HIStalk From Sterling Moss: "Re: cranky doctors. Docs may
be cranky because they are smart and don’t make as much money
as the salesmen who push drugs at them (or the lawyers in BMWs, or the
venture capitalists, or …). However, cranky or not, just
because doctors are 'smart' doesn’t mean they are adept at
business or money making. In fact, the opposite is just as likely. From
my own personal experience as a doctor involved in starting my own
manufacturing company and participating in someone else’s
startup and working as a sales consultant for yet a third company, I
can attest I and my medical colleagues are not very adept at the skills
necessary in making money in the non-clinical world. Maybe this is just
the best we can be."
From Grant Beesknees:
"Re: physician
incomes. I'm a physician and I think Ian Morrison is a little off.
Anyone can get earning statistics for the US Bureau of
Labor Statistics. On average, physicians out-earn any other
career group. Additionally, physicians out-earn their
peers practicing in almost any other country you can think of.
So, I don't think there is much for most doctors to be angry about
in terms of their total income. Now, if top doctors
want to compare themselves only to graduates of the top
business schools or top law schools, then they might find that
they don't compare as favorably. However, many in the business
or legal world spend years working their way up the ladder
until they take responsibility for multi-million
or multi-billion dollar organizations, along the way,
out-earning physicians. I don't know for sure, but I think
that most physicians' practices are substantially smaller
enterprises. Even so, physicians can reach the
higher earning levels of their profession rapidly even if they
don't provide a particularly high standard of care or produce
results. In other industries, that is somewhat less
likely. In my opinion, in America, doctors earn a good living without
too much risk and generally deserve what they earn."
From Julius L'Orange: "Re: NextGen business
services. I think the little announcement you made about NextGen
business services deserves some more attention. Did
athenahealth think that the 'standard' ambulatory EMR vendors were just
going to sit and watch them? You can bet Allscripts, GE, and
eCW are all gearing up to offer some sort of RCM service via
their PM systems in the coming months, thus making sure their
current customers don't feel the pull to AH, but more importantly,
capturing other customers who like the SaaS model for RCM, but want a
more mature EMR than AH currently has."
From Art Vandelay:
"Re: nurse barcoding.
I believe nurses are defensive about the comparison to a grocery store
clerk because nothing substantial is being done to change their
situation. At least the grocery store clerk's technology tool belt has
grown to increase precision and efficiency. Nurses are working
with outdated processes and supported by outdated models of staff
roles, training, and technology. We analyze one small area at
a time, followed by a rush to introduce technology. Examples include
the continued proliferation of individual-use devices and singularly
focused decision-support tools in support of metrics. The most
promising work I have seen is from the American Academy of Nursing
through a Robert Wood Johnson grant. Maybe the momentum from this work
can be parlayed into a win for nurses, staff, and patients."
From DrCool:
"Re: selling patient
data. In July 2007, Paul Tang said that 'some electronic
health record and personal health record vendors have placed in their
contracts stipulations that would obligate healthcare providers to
violate privacy rules.' He further said that he has personally seen
the contract language, but declined to identify the vendors or
how he came to see the offending contract provisions. 'That wouldn't be
fair,' Tang said. 'It's just those things are in there.' I'm sorry -
Tang is acting as a patient privacy expert, and is saying that he knows
of potential illegal activity, but it would not be fair TO THE VENDORS
to reveal who is doing this? The arguments would be more
powerful if they were specific. And it seems much more likely
these days that the main privacy problems we have are people leaving
unprotected laptops full of data in their back seats. Have we ever
really had a story where an EMR vendor or any other business entity
actually sold identified patient data since HIPAA was passed? Finally,
as a minuscule investor in IMS, and even as a physician, I have to
admit that it does not surprise me, nor even bother me, that the pharma
companies know what I prescribe. It is not like they have
access to specific patient data (apparently, they used to, but that
has changed). I'm a capitalist by nature and every other
business gets to use data intelligence to figure out how to do things
better. I have no problems letting the pharma people do the same. If it
bothers a doc too much, they can ban pharma reps from their
office. No one is making them see the Pfizer barbies."
Speaking of selling data, guess what companies are among those
trying to block
a Maine law that would let physicians decide individually whether to
allow data-miners to sell their prescribing information to drug
companies? McKesson, Wolters Kluwer Health, SureScripts, Cardinal
Health, NAHIT, and the eHealth Initiative.
Money certainly drives the first four, but why are non-profits and
supposed industry advocates NAHIT and eHI weighing in on a practice
that shouldn't concern them? Ditto, probably: some of their members are
data-sellers and buyers who profit from the practice by pushing
high-margin but not necessarily optimal drugs. Too bad patients
themselves aren't profitable - they might have more advocates if they
were.
Sumter Regional is looking
good to win the MRI machine, but give them some votes just to
make sure. They'll know in a couple of weeks.
EnovateIT moves
to its new headquarters in Ferndale, MI.
Misys says
its healthcare division showed slight growth in the six months ending
November 30.
CDC is
developing technical standards for sending
healthcare-associated infection data to its National Healthcare Safety
Network.
IBM is
running several healthcare IT projects in India: data
sharing, wireless hospital access, medication sensors, and drug supply
chain tracking.
athenahealth kicks
co-founder Todd Park upstairs, creating a Chief Athenista position and
giving him a board seat, but removing him from the management team.
To Julius L'Orange: deploying some web-based. third party PM system with
some third party billing system onto it is not athena - not even close.
They have 100% of their docs on one app, that they maintain – a network.
They are a services company that is based on results - and are paid that
way – I have used them for years. It is all about execution. You are right
more and more will try to copy but the large ones will not leave the warm
blanket of their software license model - look at the Nextgen CEO quote.
athena has been doing this for years and years, it inquires a vendor to go
at risk with clients for good and bad. at the end of the day athena as will
face comp from folks saying they do what they do - if that is true then
they will have the data athena has on their network, fact is they don’t.
in my opinion, athena has a huge advantage that can not be replicated in
any short amount of time. Their EMR is a service just like their rev cycle
-hence why it is is more complicated. I just started using it and looked at
all the usual guys and it was right there on functionality but with a huge
service element. Others may have more templates/specialties etc but they
are looking way down the road on what a clinical system needs to do. If
they wanted some ASP piece of EMR software they would have built it or
bought it - they know it isn’t the way to go.