Home Forums Discussions General Discussion I just came from a presentation

I just came from a presentation by a vendor pushing Allscripts along with their IT service. They pointed out how big Allscripts was and that they GUAARANTEED that you would get their stimulus money, how they were darlings of the financial sector and how it would only cost you 41K over 5 years.

For the most part I kept my mouth shut until they showed a slide of a competator (not named) that not charged 1000 dollars and 500 dollars a year and had 12 employees. They felt that the competator must be operating at 300K loss per year.

At that point I could not hold my tongue and pointed out that the competator was AC, that it was designed and run by a MD who felt that EMRs were overpriced and that he had a discussion about whether raising his prices would make him more competative since people did not take him seriously. I also pointed out that not only was he CCHIT certified, but was willing to jump through the hoops to make sure of meaningful use in order to PUT MONEY IN OUR POCKETS, NOT THE SOFTWARE COMPANY. I assured them that Jon IS making a profit, more than enough to live comfortably, and is not gready. I also pointed out that since it is a privately held company, he does not have to worry about meeting dividend to be the darling of the financial sector. Needless to say, I think they were a little annoyed with me.

They felt that doctors would not realize all that needed to be done to protect their data and that to be done well the data should be stored off site, as well as for integration for systems. They would charge extra for lab connectivity which is part of meaningful use, but they argued this is not phase 1.

OH, BTW, they could hardly get to the charting portion in the 15 minute time span they were alloted, and recommended that people see their demo in the CD they were giving out. The presentation reminded me of why I didn't like Allscripts, they must have had 4-5 screens before they got to the meat of the program and had to be 30 clicks.

What is involved in arranging lab connectivity to integrate results put out in HL7 format into AC. Why does it require that we pay AC $5,000 for the interface? Isn't it already written?

The normal cost for lab integration for individual practices is 500.00 for interfaces that have been developed, eg labcorp,quest, PAML, etc. The difficulty is non national, non-standard interfaces. Someone has to pay the fee for connectivity - although the data can be outputted in HL7 format some method to get it into a file on your computer and then tell AC where to read it is necessary.

As an aside I spoke with the lab manager at my small hospital - a HL7 interface to take results from a machine, eg CBC, Chemistry, PT/INR, etc. and upload the data to their Meditech costs around 20,000 per machine - one for each of the above machines. So some of the results are hand entered into their software (hence human error prone)....unfortunately the HL7 and interfaces are a bit of a scam as software can still make it difficult to interface. AC is actually easy - Jon and I discussed this that if a company is easy to work with and wants to work with them to make an interface he charges little or nothing to do.....and if they are hard to deal with.....you get the picture.

Our local lab is really easy to work with. They can't however, pay the $5000 we were quoted to interface with AC. They already have the HL7 interface to meditech and are already interfacingwith our OB/GYN clinic's e-clinical works emr.

I can connect directly to our hospital through AC. Just can't figure out how to transfer data in a meaningful way because I have no clue... Our Lab manager did say the wheel has been invented and he will give it to AC to allow them to do their end. Maybe I was talking to the wrong department but I gave up for now. We use two labs, one at our local hospital as I said and another for specialty labs. Both have the same capabiltity to give us data in the HL7 format.

Maybe a guru out there could teach an ol' lady how to make the programs talk with each other.

Bert, maybe you know who I could call.

Thanks,

Lois

BTW, I probably would pay the price even if it is $5000 but it will just take me a while to feel ok about it. Unless, of course, a lot of work by AC tech is involved then I would not gripe. We gotta keep our techies happy because they really do RULE!!

Bert, we had a conversation about database stuff a while back, and I recently ran across this again because I have a practice that wants their specialty lab to interface. Lab has an HL7 interface, but AC has to build the bridge in - 5K.

I brought this up at ACUC2010, and more than the money, the vibe I got is that the queue is pretty long - measured in months.

I've been doing XML since the early days, and my understanding is that the vast majority of the interface process is mapping and processing the XML encoded data.

Since it is piece work, I wonder if we can convince Jon to sub out the work, and just run the final acceptance-QA/QC in-house.

I am also depressed about the lack of easy connectivity that I assumed would come with the HL7 interface. I run a physician office lab for my practice, and connecting the software that runs the analyzers (LabDAQ by Antek) to AC is going to cost $3,500 plus another $500 paid to AC.

I know that politics rarely rears its ugly head on this forum, so I am reluctant to stir a hornets nest, but I just have this one little rant:
With all of the arguing in Congress about health care reform, I always thought one of the easiest, most obvious things to do was to mandate a connectivity standard. Why not have a national, standard interface? Imagine if Congress just said that ALL EMR's, labs, radiology sites, hospitals, etc. had to be able to communicate with the same interface. How much money would be saved by reducing IT dollars (hardware, software, and labor) which are spent trying to allow all these systems to connect? How many fewer unnecessary CT's, blood tests, etc, etc, would be done if your ER could easily find out the results of the same tests done on the same patient at the cross-town ER last week? I understand the privacy concerns about patients having a centralized medical record, but this is a different issue. Just set a national standard for connectivity. Am I missing something? I never even heard this discussed in the health care debate.

That's a great idea, although I'm more in the "privacy is dead... get over it" camp who would opt for a single database. Getting records from other physicians in a pdf format is dumb, and destroys the entire reason behind having an EMR.

If that were to happen, all those insurance companies and Tech companies would have nothing to jack us around with extra costs for. I'd be happy if Oregon would just do a central Immunization database.