Monday Morning Update 1/21/08

Francisco Partners acquires practice management software vendor AdvancedMD, a pretty good billing and scheduling performer in KLAS.

Charges against a suspect in the 2003 murder of a Cerner sales associate are dropped for police misconduct but will be re-filed, the prosecutor says. The 25-year-old Connecticut-based rep was in Kansas City for a Cerner sales conference, went to a bar and strip club, left to buy cocaine and methamphetamine, and was later shot dead in a prostitute's bed in a crack house during a robbery attempt, according to testimony.

ZDnet says Misys is one of the "biggest open source health care outfits." For making one tiny, zero-demand niche connectivity product available, sort of? Either ZDnet drank some purple Kool-Aid or it only takes one product to reach the Big Outfit list in healthcare.

Richard Temple, CIO of Saint Clare's Health System (NJ) is profiled in Information Week.

GE Healthcare's Q4 numbers: revenue up 6% to $5 billion, earnings $1.04 billion, down from $1.08 billion. Immelt blames Medicare for lower profits. I'm sure Medicare blames GE for higher costs to taxpayers.

Memorial Health of Savannah will lay off 130 employees in its elimination of 180 positions. They're combining RT and PT, which seems odd. The president says the level of care won't change, they'll just become more efficient. If that's the case, I'd lay off the management team who waited until now to make it so.

SMDC Health System (MN) bans drug company gifts and hauls off 20 shopping carts of mugs, pens, and notepads. The drug company trade organization, naturally, is horrified at the terrible misunderstanding in which they were cast as anything less than noble. "It's a bit draconian. But the onus is on us now to do a better job of explaining the job and the importance of marketing representatives. Unfortunately there are a lot of cynics in America who want to think the worst." Unfortunately, a lot of those cynics are right.

A new CHCF report reviews federal HIT initiatives. Summary: the President's agenda hasn't improved HIT/EHR adoption, NHIN is wasted money because it won't work, EHR certification efforts turned out to be the easiest project, state and federal privacy laws need to be merged into something usable, the government isn't exerting its purchasing influence to encourage HIT adoption, and ONCHIT isn't doing enough to get federal support.

MedPlus is chosen as the preferred LIS for the Canadian healthcare system.

Green Bay (WI) hospitals get a mention in the local newspaper for their physician portal project, for which Medicity is the vendor.

NAHIT's still working on defining those five acronyms (HIE, RHIO, EHR, EMR, PHR) so they're holding two-hour work group sessions at HIMSS. The press release quotes the chief marketing officer (!) of NAHIT (which they insist on calling The Alliance, which sounds sinister and mysterious) who says the definitions "will remove a major barrier to HIT adoption." Say, what does HIT mean since she used that acronym? Healthcare or hospital? Is healthcare one word or two? I smell more BearingPoint contracts! And maybe a follow-up study on how the HIT floodgates will open once these five pesky acronyms that confuse no one are put in their grammatical place by big government contractors more than happy to undertake fool's work as long as it pays well.

E-mail me. 


Inga's Update

Add a couple more products to the 2007 CCHIT certification list. Intergy by Sage and Noteworthy EHR 6.0 by Noteworthy Medical Systems gain approval this week.

The current issue of The Annals of Family Medicine has a report on the state of EHR adoption for FPs in academic facilities. A survey showed that 72% have implemented an EHR and another 18% plan to do so in the next 12 months.

E-mail Inga.


Art Vandelay on Patient Command Centers

I share Jim Stalder's vision of a patient command center. I never considered using SNMP and Zenoss as a core engine for communication of information from the devices. Merging Jim's concept with what I have been thinking for some time, the patient command center is similar to the air traffic control center at a busy airport. The air traffic control center knows who is arriving, when and where they are leaving, and they share status with all the others on the ground and in planes. 

My vision is that the patient command center will be a physical or virtual department where traditional admissions, financial folio, bed, transport and discharge management are handled. It will manage service desks for IT, facilities, clinical engineering, and equipment, as well as clinical alerts and data from medical devices and the computerized patient record for singular issues and trended problems. It will monitor throughput bottlenecks, such as ED, OR, and patients ready for discharge.

I had envisioned using real-time location tracking systems (RTLS) integrated with a real-time data store of ADT, orders, billing, enterprise scheduling and results data. Large screens with various real-time reports would be available. Think of this like the status boards for the Emergency Department on steroids. With a complex event processing (CEP) engine monitoring the information, the proper resources could be alerted to the status of the facility, patients, and staff at any point in time via visual queues on the big board, a user-specific screen, or various reports. Alerts could also be sent to the device of choice, i.e., PC, handheld, Crackberry, local mobile phone. Sorry nurses, it looks like there is another job for you to consider – Command Center Czar.

SNMP isn't that complex. What are the chances of getting the medical device vendors to add this to their devices? It already runs on the private networks and servers they use. In my opinion, the companies to watch in this space are Cerner, with their medical device push, and Philips, with their recent acquisitions. All-in-one vendors like Epic and Meditech are also well positioned with the data their systems have – in theory.