The online patient-physician communication thing seems to be getting off the ground. Relay Health has another deal with another Blues, this time Anthem in Colorado. It’s been a longish road for them (and I haven’t heard much of McKesson’s Medformation which was Relay’s big rival back in the 1999 boom days when it was called…oh, I forget but not Relay!). Anyway here’s an interesting recent presentation from the folks at Relayhealth which claims that online visits save money, increase physician productivity, lower the number of visits and are wildly popular among doctors and patients. OK so the docs and patients in the sample are self-selected, but it makes sense to me, and I wish my doctor had it.

Meanwhile, I’ve got my own problems there (much more buried in these comments over at DB’s Medrants)

Jane Sarasohn Kahn has some interesting things to say about the HIMSS exhibit hall in her iHealthBeat column. She believes that real progress is being made, and declares that less hype than usual is apparent this year!

The other article in the SF Chronicle was about El Camino hospital, a community hospital in Mountain View, CA right in the heart of Silicon Valley.  El Camino had one of the first computerized hospital information systems, made for them by local defense player Lockheed.  That ended up I think in TDS, which later became part of HBO (or am I getting my lines crossed). Anyway, as the Chron now reports having gone wireless, El Camino is vowing to go paperless. There’s nothing particularly new in the article, but it is a good introduction to healthcare IT, and for this type of article including information about spending levels on health care IT to end up in a general newspaper, that’s progress.

Having been rebuffed in the UK, Cerner is making up for lost time and getting religion–snapping up its second big deal with a big Catholic chain in as many months. It already has a deal with the big mid-western Catholic chain Ascension.  Now it’s announced a $137m deal with Catholic Healthcare West.  The stock has more or less tripled in the last 8 months following a mauling after missing numbers last May, although it’s some way below its 2000 highs.

I assume their party at HIMSS this week will be serving the expensive brand of champagne.

As Monty Python pointed out, American hospitals are full of machines that go "Ping". Health Data Management has a long but very interesting article on the challenges involved in getting what used to be analog but is now digital data from medical devices, such as X-Ray film and EKG print-outs, into the EMR.

Tommy Thompson may just get a few things right now he’s decided to leave. First he corrects the shameful rewrite his department did of a report on racial disparities in health and now Modern Healthcare reports that he’s recommending using the money recovered from Medicare fraud on health care IT projects.  At $600 odd million, it’s not that much, but it’s better than nothing.

Health-IT World reports that Kaiser’s system-wide installation of the Epic EMR is going pretty well. Given that this is probably the biggest single EMR project going out-side of the UK and that Kaiser for all its faults is on the side of the Angels, I’d say that this is good news.

For more about Kaiser see here. For more about the UK see here.

Robert Mittman has another iHealthbeat technology column, this time on the progress in health care of XML. It’s well worth a read. Particularly interesting is the suggestion that, by formatting all those transcribed dictated notes which are currently in word documents (and then printed out on paper and sometimes stuck in the chart), in XML, a physician will be able to search for and find previous notes.  They’ll also be able to search across an "on-the-fly" meta database of all patients in the institution.  This is probably some years away, but XML may just be the answer to the challenge of getting the clinical note into a machine in a format where it can be recovered usefully, without making the physician do anything different in their current workflow.

In an article in Pediatrics Carroll and Christakis report that 35% of pediatricians use a PDA at work. So for that 35%, what do they actually do with them?   80% use it for a drug reference and 65% for scheduling but as this chart shows only 22% kept patient information on the PDA and few wrote scripts (8%) or used it for billing (4%). So, as I surmised in my earlier piece on PDA use, the tools are out there, but they are not integrated into the wider clinical workflow.  Integrating these tools which are entering via the "backdoor" into the overall clinical workplace IT strategy is the challenge for CIOs.

You know that all technology diffuses in an "S" curve, and the trick is figuring out when the line goes up from snaking along the floor and starts heading up sharply–the "hockey stick" growth phase. Whisper it quietly but in terms of health care clinical IT, we may be about to enter that state.  The Dallas Business Journal reports that interest in IT spending is on the rise amongst health care CEOs. Meanwhile, on the eRX front there are a couple of interesting developments with industry giant Mckesson getting together with Surescripts to help round out the pharmacy systems integrated into Surescripts’ ePrescribing network.  In a similar vein, small but feisty handheld vendor PatientKeeper won another contract which "gives physicians real-time access to patient lists, consultation lists, the previous three days of laboratory data (with built-in alerts for labwork of critical value or results out of normal range), and dictated radiology data." PatientKeeper is also trying to move physicians to enter and update charge-capture information, which in turn should increase their revenue. In addition to this news, quite the good day was had by Cerner, which despite going 0 for 4 in its quest to win any regional UK contracts, upped profit expectations based on increased business in the US (including its recent contract with large Catholic chain Ascension Health) and was rewarded with a 15% rise in stock price yesterday.

On the plane last night I met a senior sales exec from Allscripts.  We swapped eHealth war stories, and he told me essentially how grim life had been in the trenches trying to get some sales going in the late 90’s and early Zero’s.  Allscripts was really the only eRx vendor that was left standing and that was partly because it IPOed a little sooner than iScribe, ePhysician, Parkstone et al which never got out and all died. But in the last 18 months, things had turned around and every significant medical group he was talking to had decided to do something in the clinical/physician IT space. Allscripts after some tough times is now up to 10,000 docs at around 150 sites, and maybe one of the companies poised to actually benefit from the "S" curve take-off.

Are we really entering the two to four year hockey-stick growth phase for clinical and physician IT use?  I don’t know, but to quote Ian Morrison, "if something’s going to be a big deal it’s got to start sometime."