halamka, CIO of Beth Israel Deaconness. It's in the blog of his boss, Paul Levy, BIDMC CEO, and shows him standing on a big rock, supposedly keeping in touch with the office via BlackBerry.

Reminder: the search box to our right will plow happily through 4+ years of diarrhetic HIStalk output. I've mentioned just about every company and product here at least once, so give it a click. You can sign up for the e-mail update while you're over there, too, so you get instant notification when I write something new.

Inga mentions the upcoming HIT investments of David Brailer's private equity fund. Show how smart you are: e-mail me your choice of growing HIT-related companies in which you'd recommend he invest: software companies, service providers, whatever. Lots of private equity firms are looking for investment, so what companies are worth a look? Tell me why you like them. Maybe we'll do some profiles of the lesser known.

Microsoft's healthcare interest is outlined. Says they have 600 people working in healthcare. Maybe it's been mentioned before, but I hadn't heard it: Microsoft is working on a standard for personal health records, with announcements coming in the next few weeks. Acquisitions are coming, the article says.

PACSGEAR says it got its 600th customer. The product allows sending documents to PACS. I'm not a fan of all-capitalized company names, especially when the logo on their site has it in lower case, so I'll attribute that annoying inconsistency to some confused marketing types.

Baylor docs can order images from their BlackBerry.

A Mayo doc says an "intelligent EHR" can populate an EMR using static text records, something he calls "minimally invasive informatics".

Another RHIO is spawned, this time in Minnesota. They're making the same mistakes their failing counterparts have made: trying to start out big, relying financially on the big hospitals and insurance companies that started it, and discouraging use by charging subscribers. The universal, ancient PR example is offered to the press: "You're in the ED unconscious ..."

Inga's Update

Re: the new SCI ads. I noticed the superhero ad before Mr. H pointed it out and I really like it. When I first saw it, I wasn’t sure whose ad it was, so I had to watch it for a few moments until the SCI logo came up. Anyway, I think Bob LaBla is a scrooge for his comments … it is eye-catching and fun.

I just read something about a company called Sermo and became intrigued by their offering. The news bit I read concerned the $25 million in Series C funding they just raised, with Sermo labeled as “aggregators of healthcare information.” Checking out their website, they claim to be the largest online community of physicians and serve as a site where physicians can communicate to one another online to discuss “medical insights” and “improve patient outcomes.” There is a “top postings” section where physicians had made notes of complicated cases and asked for other physicians to provide feedback. Of course, I wondered where the money came from, especially since there were no ads on the site. I liked the wording of this: “Sermo’s business model is one of information arbitrage, the opportunity that arises when breaking medical insights intersect with the demand for actionable, market-changing events in healthcare.” I didn’t get what that was saying (or not saying) the first few times I read it. Digging deeper, it appears they sell aggregated data to financial institutions, pharmaceutical companies, healthcare organizations, and government agencies – any organization that benefits from early insight into clinical events. Clients can also pay a subscription fee that enables them to post questions to the Sermo community. I thought the concept was pretty slick. I also noticed that the Cambridge, MA company was hiring, in case anyone is looking. The benefits look terrific – you can bring you dog to work, they have free catered lunch every day, and they have an Xbox (which reminds me - I am getting really, really good at Guitar Hero).

David Brailer and his Health Evolution Partners firm are ready to start giving money away. The health care private equity firm has commitments for $500 million to invest in late stage health care companies. Another $200 million will be invested in early stage ventures through partnerships with other investment funds.

Someone suggested that I might want to look at a particular company that offered some slick technology. Though I try pretty hard to fake it, I am not too much of a technology girl, so it didn’t take much to confuse me as to what this company did. I went to the guru, Mr. H, to help me understand it all. To which Mr. H made the wise commentary about many of the slick technology companies in general: “It's no wonder people don't get interested in all (this stuff) … they have zero marketing ability and just expect people to plow through the geeky exterior to get to the even geekier interior.” I thought it was a great observation that even the best technology is going to be overlooked unless some attention is given to the marketing side.

A class action lawsuit has been filed in Florida on behalf of purchasers of Health Management Associates Common stock. The suit alleges that certain company insiders sold over 900,000 shares of HMA stock for gross proceeds in excess of $17 million between January 17 and July 30, 2007.

The Doctors Clinic in Bremerton, WA selects Sage Healthcare for their 75-physicians multi-specialty medical group. The clinic will implement the Intergy suite of products for all EHR, practice management, analytical, and radiology management needs.

I really liked this story. Meditech is offering free classes in MAGIC programming in the community of Fall River, MA. Meditech is in the process of building a new site there and plans to move 500+ plus jobs into the area. Meditech needed more skilled programmers, so they worked with UMass Dartmouth to develop a program to provide a 30-hour course for participants. Though completing the course does not guarantee a job, it certainly will provide an opportunity for many. And Meditech has a new pool of trained programmers.

Poke Inga.