Tuesday, March 31, 2009

Amicas Goes South

To Australia, that is. According to PR Newswire, Amicas just cut a deal with Healthinc of Sydney, Australia, for Amicas PACS.

Healthinc is a leading provider of digital medical imaging solutions and radiology information management in Australia. Established in 2002, Healthinc supports more than 350 sites throughout Australia with cutting edge technology and end-to-end solutions that are backed by quality service and support.

AMICAS will offer its acclaimed image management solutions to the Australian marketplace through an exclusive distribution partnership with Healthinc. The AMICAS solution suite will be tightly integrated with Healthinc's market leading OCCAM RIS and fully supported locally by Healthinc's experienced sales, marketing, services, and support teams.

. . .Healthinc will be distributing AMICAS PACS Version 6.0, which introduces the next generation of AMICAS PACS. Version 6.0 combines the intuitive, easy-to-use, Web-based design of previous versions of AMICAS PACS with major enhancements to the image viewing toolset. Complementing the industry leading, workload balancing RealTime Worklist(TM), Version 6.0 introduces the Halo Viewer(TM), which includes advances in functionality aimed at increasing radiologist productivity and designed to help improve the quality of reading.

Darn. The Aussies get V6 (for real, anyway) before I do!

This sounds like a rather major deal, although I'm not sure Healthinc plans to deploy Amicas to all 350 sites, and even then, with the web-based nature of the product, they might not have to buy 350 separate PACS. (Sorry, but I couldn't keep that secret!)

By the way, the Amicas deal replaces none other than GE/Dynamic Imaging to form the new OCCAM PACS solution. From the Healthinc website news of November 2008:

Healthinc welcomes Dr Lynne Brothers and Womens Imaging Tasmania who have installed our OCCAM Centricity IW PACS solution.

Of course, I am ready, willing, and able to help out my Australian counterparts if Amicas wishes to send me down under. I'll start packing my bags right away!

Friday, March 27, 2009

Yankees, Towels, and Surgeons on Planes

There is nothing harder than returning to work after a nice vacation. Somehow, I've managed to function adequately for the past couple of days since leaving the warm beaches of Costa Rica.

The last day at Paradisus was at once the worst and the best. We went to a little place called "Monkey Park" in the morning, hoping to feed some more Capuchins. Sadly, the descriptions were a little off, and "Monkey Park" turned out to be a sort of small zoo, with a few animals in cages. Still, this is a place of animal rescue, where some of the baby critters abandoned in the wild are saved and rehabilitated, so our visit did support a good cause.

Back at the hotel, we had the joyous experience of trying to find a lounge-chair by the pool. It seems there is a Yankee trick of going to the pool at 7AM, and placing your beach-towel on a chair. Magically, the spot becomes YOURS for the rest of the day, even if your gluteus maximus never graces the chair and the towel again. Heaven forbid someone should even move it slightly (we did and the Yankees came running, bellowing about THEIR chairs!) People, this is disgusting, piggish behaviour, and it is no wonder Americans aren't well-liked. Don't blame Bush for our bad reputation!

Fortunately, this chair-fight prompted a move to a quieter section by pool (the Paradisus pool is supposedly the largest in Central America), where we met a wonderful family from Iraq, now living in Canada. The mom was a physician, the dad a computer specialist. They told us some nasty tales of Saddam's Iraq, stuff you won't hear on the news. Did you know that last names were banned? Saddam's new world order required that one take the first name of his father and grandfather as his "last name", dumping traditional family names. Had you heard that Uday and Qusay Hussein made a regular practice of going to clubs to select the women they would rape that day? A few lucky women were able to escape out of the back doors. And there was more that we never hear from the mainstream media. As for Canadian health-care, well. . . Our new friends were absolutely incredulous that we in the States wanted to copy their system. "It doesn't work!" The wait for an MRI is over 6 months, unless you have a spare $900C and can get to a big city such as Montreal, where there are a (very) few private outlets. There were numerous other examples. This isn't the way to go, but no one will believe it until it's too late.

Flying home the next day turned out to be a bit more of an adventure than I had anticipated. I had already seen the movie, so I was watching something old on my iPhone, blissfully oblivious to my sourroundings. About 45 minutes into the flight, there came the call we physicians, especially radiologists, all dread: "Is there a doctor, nurse, or P.A. on board? We have a medical emergency. . ." Hoping for the best, I pressed the call button to identify myself, and I was taken to the back of the aircraft. (Mrs. Dalai had to help me get untangled from my headphones.) Fortunately, another physician, a family practitioner, was right behind me, so I wasn't totally on my own. We found one of the flight-attendants writhing in pain in the aft-most row, and we began working with what we had available.

The in-flight medical kits are well-stocked for heart-attack victims, with drugs and devices up to and including an automatic defibrilator. There were drugs for colds, too, but there was nothing in there for nausea or pain. I guess keeping morphine in the kits would attract the wrong kind of patient. Anyway, the FP and I could do little but take vitals, listen for bowel sounds, provide moral support, and just stand around looking stupid, and wishing we had a CT scanner available. (Even a pocket ultrasound would have been nice.) The crew gave us the option to divert the plane to Miami if we thought getting the patient to the hospital an hour sooner would make a difference. But since she had a soft abdomen and no fever (although we could detect no bowel sounds over the noise of the engines) we concluded her malady was probably not life-threatening. All the while, the crew had been in touch with a ground-based physician (or nurse or P.A.?) contracted by the airline to deal with this sort of thing when no docs come forward. The service independently came to the same conclusion, which probably made the folks in Flight Operations breath a sigh of relief.

Now, here's the punch-line. After we, the radiologist and the FP, had been ministering to the poor girl for an hour, a well-dressed fellow sauntered back from First-Class, identified himself as a surgeon, and had a quick look. He got the history that she had had some sort of viral enteritis a year ago, and he was convinced that she had it again. He then told the other flight-attendants that the FP and I had it under control, and went back up to First. The FP and I looked at each other and said pretty much simultaneously, "Surgeons!"

We made it to Atlanta with no other mishaps, and the victim was able to walk off the plane to the ambulance. I don't yet know how she is doing, but hopefully she will be back on duty very soon.

In 46 years of flying (I took my first plane-ride at age 4), this is only the second time I have heard (and heeded) the call. Maybe riding up there closer to Heaven helps out some. An on-board CT would have been nice, though. Maybe if lighter-than-air travel ever comes back in vogue, that might be possible. This being a PACS blog, it occurs to me that a small ultrasound unit could be included in the spartan medical kit. Even if there is no one on board who can interpret the images, they could easily be transmitted ground-side to someone who knows what they are doing. We have night-hawks, why not Sky-Hawks? I think I'll look into it.

Monday, March 23, 2009

Dalai Down South

Mrs. Dalai and I realized that we wouldn't have much vacation time with Dalai, Jr., this year. Since I have part of Spring Break week off, we decided to give the gang a bit of adventure, and head to Costa Rica for a few days.

We are staying at the all-inclusive Paradisus Playa Conchal, on the Guanacaste coast of Costa Rica. The property is beautiful, although there aren't any rooms on the beach per se. There have been some significant service glitches, and while I'm glad we came, when we return to Costa Rica someday, we won't come back to this hotel. In brief, the personell seem to be trained to say "no" before they actually look into whether or not they could grant a particular request. A slight change in attitude would turn this from a 6-level experience to a 9 or a 10. Oh well. Look for my report on TripAdvisor in a little while.
We've had some great times. Saturday, Mrs. D and Jr. went on a zip-line through the tree-tops. I got my harness on, and then my vertigo kicked in, and I bailed. But they enjoyed it!

Sunday, we took a drive to the Palo Verde National Park, for a trip down the river to feed the crocodiles and the Capucin (white-faced) monkeys.

This was quite a lesson in "sharing the wealth". The crocs just loved the raw chicken our guide offered them, and would have taken more (and his hand) had it been offered. The monkeys were cute as can be, but overran the boat, grabbing all the pieces of banana we had, and then left a calling-card (carajo) in a seat. But it was still worth the trip to see the little guys.

Today, Jr. got to go scuba-diving for the first time. Mrs. D. and I stayed on the boat and fretted for the 30 minutes he was underwater, and out of our sight. What great parents we are!

Since this is a PACS blog, I do have to note the presence of an Agfa branch-office at the hotel:

Given all the joys going on back home, I'm wondering if they need a radiologist around here. . .


Wednesday, March 18, 2009

Henpecked Hornbill

Rhinoceros Hornbill, image courtesy of Wikipedia

Every so often, the local zoo needs some advanced imaging on one of its residents, and we are glad to help out.

It seems that our local pair of rhinoceros hornbills (see stock photo above) has not been living in wedded bliss. The male bird was young and inexperienced, and supposedly the female was upset over his not responding to her amorous advances. So, she pecked a hole in his beak to show her frustration. This was easily patched by the veterinarian, but our poor boy then started to have nasal discharge. I suppose that could be bad with a beak as prominent as pictured. Plain-films didn't tell the story, so it's off to the nearest CT!

Of course, Mr. B. Hornbill had to be anesthetized for the procedure:

Here is a clip of the volume-rendered images:

The sinuses were clear. There was a tiny calcific density which you can see somewhat centrally which might represent an osteoma, although I'm not sure birds get osteomas. Note the rather tiny brain. I guess it doesn't take much horsepower to run a bird.

Perhaps my next revenue source could be pet-scans as opposed to PET scans. . .

Sunday, March 15, 2009

Stockholders Object, Attempt To Halt Amicas/Emageon Marriage At Altar

Just when I thought there would be clear sailing for Emageon, some disgruntled investors felt the need to disrupt the apple-cart. From the Birmingham News:

Birmingham's Emageon Inc. said Friday it has been sued by shareholders who say the software firm made a bad deal when it sold to a Massachusetts company last month.

The suit was filed in Suffolk County Superior Court in Massachusetts, Emageon said in a regulatory filing.

The company, which makes software used to automate medical billing and imaging, agreed to sell to Boston rival Amicas for $39 million, or $1.82 a share.

Emageon a few weeks earlier had collected a $9 million breakup fee from a New York-based firm that had agreed to buy it for $62 million, or $2.85 a share. That deal collapsed after the buyer couldn't get financing from the Antigua bank of accused fraudster Allen Stanford.

The SEC Form 8-K filing notes:

On March 11, 2009, a putative shareholder class action lawsuit was filed against Emageon Inc. (the "Company"), the members of the Company's Board of Directors (the "Company Board") and AMICAS, Inc. ("AMICAS") in the Superior Court Department, Suffolk County, Massachusetts. The action, styled Fishman v. Williamson, et al., alleges, among other things, that the members of the Company Board violated their fiduciary duties by failing to maximize value for the Company's stockholders when negotiating and entering into the Agreement and Plan of Merger, dated February 23, 2009 (the "Merger Agreement"), among the Company, AMICAS and AMICAS Acquisition Corp. ("Purchaser"). The complaint also alleges that AMICAS aided and abetted those purported breaches. The plaintiff seeks, among other things, to enjoin the acquisition of the Company by Purchaser or, in the alternative, to rescind the acquisition should it occur before the lawsuit is resolved.

The Company believes that the allegations of the plaintiff's complaint are entirely without merit, and the Company, the Company Board and AMICAS intend to vigorously defend this action. The parties do not expect this lawsuit to have an impact on the completion of the tender offer and merger contemplated by the Merger Agreement, however, even a meritless lawsuit may carry with it the potential to delay consummation of such transactions.

Frankly, in this day and age, the shareholders ought to be: a. Thrilled that they weren't acquired by Bernie Madoff, Jr. and b. Even more thrilled that someone wants to buy their stock at all. But I guess hope and greed spring eternal. The "Fishman" in question hopefully wasn't Elliot Fishman, M.D., who said in a Johns Hopkins meeting a year or so back that he used Emageon but had some problems with it. We'll see. . .


A new SEC filing by AMICAS tells us:
On March 11, 2009, a putative shareholder class action lawsuit was filed against Emageon Inc., members of the Emageon Board of Directors and AMICAS, Inc. in the Superior Court Department, Suffolk County, Massachusetts. The action, styled Fishman v. Williamson, et al., alleged, among other things, that the members of the Emageon Board of Directors violated their fiduciary duties by failing to maximize value for Emageon's shareholders when negotiating and entering into the Agreement and Plan of Merger dated as of February 23, 2009 among Emageon, AMICAS and a subsidiary of AMICAS. The complaint alleged that AMICAS aided and abetted those purported breaches. On March 16, 2009, this action was withdrawn by the plaintiff without prejudice.
I'll bet they filed it with prejudice! This is how we keep lawyers busy, I guess. So, all systems go for merger!

Friday, March 13, 2009


While I have great expectations for iPhone PACS clients, I'm not sure they will completely do the trick. The iPhone is, after all, just a phone, right? To be fair, it's a really nice and powerful phone, running a limited version of Mac software, but, well, it just isn't a full-fledged computer.

So, enter Parvus. They make a lot of toys for the military, but this one caught my eye:

Behold the Parvus Zypad WL1100 Wrist Wearable Wireless Computer!

Now this ain't no toy, folks:

The Zypad® WL1100 Wrist Worn Personal Computer is a powerful computing device designed to be worn comfortably on the user’s wrist for hands-free operation.

The wearability and hands-free operation of the ZYPAD prevents it from being dropped while in use and overcomes the physical limitations associated with normal hand-held computers.

From its original concept the ZYPAD WL1100 has been designed to be as flexible as possible maximizing its potential application areas. The Zypad’s light-weight, versatile and completely hands-free convenience makes it of special interest to Logistics, Emergency Services, Security, Defense, Healthcare, Maintenance and any area where hands-free access to large amounts of information is necessary.

The Zypad WL1100 solidifies the concept of ubiquitous computing by integrating all the power and capabilities expected from a full size PC within an extremely versatile device. The design allows for flexible ergonomic positioning and easy fastening to the arm, even over the users work clothes, thus ensuring ideal weight distribution and maximum comfort.

The Zypad WL1100 can be quickly confi gured to access any remote host system through its integrated wired or wireless interfaces using either Linux and Windows CE operating systems. Information can be shared and services accessed regardless of location.

The system integrates the latest and most innovative features such as a tilt and dead reckoning system which detects the position of the user’s arm and sets the system to standby mode when the arm is hanging down beside the body.

Seems like that last thing might present a problem if you were using it whilst lying down, but maybe it can be adjusted to compensate.

When you look at the specs, sadly, the Zypad really isn't quite as impressive as my dear old iPhone. The Zypad has only 1284 MB of RAM while the iPhone has 16 GB. Horsepower is similar with the Zypad running an Intel Marvel processor at 400 MHz, and the iPhone running an ARM at 412 MHz.

I'm not sure about getting a PACS client to run on Windows CE. No doubt there's something out there that will work with their version of Linux.

One thing iPhone does not offer, except with aftermarket add-ons, is a ruggedized version. For that, we turn back to Parvus for their Rugged Wrist Wearable Wireless Computer, the Zypad WR1100:

It looks to me like a piece off of Boba Fett's armor:

May the PACS be with you! Always! Everywhere! Well, you get the idea.

No word on price, but I'll bet the Zypad isn't cheap, especially in military configuration.

Thursday, March 12, 2009

Competition for GE: Wal-Mart??

GE has assured us that the Centricity EHR will fulfil the yet-to-be determined certification requirements and qualify docs for incentives thereof. But wait. . . there might be a cheaper way to achieve the same goal!

The New York Times reports that Wal-Mart wants to be your EHR provider. Wal-Mart's Sam's Club will bundle Dell computers with eClinicalWorks software, as well as as installation, maintenance, and training. This package supposedly will cost as little as half of "rival health information technology suppliers". The bundle will cost under $25,000 for the first physician in a practice and $10,000 for each additional doc. Annual support will run $4,000 to $6,500.

eClinicalWorks is sold as a service over the 'Net, with little resident software on the local computer.

HIStalk Tim interviewed Girish Kumar from eClinicalWorks the other day, and he assured us that the product you might buy at Sam's is the same as what you might buy direct from eCW.
(P)eople will ask the question: if I’m able to get a comprehensive product that people are happy with at this price point with content and support, why should I spend more? Price visibility will be black and white. No longer will you see those quotes saying an EMR will cost $300,000. You will see more informed questions, pricing pressure, and frankly, higher expectations if content is provided. I don’t want to take six months to implement PM and another six months for an EMR. This is a unified product we’re offering, by the way, both EMR and PM. We’re offering five days of implementation on site with the Sam’s Club package and they can buy more for $750 a day plus travel, but our track record is that we can do it in five days.
I wonder how K-Mart and Family Dollar will compete with this. . .

Saturday, March 07, 2009

GE: "Get Your Share Of The EHR Stimulus!"

GE's stock isn't doing so well lately, much to the chagrin of those of us who own some:

GE's problems stem from a multitude of sources, some not even their fault, and for what it's worth, I'm not at all happy about any of it.

But, clever to the end, GE Healthcare IT has latched on to something that might help. Vishal Wanchoo, President and CEO of the IT division, sent a letter to physicians (I didn't get one myself, but I have my sources) telling us about the "opportunity" offered by the Economic Stimulus Plan (ESP).

The ESP promises to bring extraordinary change to a variety of business sectors, including healthcare, where billions of dollars have been pledged to develop and support information technology.

The ESP opens up many opportunities as it is designed to accelerate the delivery of information technology to improve performance and connectivity in healthcare, ultimately reducing costs and improving patient care. The bill, which strongly promotes electronic health records (EHRs), health information exchange, interoperability and quality, puts information at the center of driving real change in the industry. This focus is good news for healthcare, for you and your patients, and for us at GE Healthcare as it reinforces our combined vision.

Here's the critical part:

While there are many details yet to be resolved, the broader stimulus bill includes a package of approximately $31.2 billion for healthcare infrastructure and EHR investment, and this legislation is expected to impact providers and vendors quickly. The $31.2 billion is the gross investment that includes the Congressional Budget Office assumption that the program will save an estimated $12 billion from higher EHR adoption, resulting in a net cost to the federal government of $19.2 billion.

The investment will largely flow from Medicare and Medicaid incentives to physicians and hospitals for the "meaningful use" of certified EHRs, including those that currently have systems installed, as well as new installations or upgrades. With the incentives, non-hospital based physicians could receive up to $44,000 from Medicare or $64,000 from Medicaid (depending on the level of Medicaid patient volume) and hospitals with high Medicare and Medicaid volume and a large number of patient discharges could receive up to $11 million from both Medicare and Medicaid. These incentives will be paid out over a 4-5 year period, with initial eligibility starting in 2011.

And what does GE know about this? A lot. It seems they helped write some of the legislation!

GE Healthcare has had a number of team members dedicated to the ESP since November, working directly with government officials and legislators in Washington D.C. to shape the bill and champion for healthcare IT provisions. They will now shift their focus to tracking and guiding the implementation of this new law over the coming months. In addition, GE team members are actively engaged with the certifying and standards-setting bodies that may play a critical role in defining what is required in the EHR to enable provider organizations to take advantage of the ESP.
In other words, we know what's in it, so we'll help you (and us) profit from it.

The healthcare IT components of the bill are called the "HITECH Act," and the final text of the law can be found here. A quick search incidentally shows no mention of imaging as part of the EHR. Big omission in my book. Also, a sub-sub-sub-section of TITLE XXX--HEALTH INFORMATION TECHNOLOGY AND QUALITY creates an "HIT Policy Committee" consisting of:

‘‘(2) MEMBERSHIP.—The HIT Policy Committee shall be composed of members to be appointed as follows:
‘‘(A) 3 members shall be appointed by the Secretary,
1 of whom shall be appointed to represent the Department of Health and Human Services and 1 of whom shall be a public health official.
‘‘(B) 1 member shall be appointed by the majority leader of the Senate.
‘‘(C) 1 member shall be appointed by the minority leader of the Senate.
‘‘(D) 1 member shall be appointed by the Speaker of the House of Representatives.
‘‘(E) 1 member shall be appointed by the minority leader of the House of Representatives.
‘‘(F) Such other members as shall be appointed by the President as representatives of other relevant Federal agencies.
‘‘(G) 13 members shall be appointed by the Comptroller General of the United States of whom—
‘‘(i) 3 members shall advocates for patients or consumers;
‘‘(ii) 2 members shall represent health care providers, one of which shall be a physician;
‘‘(iii) 1 member shall be from a labor organization
representing health care workers;
‘‘(iv) 1 member shall have expertise in health information privacy and security;
‘‘(v) 1 member shall have expertise in improving the health of vulnerable populations;
‘‘(vi) 1 member shall be from the research community;
‘‘(vii) 1 member shall represent health plans or other third-party payers;
‘‘(viii) 1 member shall represent information technology vendors;
‘‘(ix) 1 member shall represent purchasers or employers; and
‘‘(x) 1 member shall have expertise in health care quality measurement and reporting.
Gotta love the insertion of a union member, and the opportunity for the President to add in folks from other agencies, thus stacking the deck. I'll volunteer to be the physician member. Fat chance of that. Have fun reading the rest of the document. It's no surprise that lawyer-lawmakers create these huge, bloated, picayune multi-hundred page extravaganzas that are full of. . . legalese!

GE has been kind enough to provide the Cliff Notes for the HITECH Act. HIMSS has its own IT-pablumized version.

Typical of a governmental program, the pricetag is listed as $19.2 billion. In truth, the project will cost $31.2 billion, but since the Congressional Budget Office assumes a $12 billion savings over 10 years, we go with the difference. I wish I could work my finances that way. . . Honey. . . I'm going to buy this nice Ferrari. . . Oh well. . .

So what do we get for our $31.2 billion $19.2 billion? GE says:

The goals of the legislation are to create and expand the current U.S. healthcare IT infrastructure, promote
electronic data exchange, and substantially and rapidly increase EHR adoption to 90 percent for physicians
and 70 percent for hospitals by 2019. Initial spending will begin in 2009 and is projected to increase
considerably in 2010 and 2011. . .

In addition, the federal government projects that it will spend a net amount of $17.2 billion for Medicare
and Medicaid incentives that will be available to providers (physicians and hospitals) meeting specified
criteria (See Questions 5 and 6). The actual incentive dollars available through this program are
approximately $29.2 billion, as the $17.2 figure is net of estimated federal program savings from increased
EHR adoption.

Again with the deceptive numbers, but that's how your government works. To get the goodies, I mean incentives, physicians have to apply for the prize from either Medicare or Medicaid, but not both, and they have to demonstrate "meaningful use" More on that shortly. Hospitals, on the other hand, can get something from both programs if they use EHR meaningfully.

The dough is doled out yearly for five years. For docs, the scale slides like so:

And this is for the hospitals:

Notice the significant reward for early adoption.
We are all of course interested in getting our incentives using EHR meaningfully. Here is GE's synopsis of a "qualified EHR":
  • Inclusion of patient demographic and clinical health information, such as medical history and
    problem lists
  • The capacity to provide clinical decision support
  • Support for physician order entry
  • The ability to capture and query information relevant to healthcare quality
  • Electronic health information exchange capabilities, including the ability to integrate such information from other sources into the EHR
Using all this in a "meaningful manner" entails:
  • Use of electronic prescribing;
  • Electronic exchange of health information, such as with health information exchange (HIE); and
  • Quality reporting
As to what that all might translate to in the real world, David Harlow notes in HealthBlawg (Health Care Law Blog):
What does "meaningful use" of EHRs mean? Providers engaged in "meaningful use" of EHRs are eligible for the stimulus incentive payments. The term will have to be defined in regulations. John Glaser expressed the hope that "meaningful use" is defined so as to include a requirement of communicating aggregated patient data to enable further development of evidence-based medicine, one of the key justifications that has been offered for computerizing medical records.
Evidence-based medicine, eh? In other words, this is the method the yet-to-be-created National Health Plan will use to spy on us monitor us be sure we are good docs. Nice.
One cannot, of course, use just any EHR; you must use a system that is "Certified" by the HIT Standards Committee. Centricity EMR naturally will be fulfill these requirements, although we don't know what they are yet. Centricity EHR does meet CCHIT and ONC-recognized standards.
GE claims to have had a significant role in the design of HITECH:

GE drew on its extensive background in healthcare IT products, policy, and standards to formulate policy positions focused on achieving high levels of EHR adoption, a continued public/private approach to standards and certification, and appropriate security and privacy provisions.

GE government relations leaders were engaged actively in providing information and advocacy perspectives throughout the congressional consideration of the groundbreaking legislation, directly and through industry organizations. In addition, GE interacted with the Obama Administration’s Transition Team and the Obama Administration as the provision was crafted and enacted into law.

As members of the Electronic Record Health Association (EHRA), a team of GE Healthcare government relations experts have participated in ongoing policy deliberations, partnering with other industry members to present recommendations and advocate as work on the stimulus package progressed, right up until its final passage.

In addition, GE team members are actively engaged with the certifying and standards-setting bodies that may play a critical role in defining what is required in the EHR to enable provider organizations to take advantage of the HITECH Act incentives.

The list of GE participants in this process is rather long, but at the Federal level we have:

Health Information Technology & Standards Panel (HITSP)
– Board Member, 3 Co-Chairs
Certification Committee for Healthcare Information Technology (CCHIT)
– 2 Members, 3 Workgroup Members
National Health Information Network (NHIN)
– 3 NHIN Phase 1 Projects
I don't know...should we have a problem with a vendor setting the governmental standards that will be used to regulate said vendor's product? To be fair, nowhere does it say that you are guaranteed to get your incentives if you use Centricity, nor does it say you won't if you use Brand X. Perhaps the unwary could assume something like that.... But Centricity EHR users should take great comfort in the fact that GE not only aims to follow the rules, it has been involved in making them. As always, bringing good things to life.

Wednesday, March 04, 2009

X-Box Jive

To Whom It May Concern:

Please fix this.


Love, Dalai

P.S. My partners are getting really, really, REALLY impatient with this problem. I'm being urged to be a little more explicit, but I'm trying hard to be good.

Sunday, March 01, 2009

Dalai, The Old Musician

One of my daughter's friends ran across this Manet painting, "The Old Musician" in her Art-History class. Notice the uncanny resemblance of the focal character to your favorite song (parody) writer. What is even more startling is the image of the little boy in the dark jacket: that could have been my son at age 8 or 9. Makes you wonder. . .

DICOM Ping Me: SOS! (Or is it SOL?)

For more midi files: midi.

Where are those MRI's, they seem so hard to find.
I tried to search for yours, but it just went offline.
What ever happened to our PACS?
I wish I understood.
PACS used to be so nice, it used to work so good.

So when I’m flailing, everything is failing,
DICOM Ping me!
The patch you sent me just won’t seem to let you
DICOM Ping me!
When its gone,
How can I even try to log on?
When it’s gone,
Though I try I just can’t carry on.

Your scan was verified, though it did not appear.
I thought PACS was alive, but then it died I fear.
I really tried to read it out,
I wish I understood.
PACS used to be so nice, it used to work so good.

So when I’m flailing, everything is failing,
DICOM Ping me!
The patch you sent me just won’t seem to let you,
DICOM Ping me!
When its gone,
How can I even try to log on?
When it’s gone,
Though I try I just can’t carry on.

So when I’m flailing, everything is failing,
DICOM Ping me!
The patch you sent me just won’t seem to let you
DICOM Ping me!
When its gone,
How can I even try to log on?
When it’s gone,
Though I try I just can’t carry on.
When its gone,
How can I even try to log on?
When it’s gone,
Though I try I just can’t carry on.