Thursday, July 18, 2002

Day 2, Ojai, continued. Good discussion with Orlando Portale, Sun's new Worldwide Marketing Manager for HC.  Small world...Orlando has a good idea about creating an open source model for HC apps. Might work, but will need companies to take on the productization and support of the OS components. Sure would be popular in academic medical centers. Speaker from CareScience - lots of good statistics. Major point - clinical fragmentation, where the primary care provider (or any provider) has no insight into the care/drugs being given to a patient by others, even in the same system. Big problem, part organizational, part IT. <Is Care Science an offshoot of the old Care Data company? He's used the "Care Data" term a couple of times with a TM symbol. If so, his stock just went down with me.> CS has a pilot project at UCSB. CS also hired McKenzie (!) to do a case study for use of their product in an IDN or community. Surprise, the ROI is very positive. Citing a cost basis of $1/life/year, as opposed to $12/life/year for CDR approaches. The more this guy talks, it sounds like the old Care Data story. Amazing that this is still kicking around - I met the principal in 1994. Editorial comment - I continue to be amazed that many of these HCOs still make the decision to custom build their apps instead of buying them. It's strange. Some nice stuff gets built, but I don't believe any of these orgs have the capacity to do long term support of the app and its users - they're not structured to be a product company. Perhaps there's a business opportunity here, where someone could take on the product management / support of a portfolio of these home grown apps. Are there economies of scale here? Probably....no, definitely. Assuming only a few things about the apps, can use the same sode management, code distribution tools, and same bug fix teams. This begins to feel like a highly specialized form of outsourcing. Hmmm... comment []12:04:09 PM

Notes from Ojai, Day 2. My talk and my panel came off very well. I got lots of sincere congrats and attaboys. It feels good to be back in the saddle, evangelizing. I get more energy from public speaking than almost anything else. Also, my two other panelists were quite good, and stuck to the program. Good stuff. Thoughts while on the panel: (1) check out Stentor; (2) focus more on why the audience should care about the topic, rather than detailed explanations of the content; (3) might want to offer to "manage" some of the speakers or panels for Rydell next year. They needed some organizational and facilitation help, before and during the event. I like the Patientkeeper model, where a mobile platform (services, not just the device) is placed at the presentation layer, above the legacy app (Cerner, IDX, etc). Having the partnerships with those companies is key - you don't want to fight them. Ran into more old friends / acquaintances - Bill Bria, and Ron Pion, who threatens to send some business my way. That would certainly make the trip worthwhile. Also, now have an invite to polay golf with Kopetsky et all this afternoon. The Ojai course is great, and there's something special about the afternoon light on the course. Not sure why, but it's striking. Next topic/panel includes Lee Anne and Ed Kopetsky. First speaker is Charles Koo, CEO of iMedica. Hope it's not a sales pitch. He's focusing on wireless apps for MDs. Several good observations from Koo, including (1) need to support any input mode - click, writing, voice, templates; (2) PDA vs tablet form factor wars are a red herring - both form factors may be used in healthcare. Koo cited a $250K experiment with 802.11a that failed because of rapid signal degradation and corresponding bandwidth drop-off. He declares 11a not ready for prime time - he may be right. Perhaps orthogonal wavelength division multiplexing isn't all it's cracked up to be. Shit, shit. I just lost a full page of notes from 2 speakers. Offline posting using Radio requires great caution - you CANNOT jump to another link from the editor mode and get back to the text being inout in the edit window - it's just gone. I've done this 2-3 times now, and it's *irritating*. I lost the notes about Mercury MD and eMedicine. Merc MD is a company that pushes the day's data and work to a Palm platform. eMed is a company that provides online medical literature at the point of care. Cie la vie...have to remember not to jump out of context while I'm posting offline. The next speaker(s) are my friends from HealthLink. Being last on the panel, a long panel, sucks. Only thing worse would be being last up for the day - there will be no one here at 2pm; we'll all be out on the course. Lee Anne's co-presenter (Melinda Costin) has to deal with a balky laptop-projector interface. They're using an InFocus projector - wonder if this is typical for InFocus? Their talk - what it's like to go into a health system as a consultant and find a dog's breakfast (my term) of systems. First point: knowledge and tech capability have far outstripped care providers' ability to use them / absorb them. Second point: medical errors are still the #1 cause of death (and half off those are medication errors), and IT can reduce the error rate. <JCN: maybe, but not certain.> Third point: It's not just IT, it's people and process that make the real difference. Agreed for the nth time. She uses a good slide describing the benefits of CPOE - would like to get that. Lee Anne finally gets to speak. "Integrating pharmacy with MD orders is one of the least advanced processes/systems around." Some guy just walked into the room talking on a cell phone, and is continuing the conversation in competition with LA's talk. Rude beyond belief. LA's big message is about difficuly of integration the systems and the work processes across pharmacy and CPOE. This doesn't even include the Pyxis-style dispensing systems. (Note - I think the CEO from Pyxis was here 4 years ago with "a new, big thing". LA cites "the 5 rights". Need to ask about that - is it from HIPAA? comment []10:09:00 AM

© Copyright 2002 Jeff Nichols.