December 3, 2007

1. Nurse IT Survey: We Need Training and Involvement, But Don't Have the Time

Facts and Background

The results of Nurses Talk Tech 2007, an IT survey of nurses in all settings, were announced Monday. Respondents said they need more IT training and are not consulted when IT decisions are made. They also reported frustration with progress toward paperless care. Confidence that IT can reduce medical errors was significantly reduced from last year's study. Still, nurses generally believe that IT can improve care and recommend it as a consideration when changing jobs.

Opinion

You know  a survey is good when you're not surprised by the results. Everything reported is easily observable in hospitals.  

Musings

• The most disturbing survey result: nurse shortages are pulling nurses away from IT and all other big-picture work to go back to bedside care. With the need for changes in healthcare and technology, its arguably most important constituency is too busy to help define them.
• Despite good intentions, executives and IT departments make most IT decisions without clinician involvement. Nurse have figured this out.
• Technology still hasn't realized its potential in reducing errors, although in its defense, that's often because nurses find ways to bypass systems bought to protect them and their patients. And in their defense, that's because those systems are poorly designed for nurse use.
• Look around a hospital at all the employed nurses who aren't involved in patient care. No wonder there's a shortage.
• Arguments can be made that practice needs required more nurse education, but hospitals controlled their own destinies when running RN diploma programs. Now, they rely on universities that have been slow to pick up the slack on supply. Professions and universities have at least some motivation to limit the supply of professionals to ensure higher wages and, therefore, higher enrollment. Hospitals have the opposite goal.

2. athenahealth Buys Maine Campus

Facts and Background

Physician practice business services vendor athenahealth announced Thursday that it will acquire a 53-acre campus in Belfast, Maine that includes 130,000 square feet of office space. The company's new Maine Center will support business continuity and expansion.

Opinion

When your IPO is the hottest of the year, why not splurge a little on a nice crib? This is not a company that thinks small. It's also not one that makes mistakes. Business is obviously good.

Musings

• Epic Systems was the last company to come out of nowhere to be a game-changer in the industry. This is the next one and a more disruptive one at that: an anti-software company that provides software for a tiny, risk-free piece of the action.
• One old saying about starting a successful business: services that no one wants to perform often pay exceedingly well (garbage hauling, murder scene cleanup, and prostitution come to mind). What could be un-sexier than reducing the friction between physician invoices and insurance company payments? athena does it very well, has the large market nearly to itself, and isn't trying to diversify itself into something unfocused. They've got a lot of room to grow without really needing to change their business model.
• Despite its electronic emphasis, athena has to deal with truckloads of paper generated by rich insurance companies that apparently can't be persuaded to give it up for something efficient. If you need a case study of administrative overhead, there's a clue where to look. That's part of what its Maine employees will manage.
• Compared to the uncreative, Dilbertesque conglomerates that occasionally halfheartedly dabble in healthcare IT, it's nice to see a few companies lilke athena that don't treat it as a marginally interesting sideline. There was a time when companies actually had passion about the business and their mission. You don't get that with interchangeable, button-down, journeymen leaders who hop effortlessly from one industry to another.

3. Omnicell Buys Mobile Cart Vendor Rioux

Facts and Background

Hospital product distribution systems vendor Omnicell of Mountain View, CA announced Friday that it would acquire mobile cart vendor Rioux Vision, Inc. for $26 million in cash. Rioux is located in Elgin, SC and has 60 employees.

Opinion

A reasonable, though not terribly exciting, transaction by which Omnicell can expand its business.

Musings

• Omnicell will finally have a product that doesn't get creamed by Cardinal Health's nearly identical Pyxis product line, which dominates the industry.
• Cart manufacturing doesn't seem like a growth business, especially with many good competitors out there. Seems like a dull business for a technology company to want, at least for its financials alone. Still, Omnicell big enough to need to either buy someone or be bought.
• Omnicell has nearly a billion-dollar market cap on sales of $200 million.

4. Carestream, IBM Link Instant Messaging to PACS

Facts and Background

Carestream Health, the former divested Kodak Health Group, announced Sunday at RSNA that it would integrate IBM's Lotus Sametime into its radiology solutions to support instant messaging, voice over IP communications, and screen sharing between radiologists and other professionals.

Opinion

Using common consumer technologies to connect PC-bound caregivers makes sense, although hospitals could do that without help from Carestream and/or IBM.

Musings

• Lotus Notes and Sametime are among the most poorly designed and frustrating applications of their kind, despite all the IBM unified communications buzzwords.
• Notes locks up so often that Googling for "killnotes" shows dozens of sites offering this free utility to clear all the Notes garbage out of memory so you can restart it without rebooting after its not-infrequent errors. It's disturbing enough that such a program was needed; even more so that IBM itself helpfully offers it from its site.
• If a hospital's IT department can figure out how to deploy one of the many free (and far better) IM clients (Yahoo, Google, Microsoft, etc.) without opening them up to the world outside the firewall, the benefit could be both immediate and free. Users are going to use instant messaging applications without permission anyway, so controlling it is a must to prevent security holes.

5. UPMC Healthcare IT Leader Mark Hopkins Dies at 47

Facts and Background

Mark Hopkins, 47, a CIO in the UPMC system, died November 13 of cancer, his family announced Tuesday. He was named by ComputerWorld as one of its Premier 100 IT Leaders in 2006.

Opinion

It's sad to lose an influential IT leader, especially one yet to hit their prime.

Musings

• Condolences to his family, friends, and colleagues.
• Memorial donations may be made to the Mark Hopkins Fund at the Baltimore Community Foundation.

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