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Podcast: HealthTrain Manifesto for the age of blogging

From the Department of Better Late than Never comes this podcast, recorded two weeks ago, in advance of the first-ever Healthcare Blogging Summit, which was held Dec. 11 in Washington, D.C. But thanks to my crazy schedule, this interview was not posted until Dec. 15 in a Florida hotel room. Most of the information is still relevant. Promise.

In this interview, Dmitriy Kruglyak, creator of the Medical Blog Network, a healthcare-focused publication in a blog format, talks with me about the growth of blogging in healthcare and explains his current project, the HealthTrain Manifesto. Essentially, it’s a statement of integrity guidelines for the highly unstructured world of grass-roots healthcare media.

Podcast details: Dmitriy Kruglyak, creator of the Medical Blog Network and HealthTrain Manifesto. MP3, mono, 64 kbps, 15.6 MB, running time 34:11.

0:50 Explanation of the Medical Blog Network
2:35 Healthcare Blogging Summit
3:40 Blogging’s effect on consumers and on healthcare organizations
5:20 The changing dynamics of information dissemination
5:51 Grass-roots transparency and how to respond to it
6:36 Speakers at the summit
8:47 Harnessing the power of the Web and new concepts on the Internet
11:25 Growth of individuals publishing information online
12:52 Power of blogging in other industries
13:45 Transformation of the role of traditional media
14:28 Blogging’s growth in healthcare
16:50 Evolution of the Internet in healthcare
18:37 HealthTrain Manifesto
19:21 Roots of it in ClueTrain Manifesto (late 1990s) for conversational media
20:51 How healthcare is different from other subject matter
22:13 HON Code and other earlier e-health standards more for top-down media
23:05 Holes that HealthTrain attempts to fill
24:21 Credibility of health information
25:10 The 18 concepts of the HealthTrain Manifesto
27:19 Survey of healthcare bloggers re: anonymity
29:48 More on how healthcare organizations should operate in new era of transparency
30:47 Support for HealthTrain Manifesto
33:00 Where to read manifesto and list of supporters

December 15, 2006 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Podcast: Sage Software

A new name on the healthcare scene is Sage Software, which entered the market in September with its $565 million purchase of Emdeon Practice Services from Emdeon Corp. Who is Sage Software and what are the company’s plans for the Intergy brand name? At last week’s Radiological Society of North America meeting in Chicago, I sat down with Paul Stinson, Sage’s senior vice president of healthcare, to find out.

Audio quality isn’t the best because a lot of ambient noise made its way into the interview booths in the press room, but I don’t think it’s worse than listening to AM radio.

Podcast details: Interview with Paul Stinson, senior vice president of healthcare for Sage Software, Nov. 27, 2006. MP3, 64kbps, 11.6 MB, running time 25:23.

0:40 Background on acquisition and on Sage
1:30 Sage’s history in accounting software
2:40 Intergy’s history in radiology and imaging
3:35 Sage’s market share
4:00 View of radiology market as part of bigger healthcare picture
5:30 Growth potential in EHR and size of customer base
6:37 Target market
8:00 Division of product line between Intergy and Medware
9:24 Assessment of market for smallest practices
11:45 Effect of Stark exemption on the market
13:37 Effect of CCHIT certification on the market
15:24 Evolution of market in next two years
17:25 Continuing relationship with WebMD
18:16 Growing interest in PHRs and providing information to patients
19:08 Physicians warming to sharing scheduling information online
20:55 Online communication with patients and e-prescribing
22:53 Patient safety improvements and malpractice insurance rates
23:40 Privacy and security issues

December 8, 2006 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

EMR? What’s that?

Need more proof that true interoperability remains a distant goal in healthcare? You should have been at the Radiological Society of North America show here in Chicago this week.

I was meeting with a provider of remote radiology services that has developed its own workflow-management software, when I asked a fairly obvious question: Can the remote physician’s notes be incorporated into the host site’s EMR?

The response? “EMR? I’m not sure what that is.”

“Electronic medical record,” I said.

“Oh, you mean like a RIS or a HIS?” this puzzled vendor rep asked me.

Kind of, I suppose.

A radiology information system usually contains clinical information, but I’ve always thought that a hospital information system was something more on the administrative side of the house. Am I wrong, or do people in radiology speak a totally different language than everyone else in health information management?

RSNA is a founding member of Integrating the Healthcare Enterprise, so interoperability definitely is on the agenda. I guess it’s hard to get the message out to the more than 60,000 attendees and 740 exhibitors, but I would expect a vendor salesperson to be a little more in-the-know.

The RSNA show always is a curious event for me. For one thing, it takes up all three buildings of McCormick Place. (I never thought I would ever have to consult the exhibitor map to find Cerner‘s booth at any conference of any kind, but when Philips has a display the length of two city blocks, other companies tend to get lost.)

Vendors apparently don’t realize the scope of this show. I got meeting invitations from a couple dozen companies I’ve never heard of, thinking that I and other journalists would find them more important than 700-some other exhibitors. If you think the HIMSS annual conference is big, you should check out RSNA.

How RSNA gets that many people to come to Chicago this time of year—and likely pass through O’Hare International Airport at the tail end of the Thanksgiving long weekend—astounds me. I live here and I won’t go near O’Hare the Sunday after Thanksgiving.

Hopefully everyone got out of town before the first snowstorm of the year hit Thursday night, and hopefully people start to figure out what an EMR is. Maybe Thursday’s news that Intel, Wal-Mart Stores and other large American companies will begin offering EMRs to their employees will accelerate the process.

By the way, regular readers of this blog should not be surprised. Here’s the link again to my exclusive interview with Intel and Wal-Mart executives about health IT.

November 30, 2006 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

The McKesson/Per-Sé merger, and the latest government freebie

In case you were wondering about last week’s announcement that McKesson would take over Per-Sé Technologies for $1.8 billion, the story broke last Monday. I put together a story for Digital HealthCare & Productivity (f.k.a. Health-IT World), but e-mail problems on both ends kept the story out of Tuesday’s newsletter. It has since been posted on the Web, so click here to read what I wrote.

In other news, late last month, the federal Agency for Healthcare Research and Quality introduced an electronic reference tool for primary care—essentially, free clinical decision support. Called the Electronic Preventive Services Selector, it is available for Palm or Windows-based PDAs or for desktop/laptop/tablet computers.

I don’t know if it interfaces with any EMRs, but I will be talking to some AHRQ people this week for a publication outside the HIT universe. At first glance, however, it seems more reality than vaporware, unlike the allegedly “free” VistA Office EHR that we’re still waiting for.

November 13, 2006 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Podcast: Malcolm Costello of Kryptiq on interoperability

At the recent Medical Group Management Association annual conference in Las Vegas, I sat down with Malcolm Costello, vice president of marketing for Kryptiq Corp., a healthcare communication and integration company in Portland, Ore. We talked about secure messaging and other means of electronic communication that are helping to improve healthcare workflows and link providers to patients.

I was surprisingly alert for 9:30 in the morning, when we recorded this, and the sound quality is better than normal because I used an actual hand-held microphone rather than the built-in mic on my digital recorder. What a concept!

Podcast details: Interview with Malcolm Costello, VP marketing, Kryptiq Corp., recorded Oct. 24, 2006 at MGMA annual conference in Las Vegas. MP3, 64 kbps, 9.0 MB, running time 19:41.

00:22 What Kryptiq does
01:20 Online communications as a way to interest physicians in IT
02:25 Michigan State case study on messaging
03:15 Memorial-Hermann case study on prescription refills
04:15 Nursing burnout from administrative inefficiency
05:05 Coordination of care from electronic messaging
06:27 Standards in messaging vs. standards in EHR
07:30 Different formats of physician portals
08:40 Where messaging fits in the RHIO discussion
09:24 No good, sustainable financial model for RHIOs
10:00 Peer-to-peer messaging is a better idea
10:58 E-mail works in other industries as a standardized communication platform
11:53 Potential of smart medical devices and other future communication technologies
14:02 E-mail for disease management
14:55 Integration of inputs from patients
16:15 Outlook for interoperability in the future
18:25 Adoption without standardization

November 7, 2006 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

A little bit of humor

My head is spinning from all the travel, deadlines, interviews, email backlogs and massive piles of paper that I have had to deal with in the past few weeks, including the loss of my precious notes somewhere between the final session of the World of Health IT at the Geneva Palexpo and the nearby train station, perhaps at the grocery store in the station pavilion. I have a podcast from last week’s MGMA meeting in to post, but that’s on my other computer and I don’t feel like dealing right now.

In its place, here are some random bits of wit and whimsy.

For those who think the Internet is going to help people manage their own care, we get this buzzkill from Stephen Colbert: “Unfortunately, Google Surgery is still in beta.” If you really must know, he said this on Oct. 18 in the context of elephant vasectomies. The proof is right here. Yes, the truthiness hurts.

The midterm elections are next Tuesday, and I’m devastated to learn that Texas gubernatorial candidate Kinky Friedman somehow left IT out of his wide-ranging healthcare plan. He always was a man of the people, and if he’s right about 6 million Texans being uninsured, the people rightfully are more concerned about coverage than EMRs.

Maybe the healthcare community also is more concerned about things other than EMRs, if the MGMA exhibit hall was any indication. Perhaps it was the venue, namely Las Vegas, but the over-the-top displays that seemed to have disappeared from the healthcare expo circuit the last couple of years were back. Case in point, this tiki bar at the Workflow EHR booth. Yes, that’s a surfboard on the outside wall and yes, those are real flames coming from the tiki torches inside. I don’t know how much the display cost, but I do know Workflow does not currently have CCHIT certification.

November 1, 2006 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Podcast: Exclusive interview with Intel and Wal-Mart execs

What was supposed to be a journalists’ roundtable with Intel Chairman Craig Barrett and Wal-Mart Stores Executive Vice President for Risk Management and Benefits Administration Linda Dillman turned into an exclusive interview for me when other invited reporters failed to show. Their loss is my gain—and yours.

I now have a podcast with two of the most powerful business people in America, on the subject of large healthcare purchasers demanding technology-driven quality from the people who provide health services to their employees. It continues on the theme that Barrett spoke on during his keynote address to the Third Health Information Technology Summit in Washington last month, which I reported on here. This interview took place shortly after the speech.

Podcast details: Exclusive interview with Intel Chairman Craig Barrett and Wal-Mart EVP Linda Dillman, Washington, D.C., Sept. 26, 2006. MP3, mono, 64 kbps, 13.9 MB, running time 30:23.

00:40 Barrett’s interest in healthcare
01:05 Pilot programs to promote IT and quality
01:30 Purchasing power of large employers
01:58 Wal-Mart’s $4 co-pay for generic drugs
03:20 Completeness of personal health records
04:33 Lack of price information for consumers
05:30 Cost shifting in healthcare
06:00 Wal-Mart’s IT investment
06:40 Looking at the big picture
07:30 Getting a broad coalition involved
08:10 Debate vs. actions, cost shifting
09:10 Consumers ultimately pay the bills
09:40 Opportunity in the health system and incentives for healthcare to modernize
10:35 Current insurance at companies
10:55 Wal-Mart will be requiring quality
11:40 How to show transparency
12:25 Feedback from employees
13:40 Employees are savvy business people
14:15 Duplication in the system
14:50 Medical liability and access to information
16:40 Systemwide quality should be overriding issue
18:00 What creates quality problems?
18:35 IT’s role in alleviating the nursing shortage
19:45 Opinion of Kolodner
20:20 Barrett on AHIC and the slow pace of reform
22:15 Every other industry has adopted technology
22:50 Framing the debate over who pays
23:35 Quality tolerance in other industries
23:50 Roles of various stakeholders
24:35 “Forcing function” of change
26:18 Private payers are middlemen responding to the rules.
27:00 How to put pressure on suppliers
27:35 Purchasers have been passive for too long
28:36 How long until purchasing changes start showing results?
28:53 American competitiveness

October 24, 2006 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Snomed for everyone

I’m in Geneva for the first World of Health IT conference, and I happened on some interesting news tonight. The College of American Pathologists and its Snomed International division will announce Thursday that they are giving up the proprietary nature of Snomed Clinical Terms, opening up access to everyone, with some conditions.

From what I understand—and I don’t know the whole story yet—Snomed essentially is making its July 2003 licensing agreement with the National Library of Medicine global. This may have something to do with healthcare providers having a tough time figuring out terms of Snomed licensing in contracts with software vendors. Again, though, I don’t know the whole story yet.

October 11, 2006 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

See you in Geneva, and a new name for my top gig

I don’t think I ever actually posted this here, but I have decided to go to the first World of Health IT conference in Geneva next week. I think I have enough work to cover the considerable expense, and even if I don’t, the trip’s booked and the airfare is nonrefundable, so I might as well get on the plane. (And if you want to offer me an assignment, I’m listening.)

If you are planning on making the trip yourself, drop me a line or post a comment at the bottom of this entry. I’m interested in seeing how many people they draw from outside of Europe.

Meanwhile, my most frequent freelance client has changed names. Effective this week, Health-IT World is now known as Digital HealthCare & Productivity, though the Web page apparently has not changed. I’ve updated the link in the right-hand column of this blog to reflect the new name. For the reasoning behind the move, click here.

Also, my phone seems to be working properly for the first time in a month, now that the number transfer to the new phone company is done. Sorry for any inconvenience the problems may have caused anyone.

And if you came here looking for real news, here’s some: Rep. Patrick Kennedy (D-R.I.) introduced legislation on Friday that would create a fund to reward physicians for using patient-controlled personal health records. The bill, called the Personalized Health Information Act (H.R. 6289), would authorize the federal government to fund incentives for Medicare beneficiaries from the Medicare trust fund and look for other payers to make voluntary contributions on behalf of privately insured patients.

Payments would start at $2 per patient, according to an e-mail from Kennedy’s office. The full text of the legislation had not been posted as of this evening, but visit http://thomas.loc.gov/ in a few days and enter the bill number.

The glacial pace of considering healthcare bills notwithstanding, I’d like to know people’s thoughts on this approach to incentivizing physicians. Post your comments below.

October 3, 2006 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Podcast: CMS administrator Mark McClellan

As promised, here’s the podcast of the delivered by outgoing CMS administrator Mark McClellan, M.D., at last week’s Third Health Information Technology Summit in Washington.

McClellan, who is stepping down in mid-October after heading Medicare for two years, spoke immediately after Robert Kolodner, M.D., gave his first public comments since being named interim national health IT coordinator the previous week. Again, the moderator who hosts the Q&A portion is John Glaser, vice president and chief information officer of Partners HealthCare, Boston.

Podcast details: Mark McClellan, M.D., Third HIT Summit, Sept. 25, 2006, Washington, D.C. MP3, mono, 64 kbps, 17.0 MB, running time 37:19.

September 30, 2006 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.