MedWorm provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest medical blog items that have been tagged with 'healthcare information'. Sat, 03 Sep 2011 02:25:58 +0100 http://www.medworm.com/index.php?rid=5182342&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F09%2Ffuture-of-pathology-jim-harrison.html This is a guest blog note by Jim Harrison, M.D., Ph.D. He is a pathologist and Associate Professor at the University of Virginia. It's a repost of a document that he circulated on the Association for Pathology Informatics (API) listserv earlier in the year and is, in part, a compilation of input from other pathologists about anticipated changes in AP and CP. Earlier this summer I posted a request to the API list for thoughts about key changes that might occur in AP and CP within the next five years and how those changes might be best supported by IT. A similar request was passed around in CAP's informatics-related committees, and the results were compiled for distribution to the CAP Pathology Transformation project. I did receive several responses from this list, so I'm summari... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=5182342 Fri, 02 Sep 2011 12:42:49 +0100 5182342 http://www.medworm.com/index.php?rid=5159861&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F08%2Ffepic-beaker-ready-or-not.html There is going to be a lot of money made as the result of the potentially large-scale deployment of Epic's immature LIS called Beaker. One of the first in line to shake this money tree will be KLAS. Here is their announcement of a report on this topic by the company (see: Epic Beaker: Ready or Not?): The laboratory market typically sees little movement. Because of the expense and complexity from a laboratory system’s deep penetration into a hospital, laboratory systems are not changed frequently. If providers do change, it is rarely from a more sophisticated solution to a more immature one. One product that seems to be bucking that trend is Epic Beaker, Epic’s newly available laboratory solution. Of surveyed Epic hospitals currently using other laboratory solutions, over half are p... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=5159861 Fri, 26 Aug 2011 13:19:45 +0100 5159861 http://www.medworm.com/index.php?rid=5159862&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F08%2Fdoes-epic-have-a-near-monoply-for-large-hospital-emrs.html Joseph Conn, who writes for ModernHealthcare.com, picked up on one of my blog notes about the Epic EMR dominance in larger hospitals (see: Not yet an Epic monopoly or conflict). Here is his note: Bruce Friedman, in a post on Lab Soft News says, "Epic has achieved a near monopoly of the (electronic health-record systems) installed in the largest U.S. hospitals." And writing in the Washington Examiner, Lachlan Markay, an investigative writer with the conservative Heritage Foundation's Center for Media and Public Policy, reveals that Epic Systems Corp. CEO Judith Faulkner not only has made campaign contributions to Democrats but also has served as a member of the federal Health Information Technology Policy Committee, which "holds in its hands the future of health informat... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=5159862 Thu, 25 Aug 2011 12:51:59 +0100 5159862 http://www.medworm.com/index.php?rid=5159863&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F08%2Fapathology-informatics-2011-conference-only-six-weeks-away-1.html The second annual Pathology Informatics 2011 conference is only about six weeks away. It will be held in Pittsburgh on October 4-7, 2011. It's the merged version of two prior, long-standing informatics conference, APIII and Lab InfoTech Summit. You can review the entire conference schedule as well as register on-line. Three separate content tracks are being offered: Clinical Information Management, System Support and Connectivity, and Digital Imaging. The 3 1/2 day conference with a venue at the Pittsburgh Wyndham Grand offers an opening day with three workshops, included in the registration fee, 10 plenary lectures, and 27 track lectures. A total of 43 faculty members will participate. Also presented will be about 40 scientific presentations and 15 e-posters that have been selected fr... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=5159863 Wed, 24 Aug 2011 12:47:29 +0100 5159863 http://www.medworm.com/index.php?rid=5159864&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F08%2Fepic-as-a-victim-of-its-own-success.html Katherine Rourke, who blogs over at Hospital EMR and EHR picked up on one of my recent notes about Epic (see: The Feasibility of Using the Epic EMR as a "Platform" to Extend Its Functionality) and posted the following note: Could Epic End Up The Victim Of Its Own EMR Success? Here is a copy of her commentary with a few minor edits. Boldface emphasis is mine: In essence, the [recent Lab Soft News] post makes three key points: Epic is implemented, or soon will be, in virtually every large U.S. hospital Epic keeps very close control of how its system is implemented and developed in an effort to control performance Given this desire for control, Epic isn’t likely to let other vendors create software to interoperate with its EMR If the Lab Soft News author has his facts right, Epi... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=5159864 Tue, 23 Aug 2011 12:46:33 +0100 5159864 http://www.medworm.com/index.php?rid=5159865&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F08%2Fsix-major-disruptions-still-to-come-in-halthcare.html Predictions about strategic shifts in healthcare intrigue me. There is always the question in one's mind about whether you agree with the list. A recent article was labeled as a list of healthcare "disruptions" but otherwise caught my attention (see: 6 Major Disruptions Still To Come In Healthcare). Here's the list stripped of the accompanying brief explanations: Conversion of physicians to electronic health records. Removing the responsibility of records-sharing from the patient. The rise of the genomic signature as part of the medical record. Moving the responsibility [for] care and outcomes from the provider location to the consumer location. The rise of health avatars. The change in physician compensation from fee-for-service to fee-for-outcomes. What interested me... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=5159865 Mon, 22 Aug 2011 12:15:33 +0100 5159865 http://www.medworm.com/index.php?rid=5140317&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F08%2Fthe-most-important-iphone-app-for-pathologists.html In response to a blog note about iPhone ecosystems (see: The iPhone Effect: Smartphones and Their App Ecosystems Have Changed Everything), a reader, Christopher Metts, asked the following question as a comment: If [you] wanted to create an app for a practicing pathologist, what do you think it should do? It's an interesting question and, for me, the answer seems to be obvious.  However, I need to qualify my answer. First, it will encompass all smart phones and not just the iPhone as well as tablets such as the iPad. Secondly. my response will include two broad functions rather than specific app products. Various apps with these functionalities do exist but I don't want to single out any of them. The two functional categories that come to mind for smartphone/tablets that will ... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=5140317 Wed, 17 Aug 2011 14:42:01 +0100 5140317 http://www.medworm.com/index.php?rid=5131063&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F08%2Fdeclining-autopsy-rates.html Discussion About Reinventing the Autopsy; Reinventing the Autopsy: CT Imaging as a Routine Part of the Procedure; NYT Highlights the "Virtopsy" Used for All Military Autopsies). The virtopsy would undoubtedly be more accurate than the classic autopsy. It also could be performed less expensively and more quickly. You can refer back to my previous notes for more details about its advantages. It is currently the norm for the U.S. military and also widely adopted in countries such as Switzerland. As noted in the excerpt above, one of the major reasons for the decline in the autopsy rate is that it's time-consuming and thus expensive. It's also an uncompensated hospital service. Needless to say, family members are also often reluctant to allow the procedure on relatives withou... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=5131063 Mon, 15 Aug 2011 17:40:33 +0100 5131063 http://www.medworm.com/index.php?rid=5119007&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F08%2Fethical-questions-posed-by-office-emr-by-epocrates.html Epocrates is a very successful smartphone app for physicians. The company recently announced the availability of an electronic health record (EHR) (see: Epocrates electronic health record raises new possibilities and ethical questions). Below is an excerpt from an article about this new product that may raise some ethical concerns: ...Targeted to small and solo physician practices, the [Epocrates EHR product] is a web-based software-as-a-service platform which will be offered on a monthly-subscription basis. At launch , it includes a native iPhone app that appears to include access to patient records as well as e-prescribing functionality, with iPad support reportedly in the works. Epocrates EHR will also include support for billing/coding, data analysis and reporting, and an interesting t... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=5119007 Wed, 10 Aug 2011 12:00:00 +0100 5119007 http://www.medworm.com/index.php?rid=5069832&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F07%2Fbetter-quality-services-when-doctors-manage-hospitals.html I have most commonly worked in hospitals where the CEO's major strengths were in financial management -- they were not MDs. Once, in the Army, I worked in a hospital where both the commander and deputy commander were physicians. My general impression has been that the former executives tended to stress the need for quality of care but often had little real understanding about the processes for achieving quality or the true cost of these processes. A recent article caught my attention and asks the question whether hospitals should be run by physicians (see: Should Hospitals Be Run by Doctors?), Below is an excerpt from it: The conventional wisdom is that doctors should focus on patient care, and managers with a business or administrative background are better suited to running the day-t... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=5069832 Tue, 26 Jul 2011 18:15:43 +0100 5069832 http://www.medworm.com/index.php?rid=5051262&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F07%2Forchard-integrated-diagnostics.html Integrated diagnostics can be achieved by breaking down the sub-specialty silos in the diagnostic specialties like pathology, laboratory medicine, and radiology. The current standard of practice is to present the procedure and test-ordering clinicians with individualized reports from the various specialty labs (e.g., surgical pathology, immunology, microbiology) and radiology units like MRI and CT. This approach results from the super-specialization and subdivision of the diagnostics specialties. Under the integrated diagnostics mantra, the goal of integrating the diverse diagnostic reports is moved upstream and becomes the responsibility of the diagnosticians themselves rather than the clinicians. In my mind, the first major movement toward integrated diagnostics on the manufacturing side... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=5051262 Tue, 19 Jul 2011 17:38:01 +0100 5051262 http://www.medworm.com/index.php?rid=5051263&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F07%2Fa-different-paradigm-for-analyzing-the-competition-between-cerner-and-epic.html In a recent note, I discussed the competition between the Cerner and Epic EMRs and quoted another blog, Chilmark Research, to the effect that Cerner was moving in new strategic direction, emphasizing a network of services to provide communities of care (see: Cerner Fights Back in the EMR Market: A Community Network of Services + PHR). Such an approach is sometimes referred to as the development of a care coordination platform. I concluded that Epic's approach closely coincided with the business model currently favored by hospital executives and would probably continue to succeed in the market. Vince Kuraitis responded to my note with a comment that included a link to a lecture he had recently delivered titled Platform Wars (see: Platform Wars). The presentation can also be accessed at ... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=5051263 Mon, 18 Jul 2011 13:43:40 +0100 5051263 http://www.medworm.com/index.php?rid=5029239&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F07%2Ffemr-based-order-sets-as-a-locus-of-control-of-hospital-based-physicians.html In a recent note, I discussed the evidence-based physician order sets that were being deployed at the University of Kansas Hospital (see: Evidence-Based Order Sets Deployed at the University of Kansas Hospital). At the end of the piece, I commented on the very large number of them and speculated that many of them would probably never be used as a practical matter. Here is the specific quote: Here's what I don't understand about the deployment of standardized order sets. Why develop 240 when most physicians will use only a small number of them? In the current case, I am sure that Zynx Health wants to prove the worth of its product to the University of Kansas Hospital and it provides bragging rights to have 240 of them. Even differentiating them by type of patient, my guess is that p... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=5029239 Fri, 15 Jul 2011 14:06:50 +0100 5029239 http://www.medworm.com/index.php?rid=5029240&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F07%2Fcerner-fights-back-in-the-emr-market-network-of-services-for-a-community-of-care.html In my opinion, Cerner is facing a formidable competitor, Epic, in the high-end, larger hospital EMR space (see: Why Does Epic Keep Hammering Cerner? Mr. HIStalk's Opinion; Is Cerner Modifying Its EMR Business Model?). John Moore who blogs over at Chilmark Research recently posted a long piece suggesting that Cerner is crafting a new strategy in order to compete more effectively with Epic. He suggests, first, that It emphasizes support for "communities of care" (i.e, city, region, state, employer). Cerner also intends to provide a "PHR with an ecosystem of third party apps." This will serve as a replacement for the now departed Google Health product (see: Google Health Calls It Quits; Lessons Learned about PHRs or Not). Here is a link to John's note (see: Steppin... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=5029240 Thu, 14 Jul 2011 14:02:53 +0100 5029240 http://www.medworm.com/index.php?rid=5008681&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F07%2Fthe-epic-emr-as-a-platform-extending-its-functionality-with-other-products.html For a number of reasons, Epic has achieved a near monopoly of the EMRs installed in the largest U.S. hospitals (see: ShandsHealth Goes Live with Epic; Company Penetration of the Hospital Market; Why Does Epic Keep Hammering Cerner? Mr. HIStalk's Opinion). In my opinion, this trend poses a significant challenge for healthcare in general. Here's a quote from the first of these two notes describing the nature of this challenge: Epic...has a reputation of closely controlling the installation and development of its EMR software products. This is the basis for its record of successful system installations and part of the appeal of the product to hospital CEOs and CIOs. Furthermore, the evolution of clinical hospital systems (e.g., EMRs, LISs, RISs, etc.) is a critical element in the over... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=5008681 Fri, 08 Jul 2011 13:31:58 +0100 5008681 http://www.medworm.com/index.php?rid=5008682&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F07%2Fshould-diagnostic-test-scheduling-be-personalized.html I have posted previous notes about the need for periodic mammograms including the frequency of routine screening based on age (see: Shift to Digital Mammography Results in Increased Patient Recalls; Confusion Caused by Conflating "False Positive" and "Overdiagnosis" in Breast Cancer). Now comes news of research suggesting that mammogram screening should be personalized (see: Mammogram scheduling should be personalized, not based on age alone: study). The article caught my attention because of the use of the term personalized. Here is an excerpt from the article: Mammograms should not be done on a one-size fits all basis, but instead should be personalized based on a woman’s age, the density of her breasts, her family history of breast cancer and other factors includin... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=5008682 Thu, 07 Jul 2011 16:12:55 +0100 5008682 http://www.medworm.com/index.php?rid=4984705&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F06%2Fwupmc-patient-portal.html In a recent post, I speculated about some of the reasons why I thought that Google Health was exiting the personal health record (PHR) business (see: Google Health Calls It Quits; Lessons Learned about PHRs or Not). Shortly after posting this note, an article came across my desk discussing the success of UPMC's patient portal and the fact that it was now going mobile (see: UPMC's patient portal goes mobile). Below is an excerpt from the article: A health portal used by patients and doctors at the University of Pittsburgh Medical Center (UPMC) is now accessible on iPhones and iPads, thanks to the new mobile HealthTrak application. With its innovative approach to managing patient health - through technology like eVisits and tethered records - easy access to the portal is becoming mor... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4984705 Wed, 29 Jun 2011 13:11:10 +0100 4984705 http://www.medworm.com/index.php?rid=4976215&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F06%2Fevidence-based-order-sets.html I am generally unenthusiastic about the term "evidence-based-medicine" (EBM) because it's often used synonymously with high-quality care. For the most part, however, I do see value for what are called "evidence-based order sets." The University of Kansas Hospital has recently gone live with 240 such order sets developed by Zynx Health’s clinical decision support unit. Here is an excerpt from the press release (see: The University of Kansas Hospital Goes Live with ZynxOrder and ZynxCare Integrated into EHR): ...The University of Kansas Hospital has gone live with 240 evidence-based order sets deployed via computerized provider order entry (CPOE)....The implementation of evidence-based order sets and plans of care within an EHR will enable The University of Kansas H... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4976215 Tue, 28 Jun 2011 13:12:07 +0100 4976215 http://www.medworm.com/index.php?rid=4976216&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F06%2Fon-the-demise-of-google-health.html I am an unabashed fan of Google. However, if the company suffers from anything, it's a corporate sense of hubris. The founders think that almost any problem can be solved by their engineering mentality and their "search" business model. It turns out that launching a personal health record product was not that easy a nut to crack so the company is now withdrawing from the business (see: Google Shuts Down Medical Records And Health Data Platform). Here's Mr. HIStalk's take on the demise of Google Health (see: Monday Morning Update 6/27/11): Google predictably did what its know-it-all technology company predecessors have done over the years: dipped an arrogant and half-assed toe into the health IT waters; roused a loud rabble of shrieking fanboy bloggers and reporters...... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4976216 Mon, 27 Jun 2011 13:33:50 +0100 4976216 http://www.medworm.com/index.php?rid=4968921&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F06%2Fpathology-resident-travel-awards-available-for-pathology-informatics-2011-conference.html The Association for Pathology Informatics is awarding a limited number of stipends of $1,500 to attend the Pathology Informatics 2011 Conference at the Pittsburgh Wyndham Grand hotel in Pittsburgh. The conference will take place on October 4-7, 2011. Awardees must be residents, post-doctoral students, or fellows in accredited teaching programs. This is the premier pathology informatics conference in the country with three workshops, three discipline tracks, multiple keynote plenary lectures, 44 participating faculty members, and more than 40 exhibitors. Last year's PI-2010 presentation marked the first of these events. The conference represents a merger of two long-standing pathology informatics meetings, APIII and Lab InfoTech Summit. The application deadline for awards is August 1, 2... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4968921 Thu, 23 Jun 2011 12:55:56 +0100 4968921 http://www.medworm.com/index.php?rid=4960336&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F06%2Fpfizer-integrating-telemedicine-into-clinical-trials.html I have a special interest in clinical trials dating back to my five-year stint on the IRB (Institutional Review Board) at my hospital. I therefore read with some interest the news that Pfizer was integrating telemedicine (i.e., remote subject participation) into one of its clinical trials (see: Pfizer Integrating Telemedicine into Clinical Trials). Here is an excerpt from the article Pfizer is starting enrollment of its first ever investigational drug trial with remote patient participation. The trial, aptly named Research on Electronic Monitoring of OAB Treatment Experience (REMOTE), is a study to assess the safety and efficacy of Detrol LA (tolterodine tartrate), a treatment for overactive bladder. The main goal is to determine whether the results of the pilot REMOTE “virtual trial” ... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4960336 Wed, 22 Jun 2011 14:59:22 +0100 4960336 http://www.medworm.com/index.php?rid=4953380&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F06%2Fshands-installs-epic-interesting-facts-about-epic-coverage-in-the-us.html ShandsHealth is a large health system located in Gainsville and Jacksonville, Florida. Like many of the high-end and academic health systems with 500 beds or more, it is converting to the Epic EMR (see: Shands' new records system should simplify things). Here is a brief listing of the new features of this EMR as listed in the press release: Shands patients will no longer have to fill out their medical history and prescription information every time they visit a Shands hospital, faculty clinic or emergency room.... All Shands patient records are instantly available to all Shands health-care providers. Patients will no longer have to fill out their medical history and prescription information every time they visit a Shands hospital, faculty clinic or emergency room. Prescriptions are se... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4953380 Mon, 20 Jun 2011 13:32:33 +0100 4953380 http://www.medworm.com/index.php?rid=4945219&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F06%2Foffice-emrs-as-a-risky-investment-for-physicians.html Although some may view physician office EMRs and hospital EMRs as first cousins, I view them in a much different light. In previous notes, I discussed how community-based physicians and the professional societies that represent them are complaining to governmental bodies about the inadequacies and cost of office EMRs, particularly those for small practices (see: Cost of Deployment of EMRs in Physician Offices;  Barriers to the Deployment of Physician Office EMRs; "Usability Failures" of EMRs Frustate Physician Users). Here's a quote from my most recent post regarding physician office EMRs: It's no surprise to me that the "usability of [physician office] EMRs doesn't appear to be the focus of the federal government when establishing meaningful use standards ... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4945219 Fri, 17 Jun 2011 12:08:48 +0100 4945219 http://www.medworm.com/index.php?rid=4945220&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F06%2Fthomson-reuters-to-sell-its-healthcare-unit.html The healthcare unit of Thomson Reuters is up for sale. John Moore who blogs over at Chilmark Research has posted two blog notes about this news (see: Likely Suitors as Thomson Reuters Exits Healthcare; also see Additional Thoughts on Thomson Reuters). Here's an excerpt from the first of them: ...Thomson Reuters (TR) announced that it intends to sell off its healthcare unit. A logical first response is: What they heck, why would they sell right now when the healthcare market is so hot and shows no signs of letting up? Thomson Reuters is a well-respected brand in healthcare and as healthcare organizations (providers and payers) of all sizes look to more effectively run their operations, TR’s portfolio of healthcare solutions are well positioned. This isn’t the first time they have tr... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4945220 Thu, 16 Jun 2011 12:46:36 +0100 4945220 http://www.medworm.com/index.php?rid=4945221&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F06%2Falgorithms-as-the-next-generation-of-innovative-laboratory-and-clinical-tests.html I was somewhat surprised by a recent article suggesting that algorithms themselves will constitute a new type of medical test. The short article cited the work of Predictive Medical Technologies as a basis for this claim. The company software generates health predictions based on previous clinical data for ICU patients (see: Algorithms are the new medical tests; How data and algorithms help doctors make use of real-time data). Below is an excerpt from the article: Predictive Medical Technologies claims that it can use real-time, intensive care unit (ICU) monitoring data to predict clinical events like cardiac arrest up to 24 hours ahead of time. Effectively, the startup's algorithms are new types of medical tests that an ICU doctor can take into consideration when deciding on a course ... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4945221 Wed, 15 Jun 2011 15:05:24 +0100 4945221 http://www.medworm.com/index.php?rid=4911833&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F05%2Ffda-gearing-up-to-regulate-apps-and-social-media-or-not-2.html I have gotten used to a degree of vacillation from the FDA regarding various lab regulatory issues. A  recent chapter in this drama was the agency's ambiguity about lab tests originally called IVDMIAs and subsequently referred to as laboratory developed tests (LDTs). Now comes news that the agency may, or may not, regulate medical smartphone/tablet (i.e., mobile) apps and the use of social media by pharmaceutical companies (see: FDA Reportedly Gearing Up to Regulate Apps). Below is an excerpt from the article: From a no less august source than American Medical News comes a report that the FDA is considering the regulation of medical apps.  See “FDA Signals it Will Regulate Medical Apps“.   The article quotes a source who relayed that at a town hall meeting h... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4911833 Wed, 08 Jun 2011 13:03:11 +0100 4911833 http://www.medworm.com/index.php?rid=4902700&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F06%2Fweb-vido-chats-as-an-important-component-of-patient-care.html This article instead emphasizes the need for a "more equal dialogue between patient and clinician and improve the nature of the relationship."  Some patients tend to get overwhelmed in a formal medical setting and may not address all of their problems with  the physician. They may also think that "the doctor is too busy to bother with my petty complaints." With video chat, the patient remains on his or her home turf and hence the discussion may be conducted on a more equal footing. (Source: Lab Soft News) Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4902700 Mon, 06 Jun 2011 18:47:23 +0100 4902700 http://www.medworm.com/index.php?rid=4893933&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F06%2Fpseudo-certification-from-chime-is-anyone-taken-in-by-this.html Mr. HIStalk reports on the CHIME CIO credentialing program (see: News 5/27/11): CHIME reports that 109 individuals have earned Certified Healthcare CIO designation since the credentialing program was launched in July 2009. I said it was a dumb idea then and I’ll stand by that opinion now. Obviously the credential hasn’t exactly gone viral if only 109 out of thousands of hospital CIOs have signed on over two years, voluntarily jumping onto the hamster wheel of spending hospital money on renewals and going to CHIME meetings to earn CE. To each his own, but I’d be embarrassed to use a non-educational  credential earned by passing a multiple choice test of job-specific knowledge (designed by asking CIOs what they do on the job, then testing them to see if they theoretically know ho... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4893933 Thu, 02 Jun 2011 19:06:55 +0100 4893933 http://www.medworm.com/index.php?rid=4872495&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F05%2Fincidentalomas-revisited-revisited.html I recently posted a note about so-called incidentalomas, lesions often "accidentally" discovered during CT scans that have been ordered on the basis of other diagnostic concerns. You may want to refer to it to refresh your memory about the topic (see: How to Avoid the Risks of a CT Incidentaloma). Dr. Mark Pool who blogs over at The Daily Sign Out has posted a a well-thought-out note that extends this discussion in some interesting ways (see: Incidentalomas revisited). Below is an excerpt from it: Dr. Bruce Friedman posted a thoughtful blog on Lab Soft News recently concerning "incidentalomas" ....This post happened to coincide with a new working committee at my hospital commissioned with developing a virtual clinic for following patients who have incidental lung nodule... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4872495 Thu, 26 May 2011 23:24:39 +0100 4872495 http://www.medworm.com/index.php?rid=4862947&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F05%2Fcomplexity-of-emrs-frustates-hospital-users.html The fact that EMRs have been failure prone is no secret (see: The Causes of EMR System Implementation Failure). The cause of such failures is multifactorial. Lab Soft News has also covered this topic in the past (see: EMR Failures and a Recipe for Their Avoidance in the Future; Modeling the Costs of IT System Failures Globally). However, I firmly believe that physicians, like most professionals, will avidly embrace any type of information technology that will improve their productivity. This is particularly true these days when healthcare reform requires physicians to work more efficiently. It follows that a large part of the rejection of EMRs by clinicians is based on the fact that they are not well designed. A recent article discusses this issue (see: Complexity of EMRs discourages new u... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4862947 Wed, 25 May 2011 13:20:01 +0100 4862947 http://www.medworm.com/index.php?rid=4862948&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F05%2Fshould-hospitals-set-up-private-social-networks-to-server-their-patients.html A recent article about how Toyota is setting up a private social network for its customers stimulated my thinking about how this idea might apply to hospitals and their patients (see: Toyota Owners To Get a Private Social Network). Below is an excerpt from it: Toyota has teamed up with Salesforce.com to create Toyota Friend, a private social network for owners of Toyota cars. The network will be accessible through PCs, tablets and smartphones, giving Toyota customers the ability to connect with their dealerships, cars and Toyota itself. For example, your car could send you an alert when its battery needs recharging, and you would be able to connect to your dealership to get maintenance tips and service information. Toyota Friend will primarily be a private network for Toyota car owners, bu... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4862948 Tue, 24 May 2011 13:57:59 +0100 4862948 http://www.medworm.com/index.php?rid=4841999&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F05%2Fthe-true-cost-of-implementing-an-emr-or-lis.html Mr. HIStalk came up with another gem of a observation recently: software license fees are often nearly irrelevant to overall project cost, especially on the often-forgotten cost of internal labor (see: Monday Morning Update 5/16/11). Below is his exchange with a reader: From Former CIO: “Re: high price of Epic. In my experience, the price of Epic software is competitive with others (at least the big guys). The difference is that they drive the customer to look at the true cost of implementation and plan for the resources, internal and external, training, etc. The other vendors hope you won’t actually add it all up until you sign the software contract. This is the best part about Epic since it gets the organization to accept the budget, even if difficult. If you are not prepared to spen... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4841999 Thu, 19 May 2011 12:00:00 +0100 4841999 http://www.medworm.com/index.php?rid=4829329&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F05%2Fmanage-raw-data.html A recent article I came across examines how the mining and analysis of "raw data" in various industries will provide an opportunity for innovation (see: New Ways to Exploit Raw Data May Bring Surge of Innovation, a Study Says). Below is an excerpt from it: Math majors, rejoice. Businesses are going to need tens of thousands of you in the coming years as companies grapple with a growing mountain of data. Data is a vital raw material of the information economy, much as coal and iron ore were in the Industrial Revolution. But the business world is just beginning to learn how to process it all. The current data surge is coming from sophisticated computer tracking of shipments, sales, suppliers and customers, as well as e-mail, Web traffic and social network comments. The quantity of ... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4829329 Mon, 16 May 2011 13:54:52 +0100 4829329 http://www.medworm.com/index.php?rid=4821173&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F05%2Fphysicians-and-the-two-screen-revolution.html In a recent note, I discussed the two-screen revolution that seems to be gaining traction (see: iPad Helping to Launch a "Two-Screen Revolution"). The basic idea is that many of us we will soon be operating with two screens, the large one being a TV or PC monitor and the small one being a tablet computer such as an iPad for simultaneously browsing the web. The large screen provides generalized, standard content and the smaller one provides customized, complementary information. I have been thinking about how this computing model relates to physicians and I think I can now describe how it may work in a hospital or large clinic. Consider the process that occurs when a physician accesses the electronic medical record of a patient using a computer monitor. He or she, using an iPad, c... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4821173 Fri, 13 May 2011 12:58:48 +0100 4821173 http://www.medworm.com/index.php?rid=4768261&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F04%2Fmedical-students-as-emr-scribes.html In two recent posts, I have reported on the growing use of EMR scribes in hospitals (see: Shift of Hospital EMR Data Entry Tasks from MDs to Scribes; Medical Students Recruited to Serve as EMR Scribes in Toledo). It makes no sense to use physicians and nurses as data entry clerks for the EMR. The user interfaces of these systems are still too awkward for these personnel to perform the necessary tasks quickly and efficiently. Hence, hospitals associated with medical schools are turning to medical students to serve as EMR scribes. These students bring to the job some knowledge of medical nomenclature and benefit from the early exposure to the patient care environment. Other hospitals are turning to college students or other suitable candidates in the community after some training. A Google s... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4768261 Fri, 29 Apr 2011 12:00:00 +0100 4768261 http://www.medworm.com/index.php?rid=4753978&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F04%2Fexhibitors-sought-for-pathology-informatics-2011-october-4-7-in-pittsburgh.html We are seeking exhibitors for the Pathology Informatics 2011 conference that will take place at the Wyndham Hotel in Pittsburgh on October 4-7, 2011. This conference resulted from a merger of two previous pathology informatics conferences, Lab Infotech Summit and APIII. The inaugural merged conference was held in Boston last September. A total of 41 exhibitors participated in that event with about 250 paid registrants in attendance. A total of twenty-five companies have signed-up thus far to participate in Pathology Informatics 2011. They are the following: Aperio, Apollo PACS, ARUP Laboratories, Aurora Interactive, Beckman Coulter, Cerner, Dawning Technologies, Definiens, Elekta, General Data, Haemonetics Software Solutions, Halfpenny Technologies, McKesson Corporation, Milestone Medical,... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4753978 Tue, 26 Apr 2011 15:07:51 +0100 4753978 http://www.medworm.com/index.php?rid=4747908&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F04%2Fradiology-job-market-trends-downward-blame-technology-and-reimbursement.html Here are summaries of three conversations that I have had recently: A newly graduated physician tells me that her colleagues widely understand that the radiology job market is lousy with the exception of interventional radiology (IR), for which there are plenty of openings. A mid-career, highly specialized  academic radiologist tells me that there would be few, suitable positions available for him if we were to change positions. A very senior radiologist in a large, midwest hospital tells me that he is working twice as hard to simply maintain his expected income; he cites digital pathology and PACS as the enabling technologies that allow him to ramp-up his personal efficiency and effectiveness. All of this caused me to search the web for some further discussion of the current radio... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4747908 Mon, 25 Apr 2011 12:12:55 +0100 4747908 http://www.medworm.com/index.php?rid=4709428&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F04%2Ftypes-of-cloud-computing.html I have been commenting about the feasibility of cloud computing for more than three years. The technology has now reached a state of maturity such that CIOs, at least outside of healthcare, are seriously considering deploying this architecture. Healthcare computing tends to trail that in most other fields so most hospitals continue to run their own "machine rooms" with dedicated servers. A recent article provides some useful definitions of the various types of cloud computing (see: Here's Why Cloud Computing Is So Hot Right Now). Below is an excerpt from it: What is cloud computing? At its simplest, cloud computing means that users are connecting to applications that run on a set of shared or pooled servers, rather than running on a single dedicated server. This is a subtle b... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4709428 Wed, 13 Apr 2011 12:14:23 +0100 4709428 http://www.medworm.com/index.php?rid=4704967&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F04%2Ftighter-integration-of-cvs-minuteclinic-with-chicagos-advocate-health-care.html There has always been some challenges associated with the business model for walk-in clinics located in retail pharmacy chain stores. Commonly staffed by nurses, they were only prepared to deal with minor health problems and routine procedures. This approach often did not generate enough business. Therefore, some began to place physicians in these clinics who were then able to treat more significant health problems. Once some of these clinics started in this direction, it made sense to contract with local hospital systems to both provide physicians and also to integrate the clinic records with those of the health system. This provided a referral network for the more seriously ill patients who were being turned away from the nurse-staffed clinics. The Cleveland Clinic was an early participa... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4704967 Tue, 12 Apr 2011 14:08:34 +0100 4704967 http://www.medworm.com/index.php?rid=4696963&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F04%2Fmedicare-billing-rife-with-fraud-need-open-access-to-claims-database.html How badly do we want to reduce the cost of Medicare? For me, one of the most important steps will be to provide public access to the Medicare claims database and use it to root out fraud. This is the goal of two senators who have introduced some new legislation (see: Senators Push to Open Database on Medicare). Below is an excerpt from the Wall Street Journal article about this topic: Two senators have introduced legislation to overturn a 1979 court injunction that bars the government from revealing what individual physicians earn from Medicare. That information is stored in the Medicare-claims database, widely considered one of the best tools for finding fraud and abuse in the $500 billion federal health-insurance program for the elderly and disabled. Soaring Medicare costs threaten to ov... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4696963 Mon, 11 Apr 2011 13:03:48 +0100 4696963 http://www.medworm.com/index.php?rid=4643005&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F03%2Ffwhy-and-how-hospitals-should-market-themselves.html For the most part and in my opinion, hospitals don't don't do a very job of marketing themselves. This is not surprising given that most of them are non-profit and most such organizations do not seem to be proficient in this area. However, the use of social media for marketing is free of cost and relatively simple to engage for this purpose. According to a recent study, even here most hospitals don't always get their message out (see: Study: Hospitals' Facebook use is poor). Below is an excerpt from the article: U.S. hospitals are not taking advantage of the opportunities Facebook creates to better engage patients, build healthcare communities or develop their hospital brands, according to a new study....According to the study, only a few hospitals across the the country ar... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4643005 Mon, 28 Mar 2011 13:04:31 +0100 4643005 http://www.medworm.com/index.php?rid=4611009&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F03%2Ffhp-unveils-new-business-strategy-cloud-and-business-analytics.html If I were an investor in HP, I would be discouraged to learn that the new CEO has only now discovered that software has a higher profit margin than software and also that there's money to be made in the cloud. Here's a report of his remarks about these topics (see: Hewlett-Packard Chief Unveils Strategy for Expansion) Léo Apotheker, chief of Hewlett-Packard, said Monday that the company would expand its software business and venture into cloud computing. He finally unveiled his strategy to investors on Monday, saying that H.P. would build out its tiny software business and expand into the cloud — a term used to describe products and services delivered online. Mr. Apotheker’s plan is not so much to reinvent H.P., but to help it evolve. Mr. Apotheker said he planned to use the c... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4611009 Fri, 18 Mar 2011 10:58:39 +0100 4611009 http://www.medworm.com/index.php?rid=4600803&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F03%2Foffice-based-specialists-abandon-hospital-call-responsibilities.html The inexorable transition toward more salaried, hospital-based physicians, hospitalists, is accelerating. Many physicians favor these positions because they can avoid the burden of managing an office practice. They are also seeking a more tolerable, and predictable, work-week. Hospital executives like to hire hospitalists because this allows them to exercise more control over the physicians on the hospital staff (see: The Emergence of the Surgicalist). One of the consequences of this shift is that many office-based physicians are losing their ability to perform various medical procedures. This void is being filled by proceduralists in hospitals (see: The Emergence of the Proceduralist in Hospitals; Two Definitions for the Physician Proceduralist). All of these changes are resulting in a ma... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4600803 Wed, 16 Mar 2011 11:53:08 +0100 4600803 http://www.medworm.com/index.php?rid=4592704&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F03%2Ffcreating-the-i-patient-bedside-diagnostic-skills-continue-to-deteriorate.html According to one prominent physician, Dr. Abraham Verghese, electronic records and our sophisticated diagnostic tools are causing physicians to increasingly focus on the electronic records and diagnostic images (i.e., the iPatient) and ignoring their flesh-and-blood patients (see: Treat the Patient, Not the CT Scan). Put another way, we are treating the iPatients rather than the physical patient. Below is an excerpt from the article: [The expanding reliance on electronic medical records] creates what I call an “iPatient” — and this iPatient threatens to become the real focus of our attention, while the real patient in the bed often feels neglected, a mere placeholder for the virtual record. Imaging the body has become so easy (and profitable, too, if you own the machine). When I was ... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4592704 Tue, 15 Mar 2011 21:19:45 +0100 4592704 http://www.medworm.com/index.php?rid=4560612&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F03%2Fhimss-booth-fees.html There is no question that the HIMSS annual conference is a huge cash-cow for the organization. With about 30,000 registrants and 1,000 vendors, it's generally a mandatory appearance for all but the smallest HIT companies. Want to know what it costs a company to participate?. A recent guest blog by a vendor representative on HIStalk spells out some of the details (see: More HIMSS Wrap-Up 3/2/11). Below is an excerpt from it: First, we vendors pay a fortune to exhibit at these shows. At more than $33/square foot for just the footprint (a small 20 x 20 booth is over $13k), plus between $15,000 and $1,000,000 for the booth construction, the tab is just beginning. Don’t forget all the rental furniture, phones, and $1,500/day for Internet hookup (can you believe that?). Shipping each booth... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4560612 Tue, 08 Mar 2011 13:35:36 +0100 4560612 http://www.medworm.com/index.php?rid=4560613&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F03%2Fblood-bank-personnel-serving-as-epic-consultants-is-this-a-good-idea-.html In a recent note, I discussed the idea that Epic is providing incentives for larger hospitals to serve as hosting sites and consultants for smaller ones (see: Epic Helps Convert Its Large Hospital Customers into Epic Hosting Sites/Consultants).The overarching strategy is obvious for hospital CEOs/CIOs -- it binds the smaller hospital to the larger one. Healthcare reform is stimulating many such mergers/realignments (see: Hospital Executives Search for the Formula for an Accountable Care Organization). However, the question should to be raised whether there are any unanticipated surprises when entering into such relationships. Below is an on-point item copied from a lab/pathology web forum (see: Epic (Beaker) Lab Module): THintz: At our facility we use Epic for our HIS and Sunquest for our ... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4560613 Mon, 07 Mar 2011 13:03:11 +0100 4560613 http://www.medworm.com/index.php?rid=4545259&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F03%2Fthepic-converts-its-academic-health-system-customer-into-franchisees.html I had not heard anything about this before but Mr. HIStalk alerts us to a new strategic initiative on the part of Epic's CEO and founder, Judith Faulkner (see: News 3/2/11). Below is a Q and A exchange posted recently: From HISJunkie: “Re: Texas Health Resources offering HIT consulting services (see: Texas Health Resources offering HIT consulting services). Epic is doing what IBM did 35 years ago, turning every client into a hosting site (see SHAS circa 1975). Epic is allowing / encouraging the large medical centers to distribute its app on a host basis to almost any remote client (particularly if they are under 150 beds) without incurring a new acquisition or license fee. Just add more work stations and pay a small seat license increment and you can buy them in ‘bulk’. I spoke t... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4545259 Thu, 03 Mar 2011 13:57:16 +0100 4545259 http://www.medworm.com/index.php?rid=4532579&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F03%2Fsee-drugmakers-create-mobile-phone-apps-to-track-diabetes-cancer-drugmakers-led-by-novartis-ag-and-merck-co-boosted-in.html This article highlights three major reasons why Big Pharma is starting to invest in smartphone apps. If patients are non-compliant, the various drugs that are being prescribed for them may be judged to be non-efficacious in retrospective, post-market studies. This non-compliance problem has arisen in response to pressure from government-run health plans. The article provides two more reasons for companies to invest in the development of smartphone apps. The FDA is breathing down their necks about direct-to-consumer (DTC) ads on television (see: It's Time for the FDA to Prohibit Direct-to-Consumer Advertising by Pharmaceutical Companies). If and when such ads are banned, the companies will have another trick up their sleeves -- drug marketing via smartphone apps. However, there is a dow... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4532579 Tue, 01 Mar 2011 14:45:25 +0100 4532579 http://www.medworm.com/index.php?rid=4532580&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F02%2Fpublic-health-alerts-to-physicians-via-office-emrs.html The objective is to identify episodes of food born illness by assessing symptoms recorded in EMRs and then alert physicians via these same systems. Below is an excerpt from the article: The Centers for Disease Control and Prevention (CDC), GE Healthcare and the Alliance of Chicago Community Health Services are collaborating on a project that aims at testing the efficacy of actionable health alerts, delivered instantly to a physician's electronic medical record. Officials made the announcement at [the recent] HIMSS and said the project will begin with a six-month prospective study, seeking to determine if the alerts are triggered often enough or too often, and if doctors take the advice displayed within the alerts. As a foundation, the study will utilize GE Healthcare's densely popu... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4532580 Mon, 28 Feb 2011 15:00:06 +0100 4532580 http://www.medworm.com/index.php?rid=4522303&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F02%2Fmultiple-privileges-extended-to-hospital-cios-at-himss.html I have been running conferences for nearly thirty years and my mantra has always been the following: no special privileges for any particular subset of registrants regardless of their status. Obviously, HIMSS does not operate under this same principle; CIOs are routed to the short lines and offered special refreshments and quiet rooms to escape the crowds. Here's a Q and A exchange just published on HIStalk about the ongoing HIMSS conference (see: From HIMSS 2/22/11): From Another CIO: “Re: VIP lines. My title is CIO, but it isn’t worth the ink to print it if all of our staff aren’t working together to accomplish everything that needs to get done.  To this end, I am literally embarrassed to hear about a ‘VIP Line’ at the HIMSS conference and wouldn’t be caught dead in... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4522303 Fri, 25 Feb 2011 13:00:00 +0100 4522303 http://www.medworm.com/index.php?rid=4501818&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F02%2Ffederal-emphsis-on-emr-funding-hurts-ancillary-system-market.html A recent article on the web emphasizes the effect of ARRA funding for EMRs on the market for ancillary systems -- RISs, PACSs, and CVISs (see: ARRA FUNDING TO HAVE A SIGNIFICANT NEGATIVE EFFECT ON THE PACS, RIS, AND CVIS MARKET THROUGH 2013). The article did not include LISs or Pathology PACSs in the list of affected ancillary systems but I will assume this to be true. Below is an excerpt from the it: According to Millennium Research Group (MRG)..., the 2009 American Recovery and Reinvestment Act (ARRA) will continue to shift the focus of hospital healthcare IT budgets away from picture archiving and communication systems (PACS), radiology information systems (RIS), and cardiovascular information systems (CVIS), and toward Electronic Medical Records (EHR). This will result in a continued d... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4501818 Mon, 21 Feb 2011 15:28:19 +0100 4501818 http://www.medworm.com/index.php?rid=4489991&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F02%2Frationale-for-the-increasing-tempo-of-physician-practices-by-hospitals.html One consequence of the recent federal healthcare reform initiative has been the purchase of physician-owned private practices and specialty clinics by hospitals (see: Physician Private Practice Declines; the Last Barrier to Emergence of "Big Medicine"; Health Systems Use Their Regional Dominance to Muscle Insurance Companies). I have attributed this trend to the greater access to capital by hospitals, the increasing paperwork required from accountable care organizations (ACOs) (see: Hospital Executives Search for the Formula for an Accountable Care Organization), and the interest of hospitals in beefing-up their ambulatory care programs. Below is an excerpt from a blog written by a physician commenting on the purchase of physician practices (see: Dr. Manoj Jain: Hospitals taking ... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4489991 Thu, 17 Feb 2011 17:09:06 +0100 4489991 http://www.medworm.com/index.php?rid=4482977&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F02%2Fa-pathologist-recounts-his-experience-with-a-demonstration-of-epics-beaker-lis.html An anonymous academic pathologist describes below, as a guest blog note, his experience with Epic and its LIS, Beaker. A number of previous notes have been posted in Lab Soft News about Beaker (see: Introducing the Epic Laboratory Information System (LIS); It's Called Beaker; An Update on Epic's LIS, Called Beaker, from HIStalk; More Information about Epic's Beaker LIS and Its Sibling; Assessing the True Cost of Serving as a Beta Test Site for the Beaker LIS; Details about Epic's Beaker LIS, Supplied by the Company). Over the last several months, there have been a few posts in Lab Soft News which have shed some light on a relative newcomer to the LIS party that goes by the name Beaker. Beaker, as you may recall from the earlier stories, is the latest development from Epic. ... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4482977 Wed, 16 Feb 2011 13:42:08 +0100 4482977 http://www.medworm.com/index.php?rid=4460190&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F02%2Fthintroducing-the-eicu-what-is-it-and-why-is-it-now-being-introduced.html I recently stumbled upon a successful example of telemedicine about which I was unaware -- the enhanced intensive care unit (eICU). Provena Health, with six hospitals in Illinois, has a web page explaining the concept which I quote from below (see: eICU - enhanced ICU): Initially one of only a handful of health systems to implement eICU technology, the Provena eICU Connection is one of 43 eICUs of its kind in the country, which collectively monitor approximately 10 percent of ICU beds nation-wide and lead the way in innovative patient care....It's a revolutionary service that utilizes enhanced computer software and physiology monitoring technologies to get immediate critical care physician and nurse input about any change in a patient's condition....eICU technology adds to current ... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4460190 Thu, 10 Feb 2011 13:02:49 +0100 4460190 http://www.medworm.com/index.php?rid=4429234&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F02%2Fdetails-about-epics-beaker-lis-supplied-by-the-company.html I have published previous notes about Epic's Beaker LIS (see: Introducing the Epic Laboratory Information System (LIS); It's Called Beaker; An Update on Epic's LIS, Called Beaker, from HIStalk; More Information about Epic's Beaker LIS and Its Sibling). Because of the popularity of the Epic EMR, extensive pressure is being placed on pathology departments to install Beaker as a component of the enterprise solution that Epic offers and many CIOs seem to lust after (see: Why Does Epic Keep Hammering Cerner? Mr. HIStalk's Opinion; Are You an Enterprise or Best-of-Breed CIO? Access to Cash May Make the Difference). It's important for pathology personnel to understand the relative immaturity of this product and that key components are lacking (see: Assessing the True Cost ... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4429234 Wed, 02 Feb 2011 14:33:32 +0100 4429234 http://www.medworm.com/index.php?rid=4419460&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F01%2Fepic-employee-turnover-keeping-up-with-the-huge-number-of-new-contracts.html In a recent note, I quoted Mr. HIStalk describing how Epic manages its sales process (see: Some Details about the Epic Sales Force and Sales Process). In the same blog note that I linked to, he also cites the recent success of Epic in writing new EMR contracts (see: Monday Morning Update 1/24/11) Until 2009, Epic was making just 10-15 new sales a year and many of those were just for ambulatory or inpatient alone, but the percentage of enterprise sales has increased each year. In 2010, they supposedly made around 40 new sales .... Continuing on in this same vein regarding Epic staffing and personnel issues, Mr. HIStalk responds to a query for a reader, QPFC, about some sour grapes from ex-employees on the web (see: News 1/26/11): From QPFC: “Re: Epic. On Glassdoor.com, ex-employees have s... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4419460 Mon, 31 Jan 2011 12:58:51 +0100 4419460 http://www.medworm.com/index.php?rid=4406041&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F01%2F23andme-builds-online-sarcoma-research-community.html Here's an interesting development. 23andMe, the online, consumer-oriented genomic testing site, is developing a sarcoma research community (see: 23andMe Achieves Milestone in Building Sarcoma Research Community). This strikes me a very novel idea that may serve as a forerunner to similar online projects. Below is an excerpt from the article explaining the concept in more detail: 23andMe’s sarcoma research efforts are well underway with collection of both phenotypic and genetic data from 500 individuals diagnosed with sarcoma already completed. The company is half way towards its goal of building a sarcoma research community of more than 1,000 individuals.... Sarcomas are a rare group of cancers that arise in connective tissues ...or in bone. It is estimated that there are approximate... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4406041 Thu, 27 Jan 2011 14:10:41 +0100 4406041 http://www.medworm.com/index.php?rid=4382956&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F01%2Fhow-healthy-is-e-health.html Here's a definition for e-health from Canada: {A]n overarching term used to describe the application of information and communications technologies in the health sector. It encompasses a range of purposes from purely administrative through to health care delivery. This definition seems to me to provide a good start but, in my opinion, is insufficient. It doesn't touch on the notion of health information acquisition by consumers via the web, which is one of the most far-reaching aspects of e-health. This pursuit of knowledge by healthcare consumers is critical because it it allows them to educate themselves and prepares them to take more responsibility for their own health. Keeping all of this in mind, I now want to turn to a recent article that raises the issue of the "health&... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4382956 Fri, 21 Jan 2011 14:43:39 +0100 4382956 http://www.medworm.com/index.php?rid=4361315&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F01%2Fis-meditech-dooomed-becasue-of-lack-of-robust-ambulatory-product.html Until about ten years ago, there was only minimal interest in IT support for ambulatory care. Successful EMR vendors such as that of Cerner were focused on inpatient care although their forward-looking "vision" statements always included ambulatory care. In terms of their major product focus, however, they were following the lead of the hospital executives who derived the bulk of their revenue from the inpatient side of the hospital. Many physicians shared this view at this time. Academic surgeons, for example, operated on mainly inpatients and then saw them as outpatients mainly to ensure that the surgical incisions were healing. All of this is now changing. Epic, for example, initially focused on IT support for ambulatory care. We all know how this has ended up (see: Why Does E... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4361315 Mon, 17 Jan 2011 15:19:55 +0100 4361315 http://www.medworm.com/index.php?rid=4349706&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F01%2Fwhats-shakin-in-verona-wi.html Verona, Wisconsin, a short drive from Madison and the home of Epic, has a lively newspaper. It's called the Verona Press. It turns out that whenever Mr. HIStalk links to an Epic story published by the Verona Press, the interest stresses their web server. Mr. HIStalk informs us about the clout his blog exercises in a recent note (see: News 1/12/11): HIStalk links to Epic-related stories provided so many incoming hits to website of The Verona Press that its top stories of 2010 had to be separated into Epic and non-Epic lists. They nicely mentioned HIStalk specifically. Epic articles outdrew other big news stories about deer season, a sausage factory fire, and bear sightings. I want to assure you that I am not going to resort to any cheap shots relating to local Wisconsin wildlife or the ... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4349706 Fri, 14 Jan 2011 15:02:59 +0100 4349706 http://www.medworm.com/index.php?rid=4331251&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F01%2Fhow-valid-is-some-criticism-of-clinical-software.html Anecdotal information is defined as being based on personal experiences or, alternatively, on reports of individual cases rather than more rigorously acquired data. With regard to the selection of a new information system such as an LIS, it is nearly impossible to obtain detailed side-by-side comparisons of competing systems in the market. I personally pay no attention to the KLAS rankings (see: Mr. HIStalk Comments on KLAS). In order to make an informed decision when replacing an LIS, is it therefore necessary to perform a rigorous request-for-proposal (RFP) (see: More Ideas about Developing and Refining an RFP, Assessing the True Cost of Serving as a Beta Test Site for the Beaker LIS). It's also very important make a number of telephone calls to current users of the system. Mr. HISta... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4331251 Tue, 11 Jan 2011 13:51:34 +0100 4331251 http://www.medworm.com/index.php?rid=4318553&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F01%2Fcerner-lowering-lis-prices.html This article on Idaho hospital EMR projects describes Cerner, being implemented at North Canyon Medical Center for $2 million, as “an economical system that works well for smaller rural hospitals.” Syringa Hospital (a strangely satisfying hospital name) paid $1.3 million. What? The Cerner EMR as “an economical system that works well for smaller rural hospitals.” I, like Mr. HIStalk, was surprised by this description and had to think about the idea for a while. Then some of my thoughts started to come together. First of all, and as I noted in a previous note, Epic is winning most of the contracts for the highest-end hospital contracts, which was one of Cerner's sweet spots (see: Why Does Epic Keep Hammering Cerner? Mr. HIStalk's Opinion). Also, and as suggested in a previous... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4318553 Thu, 06 Jan 2011 14:19:00 +0100 4318553 http://www.medworm.com/index.php?rid=4298804&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F12%2Fprediction-for-2011-apps-go-corporate.html In an end-of-the-year article discussing IT trends, the WSJ tucked-in what I consider a highly significant and insightful prediction under the "apps" category (see: The Rise of Apps, iPad and Android; subscription required). I copy it below: Coming next: Apps go corporate. AT&T, business-software developer SAP AG and other companies are working on apps that can help their employees track sales, monitor systems or check-out customers without being tied to their stations. The quick adoption of tablets by business users is helping fuel the trend. I have posted a number of notes about the usefulness of smartphones in healthcare delivery and health education. I have also discussed previously the type of programs that run on smartphones -- generally referred to as apps (see: New De... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4298804 Wed, 29 Dec 2010 16:25:21 +0100 4298804 http://www.medworm.com/index.php?rid=4295005&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F12%2Ftop-.html I tend to be a sucker for the various "top ten" lists and they are common at this time of year. I tend to always read them, mainly to see if I agree with the list. Hence my interest in the "top 11" technology innovations of the past ten years published by the IEEE (see: The top 11 technology innovations of the last 10 years, from the IEEE). IEEE is an organization that bills itself on its web site as "the world’s largest professional association dedicated to advancing technological innovation and excellence for the benefit of humanity." Why the top eleven? I suspect that there were some ties and controversy near the end of the list and they settled on eleven rather than ten. Here's their list: Smartphones. Social Networking. Voice over IP. LED Lighting... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4295005 Tue, 28 Dec 2010 14:46:39 +0100 4295005 http://www.medworm.com/index.php?rid=4281554&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F12%2Fhealth-insurance-companies-jump-into-healthcare-software.html Mr. HIStalk comments below on the recent acquisition of Medicity by the health insurance company Aetna (see: Healthcare IT From the Investor’s Chair 12/9/10). Medicity is an HIE (health information exchange) company. Speaking from my usual perch in the peanut gallery (as I’ve done work for neither company), I’m fairly astounded by the price [of Medicity’s acquisition by Aetna]. Rumor has it that $500 million (twice what Ingenix paid for Axolotl) is approaching 8x revenues, a princely multiple that dwarfs, say, Allscripts’ purchase of Eclipsys for 2x revs or even Ingenix’s purchase of Picis for 3x revs. Medicity appears to be the leader in its space, with over 750 hospitals and 125,000 physicians using its system. Still, it’s a huge bet on the HIE market that’s not quite eme... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4281554 Wed, 22 Dec 2010 13:00:00 +0100 4281554 http://www.medworm.com/index.php?rid=4266286&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F12%2Fdifference-between-software-born-in-the-cloud-and-software-moved-to-the-cloud.html I have posted a number of notes about cloud computing but have not paid particular attention to differences between applications born in the cloud as opposed to those that are moved to the cloud. Luckily, the Forbes blog Quicker, Better, Tech has reprinted a column on this topic by Aaron Levie who is the co-founder and CEO of Box.net. Below is an excerpt from his musings (see: The Open Social Enterprise). Read the whole thing if you have time. It's worth the effort. When Steve Ballmer declared that Microsoft was “betting the company” on cloud computing earlier this year, he cautioned that “the goal can’t be to throw out all the world’s software and start again.” Microsoft and the other enterprise technology behemoths may be embracing the cloud, but in many cases they’re d... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4266286 Thu, 16 Dec 2010 14:07:04 +0100 4266286 http://www.medworm.com/index.php?rid=4259217&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F12%2Fhospitals-said-to-withhold-clinical-data-from-phrs.html It may strike you as sour grapes that the president of a personal health record (PHR) company, is griping about hospital CEOs holding hostage the clinical data that they control. Mr. HIStalk recently published the following tidbit, quoting Colin Evans of Dossia (see: News 12/8/10): Colin Evans, president and CEO of PHR vendor Dossia says ...HHS and the FTC need to make big providers and health plans stop holding the medical information of their patients hostage and using liability or privacy concerns as an excuse. He says they refuse to share patient information even when patients request it, hoping to forestall competition based on service, price, and quality. He also points out that lots of them are selling the data of their patients anyway or are using PHR information to display targete... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4259217 Tue, 14 Dec 2010 14:13:24 +0100 4259217 http://www.medworm.com/index.php?rid=4225675&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F12%2Fhuntsman-gay-purchases-sunquest.html It looks like Sunquest is in play again, having now been purchased by Huntsman Gay Global Capital, a private equity fund (see: Huntsman Gay Buying Laboratory Software Company: Moody’s). It was held for only three years by its previous owner, Vista Equity Partners. Below is an excerpt from the press release: Huntsman Gay Global Capital LLC, an upstart buyout shop working through a $1.1 billion debut fund, is leading an investor group expected to pay $208 million for a 51 percent stake in Sunquest Information Systems Inc., a provider of laboratory, radiology and pharmacy software products to hospitals and commercial laboratories.....Details of the complex transaction remain sketchy. But according to Moody’s Investors Service, the company would simultaneously borrow $655 million as part o... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4225675 Fri, 03 Dec 2010 14:37:30 +0100 4225675 http://www.medworm.com/index.php?rid=4207511&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F11%2Fma-fresh-look-at-epic-from-a-financial-and-strategic-perspective.html The financial health and strategic goals of Epic are of great interest to those large healthcare systems that are totally dependent on the company for their EMR software (see: How to Avoid Software Vendor Lock-in and Account Control). Mr. HIStalk alerted me in a recent blog note to coverage of the company in a Milwaukee newspaper (see: Monday Morning Update 10/18/10). Here's his take on the company: The Milwaukee newspaper profiles  Epic with some interesting facts, with the most interesting one being confirmation of our June report that Aurora is dumping its $150 million Cerner system for Epic, which will cost them an additional $100 million. A quarter billion dollars seems like a lot for an EMR considering that Aurora showed a $50 million loss two years ago and a $116 million l... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4207511 Mon, 29 Nov 2010 12:20:57 +0100 4207511 http://www.medworm.com/index.php?rid=4197375&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F11%2Fhow-labs-can-avoid-the-dreaded-vendor-lock-in-.html People new to the field of lab computing may be unaware of the risk of vendor lock-in and account control in their purchase of software. According to the Wikipedia, vendor lock-in, also known as proprietary lock-in or customer lock-in, makes a customer totally dependent on a single vendor for products and services and unable to use other products without substantial switching costs. A recent article discussed how to avoid such a situation (see: How to Protect Against Vendor Lock-In). Below is an excerpt from it: It appears that Oracle CEO Larry Ellison is aggressively either buying or putting out of business potential competitors. SAP and HP look to be his latest targets on the latter path and his goal appears to be total account control, that is, a situation in which one vendor single-han... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4197375 Tue, 23 Nov 2010 12:01:12 +0100 4197375 http://www.medworm.com/index.php?rid=4183562&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F11%2Fnew-malamoma-detection-device-narrowly-apporoved-by-the-fda.html MelaFind, a device designed for use by dermatologists for in-vivo detection of suspicious pigmented skin lesions, has been narrowly approved by an FDA advisory panel. Here is an excerpt from the article (see: Panel Splits over Skin Cancer Detection Device): An FDA advisory panel has voted 8-7, with one member abstaining, to recommend approval for an experimental skin cancer detection system called MelaFind. A vote so close generally is not considered an endorsement in the eyes of FDA officials, who have the final say in whether to approve the device. The FDA does not have to follow the advice of its advisory committees, but it often does. Some panelists on the [committee] were concerned that relying on a device to detect melanoma could lead to unnecessary biopsies, or worse: missed skin ca... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4183562 Fri, 19 Nov 2010 17:06:09 +0100 4183562 http://www.medworm.com/index.php?rid=4175980&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F11%2Fhimss-virtual-conference.html HIMSS seems to be up to one of its revenue-generating, marketing, and sleight-of-hand tricks according to a report by Inga who blogs with Mr. HIStalk (see: News 10/29/10). Here's her account about registration for one of its virtual conferences: HIMSS is hosting another virtual conference November 3-4. I “attended” the first one two or three years ago, mostly because I was curious about the virtual format. The conference is free for “qualified” participants and $99 for “non-qualified” HIMSS members. I can’t find anywhere on the HIMSS site that clarifies what it takes to be qualified, but I can say that when I tried to sign up for a conference a year ago, I didn’t have the secret requirements. I am mildly amused because my status must have recently changed, having receiv... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4175980 Wed, 17 Nov 2010 13:00:00 +0100 4175980 http://www.medworm.com/index.php?rid=4119739&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F10%2Fthipad-as-the-owner-manual-for-hyundai.html I picked up, by chance, on a recent reference to the fact that a "free" iPad is delivered with each Hyundai Equus, substituting for the normal hardcopy user manual for the vehicle. Here is an excerpt from the article (see: A Week In The High-Tech Hyundai Equus Super Sedan): There’s enough technology within the driver’s (and backseat passenger’s) reach to require a few trips to the manual, which just so happens to be an app on the included iPad. Yep, this is the car that comes with an iPad as the user manual. It makes sense, too. Instead of following a series of step-by-step instructions to, say, change the audio settings, you can just refer to the app for a quick demonstration. It’s genius from a user experience and marketing standpoint. OK, OK! This is a car with a $96,0... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4119739 Thu, 28 Oct 2010 16:45:25 +0100 4119739 http://www.medworm.com/index.php?rid=4086527&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F10%2Fmanaging-workflow-as-the-secret-sauce-in-diagnostic-information-systems.html Have you ever wondered why pathologists and radiologists would be unable to manage their daily work without their LISs, RISs, and/or PACSs whereas many clinicians balk at using hospital EMRs? One of the primary reasons for this difference is that these former systems manage professional workflow in the diagnostic services whereas clinical EMRs largely record the results of workflow decisions previously made by physicians and nurses. Because workflow support is not broadly integrated into the clinical EMRs, physicians understand that they may be able work more efficiently without them. This is one of the reasons why scribes are now being hired in some hospitals to enter data into clinical EMRs (see: Shift of Hospital EMR Data Entry Tasks from MDs to Scribes). Such an action, to the best of ... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4086527 Wed, 20 Oct 2010 15:59:18 +0100 4086527 http://www.medworm.com/index.php?rid=4031513&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F10%2Fmin-search-of-an-accountable-care-organization.html Mr. HIStalk, in his Monday Morning Update 10/4/10, highlights a YouTube animated video entitled In Search of an Accountable Care Organization. As most of you will know by now, an ACO or Accountable Care Organization is a key requirement in the recent healthcare reform legislation. Hospital executives are searching for the secret sauce about how to transform their organizations into one. Information technology, and particularly EMRs, are critical elements in the recipe. Watch this short video -- very enlightening and uncomfortably funny. KevinMD, a well-known and highly respected blogger about health issues, has this to say about ACOs: Somewhere in the Obama Administration, there is an elitist central cabal that operates with the support of the highest organs of our central government....Mu... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4031513 Mon, 04 Oct 2010 12:31:47 +0100 4031513 http://www.medworm.com/index.php?rid=4023144&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F10%2Fmobile-phr-not-the-answer.html I came across an article recently about the relationship between mobile devices such as smart phones and healthcare and the word conflation immediately came to mind (see: Deloitte Report Finds Major Role for Mobile Devices in Health Care). It can be defined in the following way: conflation occurs when the identities of two or more individuals, concepts, or places, sharing some characteristics of one another, become confused until there seems to be only a single identity — the differences appear to become lost. Read the extract below and see if you agree with me: The Deloitte Center for Health Solutions has released a report showing how mobile technology can improve people's health and reduce health-care costs....Considering that treating chronic disease accounts for more than 70 perc... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4023144 Fri, 01 Oct 2010 14:14:31 +0100 4023144 http://www.medworm.com/index.php?rid=3999307&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F09%2Fassessing-the-true-cost-of-being-a-beta-test-site-for-beaker-lis.html I have been trying to keep abreast of the news relating to the Beaker LIS, given that Epic is closing most contracts in high-end hospitals and their labs are sure to get caught up in this process (see: Introducing the Epic Laboratory Information System (LIS); It's Called Beaker; An Update on Epic's LIS, Called Beaker, from HIStalk; More Information about Epic's Beaker LIS and Its Sibling). I have been told that Beaker is now live in a a number of physician offices labs and a few hospitals with the 500-bed Sanford Health in Sioux Falls, SD, as one of the major show sites. Two hospital systems are now considering the installation of Beaker, Allina and OHSU. The latter, previously running GE's Ultra LIS, is apparently seeking a replacement for this system with some degree of u... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3999307 Fri, 24 Sep 2010 13:53:51 +0100 3999307 http://www.medworm.com/index.php?rid=3981023&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F09%2Fthe-unitedhealthcare-business-model-comparison-with-roche-and-siemens.html The New York Times of September 16, 2010, carried a full page ad sponsored by UnitedHealthcare. I have posted a number of previous notes about this large company, some of which have not been very flattering. Emblazoned across the midriff of a running woman in the ad is the following slogan: Knowledge in numbers, Strength in numbers, Humanity in numbers, Comfort in numbers, Health in numbers. Get it -- the business model for UnitedHealthcare must have something to do with numbers, as in the management of administrative, financial, and clinical data in healthcare. The company's web site is HealthinNumbers. I am not exactly sure with whom this motto resonates, but let's move on. About a month ago, Mr. HIStalk opined about UnitedHealthcare from an investor's perspective (see: Healt... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3981023 Fri, 17 Sep 2010 12:03:23 +0100 3981023 http://www.medworm.com/index.php?rid=3954489&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F09%2Fshift-of-emr-entry-tasks-from-mds-to-scribes-.html Hospitals are the only large enterprises I know that require their most skilled and frequently highest paid employees, physicians, to act as data entry clerks. This policy made some sense in the case of physician trainees who were not in a position to push back and were still learning the ropes. In the case of community physicians who admit their patients to the hospital, they are not hospital employees and their work efficiency is not of major concern to hospital executives. This situation is changing rapidly with the much broader deployment of EMRs and the rapidly expanding ranks of hospitalists. These latter personnel are physicians on the hospital payroll and hospital executives are now more interested in how they spend their time. Enter the "medical scribe" into this mix, a ... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3954489 Thu, 09 Sep 2010 12:15:21 +0100 3954489 http://www.medworm.com/index.php?rid=3946695&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F09%2Fdicom.html This is a short guest blog by Dr. Bruce Beckwith, Chief of Pathology, North Shore Medical Center, Salem, MA. Dr. Beckwith will be providing more details about DICOM in a talk at Pathology Informatics 2010 that will be held in Boston on 19-22 September (see: Enabling Digital Pathology - Whole Slide Imaging in DICOM). Please contact him if you want more information or would like to get involved with the DICOM pathology working group. Such input is always valued. The approval of Supplement 145 (Whole slide microscopic image object definition) coupled with the prior approval of Supplement 122 in 2008 (Pathology specimen module) means that the DICOM standard now has the pathology concepts and image objects that are necessary for vendors to implement a digital pathology workflow, including AP-L... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3946695 Wed, 08 Sep 2010 12:08:11 +0100 3946695 http://www.medworm.com/index.php?rid=3943035&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F09%2Fthis-is-a-guest-blog-note-by-dr-alexis-carter-director-of-pathology-informatics-at-emory-university-school-of-medicineat-e.html This is a guest blog note by Dr. Alexis Carter, Director of Pathology Informatics at Emory University School of Medicine. She discusses some of the pitfalls of the AP-LIS documentation of the names of pathologists who serve as consultants on a surgical pathology case.At Emory, we are currently in the process of upgrading our old AP-LIS to CoPathPlus.  During this upgrade, a number of issues have arisen that need to be resolved. Sometimes a new system can address new tasks, replacing previous manual/paper solutions. Sometimes the old system was able to perform tasks that the new system cannot. Sometimes neither system can deliver an acceptable solution.  One of the problems that we are struggling with falls into this last category. Pathologists frequently show surgical pathology... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3943035 Tue, 07 Sep 2010 13:39:37 +0100 3943035 http://www.medworm.com/index.php?rid=3934506&cid=t_229208_109_f&fid=34752&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPsychsplash%2F%7E3%2FLIhdw9qwDVw%2F URL: http://www.medicaltourismmag.com/The Medical Tourism Association ™ is the first international non-profit association made up of the top international hospitals, healthcare providers, medical travel facilitators, insurance companies, and other affiliated companies and members with the common goal of promoting the highest level of quality of healthcare to patients in a global environment. For: Clinicians, ResearchersTopics: Addiction, Drug Promotion, Healthcare Information Technology, Medicine, Medico-Legal, Pharmacotherapy, Substance AbuseFeatures: Advertising, Articles, Careers, Collaborative News, Commentary and Blogs, Databases, Group Management, Information, Interviews, Networking, NewsletterThe Medical Tourism Association ™ is the first international non-profit association mad... PsychSplash blogs http://www.medworm.com/rss/comments.php?id=3934506 Sat, 04 Sep 2010 17:00:02 +0100 3934506 http://www.medworm.com/index.php?rid=3933271&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F09%2Fi-recently-got-a-copy-of-the-book-that-kaiser-just-published-about-their-multi-billion-dollar-epic-deploymentconnected-for.html I received an email narrative from Dr. Bob Miller who is the Director of Pathology Informatics at Johns Hopkins. It was full of very useful information so I am posting it below as received. I am sitting on some other emails from him in a similar vein that I will also post in upcoming days. (BAF)I recently got a copy of the book that Kaiser just published about their multi-billion dollar Epic deployment: [Connected for Health: Using Electronic Health Records to Transform Care Delivery]. Unlike many similar tomes, which typically contain theories and grandiose plans, Kaiser's book contains hard facts and descriptions of what they have actually accomplished.  I would encourage you to look at a copy. I had a fascinating time a couple of weeks ago attending the VA's "VeHU con... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3933271 Fri, 03 Sep 2010 13:34:43 +0100 3933271 http://www.medworm.com/index.php?rid=3907792&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F08%2Fp4-medicine.html I have posted a number of previous notes on the topics of preventive, predictive, personalized, and participatory medicine (see: Preventive and Predictive Medicine as Components of the Healthcare Continuum; Some Encouraging News About New Federal Funding for Preventive Medicine Initiatives; Wellness, Preventive Medicine, and the Classic Disease Model; The Need for a Preventive Medicine Infrastructure in the U.S.; A Key Link Between Predictive and Preventive Medicine; Further Consideration of the Definition for Personalized Medicine; Recruiting Office Patients into a Participatory Model of Healthcare Delivery; "Participatory Medicine" and Its Relationship to Clinical Lab Testing). There are more but you get the idea.Putting it all together, they together constitute a blueprint for... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3907792 Thu, 26 Aug 2010 11:54:35 +0100 3907792 http://www.medworm.com/index.php?rid=3896105&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F08%2Fmkey-upcoming-deadline-for-pathology-informatics-2010-conference.html The Pathology Informatics 2010 conference will take place on 19-22 September at the Westin Copley Place Hotel in Boston. It's an amalgam of three previous pathology informatics conferences: (1) APIII, held for 14 years, mainly in Pittsburgh; (2) Lab InfoTech Summit, presented for six years in Lab Vegas; and (3) AIMCL with a 21 year tenure in Ann Arbor.A key date is approaching for those interested in registering for this conference -- August 27. This marks the deadline for the reduced conference registration fee for the event and also for making a reservation at the Copley. A block of rooms have been set aside at the hotel by the conference organizers for registrants at a special price but there is no guarantee that rooms will be available after this date. On-line registration is avail... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3896105 Mon, 23 Aug 2010 12:00:00 +0100 3896105 http://www.medworm.com/index.php?rid=3876905&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F08%2Fnew-record-set-for-scientific-abstract-submissions-to-pathology-informatics-2910.html Pathology Informatics 2010 will take place on September 19-22, 2010, at the Westin Copley Place Hotel in Boston. This conference has been formed from a merger of APIII, held primarily in Pittsburgh for the past 14 years, and Lab InfoTech Summit/AIMCL that were presented in Las Vegas/Ann Arbor for the past 27 years. AIMCL has always included scientific sessions and e-posters in its programming. The former are 15-minute oral presentations selected on the basis of submitted abstracts. E-posters, as the name implies, are lecture-demo's using PCs as a substitute for the standard physical posters presented at many medical conferences.A new record has been established for scientific abstract and e-poster submissions for this year's conference with 60 of the former and 24 of the latter. In... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3876905 Tue, 17 Aug 2010 17:26:02 +0100 3876905 http://www.medworm.com/index.php?rid=3876906&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F08%2Ftuepic-staffing-guide-transfering-the-epic-culture-to-hospital-clients.html When hospitals purchase the Epic EMR, they may get more than they bargained for. One of the fascinating aspects of Epic is the extent to which the company attempts to put its own spin on the culture of its hospital clients. One such example relates to the hospital personnel who will install/manage their software and also interact with Epic personnel. This is quite different than the usual healthcare IT company that usually tries, when feasible, to accommodate to the hospital client culture. A case in point is illustrated by the Epic staffing guide, a set of recommendations from the company to newly-signed clients in preparation for the deployment of Epic software. Mr. HIStalk discussed this topic in as recent blog note. Here is the item:Epic Staffing Guide: A reader sent over a copy of the... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3876906 Tue, 17 Aug 2010 13:15:39 +0100 3876906 http://www.medworm.com/index.php?rid=3872750&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F08%2Flabcorp-collaborates-with-clearstone-in-global-clinical-trials.html Contract research organizations (CROs) such as Covance and Charles River, particularly those with expertise in clinical and anatomic pathology, have been in the forefront of efforts to develop global networks for collaborative work and information exchange (see: A Look at the World's Largest Central Laboratory Network; Covance's Execution of a Global Virtual Clinical Lab; Charles River Acquires Molecular Imaging Company; Status and Challenges of Offshore Clinical Trials). They are also leading the way in the adoption of digital pathology for their veterinary pathologists (see: Veterinary Pathologists Adopting Digital Pathology Faster than MDs). These networks allow for archiving of digital image files in central global locations plus collaborative efforts across multiple sites in ... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3872750 Mon, 16 Aug 2010 11:49:10 +0100 3872750 http://www.medworm.com/index.php?rid=3858407&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F08%2Fthe-future-of-medical-school-didactic-presentations.html The current norm for medical school lectures, and it seems for many undergraduate programs as well, is to make all lectures available on the web in the form of PowerPoint presentations. Frequently, these files have been audio-synced so that the presentations are self-contained and can be viewed anywhere and anytime. Many medical schools also offer video lectures on the web that provide more of a real-time experience. Some students use these media, appropriately in my opinion, as a means to review the live lectures that they actually attend. Their additive value is that the learner can stop them at will to review complex ideas or read a textbook passage to help explain the material being presented. Other students may never attend the live lectures at all but it's their loss. Here's ... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3858407 Wed, 11 Aug 2010 15:09:46 +0100 3858407 http://www.medworm.com/index.php?rid=3854758&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F08%2Ftudefining-downtime-for-the-mainframe-the-devil-is-in-the-details.html When I first broke into the lab computing area in 1982, I attended a meeting with the central IT manager of the hospital. This was before the era of the CIO and we used the term hospital rather than health system. Our IT manager was an IBM retread. The software running on the IBM mainframe computer in those days was referred to as the hospital information system (HIS). This software suite was used mainly for business rather than clinical applications and consisted of two major modules called PA/PM (patient accounting/patient management). Patient management included patient admission and discharge.At this meeting, she was bragging about 95% up-time for the mainframe computer. My eyes popped out of my head. I said, "Wait a minute. You take the computer down for four to five hours every ... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3854758 Tue, 10 Aug 2010 12:25:31 +0100 3854758 http://www.medworm.com/index.php?rid=3845294&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F08%2Fnext-gen-emr-emphasis-on-coordination-and-communication.html I came across a recent interview of Dr. Peter Stetson, CMIO, Columbia Doctors, in which he discusses, in part, the "next generation" of electronic health records (EHRs) (see: HIStalk Interviews Peter Stetson, CMIO, Columbia Doctors). Columbia Doctors is a multi-specialty physician group of about 1,000 physicians in New York. The company has about 150 practice sites in the Tri-State area of New Jersey, Connecticut, and New York, with its primary base at Columbia University Medical Center. Here's the portion of the Q and A interview that interested me the most:Q: What should the next generation of EHRs do that the current generation doesn’t?A: I think that the challenges that we face are specifically in coordination of care. If you imagine trying to infuse an EHR with the ... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3845294 Mon, 09 Aug 2010 11:27:06 +0100 3845294 http://www.medworm.com/index.php?rid=3831566&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F08%2Fprogress-note-on-epics-beaker-lis.html We are gradually acquiring more information about the status of Epic's LIS, which is called Beaker (see:Introducing the Epic Laboratory Information System (LIS); It's Called Beaker.; An Update on Epic's LIS, Called Beaker, from HIStalk). Now we have a submitted comment from HIStalk that the Sisters of Mercy Health System may be taking the plunge with Beaker in two of their hospitals (see: News 8/6/10). Below is the comment:From PrettyKitty: “Re: Epic Beaker LIS. After a four-year project rolling out Epic to 10 of their hospitals and replacing existing systems in an effort to standardize, Sisters of Mercy Health System is developing Epic’s Beaker lab application for their next two hospitals to be implemented in the second quarter of 2011. They had been retaining and integrat... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3831566 Fri, 06 Aug 2010 19:10:23 +0100 3831566 http://www.medworm.com/index.php?rid=3827353&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F08%2Funverified-update-on-epics-beaker-from-histalk.html I raised the topic of Epic's LIS, Beaker, in a recent note (see: Introducing the Epic Laboratory Information System (LIS); It's Called Beaker). Now comes another unverified piece of news about the product from a comment in HIStalk (see: News 8/4/10), I present it in its entirety:From LISales: “Re: Epic Beaker LIS. Word on the street is that they have one SMALL site using the system within the Wisconsin area, but nothing major yet. I’ve also heard that they are beefing up the development team while including the licensing right to the module within ALL of their enterprise licensing agreements. Also heard is that the functionality is being somewhat oversold compared to actual capability with no desire to develop certain aspects of a full-scale laboratory’s needs, Blood Bank to ... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3827353 Thu, 05 Aug 2010 11:17:41 +0100 3827353 http://www.medworm.com/index.php?rid=3816778&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F08%2Fshould-patients-be-allowed-to-read-their-medical-records.html First of all, let me dismiss the idea that there is much room for debate about whether patients should be allowed to review their own medical records. HIPAA gave them the right to read, and even amend, these records years ago. Whether this is a good idea is being addressed in an ongoing study (see: Should Patients Read the Doctor’s Notes?). Regardless of whether it's a good idea, I don't think that the law will be reversed on the basis of one or more current studies. Below is an excerpt from a recent article discussing this topic:In 1996, despite ...concerns [about patient access to their own medical records], the Health Insurance Portability and Accountability Act, or HIPAA, gave all patients the legal right to read and even amend [these documents]. At the time, a group of nat... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3816778 Tue, 03 Aug 2010 12:41:02 +0100 3816778 http://www.medworm.com/index.php?rid=3813210&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F08%2Ffirst-annual-definiens-conference-madrid-spain-october.html Item: Definiens has just announced the date for the First Annual Definiens International Symposium. It will be held on October 7-8, 2010, in Madrid. There is no charge to attend the event. Speaker and attendees are expected from  international institutions, bio-pharmaceutical companies, industry partners, and the global healthcare industry. Sessions will include the following topics: Digital pathology image analysis Cell, confocal, and small animal image analysis The developer perspective: Image analysis solution strategies Item: Pathology Visions, a long-running educational event, was initially launched as an Aperio user group, then morphed into a broad multi-vendor-supported conference. After the last conference in 2009, control was turned over to a newly-formed trade association... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3813210 Mon, 02 Aug 2010 11:22:30 +0100 3813210 http://www.medworm.com/index.php?rid=3802593&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F07%2Fth-introducing-the-the-epic-laboratory-information-system-lis-beaker.html In response to yesterday's note, Infopathic provided us with a key piece of intelligence via a comment -- the status of Epic's LIS:The Epic solution for EMR has has indeed been judged to be superior. And for those searching for a superior LIS, one with a seamless integration to this EMR would be epic! or, at least...superior. A recent peek into the EPIC LIS entry - Beaker, reveals that the search is far from over. This LIS newcomer is certainly not ready for prime time. Whereas several basic workfolows are in place and appear to be well designed, in my humble opinion, the Beaker is half-empty as a product for large, complex health systems. The search goes on...How quaint! The name "beaker" sounds to me like it was the product of a coffee klatch attended by creative, marke... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3802593 Thu, 29 Jul 2010 11:40:16 +0100 3802593 http://www.medworm.com/index.php?rid=3798839&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F07%2Fwhy-does-epic-keep-hammering-cerner.html Mr. HIStalk addresses the ongoing Cerner-Epic competition in a comprehensive and insightful manner. Here's the complete text of a question and his response from a recent blog note:Question from reader: “Re: Epic. They’re winning deals like Cerner did 15 years ago when they were small. Cerner seems to be a revenue-churning machine that the public can participate in by buying stock. The only people who benefit from Epic are the owners and/or Judy. Which company has made more millionaires? Which company will change the face of HIT for the long run?” Answer from Mr. HIStalk: Here’s the real question: why can’t Cerner, with all its billions in market capitalization and name recognition, compete with Epic for new sales? As has been asked of other Goliaths (Microsoft, GM, Dell, GE, ... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3798839 Wed, 28 Jul 2010 13:03:11 +0100 3798839 http://www.medworm.com/index.php?rid=3795064&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F07%2Ftugoogle-microsoft-compete-for-the-cloud-mail-business.html There is no question is my mind that nearly all corporate and individual email accounts will soon be managed in the cloud, a model that is referred to as cloud mail. This will be a major change for many  corporate email users whose support now comes mainly from Exchange servers managed locally by their employers. Google is competing with Microsoft for this cloud mail business and the latest account up for grabs is that of the federal government's GSA (see: Microsoft, Google Vie to Sell U.S. Cloud Mail). Below is an excerpt from the article:A new front has opened in the battle between Google and Microsoft: selling Web-based email and other software to the federal government. The two technology giants already compete to win contracts from private businesses as well as state and loc... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3795064 Tue, 27 Jul 2010 12:45:22 +0100 3795064 http://www.medworm.com/index.php?rid=3790931&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F07%2Fphilips-makes-major-move-into-digital-pathology.html Philips may be a force to contend with in the increasingly competitive U.S. digital pathology market. The company first unveiled its "work-in-progress" slide scanner and image management system at the USCAP conference last March in Washington, D.C. (see: Philips to unveil breakthrough in digital pathology). Their prototype system has been initially positioned for research but will then transition to clinical use after FDA approval. More recent news is that the company signed an agreement to integrate some of Dako's image analysis applications into Philips'  digital pathology solutions. Company officials have emphasized that anatomic pathology is an essential element in virtually every cancer diagnosis and that demand in this cancer market is increasing.  ... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3790931 Mon, 26 Jul 2010 13:02:50 +0100 3790931 http://www.medworm.com/index.php?rid=3776622&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F07%2Fvaluable-pathology-informatics-teaching-archive-now-available-online.html Recently updated on the Pathology Informatics 2010 home page is an archive of the lectures presented at Lab InfoTech Summit (LITS) from 2004-2009 and at APIII from 1996-2009. Access to the LITS lectures is simple -- from the archive index, you only need to click on the year and you will be shown the lecture titles and the name of the presenter for that year. You then have the choice of viewing or listening to the lectures or both. To access the APIII lectures, click on the year and then schedule. Scroll down the schedule and note that for most of the lectures, and adjacent to the names of the faculty members, are labels: [View Presentation] or [View PDF]. Click on these and you are in business. Also now available for viewing or download on the conference home page is the PI-2010 brochure a... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3776622 Wed, 21 Jul 2010 13:35:59 +0100 3776622 http://www.medworm.com/index.php?rid=3767331&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F07%2Fiphone-and-the-walled-garden.html App phones (see: Does the Smartphone/App Phone Provide More Functionality Than the PC?), also commonly referred to as smart phones, have rapidly become a critical tool for professionals of various types but particularly for physicians. Think of the devices as mobile computers. Then combine this concept with the increasing accessibility of on-line medical records as well as the complete medical literature and medical textbooks. Newer cell phones can support video conferencing, enabling on-line visits with patients from anywhere in the world. The cell phone was quickly adopted by most physicians and the next-gen app phone will enjoy even greater success.Most people will concede that the iPhone was the first and best app phone. However, Apple has established a significant barrier to new app a... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3767331 Mon, 19 Jul 2010 12:03:46 +0100 3767331 http://www.medworm.com/index.php?rid=3754096&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F07%2Fenterprise-versus-bestofbreed-cio-money-as-the-distinguishing-factor.html My blog note of yesterday focused on how a large health system had converted to a single EMR vendor, primarily to achieve system-wide integration (see: Integration as the Major Driver for the Epic Conversion at Carilion Clinic). I subsequently discovered a column by Anthony Guerra in Information Week Healthcare describing what he views as a division of hospital CIOs into two different camps -- the single-vendor enterprise camp and the best-of-breed camp (see: Guerra On Healthcare: A Tale Of Two CIOs), He goes on to suggest that the former have more access to cash and therefore able to pony-up the estimated, stiff $100M price for an enterprise-wide EMR solution. Below is an excerpt from his article:In what's become an epic battle for the heart and soul of sound CIO strategy, I continual... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3754096 Wed, 14 Jul 2010 12:28:48 +0100 3754096 http://www.medworm.com/index.php?rid=3750310&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F07%2Fintegration-issues-in-the-conversion-to-epic-at-carilion.html In a blog note posted yesterday, I quoted an interview of Daniel Barchi, SVP/CIO of Carilion Clinic, by Mr. HIStalk regarding the health system's conversion to Epic (see: What's Up With Soarian; CIO Barchi of Carilion Clinic Responds). There was another portion of the interview that caught my attention in which Barchi discusses the goal of system integration as the major driver for the deployment of the new software. Below is an excerpt from the interview:Q: You just finished your massive Epic project, with eight hospitals and 100 practices brought live over a couple of years. Tell me about that project.A: When we decided that we wanted to integrate from 11 different medical records — 10 electronic and one paper — down to one integrated system, it was 2006. At the time, we wer... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3750310 Tue, 13 Jul 2010 12:20:00 +0100 3750310 http://www.medworm.com/index.php?rid=3747000&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F07%2Fwhats-up-with-sorian.html A recent interview of Daniel Barchi, SVP/CIO of Carilion Clinic, Roanoke, Virginia, was filled with interesting tidbits (see: HIStalk Interviews Daniel Barchi). One that caught my attention related to the conversion of the entire health system from Siemens' Soarian to Epic. Relevant to any discussion these days about the future of the Soarian product is the fact that John Glaser, formerly CIO of the Partners Health System in Boston, was recently appointed the CEO of the Siemens' healthcare IT unit (see: John Glaser joins Siemens as CEO of health IT unit). Below is an excerpt from the HIStalk interview in a Q and A format: Q: Carilion was a high-profile Siemens client and an early Soarian adopter. What led to the change from Soarian?A: Soarian had a great reputation and was doing ... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3747000 Mon, 12 Jul 2010 11:27:16 +0100 3747000 http://www.medworm.com/index.php?rid=3737306&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F07%2Ffrequency-of-video-watching-on-youtube.html I am sure that most of the readers of this blog are aware of YouTube, the web-based video channel and perhaps have watched a video via this site or its various competitors such as Hulu and Google Videos. I also suspect that most of you, like me, have little sense of the volume of activity on such sites. Well, here's some numbers for you to contemplate (see: The Average YouTube User Watched 100 Videos in May):May was a bang-up month for YouTube, according to data released today by the comScore Video Metrix service. Having for the first time achieved the milestone of 100 videos watched per user, the video-sharing site reached an all-time high of 14.6 billion videos viewed in May. Overall, video viewership was on the upswing — in April, data showed that 178 million U.S. users watched on... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3737306 Thu, 08 Jul 2010 12:09:19 +0100 3737306 http://www.medworm.com/index.php?rid=3730115&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F06%2Fmeditechs-competitors.html It can be a challenge to analyze the sales and customer base of the various EMR/HIS software vendors because these data are considered proprietary. However, a recent interview of Howard Messing, President and CEO of Meditech by Mr. HIStalk, was very interesting (see: HIStalk Interviews Howard Messing). Below is an excerpt from that blog note:Q: [What is your] total count  [of hospital clients] ....It used to be around 2,100.A: 2,100 or 2,200....Q: What competitors do you face across the table most often?A: I think McKesson is certainly in the medium-sized hospitals as the competitor, and I think we face them most often. In the small hospitals, probably CPSI. In the large hospitals, it’s mostly Cerner. Occasionally in the largest hospitals, Epic....Q: Have the demographics of your c... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3730115 Tue, 06 Jul 2010 13:08:34 +0100 3730115 http://www.medworm.com/index.php?rid=3714460&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F06%2Fcreating-a-longitudinal-health-record.html iTriage is an app that runs on the iPhone and provides some of the following functionalities (see: Physicians Using an iPhone Application to Triage Their Patients): Information on thousands of symptoms, diseases and medical procedures A nationwide directory of hospitals, urgent care, retail clinics, pharmacies and physicians Help negotiating medical bills through an iTriage partnership with ...claims adjudication organizations Emergency Room wait times for hospitals in select parts of the country Apparently one of the founders of the company is now moving in the direction of of integration and support by the device for Google Health, a PHR, according to John Moore who blogs over at Chilmark Research (see: Consumer Challenge: Creating a Longitudinal Record). Below is an excerpt from the no... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3714460 Wed, 30 Jun 2010 12:36:16 +0100 3714460 http://www.medworm.com/index.php?rid=3710810&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F06%2Fmmergers-and-acquisitions-by-emr-companies.html I have never quite understood the logic of some of the M&A's over past years by lab and medical software vendors. In some cases, Vendor A purchased Vendor B mainly to acquire the Vendor B client list. The apparent goal of A was to convert these clients, in time, to its LIS software. The scenario frequently did not work out in this way with the Vendor B lab clients hunkering down on their aging but familiar software and draining the resources of Vendor A to support it. Forcing the issue by sun-setting the B software only infuriated them more, causing them, in time, to flee into the arms of another vendor. John Moore who blogs over at Chilmark Research recently addressed the topic of acquisitions in relationship to healthcare reform (see: Healthcare Reform, Payment Models & Acqui... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3710810 Tue, 29 Jun 2010 11:27:23 +0100 3710810 http://www.medworm.com/index.php?rid=3707017&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F06%2Fadoption-trends-in-digital-pathology.html I recently posted two guest blog notes by Steve Potts, Ph.D., focusing on the more rapid adoption of digital pathology by veterinary pathologists than MD pathologists (see: Veterinary Pathologists Adopting Digital Pathology Faster than MDs; Reasons Why DVM Pathologists Are Adopting Digital Pathology Faster Than MD Pathologists). Coincidentally, an article has just been published in Laboratory Economics entitled Adoption Trends in Digital Pathology (Volume 5, No. 6, June 2010) that provides survey data on this topic. I copy it in its entirety below.Nearly everyone agrees that digital imaging will play a big role in pathology in the future. Academic medical centers, commercial labs and large independent pathology labs are rapidly installing digital pathology systems. But its use in reimbursa... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3707017 Mon, 28 Jun 2010 12:16:14 +0100 3707017 http://www.medworm.com/index.php?rid=3618104&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F06%2Fit-as-a-critical-component-of-participatory-medicine.html Participatory medicine is defined in the following way:  a model of medical care in which the active role of the patient is emphasized. The term participatory medicine has been used...to mean one or more of four interrelated ideas: A group of people who suffer from a chronic disease form a community (often an online community, a support group) to share information and mutually support each other. Members of a patient community (or members of a community disproportionately affected by a disease) play important roles in community health decision-making. Patients [are required to] play a role as part of collaborative "treatment teams" addressing their diseases. A patient is "mindfully" involved in treatment, by making behavioral changes, meditating, or similar acts. ... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3618104 Tue, 01 Jun 2010 12:08:30 +0100 3618104 http://www.medworm.com/index.php?rid=3603884&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F05%2Fpersistence-of-the-mumps-programming-language-in-healthcare.html One of the interesting and unique aspects of the EMR world is that some of the major vendors use a programming language, MUMPS, that is virtually unknown in other IT business sectors because it was developed so long ago. There is no other industry that worships "new and novel" more than IT. Hence, the question arises about why this language persists among some of the leading EMR software vendors. Mr. HIStalk recently posted a reader comment about MUMPS and responded in the following way:From Limber Lob: “Re: MUMPS and Cache’. MUMPS takes hits because it’s still around after 30 years and many of the ancient MUMPSters are coding the way they did 30 years ago. Old COBOL, RPG, and Pascal programmers have all passed on instead.”  Reply from Mr. HIStalk: I like that analy... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3603884 Thu, 27 May 2010 12:50:44 +0100 3603884 http://www.medworm.com/index.php?rid=3595916&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F05%2Fneed-for-technololgy-evangelists-in-pathology-departments.html Here's a question for all of the readers of Lab Soft News. Do you think that pathologists in particular, and physicians in general, are more or less accepting of new technology than other professionals of the same educational level and income? I don't know the answer to this question but I do believe that the adoption of digital pathology has been much slower than I would have predicted a year or two ago. There are are number of compelling reasons for this, some of which I have documented in this blog. However, I come away with the following idea: most pathologists are very receptive to new science but not necessarily to new technology based on this science, particularly when the technology disrupts established lab workflow or invokes changes in the status quo (see: Major Drivers f... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3595916 Tue, 25 May 2010 11:33:52 +0100 3595916 http://www.medworm.com/index.php?rid=3585862&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F05%2Ffour-addiction-to-digital-networks-and-social-media.html The word addiction is always used in the pejorative sense -- no one brags about their addiction to anything at cocktail parties. Nick Carr, who blogs over at RoughType, takes on the contrarians and social critics who bemoan the addiction of many/most of us to the web. social networks, blogs, on-line news, or on-line games (see: Not addiction; dependency). Here is an excerpt from his note:The problem with the addiction metaphor [to describe use of digital networks and social media]...is that it presents the normal as abnormal and hence makes it easy for us to distance ourselves from our own behavior and its consequences. By dismissing talk of "Internet addiction" as rhetorical overkill, which it is, we also avoid undertaking an honest examination of how deeply our media devices ha... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3585862 Fri, 21 May 2010 12:25:34 +0100 3585862 http://www.medworm.com/index.php?rid=3577655&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F05%2Ftelephone-calls-and-emails-critical-component-of-primary-care.html This news will come as no surprise to readers of this blog. KevinMD reports that telephone calls and e-mails occupy a large component of the time of a primary care physician according to a recent paper in the NEJM (see: Calls and e-mails to patients is a big part of primary care). Below is an excerpt from his note:There’s been a lot of commentary on a recent article from the New England Journal of Medicine, detailing the undocumented tasks that a typical primary care physician performs. For those who haven’t read the piece, entitled, What’s Keeping Us So Busy in Primary Care? A Snapshot from One Practice....To summarize, primary care doctors are responsible for much more than seeing patients in the exam room. In the cited practice, which has a fairly typical makeup, physicians w... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3577655 Wed, 19 May 2010 11:51:42 +0100 3577655 http://www.medworm.com/index.php?rid=3573959&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F05%2Fmrisless-teleradiology-solutions-the-evolution-of-a-new-it-vocabulary-.html I frequently scan press releases from healthcare IT vendors in order to understand the vocabulary that is used to describe new products. A recent one provided me with some useful insights (see: Imaging On Call Achieves Full Speech Recognition in RIS-less Environment with Integrated Document Solutions). Integrated Document Solutions,..., a provider of web-based, modular health documentation solutions and Imaging On Call (IOC), an industry leading teleradiology provider, today announced the successful implementation of a groundbreaking RIS-less teleradiology solution using 100 percent speech recognition and template-based reporting....Using a thin-layer, cloud-based approach, IDS and IOC were able to deploy, in less than 30 days, a solution that automates report creation, advanced formatting... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3573959 Tue, 18 May 2010 12:21:33 +0100 3573959 http://www.medworm.com/index.php?rid=3570079&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F05%2Fabstracts-solicited-for-pathology-informatics-2010-conference-in-boston.html The Pathology Informatics 2010 (PI-2010) conference will take place in Boston. MA, on 19-22 September, 2010. Abstracts for scientific sessions and e-posters are being solicited in connection with the conference with a firm deadline of July 30 for both categories. PI-2010 is the largest and most comprehensive pathology informatics CME event in the country and has been created by the merger of two predecessor conferences of long standing, APIII in Pittsburgh and Lab InfoTech Summit in Pittsburgh. The former has a 14 year history in Pittsburgh and the latter was presented for 21 years and Las Vegas and Ann Arbor. The latter event was known as AIMCL.The conference web site is now up-and-running. Details about the three content tracks (applied informatics, imaging informatics, and advanced/expe... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3570079 Mon, 17 May 2010 13:31:30 +0100 3570079 http://www.medworm.com/index.php?rid=3564213&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F05%2Fed-physician-comments-on-the-advantages-of-bestofbreed-systems.html This report has re-energized the debate over the benefits of the two kinds of systems. IT professionals prefer the seamless interoperability supposedly offered by single systems, but the fact is that many large vendors have simply bought and shoehorned in a separate ED system....Overall, my specialty has been slow to adopt EHRs, not because we don’t see their importance, but because they have a reputation for being unwieldy and unresponsive to the requirements of the ED. With more and more EDs adopting BoB systems that are designed to support ED clinicians’ intricate and demanding workflows, physicians are starting to realize that an EHR can actually be an advantage in our fast-paced environment, rather than a burden. CIOs are finding that these BoB systems can offer the same, if not b... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3564213 Fri, 14 May 2010 11:48:29 +0100 3564213 http://www.medworm.com/index.php?rid=3499328&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F04%2Fththnew-use-of-the-term-apps-the-smartphone-market-for-new-software-.html Back in the day, the term apps, an abbreviated form of application, was used to refer to software programs in general. However, I became aware via a podcast, Behind This Week's Cover Story (The Apps Economy), that the definition had shifted when I wasn't looking. The term apps now refers, at least in popular culture, to any of the small programs that can be downloaded from a web site like iTunes and then run on an iPhone or other smartphone. The importance of apps has recently gone ballistic with the announcement by Steve Jobs that apps will be a vehicle for channeling advertisements to iPhone users (see: Steve Jobs Promises Developers That Apple’s iAds Won’t “Suck” and Will Make Them Money). This is a strategic move against Google by Apple to capture more advertising rev... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3499328 Fri, 23 Apr 2010 12:00:00 +0100 3499328 http://www.medworm.com/index.php?rid=3472060&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F04%2Fthmore-discussion-about-the-fdamedwatch-billboard.html In a recent note, I discussed a billboard apparently placed by FDA's MedWatch in some unspecified urban site soliciting feedback about "shoddy" electronic records (see: MedWatch Billboard Spotted Requesting Reports about "Shoddy" EMRs). In my note, I commented on what I perceived to be the ineffectiveness of such a local approach when reaching out to patients. Dr. Federico Monzon responded with the following comment:The ad doesn't specify that it is directed to patients. Health professionals could be the target of the billboard. As you mention, healthcare workers would be more likely to know about "shoddy" EMRs but they might not know where to complain if they think the EMR could be potentially impacting patient care.Federico has a good point. I s... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3472060 Thu, 15 Apr 2010 11:41:00 +0100 3472060 http://www.medworm.com/index.php?rid=3460260&cid=t_229208_113_f&fid=38236&url=http%3A%2F%2Fwww.healthcareitnews.com%2Fblog%2Fhow-stabilize-health-it-market-ehr-certification-process While the College of Healthcare Information Executives (CHIME) approves of the general concept of ONC's two-stage approach for EHR certification - a temporary and a permanent certification - the healthcare CIO organization has problems with the details of the approach. (Source: Healthcare IT News Blog) Healthcare IT News Blog blogs http://www.medworm.com/rss/comments.php?id=3460260 Mon, 12 Apr 2010 13:06:49 +0100 3460260 http://www.medworm.com/index.php?rid=3444000&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F04%2Fbillboard-request-patient-input-regarding-faulty-electronic-medical-records.html Below is an image originally posted by Mr. HIStalk and submitted to the blog by one of his readers. It's a sign in an unknown city requesting reports of "shoddy" hospital electronic medical record systems to FDA's MedWatch. The only part of this story that gave me pause is the use of the term shoddy in the sign. This does not seem like a word that would be used by the government bureau tasked with the regulation of medical devices. To make sure that it was legitimate, I called the 800 number and did get a recorded FDA announcement. So there we have it! FDA is seeking patient or consumer reports about shoddy medical record systems. Here is how MedWatch describes its mission on its web home page: Your FDA gateway for finding clinically important safety information and r... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3444000 Wed, 07 Apr 2010 11:36:30 +0100 3444000 http://www.medworm.com/index.php?rid=3441078&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F04%2Fmthe-hypermediated-postbook-book-meets-virtual-search.html Some forms of the book, as we have known it in the past, will transition into the hypermediated post-book book. This new type of book, discussed in a previous note, is beginning to look more and more like a computer application (see: Some Observations about the "Post-Book Book and Pathology Conferences). Also, as presented in this previous note, Google and other search engines are in the process of becoming virtual publishers of content. They will be able to not only provide a search engine retrieval page (SERP) but also have the capability of creating a patchwork quilt of data snippets from the web.  In so doing, they will be creating a new, original, and useful meta-document (see: Google as an Enabler and Protector of Global Information Exchange). Google maintains that it is ... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3441078 Tue, 06 Apr 2010 12:19:44 +0100 3441078 http://www.medworm.com/index.php?rid=3437951&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F04%2Fmckesson-cloud-storage-for-cvis.html I believe that cloud computing is an early stage on a certain path to becoming an essential element of all hospital-based information systems including LISs, RISs, and PACSs. In fact, healthcare computing will become, in and of itself, a vertical cloud (see: A Closer Look at the Vertical Cloud in Healthcare Computing). Adoption of this technology has been relatively slow up to this point because it is still not totally mature. However, the adoption of this architecture would be much faster if the companies selling these systems directly integrated the service and architecture into their "turn-key" products. A recent press release from McKesson presents two advanced features for the Horizon Cardiology cardiovascular information system (CVIS)  -- hosted (i.e., cloud) storage ... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3437951 Mon, 05 Apr 2010 11:50:31 +0100 3437951 http://www.medworm.com/index.php?rid=3433182&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F04%2Ffsome-observations-about-the-postbook-book-and-pathology-conferences.html Prompted by the broad interest in the release of the iPad, Nick Carr offers some interesting observations about the future of the post-book book in his blog RoughType. Here is an excerpt from his blog note (see: The post-book book):The iPad's iBooks application may or may not become our e-reader of choice...but the model of book reading (and hence book writing) the iPad promotes seems fated, in time, to become the dominant one. The book itself, in this model, becomes an app, a multihypermediated experience to click through rather than a simple sequence of pages to read through....John Makinson, the CEO of publishing giant Penguin Books, is thrilled about the iPad's potential to refresh his company's product line. "The definition of the book itself seems up for grabs,"... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3433182 Fri, 02 Apr 2010 12:48:50 +0100 3433182 http://www.medworm.com/index.php?rid=3425142&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F03%2Fwan-example-of-governmentsponsored-central-medical-data-repositories.html In a recent note, I proposed the idea of developing cloud-based central repositories to store radiology reports and images as a way to avoid redundant testing. Before new studies were ordered for patients, at least in theory, such repositories could be queried to search for prior studies. My note was prompted by a comment to a previous note discussing the increasing cost of imaging studies in the U.S. Mark Cox, an astute observer of the global LIS industry who works for Sysmex in New Zealand, responded to my second note with the following comment:In NZ this is a key focus and justification for a number of projects. Have a look at http://www.testsafe.co.nz/ & http://www.testsafe.co.nz/images/testsafe_diagram_webready.png This is a system set up that contains all pathology (hospital a... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3425142 Wed, 31 Mar 2010 12:38:40 +0100 3425142 http://www.medworm.com/index.php?rid=3416358&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F03%2Fmpractical-suggestion-about-how-to-decrease-the-number-of-medical-imaging-studies.html In a recent note, I raised the issue of how the rapidly increasing number of medical imaging studies was raising the cost of care. I must admit that I was very pessimistic about most efforts to "bend the curve downward" and listed a number of reasons for my position (see: CTs, MRIs, and PET Scans Drive Cost of Healthcare Upward). A reader, Jackie Walsh, responded with an interesting and practical comment: Bruce, I agree that it will be hard to reverse this trend for the reasons you state. However, there is a category of imaging exams that can be reduced to offset the overall growing volume. That is the percentage of exams that are ordered simply because a similar or recent exam for the same patient isn't accessible (perhaps because it lives within the firewall of another hosp... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3416358 Mon, 29 Mar 2010 12:40:33 +0100 3416358 http://www.medworm.com/index.php?rid=3415985&cid=t_229208_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F03%2F29%2Fjournal-of-medical-ethics-2009-vol-36-no-2%2F content page Fade Fave: Are patients receiving enough information about healthcare rationing? A qualitative study Fade Skinny: Clinical professionals need to understand patients’ need for detailed information when it comes to rationing, and to understand that they are the main gateway for this to be provided. However, disclosure could be distressing for both patients and professionals, and thus the most sensitive and acceptable ways to make this information available requires further investigation. (NHS Athens is required to access this article online) Filed under: Athens Password, Current Awareness, E-Journals, Journals Tagged: Athens Password, Current Awareness, E-Journals, Healthcare, Information, Rationing (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=3415985 Mon, 29 Mar 2010 11:39:25 +0100 3415985 http://www.medworm.com/index.php?rid=3370698&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F03%2Fhow-edetailing-may-change-the-relationship-of-physicians-to-big-pharma.html The pharmaceutical industry has been undergoing major changes lately including the transfer of a portion of its basic research effort to contract research organizations (CROs) (see: CROs Continue to Prosper; Benefits of Big Pharma Outsourcing) and greater emphasis on marketing including growing expenditures on direct-to-consumer (DTC) advertisements (see: Drug Company Emphasis on Marketing an Unfavorable Shift for Consumers; Effectiveness of "Direct-to-Consumer" Drug Advertisements; Why Drug Companies Want to Sell You Foot Powder). Another significant change for pharmaceutical marketing has been the greater emphasis on e-detailing and less support for CME (see: Growth of Online CME Interpreted as Bad News for Pharma Marketers; Pharma-Free CME Activities: Is This the Right Approac... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3370698 Tue, 16 Mar 2010 12:00:00 +0100 3370698 http://www.medworm.com/index.php?rid=3366446&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F03%2Fwheres-the-healthcare-it-excitement.html John Moore, who blogs over at Chilmark Research, summarizes his visit to the recently-completed HIMSS conference (see: Another Year, Another HIMSS) in the following way:Coming back from HIMSS and really scratching my head trying to think of what incredible new and novel thing(s) did I see, hear about or experience at the conference.  Nothing stood out. Here it is just my third HIMSS and I am already getting a bit bored, struggling to find those truly exciting advances that get my juices flowing. me on vendors, I can’t be getting bored that quickly can I? Was there really nothing new on display at HIMSS this year?  Or is it that I am still wet behind the ears and am unable to recognize the subtle differences occurring in the market that for others are truly significant? ... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3366446 Mon, 15 Mar 2010 13:00:00 +0100 3366446 http://www.medworm.com/index.php?rid=3327321&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F03%2Fwhy-does-himms-ignore-pacs-and-liss.html Michael Cannavo recently used HIStalk as a forum to ask the following interesting question: why are PACS vendors and topics almost invisible at HIMSS? (See: Imaging Decisions Demand Up to Date Information). I will expand his question to include the question of why HIMSS also ignores the LIS world about which I have a better understanding. Below is an excerpt from his note:Five years ago, I was approached by a PACS vendor to put together a presentation for IT folks at HIMSS. We did the presentation titled Everything IT Needs to Know About PACS (but is afraid to ask) off-site and had 75 people there. Why off-site? The vendor tried to get HIMSS to sponsor the session, but was continuously rebuffed in their attempt. Exasperated yet needing to get their potential IT clients the information they... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3327321 Wed, 03 Mar 2010 13:35:52 +0100 3327321 http://www.medworm.com/index.php?rid=3311951&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F02%2Fan-analysis-of-digital-collaboration-in-the-context-of-integrated-diagnostics.html I recently participated in a wide-ranging discussion about integrated diagnostics and the term digital collaboration cropped up. I had not heard if before so I thought it would be useful to analyze it in this context. Integrated diagnostics refers to the closer collaboration, or even eventual merger, of the diagnostic specialties, particularly lab  medicine, pathology, and radiology.To get the ball rolling, digital collaboration can be defined in the following way: working together [by] sharing ideas and [information] using online technology. What then is its relevance with regard to the emerging closer collaboration across the boundaries of the diagnostic medical specialties and also with regard to the broad effects of digital pathology and radiology on the daily work of clinicians?... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3311951 Fri, 26 Feb 2010 13:10:22 +0100 3311951 http://www.medworm.com/index.php?rid=3307114&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F02%2Fanatomy-of-a-hospitalphysician-feud-in-wisconsin.html The relationship between hospital executives and the physicians admitting patients to community hospitals has been undergoing significant changes lately. The deployment of an EMR in a hospital, particularly one not appealing to physicians, is one such change than can flare into outright warfare. Below is an excerpt from an article discussing such a scenario (see: from HIStalk):Re: articles in Racine, WI paper about All Saints. Doctors are not happy with administration and a number may leave.” Doctors and administrators are feuding, with a third of the medical staff ready to bolt. The final straw, apparently, was the hospital’s contracting with a Florida anesthesia company, replacing a local group after failing to reach an agreement about pay, on-call policies, and the use of nurse anes... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3307114 Thu, 25 Feb 2010 12:49:43 +0100 3307114 http://www.medworm.com/index.php?rid=3294827&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F02%2Fcio-and-the-three-envelopes.html A recent joke posted by Mr. HIStalk calls attention to the relatively short job tenure of some hospital CIOs (see: HIStalk). It has a kind of "gallows humor" flavor but read on and you will get the idea.A fired CIO’s replacement finds a note from his predecessor, saying he left three envelopes in the desk drawer to be opened only when things are going really badly. Six months later, the network goes down for most of a day, so the CIO opens up the first envelope and finds a note that says, “Blame the previous CIO.” Great idea! He makes up a convincing story about a historic lack of maintenance and capacity planning, saving his skin. Months later, the executive team complains about excessive IT operational and capital budgets, threatening to freeze expenses. Time to open anot... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3294827 Mon, 22 Feb 2010 13:04:57 +0100 3294827 http://www.medworm.com/index.php?rid=3273101&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F02%2Ftighter-integration-of-nighthawk-servivces-into-hospital-emrs.html "Nighthawk-type" radiology service firms, launched initially with the avid support of radiologists, have evolved to potentially be their nemesis. Defined succinctly, they provide the diagnostic services of outside radiologists to interpret medical images at times when members of a local hospital radiology group are unavailable. Such services were initially provided off-hours -- hence the name nighthawk. However, "nighthawk" firms have quickly morphed to provide around-the-clock services, putting some radiology groups out of business and causing others to fight back (see: Dayhawk Radiology and the Decline of the General Radiologist, Radiology Groups Begin to Develop Their Own "Nighthawk" Service Model). Although the concept of telemedicine has been in existence... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3273101 Mon, 15 Feb 2010 12:49:18 +0100 3273101 http://www.medworm.com/index.php?rid=3254747&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F02%2Ftucerner-outsourcing-deals.html Mr. HIStalk raised the issue of Cerner's remote hosting option (RHO) in a recent Q and A item (see: HIStalk):Q: From FreddieMac: “Re: Cerner. In order to improve cash flow, the company is aggressively pursuing complete IT outsourcing deals (like MU) among its client hospitals through any any back door they can. Of course, they think RHO Millennium translates into knowing how to run all the other aspects of health IT. I believe they got Naples Community and are trying for some other academics. Beats the hell out of trying to compete with Epic for new sales.” A: It’s a good strategy, I think, and I expect it will open some doors to hospitals who don’t consider data center operations to be core. Not to mention that, as you noted, Epic is taking most of the pie anyway.Here a cut-an... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3254747 Tue, 09 Feb 2010 13:17:37 +0100 3254747 http://www.medworm.com/index.php?rid=3239843&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F02%2Flab-soft-news-named-one-of-fifty-top-healthcare-it-blogs.html I recently received an email from James J Atkinson, The Health Sensei, telling me that he has chosen Lab Soft News as one of the top fifty healthcare IT blogs (see: Top 50 Healthcare IT Blogs). The picks are categorized (e.g., CIO and IT Technician Blogs, HIT News & Opinion Blogs, etc.) rather than displayed in rank order. Lab Soft News falls into the second bucket. The recognition is well appreciated but check out the others -- it's a great list. Take some time to savor them and bookmark the page for later reference. (Source: Lab Soft News) Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3239843 Thu, 04 Feb 2010 14:05:54 +0100 3239843 http://www.medworm.com/index.php?rid=3236115&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F02%2Fattributes-of-21st-century-healthcare-delivery.html The Dark Daily posted an article recently discussing the attributes that colored the practice of medicine and healthcare delivery during the last century and compared them with the drivers for this century. These ideas were offered by Sir Muir Gray to the attendees at the Frontiers in Laboratory Medicine (FiLM) conference that took place in Birmingham, England (see: Pathologists and Clinical Lab Professionals Urged to Think in “21st Century” Terms). Sir Muir Gray is the Chief Knowledge Officer for Great Britain’s National Health Service (NHS) National Library for Health.Here's a key quote directly from the article: “In 20th Century Medicine, quality was the term most commonly used to describe the level of service,” explained Gray. “For 21st Century Medicine, value will be m... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3236115 Wed, 03 Feb 2010 14:32:22 +0100 3236115 http://www.medworm.com/index.php?rid=3216860&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F01%2Fmajor-hipaa-breach-in-las-vegas-hospital.html There have always been rumors circulating in the hospitals where I have worked that unnamed clinical personnel were on the payroll of the medical malpractice lawyers in town. They would phone the firm whenever they learned that various types of trauma patient have been admitted to the hospital or when some medical error had occurred or been detected. Attorneys from the firm would then visit the patient and drop a business card. Obviously a very serious breach of hospital and patient confidentiality, if these rumors were true. Better documented, however, is the fact that most breaches of patient confidentiality that occur in hospitals are inside jobs.The are committed by hospital employees who have ready access to patients' physical or electronic medical records, at least in the units w... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3216860 Thu, 28 Jan 2010 12:24:46 +0100 3216860 http://www.medworm.com/index.php?rid=3197909&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F01%2Fdefiniens-takes-advantage-of-social-media-sites.html Dr. Keith Kaplan, who blogs over at Digital Pathology Blog recently alerted us to the fact that Definiens is taking advantage of social media like YouTube and Twitter to market their product as well as educate current and potential clients (see: Definiens on YouTube and Twitter):Definiens has a channel on YouTube  (Definiens Life TV) hand a Twitter page. The YouTube page...has some excellent videos including several webinars you can view that have been uploaded in the past week. Another excellent example of Medicine 2.0.Here's a brief description of Definiens copied from its web home page:Automated Image Analysis: Definiens is the No.1 Enterprise Image Intelligence company. We support customers in analyzing and interpreting images on every scale, from microscopic cell structures ... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3197909 Fri, 22 Jan 2010 14:53:36 +0100 3197909 http://www.medworm.com/index.php?rid=3146224&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F01%2Fpathology-informatics-2010-new-merged-conference-scheduled-for-fall.html The two major general pathology informatics conferences in the U.S. over the past nearly three decades, APIII and Lab InfoTech Summit (LITS), will merge into a single event this September with a new name -- Pathology Informatics 2010. The former event that has been held in Pittsburgh for the past 14 years and the latter in Lab Vegas for the past six. Lab InfoTech Summit was a direct descendant of APIII that was presented in Ann Arbor for 21 years prior to the transition to Las Vegas. The new, merged conference will convene at the Westin Copley Place hotel in Boston on September 19-22, 2010. On Sunday, September 19, a set of three workshops will be offered, one focusing on advanced informatics presented by the Association for Pathology Informatics (API) and a second on specialized imaging p... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3146224 Wed, 06 Jan 2010 14:15:27 +0100 3146224 http://www.medworm.com/index.php?rid=3142856&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F01%2Fmodeling-the-costs-of-it-failures.html Having had a connection to at least two early-stage hospital EMR failures, I have always been fascinated by this topic. Such failures are not uncommon (see: EMR Failures and a Recipe for Their Avoidance in the Future; Why Cats (and EMR Consultants) Don't Bark; Implementing an EMR or health IT system is harder than it looks). For this reason, I paid close attention to a recent blog note discussing a very rough estimate of the cost of global IT failures (see: Critique: $6.2 trillion global IT failure stats). Below is an excerpt from it:Researchers often attempt to quantify the number of failed IT projects, usually reporting statistics that discuss failures as a percentage of the overall number of IT projects. These failure stats are primarily useful to the extent they illustrate that IT ... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3142856 Tue, 05 Jan 2010 13:56:23 +0100 3142856 http://www.medworm.com/index.php?rid=3139267&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F01%2Fwipro-ge-healthcare.html I recently received an email from Birlamedsoft, a vendor of an on-line LIS located in India, promoting the sale of its software to U.S. clients. Below is an excerpt from that message:Birlamedisoft....,the Healthcare software Development Company, has pleasure to launch completely web based Online Diagnostics Centre/Laboratory Management Software today. We are No 1. Company in India providing LIMS/LIS software, having sold more than 10,500 LIS/LIMS software in the market. In today’s diagnostics world, online software is the only software for managing diagnostics centre /laboratories efficiently. There are many benefits of the online LIS software, some of them are given below. Can create any types of reports in Hematology, Biochemistry, Histopathology with pictures, Serology and any other ... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3139267 Mon, 04 Jan 2010 13:41:39 +0100 3139267 http://www.medworm.com/index.php?rid=3126810&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2009%2F12%2Funitedhealth-provides-physician-virtual-visit-technology.html The idea of web-mediated virtual patient visits is so logical that I am constantly amazed that the deployment of this technology is not more widespread (see: The Virtual Visit May Expand Access to Doctors). A recent article about this topic was worrisome but for an unexpected reason. Below is an excerpt from it:Americans could soon be able to see a doctor without getting out of bed, in a modern-day version of the house call that takes place over the Web....OptumHealth, a division of UnitedHealth Group, the nation’s largest health insurer, plans to offer NowClinic, a service that connects patients and doctors using video chat, nationwide next year. It is introducing it state by state, starting with Texas, but not without resistance from state medical associations. OptumHealth believes Now... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3126810 Tue, 29 Dec 2009 13:25:15 +0100 3126810 http://www.medworm.com/index.php?rid=3063487&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2009%2F12%2Fradiiology-groups-create-their-own-inhouse-versions-of-nighthawk.html Nighthawk Radiology Services has filled an important niche for hospital-based radiology groups in the past. As the name implies, the company offers the services of its own radiologists to interpret studies performed at night. Some of these personnel are located in countries with different time zones than the U.S. such as Australia to facilitate this process. This was viewed as a desirable alternative to having the associates of the local hospital-based radiology groups perform this night work. I have posted a number of notes about various aspect of the "Nighthawk" business model. Unfortunately for the radiology groups involved, some hospital administrators have asked the following question: If we use the Nighthawk services during off-hours, why not "disassociate" from o... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3063487 Mon, 07 Dec 2009 13:47:54 +0100 3063487 http://www.medworm.com/index.php?rid=3048374&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2009%2F12%2Fdigital-pathology-as-a-service-rather-than-a-product.html For a few years, an evolution has been occurring in the field of information technology whereby software is provided as a service rather than as a purchased product. This is approach has been referred to in the past as SaaS (software as a service). In parallel with this development has been the transition to cloud computing whereby applications and data storage are managed by a network of servers accessed via the web rather than on servers located within the enterprise. It's clear to me, that digital pathology, at some time in the near future, will be provided as a service rather than as a product. As evidence for this statement, here's what BioImagene has to say on its web site about Virtuoso, its software product, and its pricing strategy:BioImagene’s Virtuoso digital pathology... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3048374 Wed, 02 Dec 2009 13:34:28 +0100 3048374 http://www.medworm.com/index.php?rid=3023429&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2009%2F11%2Ffits-time-for-the-fda-bans-directtoconsumer-advertising-by-drug-companies.html I have generally been suspicious about direct-to-consumer (DTC) advertising by pharmaceutical companies on TV and in glossy magazines. This type of advertising provides the drug companies with an opportunity to manipulate the viewing public with brief, slick messages. I expressed my reservations in a previous blog note (see: Effectiveness of "Direct-to-Consumer" Drug Advertisements). A recent article emphasizes how these ads may not boost sales and also that the taxpayers may actually be funding them. Below is an excerpt from it (see: Drug ads ineffective for boosting sales, could cost taxpayers: UBC-Harvard study):US Taxpayers may be on the hook for the high cost of drug advertising that does little to boost sales, according to a new study led by a University of British Columbia... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3023429 Tue, 24 Nov 2009 14:17:26 +0100 3023429 http://www.medworm.com/index.php?rid=3026919&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2009%2F11%2Fmsciencedriven-medicine-bumps-up-againt-perception-of-risk-1.html The recent recommendation of a panel of experts that routine mammography is no longer necessary for women in their 40's was greeted by widespread skepticism and will probably be ignored by most physicians and patients. My personal interpretation of these events is that most women viewed early detection of breast cancer as trumping the "problems" associated with false positive reports. For those with health insurance, the cost of care for many does not play a large part in this decision process. The New York Times published a short but excellent analytical piece about this issue with a look at the future (see: Medical Science and Practice in Conflict). Below is an excerpt from the it:This week, the science of medicine bumped up against the foundations of American medical consu... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3026919 Mon, 23 Nov 2009 13:28:06 +0100 3026919 http://www.medworm.com/index.php?rid=3019246&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2009%2F11%2Fmsciencedriven-medicine-bumps-up-againt-perception-of-risk-1.html The recent recommendation of a panel of experts that routine mammography is no longer necessary for women in their 40's was greeted by widespread skepticism and will probably be ignored by most physicians and patients. My personal interpretation of these events is that most women viewed early detection of breast cancer as trumping the "problems" associated with false positive reports. For those with health insurance, the cost of care for many does not play a large part in this decision process. The New York Times published a short but excellent analytical piece about this issue with a look at the future (see: Medical Science and Practice in Conflict). Below is an excerpt from the it:This week, the science of medicine bumped up against the foundations of American medical consu... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3019246 Mon, 23 Nov 2009 13:28:06 +0100 3019246 http://www.medworm.com/index.php?rid=3012648&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2009%2F11%2Ffintroducing-the-cardiovascular-information-information-system-cvis.html I must have been sleeping at the switch. Outside of my lab/LIS world, a new category of integrated clinical information systems has arisen -- the CVIS or cardiovascular imaging and information system. McKesson provides a CVIS web site promoting the McKesson product. Listed below and copied from the "comparing solutions" tab of this web site is a summary of the functionality of their system: Reporting: (1) Real-time reporting; (2) Remote report creation and signing; and (3) Automated rules-based report distribution A single, coordinated image display, to view all medical images Single sign-on for clinicians to access multiple systems Patient-centric workflow Robust digital archiving (efficient access to historical images and data, including echocardiograms, and ECGs and hemodynami... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3012648 Fri, 20 Nov 2009 12:58:55 +0100 3012648 http://www.medworm.com/index.php?rid=2989421&cid=t_229208_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2009%2F11%2Fquieit-launch-of-new-type-of-walmart-walkin-clinic.html Up to this point, walk-in clinics in retail drug stores and big-box stores have not lived up to their expectations. In my opinion, they have enjoyed several key advantages over competing medical offices such as convenience, posted price lists, and relatively low costs for routine procedures. For many of them, however, major liabilities were the absence of a referral network for patients with more complex problems and a lack of integration of their health records with regional physician office and hospital records. This latter problem, of course, is not unique to them. It seems that Wal-Mart has reworked its business model to address at least one of these deficiencies with a co-branding strategy as described in a recent article (see: "The Clinic At Wal-Mart" To Open In Atlanta, Li... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=2989421 Fri, 13 Nov 2009 12:11:47 +0100 2989421